Early achievement of hemostasis defined by transfusion velocity: A possible mechanism for whole blood survival benefit.

Introduction: Whole blood resuscitation is associated with survival benefits in observational cohort studies. The mechanisms responsible for outcome benefits have not been adequately determined. We sought to characterize the achievement of hemostasis across patients receiving early whole blood versus component resuscitation.

Efficacy of Intraoperative Cell Salvage on Perioperative Blood Transfusion in Pelvic and Acetabular Surgery: A Matched Cohort Analysis.

Background: Pelvic fractures often result in traumatic and intraoperative blood loss. Cell salvage (CS) is a tool where autologous blood lost during surgery is collected and recycled with anticoagulation, centrifugation to separate red blood cells, and washing to be reinfused back to the patient. The purpose of this study was to investigate our experience with CS in pelvic and acetabular surgery and its relationship to perioperative transfusion requirements.

A Systematic Critical Appraisal of Clinical Practice Guidelines in Barrett's Esophagus Using the AGREE II Tool.

Background: Several clinical practice guidelines (CPGs) exist for managing Barrett's esophagus (BE). However, the methodological quality of these CPGs is not known. To summarize the methodological quality of CPGs, we performed a critical appraisal of all available CPGs for the management of BE published from January 2018 to February 2023.

The inability to predict futility in hemorrhaging trauma patients using 4-hour transfusion volumes and rates.

Background: Blood shortages and utilization stewardship have motivated the trauma community to evaluate futility cutoffs during massive transfusions (MTs). Recent single-center studies have confirmed meaningful survival in ultra-MT (≥20 U) and super-MT (≥50 U), while others advocate for earlier futility cut points. We sought to evaluate whether transfusion volume and intensity cut points could predict 100% mortality in a multicenter analysis.

Missing History: Anarcha, Betsey, and Lucy's Legacy in Gynecologic Textbooks.

The legacy of J. Marion Sims as the "father of gynecology" has become widely controversial among medical professionals and lay public because of ethical concerns surrounding the development of his surgical techniques and his exploitation of enslaved women for his experiments. Notably, in April 2018, the City of New York relocated a commemorative statue of Sims from Central Park following an art commission's investigation of his controversial practices.

Evolution of whole blood trauma resuscitation in childbearing age females: practice patterns and trends.

Background: The use of low titer group O whole blood (LTOWB) for resuscitation of patients with traumatic hemorrhage is becoming increasingly common. Practices regarding the administration of RhD-positive LTOWB to childbearing age females (CBAFs) vary between institutions due to concerns about RhD alloimmunization. This study examined practices related to LTOWB transfusion as they pertain to age and sex.

Comparison of Standard and Extended Dexamethasone Duration on Mortality in Patients with Severe COVID-19.

Objectives: Current guidelines recommend dexamethasone 6 mg/day for up to 10 days in patients with severe coronavirus disease 2019 (COVID-19) requiring supplemental oxygenation or mechanical ventilation. The practice has significant variation, however, and dexamethasone has been used for >10 days for many patients with severe COVID-19. The aim of this study was to assess the benefits and risks associated with standard versus extended use of dexamethasone in patients with severe COVID-19.

Epicardial Lead Pacer Wire Migration Causing Endocarditis in an Orthotopic Heart Transplant Patient.

• TEPW migration is a rare complication after heart transplantation. • TEE is essential in diagnosing TEPW migration. • Epicardial pacing wire migration can cause endocarditis after surgery.

Minimally Invasive Approaches to Spinal Cerebrospinal Fluid Leak Repair: Current Strategies and a Novel Technique.

Spinal cerebrospinal fluid (CSF) leaks can be caused by tears in the dura and are challenging to treat. Traditional methods of treating spinal CSF leakage include nonsurgical management, epidural blood patches (EBP), and direct surgical repair. Minimally invasive surgery (MIS) is rapidly progressing within neurosurgery due to its advantages for patient safety and comfort.

First-Generation Low-Income Individuals in Medicine: A Scoping Review.

Purpose: This comprehensive scoping review of the medical literature on first-generation low-income (FGLI) individuals in medicine aimed to synthesize the highest levels of evidence to inform medical education stakeholders.

Method: Database searches were conducted in Academic Search Premier, Education Research Premier, ERIC, Ovid MEDLINE, Ovid Embase, Professional Development Collection, PubMed, Scopus, Google Scholar, and Web of Science Core Collection from database inception through March 15, 2023. English-language articles on first-generation or low-income individuals in medicine from U.

Evidence-Based Clinical Practice Guidelines on Regenerative Medicine Treatment for Chronic Pain: A Consensus Report from a Multispecialty Working Group.

Purpose: Injectable biologics have not only been described and developed to treat dermal wounds, cardiovascular disease, and cancer, but have also been reported to treat chronic pain conditions. Despite emerging evidence supporting regenerative medicine therapy for pain, many aspects remain controversial.

Methods: The American Society of Pain and Neuroscience (ASPN) identified the educational need for an evidence-based guideline on regenerative medicine therapy for chronic pain.

Consensus on a Patient-Centered Definition of Atopic Dermatitis Flare.

Importance: Flare is a term commonly used in atopic dermatitis (AD) care settings and clinical research, but little consensus exists on what it means. Meanwhile, flare management is an important unmet research and treatment need. Understanding how various therapies might comparatively improve AD flares as a measure of treatment effectiveness may facilitate shared decision-making and enable assessment of effectiveness within and outside clinical settings.

Reproducibility of the AGREE II Tool for Assessing the Methodological Quality of Clinical Practice Guidelines for the Management of Antithrombotic Agents in Patients Undergoing GI Endoscopy.

Background: Clinical practice guidelines (CPGs) exist for the management of antithrombotic agents in the periendoscopic period; however, their methodological qualities vary. The Appraisal of Guidelines for Research & Evaluation II (AGREE II) tool has been validated for the assessment of the methodological quality of CPGs; however, its reproducibility has not been assessed. The goal of this study was to assess the reproducibility of the AGREE II tool for CPGs published within the last 6 years for the management of antithrombotic agents in the periendoscopic period.

Evaluating the incidence and risk factors for developing acute tubular necrosis after percutaneous coronary intervention in the management of coronary artery dissection.

Background: Coronary artery dissection is managed primarily conservatively with serial imaging or percutaneous coronary intervention (PCI). Exposure to contrast in either modality could potentially result in acute tubular necrosis (ATN). However, no data compares ATN incidence in these management strategies.

Geographical and sociodemographic epidemiology of inflammatory bowel disease in young females from 2010 to 2019.

Background And Aims: Inflammatory Bowel Disease (IBD) represents a significant health threat worldwide. However, there are deficiencies in large-scale epidemiological research focusing on these issues, especially among young women. We aim to examine the trend of IBD in young females globally.

B-Cell Induction Therapies in Intestinal Transplantation.

Despite advancements in short-term outcomes since the inception of intestinal transplant, significant long-term graft failure persists. Early successes are attributed to the utilization of tacrolimus for maintenance therapy, coupled with T-cell modulating induction regimens, which effectively reduce the incidence of acute cellular rejection. However, the challenge of chronic allograft injury remains unresolved.

Not all cost conversations are the same: An exploration of potential value in cost conversations during Atrial fibrillation treatment decision making.

Objectives: To explore the cost conversations taking place when patients with atrial fibrillation and their clinicians decide on whether and how to use anticoagulation to prevent strokes.

Methods: Secondary qualitative thematic analysis of conversations from 476 clinical encounters in three sites of a multicenter randomized trial comparing usual care with and without a shared decision-making tool.

Results: We identified three themes with subthemes: (1) What was discussed: conversation content (2) How content was transmitted: communication patterns and (3) Implicit conversation drivers.

Abnormal lateral meniscal signal in MRI after patellar dislocation does not indicate a meniscal tear: MR findings with surgical correlation.

Background: Combined injuries observed with first-time lateral patellar dislocation (LPD) of the knee, particularly significant soft tissue injury, can inform surgical intervention criteria.

Purpose: The purpose of this study was to compare MRI findings in LPD to surgical correlation concerning meniscal pathology as a guide for surgical management.

Study Design: Retrospective case series, Level of evidence, 4.