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Solitary marijuana use in age of puberty as being a link as well as forecaster of pot problems.
BACKGROUND Aim of our study is to analyze the impact of Early Tracheostomy (ET) in patients with cervical-spine (C-spine) injuries. METHODS We analyzed seven-year (2010-2016) ACS-TQIP databank and included all non-TBI trauma patients diagnosed with c-spine injuries. Patients were stratified into two groups based on the timing of tracheostomy (Early; ≤7days Late; >7days). Outcomes were complications, hospital and ICU stay. Regression analysis was performed. RESULTS We included 1139 patients. Mean age was 47 ± 12, median ISS was 18 [12-28], and median C-spine AIS was 4 [3-5]. 24.5% of the patients received ET. On regression analysis, patients who received ET had lower overall-complications (OR0.57) and ventilator-associated pneumonia (OR0.61). ET was associated with shorter duration of mechanical ventilation, and hospital and ICU stay. click here There was no difference in mortality rate. CONCLUSIONS Early tracheostomy in patients with C-spine injuries was associated with lower rates of ventilator-associated-pneumonia, shorter duration of mechanical ventilation, and ICU and hospital stay. BACKGROUND This study aimed to evaluate the association between nutritional risk screening (NRS) score and administration of adjuvant chemotherapy for stage III colon cancer. METHODS A total of 404 patients with stage III colon cancer who underwent curative resection between January 2012 and December 2015 were included. Patients with a preoperative high nutritional risk score (NRS ≥4) were compared with those with an NRS less then 4. Predictive factors for omission of adjuvant chemotherapy, and prognostic factors for overall survival (OS) were analyzed. RESULTS Eighty (19.8%) patients had a high nutritional risk (NRS ≥4). An NRS score ≥4 was associated with higher risk of omission of adjuvant chemotherapy (26.3% vs. 13.6%, p = 0.006), which was significant after adjusting for covariables (odds ratio = 1.862, p = 0.047). Multivariable survival analysis showed that omission of adjuvant chemotherapy was an independent poor prognostic factor for OS (hazard ratio = 4.060, p less then 0.001). CONCLUSIONS An NRS score ≥4 was associated with omission of adjuvant chemotherapy in stage III colon cancer, which resulted in poor OS. Low grade tumors located in the neck of the pancreas present a unique surgical challenge. Subtotal pancreatectomy results in significant loss of pancreatic gland and function, while pancreaticoduodenectomy may be too aggressive for these lesions. We present a case of a patient with a well differentiated neuroendocrine tumor in the neck of the pancreas who underwent a central pancreatectomy with pancreaticogastrostomy reconstruction. Patient selection and technical aspects of the procedure are described. The decision to perform a central pancreatectomy should not be made lightly as complications are frequent. Careful patient selection is imperative. BACKGROUND Participation in simulation can improve future performance, but it is unclear if observation of simulation scenarios can produce an equivalent benefit. METHODS First-year surgical residents were exposed to various simulation scenarios in groups of 4 or 5, either through active participation or passive observation. Residents were individually assessed on 3 of the scenarios. Scores were categorized based on resident level of exposure to the scenario and analyzed using a multivariate analysis. RESULTS 32 residents were enrolled and 28 underwent testing. Previous exposure to the scenario as a participant or observer led to improved performance on medical management and overall performance compared to those who had not been exposed (p 0.1). Previous exposure did not improve communication aspects of the scenarios. CONCLUSION Analyses confirmed the advantage of simulation-based training, but additionally suggest that the benefits for similar in both active participants and passive observers. This supports the idea of group based simulation training which can be more cost and time efficient. BACKGROUND Recent studies first reported the relevant role of the immune system in the pathophysiology of schizophrenia and then the association between inflammation and agitation. OBJECTIVES In this study, we aim to explore the relationship between CRP (C-reactive protein) levels and agitation in patients with schizophrenia. METHODS We conducted a cohort study with a comparison group of 60 patients with a DSM5 diagnosis of schizophrenia who were followed by the Department of Psychiatry of the University Hospital of Marrakech in Morocco. Patients were divided into two groups according to the state of agitation evaluated by the PANSS Excitement scale. These two groups have been matched according to age and gender. A comparison of CRP level, clinical and laboratory characteristics between the two groups and a monitoring of CRP level in the agitated group after 3 weeks of treatment were performed. RESULTS Inpatients with agitation displayed a significantly high CRP (P less then 0.0001), a high score of PANSS total (P less then 0.0001), PANSS positive (P less then 0.0001) and general PANSS (P less then 0.0001). After treatment, there was a significant reduction in CRP (P less then 0.0001) and PANSS excitement (P less then 0.0001). CONCLUSION These results confirm the role played by inflammation and immunity in agitation behavior in patients with schizophrenia and highlight the interest of the CRP assay at the time of admission of patients as a potential marker of agitation in hospitalized patients with schizophrenia. Several studies have investigated visual processing impairment in schizophrenia. The literature on visual exploration has described restricted scanning in schizophrenia patients. This gaze behavior is characterized by increased fixation duration, a reduced scan path length and avoidance of salient features of the face with emotional content. The aim of this paper is to give an insight on the latest update on scan path deficit. Abnormal gaze exploration was replicated in various visual stimuli. This review describes gaze patterns with stimuli that imply minimal to high cognitive process figures, objects, faces, and scenes. Interestingly, schizophrenia patients have shown cognitive flexibility by modulating gaze scanning when they are involved in an active assignment. We will also consider scanning abnormalities in real-life environment and discuss the potential therapeutic use of eye tracking in schizophrenia. The therapeutic application of eye tracking in schizophrenia is a young emerging field in psychiatry research.
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