Browsing by Author "Holmes, Victor L."
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Item A Variant of Extensor Medii Proprius: A Case Report(2015-03) Holmes, Victor L.; Liu, Hao (Howe); Rosales, Armando; Kirchhoff, Claire A.Purpose: The extensor medii proprius (EMP), a documented variation of human hand extensor muscles, originates from the distal 1/3 of the ulna and inserts on the dorsal aponeurosis (extensor expansion) of the 3rd manual digit. This case report describes an anomaly in which the EMP originates from the lunate, an origination reported in the medical literature. Methods: During routine gross anatomy dissection of the left hand of a 67-year old female who died of “stroke,” an unusual EMP muscle was observed and documented. Results: The flat, fleshy muscle originated from the lunate bone, narrowed into a flat tendon near the 3rd metacarpophalangeal joint, and continued distally to insert on the extensor expansion of the 3rd digit. A branch from the posterior interosseous nerve was traced to the EMP. We propose that this previously unreported variation be termed extensor medii proprius brevis (EMPB). Conclusions: Several anomalies found here have not been previously reported in the literature. First, the EMP originated at the lunate, which means the muscle does not cross the radiocarpal joint as described in previous reports. Second, the co-existence of the EMP with the extensor indicis or related muscles was not observed in this case. Third, the EMP tendon traveled deep to the intertendinous connection between the 2nd and 3rd tendon slips of the extensor digitorum muscle. Finally, this is the first time that the EMP was found to be innervated by a branch from the posterior interosseous nerve. In functional terms, the EMP/EMPB may act as an accessory MCP extensor. Due to its small size, however, the impact of EMP/EMPB on MCP extension may be negligible. Clinicians should still be aware of this variation, since swelling or tenderness of the muscle may lead to misdiagnoses of ganglion cysts or adipose tumors around this area of the dorsal hand.Item Do COPD Rates Differ by Veteran Status in Males 50-79 Years of Age?(2019-03-05) Stellato, Jordan; Vogler, Kelli; Whorley, Jourdan; Holmes, Victor L.; Hartos, Jessica; Knutson, KolePurpose: With little research that compares the rate of Chronic Obstructive Pulmonary Disease (COPD) status between the veteran population and the general population, the purpose of this study is to assess whether COPD rates differ by veteran status in males 50-79 years of age in the general population. Methods: This study was a cross sectional analyses using 2016 BRFSS data for males ages 50 to 79 in Arkansas (N=1,283), Montana (N=1,586), New Jersey (N=1,842), Tennessee (N=1,473), and West Virginia (N=1,854). Multiple Logistic Regression analyses were performed by state to determine whether COPD rates differed by veteran status when controlling for age, ethnicity, tobacco use, weight status, general health, asthma, income, education, and employment. Results: Across states, few participants reported having COPD (9-18%) and about one third were veterans (25-40%). After controlling for socioeconomic, demographic, and health influences, there was a significant consistent relationship between COPD and veteran status in three out of five states. There was also a significant consistent relationship between COPD and tobacco use, general health, and ever being diagnosed with asthma in five out of five states. Conclusion: The results found that in males ages 50-79, COPD rates were higher in veterans when compared to non-veterans. In addition, COPD was highly related to smoking, asthma, and general health. Providers should screen and treat COPD and any other health conditions to make sure they are managed properly. Most importantly, educate and refer smokers for treatment to assist with smoking cessation.Item Do physical activity levels differ by number of children at home in women aged 25 and 44 in the general population?(2020) Hartos, Jessica; Tanase, Kelly; Gilmore, Madison; Winnicki, Anna; Holmes, Victor L.; Abell, Laura P.Purpose: While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels differ by number of children at home in women aged 25and44 in the general US population. Methods: This cross-sectional analysis used 2017 BRFSS data for females aged 25and44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors. Results: About half of participants reported insufficient physical activity and about two-thirds reported children at home. Results of adjusted analysis indicated that physical activity level was significantly related to having one child (AOR = 0.75, 95% CI = 0.63, 0.89), two children (AOR = 0.79; 95% CI = 0.67, 0.93), and three or more children (AOR = 0.80, 95% CI = 0.67, 0.94) at home. Overall, physical activity levels were significantly related to presence of children at home, but increasing number of children at home did not impact effect size. Conclusions: For women aged 25and44 in a primary care setting, a moderate prevalence of insufficient physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, especially those with children; educate patients about the benefits of regular physical activity; and provide resources to help them integrate physical activity into their daily lifestyles.Item Do physical activity levels differ by number of children at home in women aged 25-44 in the general population?(Sage Publications, 2019-09-09) Abell, Laura P.; Tanase, Kelly A.; Gilmore, Madison L.; Winnicki, Anna E.; Holmes, Victor L.; Hartos, Jessica L.OBJECTIVES: While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels differ by number of children at home in women aged 25-44 in the general US population. METHODS: This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females aged 25-44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors. RESULTS: About half of participants reported "inactive" or "insufficiently active" physical activity levels and about two-thirds reported having one or more children at home. The results of adjusted analysis indicated that physical activity level was significantly related to having one child (adjusted odds ratio = 0.75, 95% confidence interval = 0.63, 0.89), two children (adjusted odds ratio = 0.79; 95% confidence interval = 0.67, 0.93), and three or more children (adjusted odds ratio = 0.80, 95% confidence interval = 0.67, 0.94) at home. CONCLUSION: Overall, physical activity levels were significantly related to presence of children at home for women aged 25-44, but increasing number of children at home did not impact effect size. For women aged 25-44 in a primary care setting, a moderate prevalence of inactive or insufficiently active physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, but particularly for women with children at home; educate patients about the health benefits of regular physical activity; and provide resources that will help them integrate physical activity into their daily lifestyles.Item Does Arthritis Risk Differ by Veteran Status in Males 35-54?(2016-03-23) Hartos, Jessica; Moore, Madeline; Kerbow, Amber; Barr, Hayley; Witter, Timothy; Holmes, Victor L.Introduction: Studies suggest that arthritis is common among veterans and activity duty service members. This study assessed whether serving in the armed forces increases the risk for arthritis in a representative sample of males ages 35 to 54. Methods: This was a cross-sectional analysis using 2013 Behavioral Risk Factor Surveillance System (BRFSS) data for males ages 35 to 54 in California, Florida, North Carolina, Texas, and Virginia. Multiple logistic regression was used to assess the relationship between veteran status and arthritis while controlling for age, educational level, employment status, income level, marital status, race/ethnicity, general health, activity level, activity limitations, weight status, chronic health problems, depression, alcohol use, and tobacco use. Results: About 13-22% of males reported arthritis; 11-24% reported veteran status; and 24% of veterans reported arthritis. The results of adjusted analyses indicated that veteran status and arthritis are significantly related. Conclusions: Overall, veteran status and arthritis were significantly related after controlling for demographic and psychosocial variables in a representative sample of males ages 35-54. Awareness of risk factors for arthritis including veteran status in males ages 35-54 can aid in the early diagnosis and treatment of this disease.Item Does General Health Differ by Healthcare Access in Diabetic Females 30-50 Years of Age?(2018-03-14) Vaswani, Roma; Chua, Josh; Swartzentruber, Valerie; Holmes, Victor L.; Hartos, Jessica; Alarcon, AngelaPurpose: Diabetes is one of the fastest growing epidemics requiring regular medical management, yet 12.6% of U.S. adults were without health coverage in 2015 (1,2). Our study aims to determine whether general health differs by healthcare access in diabetic females 30-50 years of age. Methods: This cross-sectional analysis used data from the 2015 BRFSS for females ages 30-50, from Louisiana, Mississippi, Oklahoma, and Tennessee. The relationship between general health to healthcare access and healthcare cost was analyzed using multiple logistic regression analysis controlling for weight status, comorbid conditions, age, ethnicity, marital status, income, education level, and state. Results: A high prevalence of participants reported having healthcare coverage (80%) and a moderate prevalence reported good or better overall general health (60%). There is a significant inverse relationship between healthcare cost and general health (OR=0.55, 95% CI=0.31, 0.97). There was no significant relationship between healthcare access and general health outcome. Additionally, relationships were shown between general health and comorbid conditions (OR=0.08, 95% CI=0.02, 0.27), income (OR=2.54, 95% CI=1.44, 4.45), and education level (OR=1.97, 95% CI=1.06, 3.66). Conclusions: Results show a significant relationship between healthcare cost, comorbidities, education, and income to participant’s general health. However, healthcare coverage was not significantly related to participant’s general health. Results may be utilized in primary care practice settings managing diabetic females aged 30-50. This population of patients should be screened for poor general health and additional comorbid conditions in low socioeconomic patient populations.Item For General Health, Does Diabetes Status Differ by Veteran Status in Males Ages 25 to 45?(2017-03-14) Ihediwa, Chiamaka; Holmes, Victor L.; Hartos, Jessica; Salaices, VeronicaIntroduction: Diabetes mellitus is a chronic medical condition in the U.S. population and in the veteran population, but little information is available for the relationship between diabetes and veteran status for different age groups. Thus, the purpose of this study was to assess whether diabetes status differs by veteran status in males ages 25 to 45. Methods: This cross sectional analysis used 2014 BRFSS data for males ages 25 to 45 from Alabama, Georgia, and Texas. Multiple logistic regression analysis was used to assess the relationship between diabetes status and veteran status, while controlling for age, ethnicity/race, weight status, mental health, heart disease, tobacco use, and alcohol use. Results: Across states, few males ages 25-45 reported diabetes (4-7%) or veteran status (14-19%). After controlling for psychosocial and demographic factors, diabetes status was not significantly related to veteran status in any of the 3 states. Conclusions: Overall, diabetes was not related to veteran status in representative samples of males ages 25 to 45. Additionally, the prevalence of both diabetes status and veteran status was low. The study was limited by the dichotomous measurement of the variables which did not provide additional pertinent information about their diagnosis or military role. It is recommended that clinicians screen for diabetes in this age group if there are symptoms, especially in those that are older as diabetes may become more prevalent as men age.Item Variation of Sternalis Muscle: A Case Report(2015-03) Liu, Hao (Howe); Holmes, Victor L.; Kirchhoff, Claire A.; Reeves, RustinPurpose: The sternalis muscle was first documented in the 19th century and since has been shown to have variations in its origins, insertions, direction, extra muscle slips, and nerve innervations. This case report describes anomalous features not previously reported in the medical literature. Methods: During routine gross anatomy dissection of the anterior chest wall of an 100-year old woman who died of “natural causes” at UNTHSC, obvious anomalies in the bilateral appearance of the sternalis muscle were observed and documented. Results: The left sternalis originated from the clavicular origin of the left sternocleidomastoid (SCM) muscle, while the right emerged from the sternal origin of the right SCM muscle. Both the left and right original tendons of the sternalis’ were separated but wrapped in a tight connective tissue band. The fleshy muscle bellies of each sternalis travelled down inferolaterally to insert on the aponeurosis of the left and right external oblique muscles, respectively. The innervation to the muscle could be traced to the 4th, 5th, and 6th anterior intercostal nerves. Conclusions: Several anomalies found here have not been previously reported in the literature including (1) the sternalis muscles originating from the clavicular head of the SCM muscle, (2) the tendinous band suspended over and slightly left of the sternal angle with only a loose connection to the underlying sternal angle, and (3) the inferolateral and nearly symmetrical 30 degree angle traveled by the sternalis to the sternum. Awareness of the location of the sternalis will help radiologists and reconstructive surgeons avoid misdiagnosis during mammography or misjudgment during breast surgery. Because of its superior attachment to the sternocleidomastoid muscle, therapists may need to be aware that a person with such an anomaly may have an automatic accessory inspiration with head rotation.