Blood culture bottle shortage mitigation efforts: analysis of impact on ordering and patient impact.

Objective Design: In June of 2024, Becton Dickinson experienced a blood culture bottle shortage for their BACTEC system, forcing health systems to reduce usage or risk exhausting their supply. Virginia Commonwealth University Health System (VCUHS) in Richmond, VA decided that it was necessary to implement austerity measures to preserve the blood culture bottle supply.

Setting: VCUHS includes a main campus in Richmond, VA as well as two affiliate hospitals in South Hill, VA (Community Memorial Hospital (CMH)) and Tappahannock Hospital in Tappahannock, VA.

Increased Afferent Nerve Firing Is Correlated With the Detection of Bladder Wall Micromotion in a Perfused Ex-Vivo Porcine Model.

Introduction And Objective: Observable autonomous rhythmic changes in intravesical pressure, termed bladder wall micromotion, is a phenomenon that has been linked to urinary urgency, the key symptom in overactive bladder (OAB). However, the mechanism through which micromotion drives urinary urgency is poorly understood. In addition, micromotion is inherently difficult to study in human urodynamics due to challenges distinguishing it from normal cyclic physiologic processes such as pulse rate, breathing, rectal contractions, and ureteral jetting.

Remplissage Using Percutaneous Needle Navigation With Knotless Anchors in a Suture Staple Configuration.

Remplissage is a procedure that decreases the rate of recurrent instability after arthroscopic stabilization in patients with an engaging Hill-Sachs lesion. This technique involves capsulotenodesis of the infraspinatus tendon and posterior capsule into the Hill-Sachs lesion using 2 knotless anchors with suture passage through the infraspinatus tendon guided by a percutaneous needle. Previously described techniques use knots or anchor placement through the infraspinatus, which can be challenging to control and irreversible if tendon penetration occurs in an undesirable location.

Revision Triceps Reconstruction With Achilles Bone Block Allograft Augmentation: A Novel Inlay Technique.

Managing rerupture of the triceps brachii tendon after surgical repair is challenging due to poor tissue quality, retraction, and adhesions. This clinical scenario often requires augmentation with native tissue or tendon allografts. Traditional techniques include V-Y advancement, reinforced triceps advancement with double row or suture bridge fixation, and allograft tendon augmentation.

Difficulties and Disparities in Colorectal Cancer End-of-Life Care: A Patient's Story.

Patients with advanced colorectal cancer nearing the end of life require a multidisciplinary approach to address the unique challenges they face. Using a case vignette, we outline the various stages of a patient's journey with advanced rectal cancer and the common obstacles to their care as they interface with the medical system. We highlight how Black persons might be vulnerable to differences in screening, treatment, procedural interventions, end-of-life care, and health care decision-making.

Cardiovascular-Liver-Metabolic Health: Recommendations in Screening, Diagnosis, and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease in Cardiovascular Disease via Modified Delphi Approach.

There is a new awareness of the widespread nature of metabolic dysfunction-associated steatotic liver disease (MASLD) and its connection to cardiovascular disease (CVD). This has catalyzed collaboration between cardiologists, hepatologists, endocrinologists, and the wider multidisciplinary team to address the need for earlier identification of those with MASLD who are at increased risk for CVD. The overlap in the pathophysiologic processes and parallel prevalence of CVD, metabolic syndrome, and MASLD highlight the multisystem consequences of poor cardiovascular-liver-metabolic health.

Comparative Neuroexcitation Patterns Using fNIRS in Women With Overactive Bladder.

Importance: Functional near-infrared spectroscopy (fNIRS) is a noninvasive technique used to quantify prefrontal cortex (PFC) neuroexcitation. The PFC is involved in the decision to void, and dysfunction in the region has been associated with overactive bladder (OAB). This study demonstrates neuroexcitation differences in the brain region associated with the decision to void (prefrontal cortex) using noninvasive fNIRS.

Development of a professional advancement model for perfusionists.

Background: Improvement in professional advancement opportunities may reduce turnover and improve retention for perfusionists. However, the current literature lacks examples of professional advancement models (PAMs) for perfusionists.

Methods: This review looks at examples from other healthcare fields to provide the rationale and develop a framework for such a model.

Self-Reported Comfort and Use of Tobacco Cessation Interventions by Healthcare Providers.

Background The effects of tobacco use create a significant burden on the American healthcare system. The U.S.

Increased risk of adverse events following the treatment of associated versus elementary acetabular fractures: a matched analysis of short-term complications.

Purpose: This retrospective cohort study aims to compare short-term complication rates between patients receiving open reduction and internal fixation (ORIF) for associated versus elementary acetabular fractures, with a secondary objective of identifying independent risk factors for adverse outcomes.

Methods: The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using current procedural terminology (CPT) codes to identify patients that underwent ORIF for associated acetabular (CPT 27228) or elementary acetabular fractures (CPT 27226, 27227) from 2010 to 2021. Propensity score matching was employed to account for baseline differences and the short-term complication rates were compared between the cohorts.

Identifying 10-year cumulative incidence and risk of revision following total hip arthroplasty in patients with and without a diagnosis of human immunodeficiency virus.

Introduction: Prior studies have shown human immunodeficiency virus (HIV) may be a risk factor for early revision following THA, but little data exists looking at long-term implant survivorship. Therefore, the purpose of this study was to compare the 10-year cumulative incidence rate for revision following THA in patients with and without HIV.

Methods: A retrospective cohort analysis of patients with HIV undergoing elective THA was conducted using a national database.

Outcomes of ingested superabsorbent polymers ("water beads"): A poison center study.

Background: Superabsorbent polymers (SAPs) are hydrophilic polymers that expand many-fold from their original size after contact with water. Ingestions of "water beads" by young children have been reported to cause bowel obstruction however, the incidence of bowel obstructions is unknown.

Methods: We conducted a retrospective study analyzing ingestions reported to our regional poison center from January 1, 2002 to April 25, 2023.

Dose finding, bioavailability, and PK-PD of oral triapine with concurrent chemoradiation for locally advanced cervical cancer and vaginal cancer (ETCTN 9892).

Background: The addition of IV triapine to chemoradiation appeared active in phase I and II studies but drug delivery is cumbersome. We examined PO triapine with cisplatin chemoradiation.

Methods: We implemented a 3 + 3 design for PO triapine dose escalation with expansion, starting at 100 mg, five days a week for five weeks while receiving radiation with weekly IV cisplatin for locally advanced cervical or vaginal cancer.

Genome-Wide European Ancestry Study Identifies Coronary Artery Disease-Associated Loci Through Gene-Sex Hormone Interaction.

Background: Although sex differences in coronary artery disease (CAD) risk have been observed, little is known about the role of sex hormones in CAD genetics. Accounting for sex hormone levels may help identify CAD-risk loci and extend our knowledge of its genetic architecture.

Methods And Results: A total of 365 662 individuals of European ancestry enrolled in the UK Biobank were considered.

Healing Effect of in Burn Injuries.

Background: Burn injury is still the leading cause of mortality and morbidity in burn patients. We comapred healing effect of , silver sulfadiazine and alpha ointments on burn injuries in rat model.

Methods: Sixty female Sprague-Dawley rats in an animal experimental study were randomly divided to 5 equal groups as , silver sulfadiazine and (SSD), alpha, gel base and the burn injury left untreated.

Does machine learning improve prediction accuracy of the Endoscopic Third Ventriculostomy Success Score? A contemporary Hydrocephalus Clinical Research Network cohort study.

Purpose: This Hydrocephalus Clinical Research Network (HCRN) study had two aims: (1) to compare the predictive performance of the original ETV Success Score (ETVSS) using logistic regression modeling with other newer machine learning models and (2) to assess whether inclusion of imaging variables improves prediction performance using machine learning models.

Methods: We identified children undergoing first-time ETV for hydrocephalus that were enrolled prospectively at HCRN sites between 200 and 2020. The primary outcome was ETV success 6 months after index surgery.

Congenital Syphilis on the Rise: A Case Series and Discussion of Two Patients With Orthopaedic Manifestations of a Rare but Increasingly Common Disease.

Congenital syphilis is becoming increasingly common in the United States. Early identification and treatment are critical in preventing long-term sequelae, such as musculoskeletal deformity, and neurologic deficits. At our North American institution, two recent cases of congenital syphilis were identified primarily by their musculoskeletal manifestations.

Approaches to management of HIT in complex scenarios, including cardiac surgery.

Although heparin-induced thrombocytopenia (HIT) presents management challenges for any population, it adds complexity to the management of certain patient populations, including those undergoing cardiac surgery and those with refractory HIT and/or acute bleeding. For each of these scenarios, we review alternative management strategies when standard therapies-heparin cessation and the initiation of a nonheparin anticoagulant-are either insufficient or not practicable. In patients with HIT undergoing cardiac surgery, we review the clinical experience for heparin reexposure using therapeutic plasma exchange (TPE) or antiplatelet therapy.

Local control and patient survival after stereotactic radiosurgery for esophageal cancer brain metastases: an international multicenter analysis.

Objective: This study aimed to evaluate local control (LC) of tumors, patient overall survival (OS), and the safety of stereotactic radiosurgery (SRS) for esophageal cancer brain metastases (EBMs).

Methods: This retrospective cohort study used data from 15 International Radiosurgery Research Foundation facilities encompassing 67 patients with 185 EBMs managed using SRS between January 2000 and May 2022. The median patient age was 63 years, with a male predominance (92.

Fostamatinib for Hospitalized Adults With COVID-19 and Hypoxemia: A Randomized Clinical Trial.

Importance: Fostamatinib, a spleen tyrosine kinase inhibitor, has been reported to improve outcomes of COVID-19.

Objective: To evaluate the efficacy and safety of fostamatinib in adults hospitalized with COVID-19 and hypoxemia.

Design, Setting, And Participants: This multicenter, phase 3, placebo-controlled, double-blinded randomized clinical trial was conducted at 41 US sites and 21 international sites between November 17, 2021, and September 27, 2023; the last follow-up visit was December 31, 2023.