Declining pain medicine fellowship applications from 2019 to 2024: A concerning trend among anesthesia residents and a growing gender disparity.

Introduction: The fields of anesthesiology and pain medicine are experiencing significant changes driven by market forces and professional preferences. While demand for anesthesiologists is rising, pain medicine is facing a decline in fellowship applications.

Methods: This study analyzed data from the Electronic Residency Application Service (ERAS) and the National Resident Matching Program (NRMP) from 2019 to 2023, focusing on trends in fellowship applications to pain medicine programs.

Severe altered mentation due to cervicothoracic intrathecal pump after correction of cervical stenosis: a case report.

Background: Cerebral spinal fluid (CSF) dynamics are complex and changes in spinal anatomy may influence the rostrocaudal movement of intrathecal medications. We present the first reported case demonstrating that acute cervical spinal stenosis may impede the distribution of adjacent intrathecal medications, and that correction of such stenosis and the resulting changes in CSF flow may necessitate significant adjustments in the intrathecal infusates.

Case Presentation: We present a case of a 60-year-old male patient with a cervicothoracic intrathecal pump (ITP) infusing morphine, bupivacaine, and baclofen for chronic neck pain.

Perioperative takotsubo cardiomyopathy: Implications for anesthesiologist.

Takotsubo cardiomyopathy (TCM) is characterized by transient ventricular dysfunction in the absence of obstructive coronary artery disease that may be triggered by an acute medical illness or intense physical or emotional stress. TCM is often confused with acute myocardial infarction given the similar electrocardiographic changes, cardiac enzymes, hemodynamic perturbations, and myocardial wall motion abnormalities. In the perioperative setting, the clinical picture may be more confusing because of the effect of anesthesia as well as hemodynamic changes related to the surgery itself.

A case of endogenous endophthalmitis with subretinal abscess secondary to splenic abscess.

Early diagnosis and treatment of endophthalmitis will optimise visual prognosis. Blood culture sensitivities should tailor antibiotic choice.

Kyphoplasty increases vertebral height, decreases both pain score and opiate requirements while improving functional status.

Vertebral compression fractures can result from advanced osteoporosis, or less commonly from metastatic or traumatic insults to the vertebral column, and result in disabling pain and decreased functional capacity. Various vertebral augmentation options including kyphoplasty aim at preventing the sequelae of pain and immobility that can develop as the result of the vertebral fractures. The mechanism for pain relief following kyphoplasty is not entirely understood, and the restoration of a portion of the lost vertebral height is a subject of debate.

Antitumor properties of five-coordinate gold(III) complexes bearing substituted polypyridyl ligands.

In an on-going effort to discover metallotherapeutic alternatives to the chemotherapy drug cisplatin, neutral distorted square pyramidal gold(III) coordination complexes possessing 2,9-disubstituted-1,10-phenanthroline ligands {[((R)phen)AuCl3]; R = n-butyl, sec-butyl} have been previously synthesized and characterized. A structurally analogous gold(III) complex bearing a 6,6'-di-methylbipyridine ligand ([((methyl)bipy)AuCl3]) has been synthesized and fully characterized to probe the effect of differing aromatic character of the ligand on solution stability and tumor cell cytotoxicity. The two compounds [((sec-butyl)phen)AuCl3] and [((methyl)bipy)AuCl3]) were subsequently assessed for their stability against the biological reductant glutathione, and it was found that the [((sec-butyl)phen)AuCl3] complex exhibits slightly enhanced stability compared to the [((methyl)bipy)AuCl3] complex and significantly higher stability than previously reported square planar gold(III) complex ions.

Evaluation of multiple modes of oximetry monitoring as an index of splanchnic blood flow in a newborn lamb model of hypoxic, ischemic, and hemorrhagic stress.

Early and aggressive treatment of circulatory failure is associated with increased survival, highlighting the need for monitoring methods capable of early detection. Vasoconstriction and decreased oxygenation of the splanchnic circulation are a sentinel response of the cardiovasculature during circulatory distress. Thus, we measured esophageal oxygenation as an index of decreased tissue oxygen delivery caused by three types of ischemic insult, occlusive decreases in mesenteric blood flow, and hemodynamic adaptations to systemic hypoxia and simulated hemorrhagic stress.

Outcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: a randomized controlled trial.

Intraoperative goal directed fluid therapy (GDT) guided by an arterial pressure-based cardiac output system has been reported to improve gastrointestinal (GI) recovery in high-risk patients. This study evaluates the impact of this approach on GI recovery in low to moderate risk patients undergoing major abdominal surgery. IRB approved randomized controlled trial in low to moderate risk adults scheduled for major surgery.

Presumed tuberculous uveitis: diagnosis, management, and outcome.

Purpose: To assess the effectiveness of anti-tuberculous treatment in patients with chronic uveitis and either active systemic or latent tuberculosis (TB) in a non-endemic community.

Methods: Retrospective study of patients with chronic uveitis, non-ocular evidence of latent or active TB and no other identified cause of uveitis who underwent a 6-month course of standard anti-tuberculous chemotherapy. Response to treatment was assessed at 6 and 12 months after initiation of treatment.

Spontaneous sub-conjunctival haemorrhage in patients using long-term topical corticosteroids.

Purpose: to investigate the observed high prevalence of spontaneous sub-conjunctival haemorrhage (SCH) in patients using long-term topical steroid treatment.

Patients And Methods: a cross sectional survey of the occurrence of SCH was carried out in 248 patients using steroid eye drops and in a comparison group of 113 patients using topical glaucoma medication.

Results: twenty-four patients with uveitis (10% of total) experienced single or recurrent SCH.

Very severe HLA B27-associated panuveitis mimicking endophthalmitis: a case series.

Purpose: To report rare but important instances of very severe, hyperacute HLA B27-associated panuveitis, mimicking infective endophthalmitis and providing challenges to both diagnosis and management.

Design: Retrospective case review.

Methods: Four patient records were reviewed.

Study of clinical applications and safety for Pascal® laser photocoagulation in retinal vascular disorders.

Purpose: To establish safe laser parameter standards for 10-30 ms Pascal(®) laser in clinical practice and to evaluate clinical and visual outcomes using this 532-nm multi-spot photocoagulation system.

Methods: Retrospective observational case series of 313 patients treated between 2006 and 2008. Evaluation of eight groups: A - panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR); B - focal laser treatment for clinically significant diabetic macular oedema; C - grid laser for diffuse diabetic macular oedema; D - sector PRP for ischaemic branch retinal vein occlusions (I-BRVO); E - full PRP for ischaemic central retinal vein occlusions (I-CRVO); F - macular laser treatment for macular oedema secondary to non-ischaemic BRVO; G - full PRP for rubeosis iridis and/or neovascular glaucoma (NVG) secondary to I-BRVO, I - CRVO or PDR; H - laser retinopexy for retinal breaks/degenerations.

Synthesis and characterization of gold(III) complexes possessing 2,9-dialkylphenanthroline ligands: to bind or not to bind?

In an effort to discover potential alternatives to the anti-cancer drug cisplatin, the synthesis of gold(III) polypyridyl coordination complexes was pursued. Specifically, this report describes the synthesis and characterization of a series of 2,9-dialkyl-1,10-phenanthroline (Rphen) gold(III) coordination complexes (R = n-butyl, sec-butyl, and tert-butyl). Due to the steric hindrance imparted by the alkyl substituents, these ligands do not react with HAuCl4 to form square-planar gold(III) dichloride complex ions, as is the case with 1,10-phenanthroline, but instead form salts comprised of [AuCl(4)](-) anions and protonated 2,9-dialkylphenanthroline cations (compounds 1 and 2).

Initial experience with the Pascal photocoagulator: a pilot study of 75 procedures.

Background: The Pascal is a semiautomated photocoagulator that delivers a pattern array of multiple burns in a rapid predetermined sequence with a single foot pedal depression. Each burn is reduced to 10 or 20 ms to achieve this. The authors report their early experience with this system.

Non-Hodgkins lymphoma presenting with proptosis in an infant.

We describe a 9-week-old infant with rapidly progressive proptosis secondary to a rare orbital neoplasm, a variety of non-Hodgkins lymphoma.

Mycobacterium fortuitum keratitis.

We report a case of mycobacterial keratitis characterized by apparently spontaneous onset, delayed diagnosis, and eventually necessitating evisceration inspite of systemic antibiotics and repeated corneal grafts.

Efficacy of reiki on patients undergoing coronary artery bypass graft surgery.

Reiki was administered to 50 patients out of 100 patients with normal left ventricular function scheduled for elective coronary artery bypass grafting. Blood components and inflammatory markers were estimated at various time points. Haemodynamic parameters, psychological analysis, intensive care unit stay,incidence of infection, chest tube drainage and mortality were recorded.

Bilateral persistent hyperplastic primary vitreous.

We report a case of bilateral persistent hyperplastic primary vitreous (PHPV) in a 5-month-old infant who presented with bilateral leukokoria. The child was referred for ocular ultrasound with a clinical suspicion of retinoblastoma. Grey-scale evaluation revealed an echogenic band in the posterior segment of the left globe extending from the posterior surface of the lens capsule to the optic disc.

Uveitis and the menstrual cycle.

Purpose: To establish whether there is a variation in the incidence of onset of acute anterior uveitis (AAU) in women during the phases of the menstrual cycle.

Methods: Prospective open study in women attending the Acute Referral Centre with a first or recurrent attack of AAU.

Results: There was a significant increase in the incidence of AAU during the late stages of the menstrual cycle.