Notes

Polyunsaturated fatty acid intake and extra weight in pregnancy: NISAMI Cohort study.
eliminating school fees, could help reduce adolescents' perceived need to acquire sponsors. Our findings suggest a need to update guidelines for sexual and reproductive health counseling in schools and community settings to openly discuss why ITS is so commonplace and engage in risk reduction conversations with adolescents.
Violence is the leading cause of death among adolescents and young adults in the Americas. Community-Based Participatory Action Research engaged youth and parents to develop and implement two interventions. A Violence Prevention Program (VPP) focused on risk factors for violence, and a Positive Youth Development Program (PYDP) focused on protective factors. Program effects on violence outside of and in school were assessed at 6 and 12months.

Both interventions included an 8-week internet-based program and an in-person youth summit. Participants were prospectively randomized twice, first to the VPP and a no-VPP control group and again to the PYDP and a no-PYDP control group. Participants self-reported violence outside of and in school through self-administered baseline surveys with repeat assessments at 6 and 12months. Analysis of covariance models examined VPP and PYDP effects on violence.

The analysis sample was 86% Latino, 56% female, 36% aged 10-13 years, 45% aged 14-18, and 19% aged 19-23years. Analysis of covariance models of violence outside of school demonstrated small program interaction effects at 6months (partial eta
= .030; p= .007) and small VPP effects at 12months (partial eta
= .023; p= .025). Models of violence in school demonstrated small PYDP effects at 6months (partial eta
= .023; p= .018).

Community-Based Participatory Action Research engaging adolescents, young adults, and parents to address locally relevant health issues can have multiple benefits. In this study, a VPP had positive effects on violence outside of school at 12months, and a PYDP had positive effects on violence in school at 6months.
Community-Based Participatory Action Research engaging adolescents, young adults, and parents to address locally relevant health issues can have multiple benefits. In this study, a VPP had positive effects on violence outside of school at 12 months, and a PYDP had positive effects on violence in school at 6 months.
Hormonal therapy with tamoxifen and aromatase inhibitors reduces breast cancer recurrence and mortality but represents a risk factor for thromboembolic events. Therefore, most surgeons discontinue hormonal agents before microvascular surgery and for a variable period thereafter. There are no guidelines regarding when therapy should be stopped (preoperatively) or when it should be resumed (post-operatively). We, therefore, audited our hospital practice with the objective of making recommendations for microvascular breast reconstruction patients.

A review was performed of all free flap breast reconstructions between 2014 and 2019. Patients were classified according to hormone medication status at operation. Timings of drug cessation and recommencement were recorded. Thrombotic events, namely flap microvascular thrombosis, deep vein thrombosis, superficial vein thrombosis and pulmonary embolism, were compared.

A total of 240 patients had 275 free flaps over five years with 36 receiving hormone therapy withr to reconstructive surgery, this study does not support such practice being beneficial in terms of thromboembolic events and flap viability. Large-scale trials are needed to establish definitive protocols.During the recovery restitution phase of the coronavirus pandemic, breast reconstruction teams have faced particular challenges to restarting this essential service. GSK269962A This is due to the length and complexity of the surgery, along with the demands on healthcare staff. The Royal College of Surgeons have classified immediate breast reconstruction as priority 2 and the National Institute for Health and Care Excellence have provided a pre-operative pathway for resumption of elective procedures. We therefore describe our experience in restarting our service for providing a breast reconstruction service from the 29th June 2020.
Carbapenem-resistant Klebsiella pneumoniae (CRKP) causes high morbidity and mortality worldwide. The purpose of the study was to assess the synergistic activity of fosfomycin in combination with other antimicrobial agents against CRKP isolated from patients in Songklanagarind Hospital, Thailand.

A total of 35 K.pneumoniae isolates were obtained from patients in Songklanagarind Hospital. The MICs of imipenem and meropenem were determined in all isolates by broth microdilution. In all CRKP isolates, the presence of carbapenemase and extended-spectrum β-lactamase (ESBL) genes was investigated by PCR, while the production of these enzymes was determined by combined disk test. In the carbapenemase-genes-negative CRKP isolates, the porin loss and efflux pump were characterized by SDS-PAGE and broth microdilution, respectively. Finally, the synergistic effects of fosfomycin and other antimicrobial agents were evaluated by checkerboard analysis.

Twenty-one of 35 K.pneumoniae isolates were classified as CRKP. Most of CRKP isolates carried bla
(n=18), bla
(n=21), bla
(n=21), and bla
(n=16). In fosfomycin-based combination, the result showed that the highest synergistic activity in this study was observed in the combination of fosfomycin and gentamicin (61.9%).

These findings suggested that the fosfomycin and gentamicin combination might be useful as a possible treatment option for CRKP infection.
These findings suggested that the fosfomycin and gentamicin combination might be useful as a possible treatment option for CRKP infection.
There is a paucity of data comparing the left radial approach (LRA) and right radial approach (RRA) for percutaneous coronary intervention (PCI) in all-comers populations and performed by operators with different experience levels. Thus, we sought to compare the safety and clinical outcomes of the RRA and LRA during PCI in "real-world" patients with either stable angina or acute coronary syndrome (ACS).

To overcome the possible impact of the nonrandomized design, a propensity score was calculated to compare the 2 radial approaches. The study group comprised 18 716 matched pairs with stable angina and 46 241 with ACS treated with PCI and stent implantation between 2014 and 2017 in 151 tertiary invasive cardiology centers in Poland (the ORPKI Polish National Registry).

The rates of death and periprocedural complications were similar for the RRA and LRA in stable angina patients. A higher radiation dose was observed with PCI via the LRA in both clinical presentations (stable angina 1067.0±947.1 mGy vs 1007.
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