Publications by authors named "Michael Wesolowski"

8 Publications

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Medical Supervision of Illinois Public and Private High School Athletics.

Phys Sportsmed 2020 Dec 31:1-7. Epub 2020 Dec 31.

Department of Orthopaedic Surgery and Anesthesiology, Loyola University Medical Center, Maywood, Illinois, USA.

: High-school sports participation in the United States has increased over the years with a corresponding increase in the number of injuries. Leading medical and sports organizations nationwide advocate for an increase in proper medical supervision of athletes.: To analyze athletic medical coverage in Illinois high schools and compare differences between public and private Illinois high school.: A survey addressing various components of sports medical coverage was distributed in 2018 to all 810 Illinois High School Association (IHSA) high schools to be completed electronically.: The response rate was 50% (407/810 schools). Of the responding schools, 14% were private high schools and 86% public high schools. An orthopedic surgeon, family doctor, pediatrician, or another type of physician were present on sidelines in 9.2% of private high schools and 8.5% of public high schools. Athletic trainers (ATs) were present on sidelines in 91% of private high schools and in 79% of public high schools. There was 68% of private high schools reporting coaches trained in CPR versus 85% in public high schools. Both private and public high schools had high rates of having written emergency action plans (89% vs 91%), AED on site (100% vs 99%), written concussion management protocols (96% vs 97%).: Our study found similar rates of high school medical coverage as compared to national studies, with some significant differences found between private and public high schools. Most Illinois high schools had high rates of having written EAPs, concussion management protocols and AEDs on site. Overall, an increase of medical supervision and emergency preparedness is needed, which should come in the form of increasing AT and physician presence alongside community and school engagement for improved implementation of coverage.
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http://dx.doi.org/10.1080/00913847.2020.1868954DOI Listing
December 2020

Coronal Remodeling Potential of Pediatric Distal Radius Fractures.

J Pediatr Orthop 2020 Nov/Dec;40(10):556-561

Department of Orthopaedic, Surgery & Rehabilitation, Loyola University Health System, Maywood, IL.

Background: Distal radius fractures in the pediatric population are common injuries with a remarkable capability to remodel. The degree of angulation that can reasonably be expected to remodel is controversial though, particularly when it comes to angulation in the coronal plane. The purpose of this study was to quantify the rate of coronal remodeling, via the distal radius physis, present in a retrospective cohort of skeletally immature patients with coronally angulated distal radius fractures.

Methods: A retrospective chart review was performed to identify skeletally immature patients treated for an angulated distal radius fracture with over 10 degrees of angulation in the coronal plane during the healing process at a single institution by either a pediatric orthopaedic surgeon or an orthopaedic trauma surgeon from 2009 to 2018. Coronal angulation was measured at every visit where radiographs were available from time of injury to the final follow-up visit to determine the rate of remodeling.

Results: In total, 36 patients with distal radius fractures with a mean age of 7.93 years (range, 4 to 12 y) at the time of injury were identified. The median peak angulation during the healing process in the coronal plane was 17 degrees (range, 12.4 to 30.4 degrees). The mean follow-up period was 6.4 months from the time of maximum angulation to the final visit. The median time from cast removal to final follow-up was 6.59 months (range, 2.5 to 8.72 mo). At final follow-up, the median coronal angulation was 3.35 degrees (range, 0.24 to 14.0 degrees). At the 95% confidence level, remodeling rates ranged from 2.00 to 2.59 degrees per month. The mean rate of coronal angulation remodeling from maximum angulation to final follow-up was 2.30 degrees per month.

Conclusions: Distal radius fractures have a large capacity to remodel in the pediatric population. This remodeling occurs in a predictable and reliable manner, even in the coronal plane. On the basis of this study, coronal angulation was shown to remodel at a rate of at least 2 degrees per month for the first 6 months following the injury, which should likely continue at a similar rate for the first year after the injury. Repeat manipulation is not indicated in skeletally immature patients where the maximum coronal angulation is <24 degrees, which provides a conservative estimate of the amount of remodeling that can be expected to occur in the first year after fracture.

Level Of Evidence: Level III-retrospective comparative study.
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http://dx.doi.org/10.1097/BPO.0000000000001580DOI Listing
March 2021

Risk of Complications With the Total Contact Cast in Diabetic Foot Disorders.

Foot Ankle Spec 2021 Feb 31;14(1):25-31. Epub 2019 Dec 31.

Loyola University Medical School, Maywood, Illinois (AR, RL, MW).

The custom-fabricated total contact cast is commonly used in the treatment of diabetic foot disorders. This resource-consuming treatment option has been associated with iatrogenic morbidity as well as the need for urgent cast removal and inspection of the underlying limb when potential problems arise. Over a 10-year period, 381 diabetic patients had 2265 total contact cast applications by certified orthopaedic technologists, in a university orthopaedic practice, under the supervision of university faculty. Patients were stratified by glycemic control based on hemoglobin A1c levels, and obesity based on body mass index (BMI). Complications were grouped as (1) development of a new ulcer or wound, (2) new or increasing odor or drainage, (3) wound infection, (4) gangrene, (5) newly identified osteomyelitis, and (6) pain or discomfort necessitating cast change or removal. At least 1 complication was observed in 159 of 381 patients. The odds of experiencing a cast-related event for patients with a BMI greater than 30 kg/m was 1.55 times greater than patients with a BMI less than 25 kg/m. As compared to patients with good glycemic control, the odds of experiencing a cast-associated complication was 1.27 times greater in patients with moderate glycemic control and 1.48 times greater in patients with poor glycemic control. The total contact cast is commonly used in the treatment of diabetic foot morbidity. Treatment-associated morbidity may well be greater than previously appreciated. Complications are more likely in patients who have poor glycemic control and are morbidly obese. This information will hopefully stimulate interest in developing commercially available nonrigid alternatives that retain the attributes of the resource-consuming rigid device, with the potential advantage of avoiding the associated morbidity.: Level IV, retrospective chart review.
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http://dx.doi.org/10.1177/1938640019895920DOI Listing
February 2021

A 3-dimensional comparison of hand and power reamers in accuracy of glenoid retroversion correction.

J Shoulder Elbow Surg 2020 Mar 24;29(3):609-616. Epub 2019 Oct 24.

Department of Orthopaedic Surgery and Rehabilitation, Loyola University Health System, Maywood, IL, USA.

Background: The study objective was to compare the reaming congruency of hand, power, and visual feedback axial alignment-guided (Marksman) reamers on glenoid models. We hypothesized that (1) a significant difference in average reaming deviation would be found between reamer types and (2) less ream-to-ream variation would occur with the Marksman reamer.

Methods: Retroversion correction of 18 identical Sawbones glenoid models was conducted using either a hand, power, or Marksman reamer with a 40-mm curvature radius. Glenoid correction with either 0° or 10° reaming was conducted in triplicate sets for each reamer. Reamed glenoid computed tomography images were 3-dimensionally reconstructed using Mimics Medical software (version 21.0). Congruency between the glenoid surface and a 3-dimensional sphere with a 40-mm curvature radius was analyzed. Average deviation and ream-to-ream variance were compared between the hand, power, and Marksman reamer groups.

Results: The power reamer demonstrated the smallest median deviation (0.08 mm; interquartile range [IQR], 0.07-0.19 mm), followed by the Marksman (0.09 mm; IQR, 0.08-0.17 mm) and hand (0.11 mm; IQR, 0.10-0.13 mm) reamers. Kruskal-Wallis analysis indicated no significant difference in deviation among the 3 reaming methods (P = .42). The Marksman reamer demonstrated the least variance (0.0034 mm), followed by the power (0.0076 mm) and hand (0.0093 mm) reamers. The results of the Conover squared ranks test indicated no significant difference in variance among the 3 reaming methods (P = .32).

Conclusion: Our findings showed no statistically significant difference in the accuracy or consistency of reaming between reamer types. Trends showed less variance in the Marksman reamer group compared with the hand and power reamer groups, although differences in variation between groups were not statistically significant.
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http://dx.doi.org/10.1016/j.jse.2019.08.011DOI Listing
March 2020

Complex and non-redundant signals from individual odor receptors that underlie chemotaxis behavior in Drosophila melanogaster larvae.

Biol Open 2014 Sep 19;3(10):947-57. Epub 2014 Sep 19.

Department of Biological Sciences, Dominican University, 7900 West Division Street, Parmer Hall 244, River Forest, IL 60305, USA

The rules by which odor receptors encode odors and allow behavior are still largely unexplored. Although large data sets of electrophysiological responses of receptors to odors have been generated, few hypotheses have been tested with behavioral assays. We use a data set on odor responses of Drosophila larval odor receptors coupled with chemotaxis behavioral assays to examine rules of odor coding. Using mutants of odor receptors, we have found that odor receptors with similar electrophysiological responses to odors across concentrations play non-redundant roles in odor coding at specific odor concentrations. We have also found that high affinity receptors for odors determine behavioral response thresholds, but the rules for determining peak behavioral responses are more complex. While receptor mutants typically show loss of attraction to odors, some receptor mutants result in increased attraction at specific odor concentrations. The odor receptor mutants were rescued using transgenic expression of odor receptors, validating assignment of phenotypes to the alleles. Vapor pressures alone cannot fully explain behavior in our assay. Finally, some odors that did not elicit strong electrophysiological responses are associated with behavioral phenotypes upon examination of odor receptor mutants. This result is consistent with the role of sensory neurons in lateral inhibition via local interneurons in the antennal lobe. Taken together, our results suggest a complexity of odor coding rules even in a simple olfactory sensory system.
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http://dx.doi.org/10.1242/bio.20148573DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197443PMC
September 2014

The clinical nurse leader in the perioperative setting: a preceptor experience.

AORN J 2014 Jul;100(1):30-41

The U.S. Veterans Administration (VA) has implemented the clinical nurse leader (CNL) role nationwide. Nursing leaders at the Malcolm Randall VA Medical Center in Gainesville, Florida, implemented the development of the CNL role in the perioperative setting during the summer of 2012. The perioperative department developed the position in partnership with the University of Florida College of Nursing, Gainesville, Florida. The team developed a description of the roles and experiences of the preceptors, the clinical nurse leader resident, and the University of Florida faculty member. The clinical nurse leader resident's successes and the positive outcomes, such as improved patient outcomes, experienced by the perioperative department demonstrated the importance of the CNL role.
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http://dx.doi.org/10.1016/j.aorn.2013.11.021DOI Listing
July 2014

Pioneer profiles: An interview with Don Baer.

Behav Anal 2002 ;25(2):135-50

This is an interview with Donald M. Baer. The interview includes discussion of his education at the University of Chicago, his work at the University of Washington and the University of Kansas, events that influenced his career, and his perspectives on various issues. His accomplishments include developing the standards for the practice of applied behavior analysis, creating an empirical research base for language training for people with severe disabilities, initiating procedures that led to generalized imitation, formulating experimental designs for applied behavioral research, and devising procedures for generalization and maintenance of behavior.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731614PMC
http://dx.doi.org/10.1007/BF03392053DOI Listing
August 2012

Pioneer profiles: A few minutes with Sid Bijou.

Behav Anal 2002 ;25(1):15-27

This article is an interview with Sidney W. Bijou. His education, work, accomplishments, and honors in the field of behavior analysis are reviewed and described in his own words. Some of his accomplishments include applying operant methodology to normal children and children with retardation, extending operant methodology with children from the laboratory to the natural environment, carrying the banner of behavior analysis to many foreign countries, teaching and advising many students of behavior analysis who have become well known as behavior analysts, and researching, developing, and commercializing such well-known products as the Edmark reading program, the Portage parent training program, and the Wide Range Achievement Test.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2731592PMC
http://dx.doi.org/10.1007/BF03392041DOI Listing
August 2012