Study Design: Descriptive study. Summary of Background Data: Patients commonly use online patient education materials (PEM) to learn about anterior cervical discectomy and fusion (ACDF). Objective: The purpose of this study is to evaluate the readability of patient education materials on anterior cervical discectomy and fusion. Methods: The Google search engine was queried using the term “Anterior Cervical Discectomy and Fusion patient information.” The first 25 websites meeting inclusion criteria for this term were evaluated. Readability scores were automatically calculated by transferring the texts to http://www.readabilityformulas.com. Descriptive statistics were calculated for each measure using SPSS version 28.0.0. Results: The mean average reading level was 9.2±2.4. The mean readability score out of 100 for the FK Reading Ease Score was 55.2±8.6. The remaining scores were: Gunning Fog, 12.7±2.2; FK Grade Level, 8.9±2.0; The Coleman Liau Index, 11.0±1.7; SMOG Index, 48.1±197.0; Automated Readability Index, 8.1±3.11; Linsear Write Formula, 9.8±2.1. Only 2 of the PEMs were written at or below a sixth grade level and only 7 were written at or below an eighth grade reading level. Conclusion: Patient readability is an important component of patient care and the current readability level of ACDF PEMs is insufficient. At their current state, PEMs may not allow a significant portion of the population to understand the nature of their condition and procedure properly. Level of Evidence: Level III.

Background: The ideal antibiotic prophylaxis for open fractures is unknown. We evaluated outcomes following different antibiotic prophylaxis regimens for open fractures. Methods: This is a secondary analysis of data from PREP-IT. Prophylactic antibiotics were defined as any intravenous antibiotic given on the day of admission. The outcomes were surgical site infection (SSI) within 90 days and reoperation within 1 year. Logistic regression and an instrumental variable analysis that leveraged site-level variation accounted for confounding. Subgroup variation was evaluated by stratifying by Gustilo-Anderson classification (Types I and II versus III). Results: Of the 3,331 included participants, the mean age was 45 ± 18 years, 63% were male, 73% were White, 21% were Black, 2% were Asian, and 10% were Hispanic. Cefazolin monotherapy (58% of patients), ceftriaxone monotherapy (10%), and cefazolin plus gentamicin (6%) were the most common regimens. In the instrumental variable analysis, the odds of infection did not significantly differ with ceftriaxone use (odds ratio [OR], 1.24; 95% confidence interval [CI], 0.70 to 2.20; p = 0.45) or cefazolin plus gentamicin use (OR, 0.25; 95% CI, 0.03 to 2.04; p = 0.20) compared with cefazolin monotherapy. There were no significant differences between the regimens with respect to infection when stratified by Gustilo-Anderson type. However, we did observe a nearly 3-fold increase in the odds of infection with ceftriaxone use compared with cefazolin monotherapy (OR, 2.73; 95% CI, 0.96 to 7.79; p = 0.06) in Type-I and II fractures, and a 75% decrease in the odds of infection with cefazolin plus gentamicin use (OR, 0.25; 95% CI, 0.03 to 2.02; p = 0.19) compared with cefazolin monotherapy in Type-III fractures. Conclusions: Among patients with open fractures, antibiotic prophylaxis with ceftriaxone monotherapy did not provide significant benefits compared with cefazolin monotherapy in preventing infection in Type-I and II fractures. The findings suggest that cefazolin plus gentamicin might reduce the odds of infection in Type-III fractures compared with cefazolin monotherapy, but this difference was not statistically significant. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cancer induced cachexia, the involuntary loss of lean body mass and adipose tissue, is a debilitating syndrome experienced in up to 80% of all cancer patients. Cachexia is associated with poor treatment outcomes including decreased quality of life, increased risk of infection, disease progression, and mortality. Recent research suggests that exercise interventions may improve cachexia; however, there is a need for comprehensive and systematic review of the literature to evaluate the role of specific interventions on cancer-induced cachexia. We conducted a systematic review examining the efficacy of physical activity interventions, particularly resistance training, on cancer-induced cachexia outcomes. We searched seven electronic databases (PubMed, Embase, EBSCO, SCOPUS, Web of Science, PsychINFO, Cochrane) for articles published up to September 2023, yielding 7 eligible studies. Sample sizes ranged from 20 to 190 participants per study. Studies included pancreatic (n ​= ​3), head & neck (n ​= ​3), and Gastrointestinal (n ​= ​1) cancers. Mean age ranged from 51.90 to 67.1 years old and females comprised 51% of the participants. Most studies implemented resistance training interventions (73%), ranging from 3 months to 6 months in duration. Although the patterns of outcomes indicate promising results, the effect sizes for all models were small and not statistically significant. The science of exercise interventions to improve outcomes in those with cancer-related cachexia is still emerging although progressive resistance training appears to be the most promising countermeasure. Authors encourage the development of high-quality, fully powered randomized controlled trials (RCTs) examining physical exercise interventions aimed at mitigating cancer-induced cachexia.