Lumbar Sympathetic Block for Treatment of Knee Pain From Synovial Plica Syndrome: A Case Report.

Lumbar sympathetic blocks (LSBs) are used to treat sympathetically mediated pain in the lower extremities, kidneys, ureters, and genitals. LSBs use local anesthetic to block the sympathetic system to modulate pain response. In this case report, an avid runner was diagnosed with synovial plica syndrome.

Vasoactive and Antifibrotic Properties of Cannabinoids and Applications to Vasospastic/Vaso-Occlusive Disorders: A Systematic Review.

Background: Management of vasospastic and vaso-occlusive disorders is a complex challenge, with current treatments showing varied success. Cannabinoids have demonstrated both vasodilatory and antifibrotic properties, which present potential mechanisms for therapeutic relief. No existing review examines these effects in peripheral circulation in relation to vasospastic and vaso-occlusive disorders.

Acute Respiratory Failure Complicating Endoscopic Sleeve Gastroplasty: A Case Report.

Endoscopic sleeve gastroplasty (ESG) is a safe and minimally invasive procedure for the treatment of obesity. We report the case of a patient with obesity who underwent ESG complicated by postprocedural respiratory failure. During the procedure, she developed a Pao2/fraction of inspired oxygen (Fio2) ratio that necessitated postoperative mechanical ventilation.

Intraoperative Kounis Syndrome and Fixation Errors: A Case Report.

Postinduction hypotension, though frequently due to anesthetic medications, has a variety of causes. We present a case of presumed intraoperative Kounis syndrome, or anaphylaxis-induced coronary vasospasm, in which the patient's perioperative course was initially attributed to anesthesia-induced hypotension and iatrogenic rebound hypertension leading to Takotsubo cardiomyopathy. A second anesthetic event with immediate recurrence of hypotension after the patient received levetiracetam appears to confirm the diagnosis of Kounis syndrome.

The CROWNing Event on Hair Loss in Women of Color: A Framework for Advocacy and Community Engagement (FACE) Survey Analysis.

Hair loss is a primary reason for women with skin of color to seek dermatologic care. In addition to physical disfigurement, patients with hair loss are more likely to report feelings of depression, anxiety, and low self-esteem. There is a critical gap in dermatology advocacy efforts and educational information intended for women with skin of color.

Acellular Dermal Matrix Favorably Modulates the Healing Response after Surgery.

When first described for breast reconstruction, the presence of acellular dermal matrices was associated with increased seroma formation and infection. However, clinical safety data have gradually improved with surgeon experience to an acceptable outcomes profile of acellular dermal matrix-assisted reconstruction when compared to submuscular implant coverage. In fact, acellular dermal matrix use potentially decreases capsular contracture rates and facilitates expansion for staged prepectoral breast reconstruction.

Evaluating the Costs of Nurse Burnout-Attributed Turnover: A Markov Modeling Approach.

Objective: Burnout is a public health crisis that impacts 1 in 3 registered nurses in the United States and the safe provision of patient care. This study sought to understand the cost of nurse burnout-attributed turnover using hypothetical hospital scenarios.

Methods: A cost-consequence analysis with a Markov model structure was used to assess nurse burnout-attributed turnover costs under the following scenarios: (1) a hospital with "status quo" nurse burnout prevalence and (2) a hospital with a "burnout reduction program" and decreased nurse burnout prevalence.

States' Rights, Gun Violence Litigation, and Tort Immunity.

The devastating toll of gun violence has given rise to hundreds of lawsuits seeking justice on behalf of victims and their families. A significant number of challenges against gun companies, however, are blocked by courts' broad reading of the Protection of Lawful Commerce in Arms Act (PLCAA) - a federal statute often interpreted to shield the gun industry from civil liability. This article reexamines PLCAA in light of the Supreme Court's recent federalism caselaw, which counsels courts to narrowly construe federal laws that could otherwise upset the balance of power between states and the federal government.

Brain Injury Medicine Fellowship Applicant Survey: Trends in the Brain Injury Medicine Fellowship Application Process Between 2016 and 2019.

There is a lack of research regarding trends in the brain injury medicine fellowship match process. The objectives of this study were to (1) identify recent trends in the brain injury medicine fellowship application process, (2) provide meaningful information to future fellowship candidates, and (3) provide fellowship programs information on fellowship candidates' values. A cross-sectional study was conducted, in which a survey was sent to brain injury medicine applicants involved in the match process from 2016 to 2019.

A Randomized Trial of Closed-Loop Control in Children with Type 1 Diabetes.

Background: A closed-loop system of insulin delivery (also called an artificial pancreas) may improve glycemic outcomes in children with type 1 diabetes.

Methods: In a 16-week, multicenter, randomized, open-label, parallel-group trial, we assigned, in a 3:1 ratio, children 6 to 13 years of age who had type 1 diabetes to receive treatment with the use of either a closed-loop system of insulin delivery (closed-loop group) or a sensor-augmented insulin pump (control group). The primary outcome was the percentage of time that the glucose level was in the target range of 70 to 180 mg per deciliter, as measured by continuous glucose monitoring.

Evaluation of multiple sclerosis disability outcome measures using pooled clinical trial data.

Objective: We report analyses of a pooled database by the Multiple Sclerosis Outcome Assessments Consortium to evaluate 4 proposed components of a multidimensional test battery.

Methods: Standardized data on 12,776 participants, comprising demographics, multiple sclerosis disease characteristics, Expanded Disability Status Scale (EDSS) score, performance measures, and Short Form-36 Physical Component Summary (SF-36 PCS), were pooled from control and treatment arms of 14 clinical trials. Analyses of Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT), Low Contrast Letter Acuity (LCLA), and Symbol Digit Modalities Test (SDMT) included measurement properties; construct, convergent, and known group validity; and longitudinal performance of the measures individually and when combined into a multidimensional test battery relative to the EDSS and SF-36 to determine sensitivity and clinical meaningfulness.

Six-Month Randomized, Multicenter Trial of Closed-Loop Control in Type 1 Diabetes.

Background: Closed-loop systems that automate insulin delivery may improve glycemic outcomes in patients with type 1 diabetes.

Methods: In this 6-month randomized, multicenter trial, patients with type 1 diabetes were assigned in a 2:1 ratio to receive treatment with a closed-loop system (closed-loop group) or a sensor-augmented pump (control group). The primary outcome was the percentage of time that the blood glucose level was within the target range of 70 to 180 mg per deciliter (3.

Society of Cardiovascular Anesthesiologists Clinical Practice Improvement Advisory for Management of Perioperative Bleeding and Hemostasis in Cardiac Surgery Patients.

Bleeding after cardiac surgery is a common and serious complication leading to transfusion of multiple blood products and resulting in increased morbidity and mortality. Despite the publication of numerous guidelines and consensus statements for patient blood management in cardiac surgery, research has revealed that adherence to these guidelines is poor, and as a result, a significant variability in patient transfusion practices among practitioners still remains. In addition, although utilization of point-of-care (POC) coagulation monitors and the use of novel therapeutic strategies for perioperative hemostasis, such as the use of coagulation factor concentrates, have increased significantly over the last decade, they are still not widely available in every institution.

Benefits of Using The Pause after Death in Emergency Departments: A Delphi Study.

Objective: The Pause is a short-term, microbreak created by an emergency nurse in 2009. It provides care team members a few seconds of silence to honor a patient who has died while also honoring the efforts of the team. It is used now on four continents as a standard of care.

Caregiver Training for Pediatric Home Parenteral Nutrition: A 5-Session Discharge Curriculum.

To maximize safety and the patient experience, caregivers require intensive training to administer home parenteral nutrition (HPN) before initial hospital discharge. This article provides the rationale, best practices, and a template for caregiver predischarge HPN education provided by nurses. The standardized HPN discharge curriculum is outlined over 5 didactic and hands-on sessions.

Clinical Outcomes After Reverse Shoulder Arthroplasty With and Without Subscapularis Repair: The Importance of Considering Glenosphere Lateralization.

Introduction: Recent biomechanical data suggests that repairing the subscapularis during reverse shoulder arthroplasty (RSA) can increase the force required by the posterior rotator cuff and deltoid to elevate the arm.

Methods: We retrospectively studied patients who underwent primary RSA and had baseline and minimum 2-year postoperative American Shoulder and Elbow Surgeons (ASES) shoulder scores, stratified them according to subscapularis management, then subgrouped them according to lateralization of the glenosphere component.

Results: Patients with subscapularis repair and a lateralized glenosphere had significantly less improvement in ASES scores than did those without lateralization (P = 0.

Total Knee Arthroplasty Revision in a Patient With End-Stage Heart Failure With a Left Ventricular Assist Device Using Peripheral Nerve Blocks: A Case Report.

We report the successful use of peripheral nerve blocks for provision of surgical anesthesia for knee surgery in a patient who had end-stage heart failure, who was supported by a HeartMate II left ventricular assist device, and who was anticoagulated. We discuss the anesthetic implications involved in the care of patients being anticoagulated and on left ventricular assist device.