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Implementing mental removal therapy (CRT) inside a psychological wellbeing service: workers coaching.
The procedure was performed following informed consent.Cerebral revascularization is the treatment of choice for select complex intracranial aneurysms unamenable to traditional approaches.1 Complex middle cerebral artery (MCA) bifurcation aneurysms can include the origins of 1 or both M2 branches and may benefit from a revascularization strategy.2,3 A novel 3-vessel anastomosis technique combining side-to-side and end-to-side anastomoses, allowing for bihemispheric anterior cerebral artery revascularization, was recently reported.4 This 2-dimensional operative video presents the case of a 73-yr-old woman who presented as a Hunt-Hess grade 4 subarachnoid hemorrhage due to the rupture of a large right MCA bifurcation aneurysm. TAS-102 cost The aneurysm incorporated the origins of the frontal and temporal M2 branches and was deemed unfavorable for endovascular treatment. A strategy using a high-flow bypass from the external carotid artery to the MCA with a saphenous vein (SV) graft was planned to revascularize both M2 branches simultaneously, followed by clip-trapping of the aneurysm. Intraoperatively, the back walls of both M2 segments distal to the aneurysm were connected with a standard running suture, and the SV graft was then attached to the side-to-side construct in an end-to-side fashion. Catheter angiograms on postoperative days 1 and 6 demonstrated sustained patency of the anastomosis and good filling through the bypass. The patient's clinical course was complicated by vasospasm-related right MCA territory strokes, resulting in left-sided weakness, which significantly improved upon 3-mo follow-up with no new ischemia. The patient consented for inclusion in a prospective Institutional Review Board (IRB)-approved database from which this IRB-approved retrospective report was created.
The aim of this retrospective study is to evaluate the perioperative complications and prognosis of patients with a history of resected esophageal carcinoma who subsequently underwent pulmonary resection of a primary lung cancer.

The study cohort comprised 23 patients who had undergone curative resection of a primary lung cancer following esophagectomy for a primary esophageal carcinoma. Clinical characteristics and surgical outcomes were analyzed.

The initial treatment for esophageal carcinoma was esophagectomy by thoracotomy in 10 patients and video assisted thoracoscopic surgery in 13. The treatments for lung cancer comprised wedge resection in three patients, segmentectomy in seven and lobectomy in 13. The pulmonary resections were performed by thoracotomy in six and video assisted thoracoscopic surgery in 17. The average operating time for the lung cancer surgeries was 202min and average blood loss 122ml. There were no perioperative deaths or severe complications. Three- and Five-year overall survinosis, and the indication for surgery in these patients should be carefully considered.
This study investigated the association between ambient nighttime temperature and sleep problems assessed by the prescription dose of sleeping pills in South Korean adults.

We used the 2002-2015 National Health Insurance Service-National Sample Cohort. A total of 711,079 adults who were 20 years old or older were included, wherein 42,858 adults (~6%) had been prescribed hypnotic medications including zolpidem (N05CF02) and triazolam (N05CD05). Ambient temperature data was calculated as the mean highest temperature of nighttime (2300-0700) for every month from January to December. We combined the drug-prescribed date with the administrative districts-level daily nighttime temperature between 2002 and 2015.

We found that a non-linear, U-shaped relationship between nighttime temperature and hypnotic medication prescription. With an increase per 1°C temperature or an increase in a square per 1°C, the prescription dose of sleeping pills was significantly increased (both p < 0.05). At each 5°C nighttime temperature, subjects belonging to low (≤0°C and 0-5°C) or high (20-25°C and ≥25°C) temperature categories had significantly higher doses of sleeping pills than those at the reference temperature (10-15°C). Changes in nighttime temperature had a significant non-linear effect on the prescribed dosage of hypnotic medications for both adults (p < 0.0001) and the elderly (p = 0.0006).

We found that either a high or low nighttime temperature was significantly associated with a high daily dose of hypnotic medications in the Korean population.
We found that either a high or low nighttime temperature was significantly associated with a high daily dose of hypnotic medications in the Korean population.Schizophrenia (SCZ) and bipolar disorder (BP) share a number of features. For example, multiple transcriptome analyses have reported molecular alterations common to both diagnoses, findings supported by the considerable overlap in the genetic risk for each disorder. These molecular similarities may underlie certain clinical features that are frequently present in both disorders. Indeed, many individuals with BP exhibit psychosis, and some individuals with SCZ have prominent mood symptoms that warrant the diagnosis of schizoaffective disorder (SA). To explore the potential relationships between molecular alterations and certain clinical features among subjects with these diagnoses, we analyzed RNA sequencing data from the dorsolateral prefrontal and anterior cingulate cortices, provided by the CommonMind Consortium, in subjects from the University of Pittsburgh Brain Tissue Donation Program. Relative to unaffected comparison subjects, in each brain region, robust differential gene expression was present only in SCZ, including a lower expression of genes involved in mitochondrial function and an elevated expression of immune-related genes. However, correlation analyses showed that BP subjects had similar, although less pronounced, gene expression alterations. Comparisons across subgroups of subjects revealed that the similarities between SCZ and BP subjects were principally due to the BP subjects with psychosis. Moreover, the gene expression profile in BP subjects with psychosis was more similar to "pure" SCZ and SA subjects than to BP subjects without psychosis. Together, these analyses suggest that similarities in gene expression between SCZ and BP are at least partially related to the presence of psychosis in some BP subjects.
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