Oral switch antibiotic therapy in uncomplicated bloodstream infection.

Background: The role of oral switch antibiotic therapy in uncomplicated bloodstream infection (BSI) remains unclear. This retrospective cohort study examines the effectiveness of oral switch compared with standard intravenous antibiotic therapy in uncomplicated BSI.

Methods: Adults with first episodes of uncomplicated monomicrobial BSI were admitted to 10 Prisma Health hospitals in South Carolina from January 2021 to June 2023 were included.

Interest in Injectable and Oral PrEP for HIV Prevention Among Women and Men Who Inject Drugs.

Background: People who inject drugs (PWID) are at increased risk for human immunodeficiency virus (HIV). Women who inject are a particularly vulnerable group. Preexposure prophylaxis (PrEP) is effective, but access and uptake has been limited.

Primary splenic involvement in kaposiform lymphangiomatosis: A case report.

Introduction: Kaposiform Lymphangiomatosis (KLA) is a rare, pathologically distinct lymphatic anomaly characterized by abnormal lymphatic channel malformation and a high mortality rate. Previous studies describe primary thoracic involvement.

Presentation Of Case: A previously healthy eighteen-month-old female presented to the pediatric emergency department with sudden onset of petechiae and bruising.

Team-Based Learning in Physician Assistant/Associate Education: A Mixed Scoping Review.

Introduction: Team-based learning (TBL) is a type of active learning. While TBL was first used in medical instruction at the start of the 2000s, its efficacy within the physician assistant (PA) education has yet to be demonstrated. The objective of this study was to determine existing information about TBL in PA education and to demonstrate the need for further study.

Associations of time to the operating room on outcomes in odontogenic infection.

The purpose of this study was to determine if there were correlations between the length of time from hospital admission to surgical intervention and the frequency of complications in patients with odontogenic infections. While odontogenic infection is well studied in terms of interventions and outcomes, less is known about hospital utilization and resource burden of odontogenic infection with respect to timeliness to intervention. A retrospective cohort analysis was used to examine correlations between time from admission to surgical intervention and clinical outcomes.

Anticipating impending peripheral intravenous catheter failure: A diagnostic accuracy observational study combining ultrasound and artificial intelligence to improve clinical care.

Objective: Peripheral intravenous catheter (PIVC) failure occurs in approximately 50% of insertions. Unexpected PIVC failure leads to treatment delays, longer hospitalizations, and increased risk of patient harm. In current practice there is no method to predict if PIVC failure will occur until it is too late and a grossly obvious complication has occurred.

Demographic trends of boxing-associated fractures over 10 years.

Background: Boxing is a sport well-known for the risk of injury. However, the epidemiology of boxing-associated fractures has not been well studied. This study aims to report the characteristics of boxing fractures that lead to presentation to the emergency room and evaluate the demographics and practices of the patients to prevent these injuries.

A Timeline From Index Procedure To Complex Reinterventions For Thoracoabdominal Aortic Dissection.

The optimal management of acute type A aortic dissection (ATAAD) remains a controversial subject. While some surgeons opt for a hemiarch approach to minimize bypass and cross-clamping time, others prefer partial or total arch replacement to prevent the need for additional operations. The advent of hybrid approaches offers a variety of options to the aortic surgeon in treating ATAAD.

Comparison of Partial Endoscopic vs Surgical Fundoplication after Hiatal Hernia Repair.

Background: The concomitant hiatal hernia repair with endoscopic fundoplication (c-TIF) is a novel anti-reflux procedure that addresses the hiatus and the gastro-esophageal flap valve for surgical candidates with GERD. We aim to compare the outcomes of a hiatal hernia repair with endoscopic fundoplication (TIF) vs surgical partial fundoplication (anterior and posterior) with regards to quality-of-life scores at 12 months after surgery.

Study Design: Following IRB approval, a prospectively maintained anti-reflux database was retrospectively reviewed to identify patients who underwent a c-TIF procedure or a surgical hiatal hernia repair with partial fundoplication.

Barriers to Buprenorphine: A Case Series of Misadventures Implementing a Prehospital Buprenorphine Protocol.

While several studies have focused on preliminary data and outcomes associated with prehospital buprenorphine administration interventions, to date there has been little discussion of the challenges experienced during the initial implementation of a prehospital buprenorphine protocol. In this case series we examine 3 separate patient encounters with different crews, patients, and receiving emergency medicine (EM) physicians, which highlight initial challenges experienced with implementing the first prehospital buprenorphine program in a rural Appalachian County within South Carolina. In 2 cases we highlight conflicts that may require collegial intervention and education of local receiving EM physicians regarding the new prehospital protocol.

Impact of Body Mass Index on Operative Time in Women Undergoing Benign Hysterectomy.

Background: Optimization of surgical scheduling represents an opportunity to improve resource utilization and increase patient access. Increasing body mass index (BMI) has been associated with increased operating time and may provide an opportunity to more accurately predict operating time.

Objective: To investigate the relationship between BMI and operative time for benign hysterectomy and develop a predictive model for hysterectomy operating time based on patient BMI.

Exploring the gaps: A scoping review of burn injury research in skin of colour.

Burn injury management and outcomes reveal observed disparities in individuals with darker skin tones, likely influenced by limited representation in medical literature and clinical research. These gaps may contribute to variations in care quality and outcomes for these populations. A comprehensive literature search was conducted across PubMed, Scopus, and Embase databases, initially yielding 74 articles.

Outcomes of NSTEMI Admissions and Significance of TIMI Scores: A Nationwide Analysis Using the National Inpatient Sample.

: The main aim of this study is to analyze the outcomes of NSTEMI admissions and test the relevance of TIMI as a risk score in a real-world setting. We also examine any potential social or health care disparities involved with outcomes of NSTEMI admissions. This study also investigates factors associated with mortality in NSTEMI admissions and its correlation with heart catheterization during admission.

Human-centered design of a health recommender system for orthopaedic shoulder treatment.

Background: Rich data on diverse patients and their treatments and outcomes within Electronic Health Record (EHR) systems can be used to generate real world evidence. A health recommender system (HRS) framework can be applied to a decision support system application to generate data summaries for similar patients during the clinical encounter to assist physicians and patients in making evidence-based shared treatment decisions.

Objective: A human-centered design (HCD) process was used to develop a HRS for treatment decision support in orthopaedic medicine, the Informatics Consult for Individualized Treatment (I-C-IT).

FibroScan Discordance With Liver Biopsy Significantly Overestimates Advanced Fibrosis and Cirrhosis in MASLD Subjects With Class 3 Obesity: Implications for Resmetirom Eligibility.

Goals: To investigate the effect of obesity on the stages of fibrosis discordance between FibroScan and liver biopsy.

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of liver disease worldwide. Accurate fibrosis assessment is essential in MASLD patients for prognosis and treatment.

Recommended Elements of a Musculoskeletal Course for Fourth-Year Medical Students: A Modified Delphi Consensus.

Background And Objectives: A recognized gap exists between primary care physicians' training in musculoskeletal (MSK) medicine and the burden of MSK complaints in primary care. Family medicine interns often lack adequate baseline MSK physical exam skills, which prompted a proposal to introduce a fourth-year preceptorship to reinforce MSK education. The aim of this study was to prioritize the most important elements to include in this new clinical rotation.

Evaluating medical learners' experiences with health literacy at a southeastern medical school.

Background: Health literacy (HL) is crucial for making informed health decisions. Over one-third of US adults have limited HL, leading to adverse health outcomes. Despite its importance, HL education lacks standardization in medical training.

Implementing and evaluating the comprehensive integration of physical activity into a major health system: study design and protocol.

Introduction: The healthcare sector has great potential for promoting physical activity (PA) for chronic disease prevention, treatment and management; however, multiple adoption and implementation barriers exist, ranging from practice integration to information flow. In 2016, Exercise is Medicine Greenville (EIMG), a comprehensive clinic-to-community approach that involves PA assessment, recommendation and/or prescription and provider-based referral of patients to community-based PA programmes, was launched by Prisma Health in Greenville, South Carolina, USA. Since inception, variability has emerged in adoption and implementation, impacting patient reach, referral rates and engagement in the community-based PA programmes, highlighting the need for closer evaluation and refinement of strategies to maximise programme impact.

The Moreton Lecture Series: The Renin-Angiotensin-Aldosterone System-Physiology, Pathophysiology, and Pharmacological Inhibition.

The renin-angiotensin-aldosterone system (RAAS) is a complex regulator comprising hormones, proteins, and enzymes. The discovery of the RAAS and its pharmacological manipulation has been essential in the management of cardiovascular diseases, including hypertension. Beyond the benefits of hypertension, RAAS inhibition has implications for heart failure, atherosclerotic disease, and kidney disease.

A Cost Analysis of Opioid/Acetaminophen Therapy Versus a Multidrug, Opioid-Free Multimodal Postoperative Pain Control Regimen.

Opioids are often part of the post-operative pain regimen after orthopaedic surgery. Novel multimodal post-operative pain control regimens have been developed to decrease the amount of opioid usage due to their negative side effects including nausea, constipation, and addiction. The purpose of this study was to compare the cost of postoperative pain management treatment methods after orthopaedic surgery between opioid/acetaminophen therapy and an opioid-free, multidrug, multimodal pathway.

Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research.

During the past decade, there has been extraordinary public, media, and medical research interest in psychedelics as promising therapeutics for difficult-to-treat psychiatric disorders. Short-term controlled trial data suggest that certain psychedelics are effective and safe in the treatment of major depressive disorder, treatment-resistant depression, and posttraumatic stress disorder. Preliminary evidence also supports efficacy in other psychiatric disorders (e.