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Objective We examined reasons for e-cigarette use, tobacco product polyuse, and tobacco cessation interest among tobacco-using young adults from an urban setting. Methods Participants (N = 97) completed a risk factor survey. Descriptive statistics and prevalence estimates of polytobacco use patterns, motivations for tobacco use, tobacco cessation interest, and beliefs and risk perceptions about tobacco use were explored. Results All participants had a history of polyuse, and 85% were current polyusers. Stress was the primary reason reported for tobacco use. Compared to single-product users, current polyusers also were more likely to mention environment and cheap cost as reasons for use. Most participants perceived cigarettes to be as addictive as cocaine or heroin, although this perception was less common among e-cigarette users than non-users. Among study participants, 59% reported wanting to stop using tobacco completely. Among current polyusers, those that used e-cigarettes were more likely to report cessation attempts during the past year and express interest in enrolling in a quit smoking text messaging program. Conclusion In our sample there was a high prevalence of polytobacco product use and complex tobacco use patterns among young adults, both in and out of college, from an urban community.Background Retrospective, consecutive case series to evaluate the implantation of two second-generation trabecular microbypass stents in combination with cataract surgery in a real-world, clinical setting. Methods The series included 56 eyes implanted with the iStent inject device with phacoemulsification. The series consisted of eyes with primary open-angle glaucoma (n = 52) and pseudoexfoliative glaucoma (n = 4). Primary outcome measures included intraocular pressure (IOP) and number of glaucoma medications. Safety outcomes included the need for secondary surgical intervention and the incidence of IOP spikes ≥10 mmHg and ≥ 15 mmHg. Results IOP was reduced by 21% to 14.7 ± 2.9 mmHg (p less then 0.01) at 6 months postoperative from 18.7 ± 5.8 mmHg at baseline. Preoperatively, the mean number of glaucoma medications was 1.5 ± 0.9 and reduced by 39% to 0.9 ± 1.2 (p less then 0.01) at 6 months. At 6 months, 68% of eyes had an IOP ≤15 mmHg, increased from 30% at baseline. selleck kinase inhibitor 55% of eyes were medication-free at 6 months, up from 18% at baseline. There were no severe postoperative complications. No eyes underwent an additional glaucoma procedure. Conclusions Implantation of the iStent inject device with concomitant cataract surgery effectively provides a sustained reduction in IOP with a markedly improved medication burden out to 6 months postoperative. The safety profile is excellent.Background Meniscal root tears and ramp lesions have been rigorously characterized in recent literature. However, one of the most common lateral meniscal injuries identified with an acute anterior cruciate ligament (ACL) disruption, a posterior horn lateral meniscal oblique radial tear (LMORT), has not been thoroughly described. Purpose To determine the incidence of all meniscal tears and, more specifically, the incidence of posterior horn LMORTs in a multicenter cohort of consecutive, acute ACL reconstructions. Additionally, the authors aimed to develop a new classification system to help guide treatment of posterior horn LMORTs. Study design Cross-sectional study; Level of evidence, 3. Methods A multicenter retrospective cohort design was used to analyze 200 consecutive cases of acute ACL reconstruction from each of 3 different surgeons, for a total of 600 patients. The operative notes and intraoperative photos were analyzed to determine the incidence and laterality of all meniscal tears. A classification system based on tear characterization was then used to categorize tear patterns into similar groups. Results A total of 396 (66%) of the 600 patients with acute ACL disruption had concomitant meniscal tears. Specifically, 187 (31%) had a lateral meniscal injury, 89 (15%) had a medial meniscal injury, and 122 (20%) had both medial and lateral meniscal injuries. The most common lateral meniscal tear was an LMORT; 71 (18%) patients with meniscal tears had a posterior horn LMORT. Overall, the incidence of ACL injury with a concomitant posterior horn LMORT was 12%. A classification was developed, which included type 1 tear (partial thickness 10 mm from root). Conclusion In 600 consecutive acute ACL reconstructions, the incidence of concomitant ACL injury with meniscal injury was 66%, and posterior horn LMORTs represented a large proportion of all meniscal tears (12%). A classification scheme was developed for posterior horn LMORTs to aid reporting and clinical decision making for these common tears.Background The widespread historical abandonment of lateral extra-articular procedures in anterior cruciate ligament (ACL) injuries occurred as a result of concerns about high rates of adverse events. Recently, the popularity of lateral extra-articular procedures has resurged, warranting an urgent evaluation of their safety profile. Purpose/hypothesis The aim of this study was to perform an interim analysis of the ongoing SANTI randomized controlled trial to determine whether combined ACL and anterolateral ligament reconstruction (ACL + ALLR) is associated with an increased rate of adverse outcomes when compared with isolated ACL reconstruction (ACLR). The hypothesis was that there would be no significant difference between groups at a minimum follow-up of 1 year. Study design Randomized controlled trial; Level of evidence, 1. Methods Recruitment commenced in November 2016. Patients scheduled for ACLR were randomized to either isolated ACLR (with bone-patellar tendon-bone [BPTB] autograft) or combined ACL + A P = .0048), Lysholm (88 vs 92; P = .0131), and some components of the KOOS were significantly better in the combined ACL + ALLR group. Conclusion This study demonstrates no evidence of an increased risk of short-term adverse events after combined ACL + ALLR compared with isolated ACLR with BPTB graft. Registration NCT03740022 (ClinicalTrials.gov Identifier).
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