Statewide Ketamine and Esketamine Prescribing Trends in Rhode Island, 2017-2023.

Ketamine is a versatile anesthetic that has been widely used off-label to treat a variety of indications. Esketamine, a derivative of ketamine, is FDA-approved to treat treatment-resistant depression. This report compares statewide prescription ketamine and esketamine trends.

Is This Organ Donor Safe?: Donor-Derived Infections in Solid Organ Transplantation.

Infection is an inevitable complication of solid organ transplantation. Unrecognized infection may be transmitted from a donor and result in disseminated disease in the immunosuppressed host. Recent outbreaks of deceased donor-derived infections resulting in high rates of mortality and severe morbidity have emphasized the need to be cautious in using donors with possible meningoencephalitis.

Is This Organ Donor Safe?: Donor-Derived Infections in Solid Organ Transplantation.

Infection is an inevitable complication of solid organ transplantation. Unrecognized infection may be transmitted from a donor and result in disseminated disease in the immunosuppressed host. Recent outbreaks of deceased donor-derived infections resulting in high rates of mortality and severe morbidity have emphasized the need to be cautious in using donors with possible meningoencephalitis.

Hospitalized Patients' Perceptions of Resident Fatigue, Duty Hours, and Continuity of Care.

Background: Physicians' perceptions of duty hour regulations have been closely examined, yet patient opinions have been largely unstudied to date.

Objective: We studied patient perceptions of residency duty hours, fatigue, and continuity of care following implementation of the Accreditation Council for Graduate Medical Education 2011 Common Program Requirements.

Methods: A cross-sectional survey was administered between June and August 2013 to inpatients at a large academic medical center and an affiliated community hospital.

Resident duty hours: a survey of internal medicine program directors.

Introduction: In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new Common Program Requirements to regulate duty hours of resident physicians, with three goals: improved patient safety, quality of resident education and quality of life for trainees. We sought to assess Internal Medicine program director (IMPD) perceptions of the 2011 Common Program Requirements in July 2012, one year following implementation of the new standards.

Methods: A cross-sectional study of all IMPDs at ACGME-accredited programs in the United States (N = 381) was performed using a 32-question, self-administered survey.

Fungal osteomyelitis and septic arthritis.

Management of fungal osteomyelitis and fungal septic arthritis is challenging, especially in the setting of immunodeficiency and conditions that require immunosuppression. Because fungal osteomyelitis and fungal septic arthritis are rare conditions, study of their pathophysiology and treatment has been limited. In the literature, evidence-based treatment is lacking and, historically, outcomes have been poor.

The Current State of United States Spine Surgery Training: A Survey of Residency and Spine Fellowship Program Directors.

Study Design: Program director survey.

Objectives: To collect data on spine surgical experience during orthopedic and neurological surgery residency and assess the opinions of program directors (PDs) from orthopedic and neurological surgery residencies and spine surgery fellowships regarding current spine surgical training in the United States.

Summary Of Background Data: Current training for spine surgeons in the United States consists of a residency in either orthopedic or neurological surgery followed by an optional spine surgery fellowship.

The impact of 2011 duty hours requirements on family medicine residents.

Background And Objectives: Our objective was to determine family medicine residents' perception of changes in education, patient care, and quality of life following implementation of the 2011 Accreditation Council of Graduate Medical Education (ACGME) Common Program Requirements.

Methods: Designated institutional officials at all 682 ACGME-accredited institutions were contacted and asked to distribute an anonymous, electronic survey to all residents at each sponsoring institution. The survey was administered to 2,956 family medicine residents at 61 institutions between December 2011 and February 2012.

Paperwork versus patient care: a nationwide survey of residents' perceptions of clinical documentation requirements and patient care.

Background: The current health care system requires a substantial amount of documentation by physicians, potentially limiting time spent on patient care.

Objective: We sought to explore trainees' perceptions of their clinical documentation requirements and the relationship between time spent on clinical documentation versus time available for patient care.

Methods: An anonymous, online survey was sent to trainees in all postgraduate years of training and specialties in Accreditation Council for Graduate Medical Education-accredited programs.

A thematic review of resident commentary on duty hours and supervision regulations.

Background: The implementation on July 1, 2011, of new Accreditation Council for Graduate Medical Education (ACGME) standards for resident supervision and duty hours has prompted considerable debate about the potential positive and negative effects of these changes on patient care and resident education. A recent large-sample study analyzed resident responses to these changes, using a Likert scale response. In this same study, 874 residents also provided free-text comments, which provide added insight into resident perspectives on duty hours and supervision.

Approval and perceived impact of duty hour regulations: survey of pediatric program directors.

Objectives: To determine pediatric program director (PD) approval and perception of changes to resident training and patient care resulting from 2011 Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements.

Methods: All US pediatric PDs (n = 181) were identified from the ACGME. Functional e-mail addresses were identified for 164 (90.

Critical analysis of a trauma fellowship-modeled, six-year orthopaedic surgery training program.

Background: Work-hour restrictions and increased supervision requirements have altered the clinical experience of orthopaedic surgery residents, while the specialty's body of knowledge and requisite skill set continue to expand. This dilemma means that the duration and practice experience of the traditional orthopaedic residency may not meet the needs of today's trainees. For the past eighteen years, however, residency training in the Department of Orthopaedic Surgery at Brown University has included a mandatory postgraduate year six (PGY6) trauma fellowship-modeled year, during which trainees are conferred full staff admitting and operating privileges, with time allotted for completing research.

Video-assisted Thoracoscopic Surgery (VATS) drainage of salmonella enteritidis empyema and needle-localization for retrieval of a dropped gallstone.

Introduction: Spillage of gallstones into the peritoneal cavity (dropped gallstones) is more common in laparoscopic compared with open cholecystectomy. Subsequent infectious complications are often delayed, occurring in 0.1% to 2.

Klebsiella pneumoniae-associated vertebral osteomyelitis after laparoscopic cholecystectomy.

We report a case of a patient who underwent elective laparoscopic cholecystectomy and subsequently developed Klebsiella pneumoniae-associated vertebral osteomyelitis after 2 months. Development of vertebral osteomyelitis after laparoscopic cholecystectomy has never been reported previously. Diagnosis was made via magnetic resonance imaging.

Infections transmitted by transplantation.

Infections are frequently transmitted through solid-organ and, to a lesser extent, stem cell transplantation. There are 2 major types of donor-derived infections that are transmitted: those that would be expected secondary to donor and recipient screening (ie, transmission of cytomegalovirus, Epstein-Barr virus, or toxoplasmosis from a seropositive donor to a seronegative recipient) and those that are unexpected despite routine donor screening (ie, human immunodeficiency virus and hepatitis C virus transmitted from a seronegative donor). Expected transmissions occur frequently and screening and prophylaxis strategies are applied to at-risk individuals in nearly all transplant centers globally.

Propionibacterium acnes colonization of the human shoulder.

Background: Propionibacterium acnes (P. acnes) is frequently cultured in patients with wound infections after shoulder surgery. The purpose of this study was to characterize the colonization of various anatomic locations with P.

Emerging viruses in transplantation: there is more to infection after transplant than CMV and EBV.

Transplant physicians and surgeons are familiar with the risks, clinical behavior, and management of cytomegalovirus in transplant recipients. Donor-transmitted viral infections are uncommon but in recent years have brought to light the clinical manifestations of rabies, West Nile virus, and lymphocytic choriomeningitis virus in the early posttransplant period. Later posttransplant, infection with viruses circulating in the community can occur with a number of pathogens, including some vaccine-preventable illnesses such as measles and mumps.