Safety, tolerability and pharmacokinetics of subcutaneous meropenem as an alternative to intravenous administration.

Background: Subcutaneous delivery of antibiotics is a practical alternative to IV administration. Meropenem is commonly used to treat infections caused by resistant Gram-negative organisms.

Methods: This was a prospective, crossover self-controlled study in 11 stable inpatients established on meropenem.

Enhancing data standards to advance translation in spinal cord injury.

Data standards are available for spinal cord injury (SCI). The International SCI Data Sets were created in 2002 and there are currently 27 freely available. In 2014 the National Institute of Neurological Disorders and Stroke developed clinical common data elements to promote clinical data sharing in SCI.

Neurologic Complications Associated With Burn Injury and Resuscitation.

Background: Treatment for large burn injuries relies on adequate fluid resuscitation secondary to the severe systemic inflammatory response. With improved critical care and better understanding of the complications of over and under resuscitation, morbidity and mortality rates are decreasing. Neurologic complications are not often considered as an over-resuscitation complication after burn injury but may be considered an additional form of compartment syndrome-intracranial compartment syndrome; however, it has not been evaluated for a possible threshold similar to the Ivy Index for abdominal compartment syndrome.

Effects of intraoperative fluid management on hemodynamics and tissue oxygenation according to the Pleth Variability Index in thoracic surgery.

Background: The aim of this study was to compare the total fluid volume performed by noninvasive Pleth Variability Index in thoracic surgery patients in comparison to conventional fluid management.

Methods: In this prospective randomized controlled study conducted between May 2019 and May 2020, 80 patients (68 males, 12 females; mean age: 58.5±6.

The Association Between Perioperative Red Blood Cell Transfusions and 1-Year Mortality After Major Cancer Surgery: An International Multicenter Observational Study.

Background: Packed red blood cell (pRBC) transfusions in patients undergoing surgery for cancer are given to treat anemia or acute hemorrhage. Evidence indicates that pRBC transfusions are associated with poor perioperative and oncological outcomes. The ARCA-1 (Perioperative Care in the Cancer Patient-1) study was designed to test the association between perioperative pRBC transfusions and postoperative morbidity and mortality in patients undergoing cancer surgery.

A Nationwide Comparison of Outcomes and Resource Use in Staged vs Simultaneous Cervical and Lumbar Fusions: A Retrospective Database Study.

Although the coexistence of cervical and lumbar spinal conditions is fairly common, surgical treatments are usually staged, even though simultaneous fusion of the cervical and lumbar spine may be a viable option for appropriate candidates. We sought to investigate the outcomes of staged vs simultaneous cervical and lumbar fusions in terms of differences in postoperative complications and resource use. We performed a retrospective cohort study using claims data from the 2006 to 2020 all-payer Premier Health Database.

Implementation of ERAS Protocols: In Theory and Practice.

The enhanced recovery after surgery (ERAS) pathway is a perioperative care pathway intended to facilitate early recovery and minimize hospital stays among patients undergoing major surgery. Critical factors for successful ERAS implementation, which may vary depending on care processes, include a multidisciplinary team, organizational commitment to change, and a real-time system for compliance and outcome audits. As most clinicians and health organizations can attest, incorporating and implementing new evidence-based practice changes almost always involves overcoming systemic challenges and obstacles.

Pediatric pain physician workforce: an assessment of supply and demand.

Introduction: Many youth with pain lack access to pediatric pain expertise. There is a critical shortage of pediatric pain physicians, due partly to a paucity of training programs in Pediatric Pain Medicine. Pain fellowships are Anesthesiology-based and there is no pathway to fellowship training or Pain Medicine board certification for pediatricians.

Association between Scabies Treatment and Parkinson's Disease: A Nationwide, Population-Based Study.

Background: Scabies is typically treated with scabicides like lindane, which poses a risk for acute neural toxicity. Lindane's prolonged use, particularly in agriculture, is linked to neurodegenerative diseases, including Parkinson's disease (PD), the second most common neurodegenerative disorder. This study aimed to evaluate whether scabies patients, particularly those treated with topical lindane, are at increased risk of developing PD.

Prevention of perioperative venous thromboembolism: 2024 guidelines from the French Working Group on Perioperative Haemostasis (GIHP) developed in collaboration with the French Society of Anaesthesia and Intensive Care Medicine (SFAR), the French Society of Thrombosis and Haemostasis (SFTH) and the French Society of Vascular Medicine (SFMV) and endorsed by the French Society of Digestive Surgery (SFCD), the French Society of Pharmacology and Therapeutics (SFPT) and INNOVTE (Investigation Network On Venous ThromboEmbolism) network.

Background: Any surgical procedure carries a risk for venous thromboembolism (VTE), albeit variable. Improvements in medical and surgical practices and the shortening of care pathways due to the development of day surgery and enhanced recovery after surgery, have reduced the perioperative risk for VTE.

Objective: A collaborative working group of experts in perioperative haemostasis updated in 2024 the recommendations for the Prevention of perioperative venous thromboembolism published in 2011.

Ethics and Management of Substance Use Disorders in Anesthesiology: Detection, Intervention, and Treatment Through Recovery and Return.

Prevention, detection, intervention, treatment, and recovery from substance use disorders (SUDs) in anesthesiology must include adherence to the 4 principles of bioethics. Impaired physicians must be afforded autonomy to the extent appropriate while also ensuring that no patient is harmed, or care compromised. Departments and health systems must also avoid causing further harm to the physician suffering from an SUD.

Causal inference can lead us to modifiable mechanisms and informative archetypes in sepsis.

Medical progress is reflected in the advance from broad clinical syndromes to mechanistically coherent diagnoses. By this metric, research in sepsis is far behind other areas of medicine-the word itself conflates multiple different disease mechanisms, whilst excluding noninfectious syndromes (e.g.

Short-term neurologic outcomes in pediatric extracorporeal membrane oxygenation are proportional to bleeding severity graded by a novel bleeding scale.

Introduction: This study aimed to characterize the severity of bleeding and its association with short-term neurologic outcomes in pediatric ECMO.

Methods: Multicenter retrospective cohort study of pediatric ECMO patients at 10 centers utilizing the Pediatric ECMO Outcomes Registry (PEDECOR) database from December 2013-February 2019. Subjects excluded were post-cardiac surgery patients and those with neonatal pathologies.

Addressing the Urgent Need for Clinical Nutrition Education in PostGraduate Medical Training: New Programs and Credentialing.

The importance of nutrition in the development of disease, and in the recovery from illness, is among the most fundamental tenets in human biology and optimal health. Nutrition was fundamental in many traditional forms of medicine until its role in medical care experienced a rapid decline over the last century. We believe a key cause of the decline in nutrition's essential role in healthcare and preventative medicine is the escalating crisis of inadequate nutrition education in medical training.