Beaumont Health is Southeast Michigan’s largest health care system (based on inpatient admissions and net patient revenue). The organization, headquartered in Southfield, Michigan, has net revenue of $4.7 billion and consists of eight hospitals with 3,375 beds, 155 outpatient sites, nearly 5,000 physicians, more than 33,000 employees and about 2,000 volunteers. In 2019, Beaumont had 179,600 discharges, 17,600 births and 577,000 emergency visits. The flagship hospital of the system is the Beaumont Hospital, Royal Oak, located in the Detroit suburb of Royal Oak, Michigan..
Patients with colour vision deficiency (CVD) may not see blood in urine or stool, often the first sign of bladder or colorectal cancer, respectively. Here we sought to identify whether patients with bladder or colorectal cancer and CVD have worse outcomes when compared to matched patients without CVD, using an electronic health records research network (TriNetX). A total of 135 patients with CVD and bladder cancer showed shorter overall survival (χ2 = 4.85, P = 0.028) as compared to 135 matched patients without CVD. There was no significant difference among 187 patients with colorectal cancer and CVD, and controls. This suggests that patients with bladder cancer and CVD may be at risk of reduced survival. This is a hypothesis-generating paper that should raise clinicians’ diagnostic suspicion for bladder cancer in patients with CVD and prompt further investigation into whether screening for bladder cancer should be introduced for high-risk individuals with CVD. In a retrospective case–control study of electronic health records, patients with bladder cancer and colour vision deficiency (CVD) had a 52
Uterine rupture is a rare and potentially fatal complication seen after vaginal birth after cesarean section (VBAC). We present two cases of uterine dehiscence and uterine rupture following successful VBAC, each demonstrating distinct clinical presentations and outcomes. A 34-year-old gravida 2, para 1001 developed persistent brisk bleeding after a successful VBAC, raising concern for uterine dehiscence. She was found to have a 2-cm anterior uterine defect that was successfully repaired. In contrast, a 31-year-old gravida 2, para 1001 developed hemodynamic instability following a successful VBAC and was found to have a 6-cm uterine rupture of the anterior wall, contiguous with a 4-cm posterior defect. The patient was started on a massive transfusion protocol and initially stabilized in the operating room; however, due to recurrent hemodynamic instability, an abdominal hysterectomy was performed. These cases highlight a rare yet serious complication of trial of labor after cesarean, with uterine dehiscence and rupture occurring at the prior hysterotomy site following successful VBAC. There is limited literature on the postpartum diagnosis of uterine rupture and dehiscence in the setting of VBAC; this report provides insight into their variable clinical presentations and management.
Background The purpose of this study was to provide 2-year postoperative clinical outcomes and survivorship of a novel, fully 3D printed humeral prosthesis. Methods This is a prospective case series of 34 patients who underwent anatomic total shoulder arthroplasty (TSA) with a fully 3D printed humeral prosthesis. Minimum postoperative follow-up was two years. Patient demographics, clinical outcomes, and radiographic outcomes were collected. X-rays were examined for radiolucent lines surrounding the implant. The primary outcome was TSA survivorship. Secondary outcomes were patient-reported outcome metric (PROM) scores and radiographic findings. Results At a minimum follow-up of 2 years, there were no revisions or reoperations with a prosthetic survivorship of 100%. At final follow-up, patients had significant improvement in American Shoulder and Elbow Surgeons (ASES) and Visual Analogue Scale (VAS) scores (p<0.001), with a mean postoperative ASES of 93 and VAS of 0.5. The rate of any peri-prosthetic radiolucent line on XR was 2 of 34 (6%). All identified radiolucent lines were <0.5 mm. Discussion The results of early clinical follow-up of this fully 3D printed off-the-shelf humeral prosthetic are encouraging. Postoperative radiolucent lines appear to be minimal in thickness, infrequent, and of unclear clinical significance given 100% survivorship and reassuring PROMs. Further clinical follow-up of this and other 3D printed systems is necessary to confirm that additive manufacturing is a mechanically durable and viable method for off-the-shelf TSA manufacturing.
Background: The purpose of this study was to provide 2-year post-operative clinical outcomes and survivorship of a novel, fully 3D-printed humeral prosthesis. Methods: This is a prospective case series of 34 patients who underwent anatomic total shoulder arthroplasty (TSA) with a fully 3D-printed humeral prosthesis. Minimum post-operative follow-up was two years. Patient demographics, clinical outcomes, and radiographic outcomes were collected. X-rays were examined for radiolucent lines surrounding the implant. The primary outcome was TSA survivorship. Secondary outcomes were patient-reported outcome measure (PROM) scores and radiographic findings. Results: At a minimum follow-up of 2 years, there were no revisions or reoperations with a prosthetic survivorship of 100%. At final follow-up, patients had significant improvement in American Shoulder and Elbow Surgeons and visual analog scale scores (P < .001), with a mean post-operative American Shoulder and Elbow Surgeons of 93 and visual analog scale of 0.5. The rate of any periprosthetic radiolucent line on X-ray was 2 of 34 (6%). All identified radiolucent lines were <0.5 mm. Discussion: The results of early clinical follow-up of this fully 3D-printed, off-the-shelf humeral prosthetic are encouraging. Post-operative radiolucent lines appear to be minimal in thickness, infrequent, and of unclear clinical significance given 100% survivorship and reassuring PROMs. Further clinical follow-up of this and other 3D-printed systems is necessary to confirm that additive manufacturing is a mechanically durable and viable method for off-the-shelf TSA manufacturing.
