Clinical Documents

To edit the draft, click on the text box below.

×

Draft a comprehensive differential diagnosis for acute substernal chest pain in a 45-year-old male with hypertension and hyperlipidemia, diaphoresis, exertional onset, and normal initial ECG/troponin; include life-threatening causes first, key distinguishing features, and immediate diagnostic next steps.

Draft a detailed differential diagnosis for new-onset unilateral throbbing headache with visual aura and brief monocular vision loss in a 32-year-old female on oral contraceptives; include red-flag symptoms, stroke/TIA considerations, and recommended initial workup.

Draft an assessment and plan for stage-2 hypertension (BP 162/98) in an obese 52-year-old with suspected obstructive sleep apnea; include ASCVD risk estimate, lifestyle prescriptions, first-line pharmacotherapy with drug/dose/targets, baseline labs/monitoring, and 4–6 week follow-up.

Draft an assessment and plan for type 2 diabetes follow-up with A1c 9.2% on metformin 1,000 mg BID and eGFR 65; compare adding a GLP-1 receptor agonist vs an SGLT2 inhibitor, address weight loss goals, hypoglycemia education, vaccinations, and micro/macrovascular screening.

Draft a history and physical for a patient presenting with chest pain, including HPI using OLDCARTS, pertinent ROS, PMH/meds/allergies, FH/SH, focused cardiac/pulmonary exam, initial labs and imaging orders, prioritized differential, HEART score risk stratification, and early management.

Draft a history and physical for a new patient with progressive exertional dyspnea, orthopnea, and bilateral leg edema; include differential (heart failure, COPD, PE, anemia, renal disease), targeted exam maneuvers, and first-line diagnostics and management.

Draft a progress note for COPD follow-up two weeks after an acute exacerbation treated with prednisone and antibiotics; include symptom trajectory, CAT score (if available), inhaler technique/adherence, oxygen needs, spirometry plan, smoking cessation counseling, and return precautions.

Draft a progress note for post-operative day 2 after total knee arthroplasty; include pain control strategy, DVT prophylaxis, PT/OT milestones, wound status, bowel/urinary function, labs/vitals review, complications screening, and discharge readiness.

Draft a discharge summary for community-acquired pneumonia admission; include admission/discharge dates, presenting symptoms, radiology/labs, pathogen if identified, inpatient therapies and response, discharge medications with durations, pending tests, follow-up appointments, and return precautions.

Draft a discharge summary for myocardial infarction managed with PCI and drug-eluting stent placement; include cath findings, complications, inpatient course, discharge medications (DAPT, statin, beta-blocker, ACEi/ARB), cardiac rehab referral, and follow-up plan.

Draft discharge instructions for a patient hospitalized with acute decompensated heart failure; include daily weights, sodium and fluid restriction amounts, medication list with dosing, signs of worsening heart failure, follow-up appointments, and lab monitoring plan.

Draft discharge instructions for an asthma exacerbation; include controller and reliever regimen, steroid taper schedule, spacer technique, trigger avoidance, a written asthma action plan, return precautions, and follow-up timing.

Draft a patient handout on managing high blood pressure in plain language; explain what BP numbers mean, key lifestyle steps (DASH diet, sodium limits, alcohol moderation), home BP monitoring instructions, medication adherence tips, and when to call the doctor.

Draft a patient handout for type 2 diabetes education in plain language; cover A1c goals, the plate method, physical activity targets, self-monitoring of blood glucose, hypoglycemia signs and the 15-15 rule, foot care basics, and a vaccination checklist.

Draft a summary of the latest CDC and WHO guidelines for managing community-acquired pneumonia in adults, including empiric antibiotic choices, duration of therapy, and follow-up recommendations.

Draft a plain-language overview of the ADA and AACE guidelines for diabetes management, focusing on A1c goals, weight management, and the use of GLP-1 receptor agonists and SGLT2 inhibitors.

Draft a summary of the 2024 USPSTF breast cancer screening recommendations, including updated screening intervals, risk-based approaches, and the role of MRI for high-risk patients.

Draft a concise summary of NCCN guidelines for melanoma management, including staging, surgical margins, adjuvant therapy, and checkpoint inhibitor recommendations.

Draft treatment alternatives for community-acquired MRSA skin infections in patients allergic to sulfa drugs; include oral and IV options, dosing, and duration.

Draft treatment alternatives for patients with type 2 diabetes who are unable to tolerate GLP-1 receptor agonists due to nausea; include medication substitutions and lifestyle recommendations.

Draft a summary of options for treating refractory depression, comparing ketamine infusions, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT).

Draft treatment options for advanced prostate cancer, including hormonal therapy, radiopharmaceuticals, and novel androgen receptor pathway inhibitors.

Draft a summary of recent research on mRNA vaccine technology beyond COVID-19, including applications in oncology and autoimmune disease prevention.

Draft an easy-to-understand overview of long COVID research, summarizing major symptoms, hypothesized mechanisms, and emerging treatment approaches.

Draft a summary of current research on Alzheimer’s disease biomarkers, including amyloid and tau imaging, and discuss how they influence diagnosis and trial design.

Draft an explanation of the interaction between warfarin and antibiotics such as ciprofloxacin or TMP-SMX, including INR effects and management recommendations.

Draft a summary evaluating drug interactions for patients taking Paxlovid and common cardiovascular drugs; include mechanism and recommended dose adjustments.

Draft a summary of the common and serious side effects of semaglutide, including GI intolerance, gallbladder disease, and thyroid-related warnings.

Draft an overview of potential side effects associated with long-term corticosteroid use, including osteoporosis, glucose intolerance, and adrenal suppression.

Draft a summary of essential lab tests to order in suspected acute pancreatitis, including amylase, lipase, liver enzymes, and metabolic panels, with interpretation guidance.

Draft laboratory workup recommendations for suspected hypothyroidism, including TSH, free T4, thyroid antibodies, and when to consider secondary causes.

Draft an explanation of which labs should be monitored in patients receiving methotrexate therapy, including CBC, LFTs, renal function, and frequency of monitoring.

why choose us

Edit Geo

×

300×250 Ad Slot

Research Article: Association between flexibility assessment based on prone full-spine CT scout view and surgical strategy for old thoracolumbar fracture with kyphotic deformity

Date Published: 2026-09-22

Abstract:
This study aimed to investigate whether spinal flexibility, assessed by the alignment difference between Full-length Spine CT scout view (FLS-CT) and standing radiographs, was associated with the eventual use of three-column osteotomy (3CO) in patients with old thoracolumbar fracture with kyphotic deformity (OTLFK). This single-center, dual-surgeon retrospective study included patients with OTLFK who underwent corrective surgery between August 2021 and August 2024. Patients were categorized into the 3CO group and the non-three-column osteotomy (N3CO) group according to whether 3CO was ultimately performed. Demographic characteristics, surgical variables, radiographic parameters, and clinical outcomes were compared between groups. Clinical outcomes included Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) assessed at 1 month, 6 months, and final follow-up. To quantify positional flexibility relative to the correction ultimately achieved, the kyphosis flexibility percentage (Kflx%) was retrospectively calculated using local kyphosis Cobb angle (LKCA) measurements from preoperative standing radiographs, preoperative prone FLS-CT, and postoperative standing radiographs. Because its denominator included postoperative standing LKCA, Kflx% was treated as a postoperative target-referenced metric rather than a purely preoperative predictor. Its apparent discrimination for classifying the observed use of 3CO was explored using a receiver operating characteristic (ROC) curve. A total of 109 patients were included, comprising 75 in the 3CO group and 34 in the N3CO group. Compared with the N3CO group, the 3CO group had significantly lower preoperative standing lumbar lordosis and significantly higher preoperative prone LKCA and T1 pelvic angle. Kflx% was significantly lower in the 3CO group than in the N3CO group (34.2% vs. 60.6%, P <?0.001). Among the variables entered into the multivariate logistic regression model, Kflx% was independently associated with the observed use of 3CO (OR?=?0.940, 95% CI 0.910–0.970, P <?0.001). ROC analysis identified an exploratory, cohort-derived Kflx% threshold of 49.7%, with a sensitivity of 82.7%, specificity of 61.8%, and positive predictive value of 82.9% for classifying patients who ultimately underwent 3CO. VAS and ODI improved significantly after surgery in both groups, without significant between-group differences at the same follow-up time points. In this institutional cohort, lower Kflx% was associated with 3CO use. Kflx% was calculated retrospectively and normalized to the correction achieved after surgery. The 49.7% cutoff is exploratory and should not be regarded as a validated preoperative decision threshold. Prospective evaluation using alignment targets defined before surgery is required.

Introduction:
Old thoracolumbar fracture with kyphotic deformity (OTLFK) often results from improper or delayed treatment of thoracolumbar fractures and usually requires corrective osteotomy ( 1 – 3 ). With the growing understanding of spinal biomechanics, restoration of optimal sagittal alignment has become the primary surgical objective, leading to an increased application of three-column osteotomy (3CO), particularly pedicle subtraction osteotomy (PSO, Grade III) and modified pedicle subtraction osteotomy (mPSO, Grade IV) (…

Read more

300×250 Ad Slot

×
Chat & Ask Questions Career Openings Medical Doctors Check on Drug
Interactions Latest Health News
by WebHealthNetwork Get CME Credits Latest Clinical Trials Latest Research Articles Clinical Documents Update Profile

News

Chat

HCP Tools

Careers

Update Profile