Anesthesiology
Audio Summaries

The Association Between Receiving Medications for Opioid Use Disorder and Human Immunodeficiency Virus Testing: Findings From the Rural Opioid Initiative

The authors aimed to investigate the relationship between receiving medications for opioid use disorder (MOUD) and the likelihood of undergoing HIV testing among people who use drugs (PWUD) in rural areas. Their findings indicate that individuals who received MOUD were significantly more likely to have been tested for HIV in the past year compared to those who did not receive MOUD, highlighting a potential opportunity for enhancing HIV screening in addiction treatment settings. The study calls for further research to identify strategies for increasing HIV testing in rural drug treatment environments.

Outcomes from a Longitudinal Palliative Care Curriculum for Medical Students

The authors aimed to evaluate the effectiveness of a longitudinal palliative care curriculum at the University of Pennsylvania's Perelman School of Medicine, focusing on its acceptability, impact on student knowledge and attitudes, and engagement in palliative care opportunities. Through a comprehensive assessment using both qualitative and quantitative methods, the study found that the curriculum successfully met its intended outcomes and provided valuable insights into its broader impacts. This evaluation serves as a model for other medical schools looking to assess similar palliative care educational initiatives.

Clinical Criteria for the Definition of Refractory Septic Shock: A Joint Delphi Consensus from the Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM)

The authors aimed to establish a consensus on clinical criteria for defining refractory septic shock to improve diagnosis, management, and research in this severe condition. Through a Delphi process involving critical care experts, they identified 13 key criteria, including markers of organ dysfunction, tissue perfusion indicators, and specific treatment requirements, such as high doses of norepinephrine and the use of critical care ultrasound. This consensus provides a structured framework for recognizing and managing refractory septic shock in clinical practice.

Proton beam therapy for oropharyngeal cancer (TORPEdO): a phase 3, randomised controlled trial

The authors conducted a phase 3 trial (TORPEdO) to compare the clinical benefits of intensity-modulated proton therapy (IMPT) versus intensity-modulated radiation therapy (IMRT) in patients with locally advanced oropharyngeal squamous cell carcinoma, specifically assessing treatment-related effects on physical function and quality of life. The results indicated that both treatment modalities yielded similar outcomes regarding late physical quality of life, gastrostomy-tube dependence, disease control, and overall survival, suggesting that IMRT remains the standard of care in settings where IMPT is not routinely utilized.

Evaluating Clinicians' Perspectives on Initiation of Medications for Opioid Use Disorder During Psychiatric Admissions

The authors aimed to evaluate clinicians' perspectives on the initiation of medications for opioid use disorder (MOUD) during psychiatric admissions, given the high prevalence of opioid use disorder among this population. Through semistructured interviews with clinical staff, they identified themes related to the acceptance of opioid withdrawal treatment, misconceptions about MOUD, and the impact of stigma, ultimately advocating for improved education and a multidisciplinary approach to enhance MOUD implementation in psychiatric settings.

A Case of 7-Hydroxymitragynine Use Disorder Treated With Buprenorphine

The authors investigate the management of 7-hydroxymitragynine (7-HMG) use disorder, a condition that is becoming more prevalent due to the increasing availability of this potent opioid. They present a case of a man treated successfully with a combination of methadone and buprenorphine, highlighting the need for further research on 7-HMG's effects and treatment strategies. The study underscores the potential for medication-assisted treatment in addressing 7-HMG addiction.

Stimulant-induced Psychosis: A Comparative Systematic Review and Meta-analysis of Psychotic Outcomes from Therapeutic and Nontherapeutic Use of Stimulants

The authors aimed to compare the incidence and prevalence of stimulant-induced psychosis between therapeutic (prescribed) and nontherapeutic (illicit or misused) stimulant use. Their systematic review and meta-analysis of 77 studies revealed a significantly lower incidence of psychosis in therapeutic users (0.6%) compared to a high prevalence in nontherapeutic users (32.8%), highlighting the need for careful monitoring and harm-reduction strategies in nonmedical contexts. The findings suggest that while prescribed stimulants carry a low risk, nontherapeutic use poses a substantial public health concern due to the severity and recurrence of psychotic symptoms.

Effects of a Combined Lifestyle Intervention on Recovery of ICU Survivors: A Randomized Controlled Trial

The authors aimed to evaluate the effects of a combined lifestyle intervention, including exercise and dietary support, on perceived physical functioning (PF) and health-related quality of life (HRQoL) in ICU survivors. The study found that participants in the intervention group experienced a significant improvement in PF scores and increased protein intake compared to the control group, suggesting that such interventions may benefit recovery in this population.

Primary sclerosing cholangitis

This article investigates the clinical features, pathogenesis, and management challenges of primary sclerosing cholangitis (PSC), a rare chronic liver disease often associated with inflammatory bowel disease. The authors aim to clarify the disease's variable presentation, the role of genetic and environmental factors, including the intestinal microbiome, and the limited treatment options available. The seminar highlights the need for a deeper understanding of PSC to improve patient outcomes and management strategies.

Ready for Donation, Not for Death: A Qualitative Study of Families' Experience With Controlled Donation After Circulatory Determination of Death in Intensive Care

This qualitative study investigates the experiences and challenges faced by families of patients undergoing controlled donation after circulatory determination of death (cDCDD). Through in-depth interviews, the authors explore themes related to decision-making, the waiting period before death, and the controlled environment of the dying process, highlighting the need for better support for families during this time. The findings suggest that while families can engage meaningfully in the cDCDD process, proper preparation and emotional support are essential to mitigate distress.