Safety, complications and clinical outcome after ultrasound-guided paravertebral catheter insertion for rib fracture analgesia: a single-centre retrospective observational study.

Rib fractures are associated with significant morbidity and mortality. Ultrasound-guided thoracic paravertebral catheter insertion has been described for the management of pain secondary to rib fractures. We conducted a retrospective observational study of all patients with rib fractures who had a paravertebral catheter inserted for analgesia provision over a 4-year period. Data from the Trauma Audit and Research Network were used to compare patients with rib fractures who were managed with paravertebral catheters to those managed with systemic analgesia. A total of 314 consecutive paravertebral catheters were inserted in 290 patients. Five (1.9%) catheters were removed due to ineffective analgesia. Other minor complications occurred in three cases (0.96%). The proportion of rib fracture patients managed with paravertebral catheters increased from 31/200 (15.5%) in the first year of study to 81/168 (48.2%) in the fourth; over this time-period the observed:predicted mortality ratio fell from 1.04 to 0.66. Proportional hazard regression with and without propensity score matching demonstrated a reduction in mortality associated with paravertebral catheter use, but this became statistically non-significant when time-dependent analysis was used. Paravertebral catheters are a safe and effective technique for rib fracture analgesia; however, our data were insufficient to demonstrate any improvement in mortality.

Eating disorders and dieting behavior among Australian and Swazi university students.

The eating behaviors of 192 Australian and 129 Swaziland university students were examined by using the Eating Attitudes Test (EAT-26; D. M. Garner, M. P. Olmsted, Y. Bohr, & P. E. Garfinkel, 1982). The results did not support the hypothesis that more Australian students than Swazi students would display eating disorder symptoms. Australian women scored significantly higher than Australian men. Surprisingly, scores on the EAT-26 for men and women from Swaziland did not differ significantly. Furthermore, there was little difference between the scores of Swazi men and either Australian women or Swazi women. Results are discussed in relation to various cultural factors and assessment issues.

Peritoneal absorption of moxalactam.

We evaluated the rate and extent of the systemic absorption of moxalactam given intraperitoneally to patients with peritonitis and end-stage renal disease who were being maintained on continuous ambulatory peritoneal dialysis. Moxalactam was administered at a concentration of 200 mg per 2-liter dialysate for the first dose, followed by 60 mg per 2-liter exchange for 23 1-h exchanges. Moxalactam concentrations in serum (mean +/- standard deviation) were 2.5 +/- 0.9 mg/liter after the first hourly dialysis, increasing to 10.3 +/- 4.8 mg/liter after 24 h of drug administration. Moxalactam levels in serum at 1 h were above the minimal inhibitory concentrations for most gram-negative organisms except Pseudomonas aeruginosa. No adverse effects of the drug were observed.