Comparison of Intraoperative Fentanyl Usage and Waste After Transition from 100-μg Vials to 50-μg Preloaded Syringes: A Single-Center Retrospective Study.

Background: The rapidly acting opioid fentanyl commonly used in the perioperative setting, has traditionally been packaged in 100 or 250-μg vials. In September 2021, our institution implemented a change from fentanyl 100-μg vials to 50-μg preloaded syringes in our operating rooms. The objective of this study was aimed at assessing the association of the fentanyl product change on reducing medication waste and the amount of fentanyl administered during surgery.

Comparing the emotional experiences of students in similar dissection- and prosection-based medical gross anatomy courses: A mixed-methods study.

The anatomy laboratory can incite strong emotional reactions in students, which can in turn facilitate growth in empathy, care for vulnerable others, and professionalism. Despite this, little is known about the relative emotional impacts of different laboratory modalities. The response to the COVID-19 pandemic created an opportunity to compare the emotional experiences of students in similar courses in which one group of students dissected donors and the other group learned from prosected donors.

Comparing autism phenotypes in children born extremely preterm and born at term.

Children born preterm are at increased risk for autism spectrum disorder (ASD). There is limited knowledge about whether ASD phenotypes in children born preterm differ from children born at term. The objective of this study was to compare ASD core symptoms and associated characteristics among extremely preterm (EP) and term-born children with ASD.

Satisfaction With the Process vs Outcome of Care in Total Hip and Knee Arthroplasty.

Background: Patient satisfaction, with both process of care and outcome of care, is critical for measuring the quality and value of elective procedures such as arthroplasty. The purpose of this study is to evaluate the correlation between early postoperative satisfaction with the process of care and 2-year satisfaction with the outcome of care after total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods: We retrospectively analyzed data from institutional arthroplasty registries.

Breastfeeding and Risk of Late-Onset Group B Streptococcal Disease.

Background: Group B (GBS) is a major contributor to neonatal sepsis worldwide. Late-onset group B disease (LOGBS) and its risk factors remain poorly understood. The isolation of GBS from breast milk has been described in cases of LOGBS.

The impact of Charlson and Elixhauser comorbidities on patient outcomes following shoulder arthroplasty.

Aims: To investigate the impact of the Charlson and Elixhauser comorbidity indices on patient-reported outcomes measures (PROMs) following shoulder arthroplasty.

Methods: Patients undergoing total shoulder arthroplasty (TSA), reverse shoulder arthroplasty (RSA), or hemiarthroplasty (HA) from 2016 to 2018 were identified, along with the Charlson and Elixhauser comorbidities listed as their secondary diagnoses in the electronic medical records. Patients were matched to our institution's registry to obtain their PROMs, including shoulder-specific (American Shoulder and Elbow Society (ASES) and Shoulder Activity Scale (SAS)) and general health scales (12-Item Short Form Survey (SF-12) and Patient-Reported Outcomes Measurement Information System-Pain Interference).

Clinical characteristics and patient-reported outcomes of total shoulder arthroplasty after anterior stabilization: a retrospective matched control study.

Background: Instability arthropathy is a known cause of glenohumeral osteoarthritis (OA) among patients with and without prior shoulder stabilization. This study aims to compare the clinical, radiographic, and patient-reported outcome measure (PROM) scores among total shoulder arthroplasty (TSA) patients with and without a history of shoulder stabilization.

Methods: A case-control study was performed comparing 20 patients with a history of anterior shoulder stabilization (11 open, 9 arthroscopic) who underwent TSA to a matched cohort of 20 TSA patients without a history of shoulder surgery (mean follow-up = 2.

Racial Disparities in Total Knee Replacement Failure As Related to Poverty.

Objective: To determine whether racial disparities in total knee replacement (TKR) failure are explained by poverty.

Methods: Black and white New York state residents, enrolled in a prospective single-institution TKR registry January 1, 2008 to February 6, 2012, who underwent primary unilateral TKR (n = 4,062) were linked to the New York Statewide Planning and Research Cooperative System database (January 1, 2008 to December 31, 2014) to capture revisions performed at outside institutions. Patients were linked by geocoded addresses to residential census tracts.

Medical alert tattoos-A pinch of style along with patient safety.

The use of medical tattoos can potentially be life-saving. We present a 16-year-old patient who chose to tattoo a medical condition on her forearm. Her tattoo is more extensive than most medical tattoos and shows the measures a mother will take to ensure her daughter's safety.

Disease burden and pain in obese cancer patients with chemotherapy-induced peripheral neuropathy.

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) and obesity are prevalent in cancer survivors and decrease quality of life; however, the impact of the co-occurrence of these conditions has garnered little attention. This study investigated differences between obese and non-obese cancer survivors with CIPN and predictors of symptom burden and pain.

Methods: Patients with CIPN were administered the MD Anderson Symptom Inventory and a modified version of pain descriptors from the McGill Pain Inventory.

Effectiveness of Splanchnic Nerve Neurolysis for Targeting Location of Cancer Pain: Using the Pain Drawing as an Outcome Variable.

The effectiveness of splanchnic nerve neurolysis (SNN) for cancer-related abdominal pain has been investigated using numeric pain intensity rating as an outcome variable. The outcome variable in this study used the grid method for obtaining a targeted pain drawing score on 60 patients with pain from pancreatic or gastro-intestinal primary cancers or metastatic disease to the abdominal region. Results demonstrate excellent inter-rater agreement (intra-class correlation [ICC] coefficient at pre-SNN = 0.

Differentiation of Illusory and True Halo in Writing Scores.

This report summarizes an empirical study that addresses two related topics within the context of writing assessment-illusory halo and how much unique information is provided by multiple analytic scores. Specifically, we address the issue of whether unique information is provided by analytic scores assigned to student writing, beyond what is depicted by holistic scores, and to what degree multiple analytic scores assigned by a single rater display evidence of illusory halo. To that end, we analyze student responses to an expository writing prompt that were scored by six groups of raters-four groups assigned single analytic scores, one group assigned multiple analytic scores, and one group assigned holistic scores-using structural equation modeling.

Water extract from Pleurotus pulmonarius with antioxidant activity exerts in vivo chemoprophylaxis and chemosensitization for liver cancer.

Chemoprophylaxis and chemosensitization are promising strategies to combat human cancers. Natural antioxidant agents show great promise in cancer therapy, and the use of edible mushrooms against cancer is receiving more interest globally. In this study, the radical scavenging activities including diphenyl-1-picrylhydrazyl, superoxide anion radical, hydroxyl radical, and hydrogen peroxide were compared among hot water extracts from 3 edible mushrooms, among which Pleurotus pulmonarius (Pp) possessed the highest antioxidant potential.

Physiologic or pathologic hypertrophy: how can we know?

Pathologic left ventricular hypertrophy due to hypertrophic cardiomyopathy is typically diagnosed based on compatible clinical and imaging findings. In a subset of patients however, the diagnosis is unclear, either due to the finding of concentric hypertrophy raising the possibility of physiologic hypertrophy due to athlete's heart or due to the potential of so-called hypertrophic cardiomyopathy 'phenocopies', which include Anderson-Fabry disease and cardiac amyloidosis. We review each of these diseases, highlighting important distinguishing features, the knowledge of which should permit the resolution of such diagnostic dilemmas.

Enhanced lithium-induced brain recovery following cranial irradiation is not impeded by inflammation.

Radiation-induced brain injury occurs in many patients receiving cranial radiation therapy, and these deleterious effects are most profound in younger patients. Impaired neurocognitive functions in both humans and rodents are associated with inflammation, demyelination, and neural stem cell dysfunction. Here we evaluated the utility of lithium and a synthetic retinoid receptor agonist in reducing damage in a model of brain-focused irradiation in juvenile mice.

Cardiac medication prescribing and adherence after acute myocardial infarction in Chinese and South Asian Canadian patients.

Background: Failure to adhere to cardiac medications after acute myocardial infarction (AMI) is associated with increased mortality. Language barriers and preference for traditional medications may predispose certain ethnic groups at high risk for non-adherence. We compared prescribing and adherence to ACE-inhibitors (ACEI), beta-blockers (BB), and statins following AMI among elderly Chinese, South Asian, and Non-Asian patients.

Influence of age on Salvia divinorum use: results of an Internet survey.

An Internet-based survey of Salvia divinorum ("salvia") users was conducted to identify correlates surrounding its use. Salvia-knowledgeable persons were recruited via "social networking Internet websites" (n = 23) where notices were posted on recreational salvia group message boards (n = 69). Data collection included demographics, use circumstances, experiences, and age (current and at first salvia use).

Modulation of arm stiffness in relation to instability at the beginning or the end of goal-directed movements.

In reaching to a target, stability near the target may be more critical for success than stability far from the target. Consequently, we postulated that high instability near the start would evoke less compensation than high instability near the target. Three stability conditions were implemented using a robot manipulandum: neutral stability everywhere (null field); high instability along the first half of the trajectory decreasing as the target was approached (start unstable); and instability increasing along the first half of the trajectory and remaining high as the target was approached (end unstable).