#1: Should We Use Normal Saline vs Balanced Fluid for TBI?
Spoon Feed —
This large meta-analysis of ICU RCT subgroups found decreased mortality in patients with traumatic brain injury treated with normal saline vs. crystalloid and an increase in those without.
Source
Effect of Treatment With Balanced Crystalloids Versus Normal Saline on the Mortality of Critically Ill Patients With and Without Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Anesth Analg. 2025 Jan 20. doi: 10.1213/ANE.0000000000007368. Epub ahead of print. PMID: 39832223
#2: Understanding the Jarisch-Herxheimer Reaction in Syphilis Treatment
Spoon Feed —
One in four patients had a Jarisch-Herxheimer reaction (JHR) when treating syphilis with benzathine penicillin G. The JHR was associated with secondary syphilis, HIV-negative status, and a better treatment response at six months.
Source
Jarisch-Herxheimer Reaction After Benzathine Penicillin G Treatment in Adults With Early Syphilis: Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. 2025 Feb 3;8(2):e2459490. doi: 10.1001/jamanetworkopen.2024.59490. PMID: 39946129
