Common Reason Research Articles

Relationship between long-acting reversible contraception and acne in a cohort of adolescents and young adults.

The use of progestin-only long-acting reversible contraception (LARC) may be a risk factor for acne. Few studies have focused primarily on the effects of hormonal LARC on the development or exacerbation of acne in adolescents and young adults. We sought to understand the incidence and management of acne following hormonal LARC insertion in this adolescent/young adult population. A secondary data analysis was conducted of prospectively collected quality improvement (QI) data from the Adolescent Medicine LARC Collaborative. Subjects were evaluated by clinicians in adolescent medicine clinics at participating study sites, and acne severity was documented using a standardized recording instrument and scale. Descriptive statistics were reported as frequencies and percentages for categorical variables or mean and standard deviation (SD) for continuous variables. We compared demographic and clinical characteristics by those who had worsening acne, accounting for site inter-correlation using Cochran-Mantel-Haenszel chi-square tests for categorical variables and linear generalized estimating equation (GEE) regression for continuous variables. Of 1319 subjects who completed LARC insertion, 28.5% (376/1319) experienced worsening acne following use of progestin-only LARC. Acne was a contributing factor to LARC removal in only 3% (40/1319), and the sole reason for removal in 0.4% (5/1319) of all subjects. As this was a secondary analysis of prospectively collected QI data, limitations of this study include incomplete or inaccurate documentation of acne severity. Moreover, LARC insertions without follow-up/removal visits or with only follow-up/removal within 8 weeks of insertion were excluded from our study, which may also bias results. Adolescents and young adults seeking progestin-only LARC should be counseled about the potential for developing acne or experiencing a worsening of existing acne during LARC use. However, acne was not a common reason for LARC discontinuation.

Reasons for repeat urgent cardiac procedures within the same day.

With advances in technology and technique, the expectations are that patients undergoing procedures in the cardiac catheterization laboratory will not need to return for a repeat procedure within the same day. Report why subjects undergoing cardiac procedures return urgently to the catheterization laboratory for a repeat procedure during the same day. We retrospectively reviewed patients who were brought back to the cardiac catheterization laboratory within the same day for a repeat procedure. The reasons for index and repeat procedure were identified. Patients who were transferred from an outside center after an initial procedure at other centers were excluded. Between November 2013 and January 2022, 55,942 catheterization procedures were performed at our institution, of which 140 entries were included in our analysis. Common reasons for the index procedure were diagnostic angiography (35.0%), percutaneous coronary intervention (PCI, 29.2%), and transcatheter aortic valve replacement (15.0%). The most common reason for bringing these patients back to the cardiac catheterization laboratory within the same day was vascular complications (24.2%), followed by repeat PCI (20.7%), need for hemodynamic support (15.0%), heart team discussion and PCI (10%), and pacemaker implantation (10%). Acute limb ischemia was the most commonly identified vascular complication (7.1%), followed by pseudoaneurysm (5%). Our study demonstrates that a very small number of patients underwent repeat procedures within the same day. Special attention should be paid to vascular access and closure and assessment of recurrent chest pain postprocedure, as these are the main reasons for same-day repeat procedures.

Reasons for laparosopic cholecystectomy conversion in a small general hospital

Background: Laparoscopic cholecystectomy is one of the most common procedures in abdominal surgery. This procedure is the gold standard for the treatment of symptomatic cholelithiasis and acute cholecystitis. However, thedifficulty and possibility of safely performing laparoscopic cholecystectomy vary considerably due to the variety of local findings and the course of the procedure. If it is not possible to complete the procedure safely by laparoscopy, due to intraoperative complications or to avoid the occurrence of complications, it is necessary to convert laparoscopic cholecystectomy to open cholecystectomy.Methods: We performed retrospective research on cases of cholecystectomy performed on all patients at the Dr. Mustafa Beganović General Hospital in Gračanica from 2014 to 2020, which were started by laparoscopy and finished using laparoscopy or converted to open cholecystectomy. Results: There were 888 cases that started as laparoscopic cholecystectomy. In 43, or 5.39% of cases laparoscopic cholecystectomy was converted to open cholecystectomy. The most common reasons for conversion from LC to OC were adhesions, the inability to identify anatomical structures, and inflammation.Conclusion: The number of conversions in our sample is in accordance with the data from the relevant research and at the same time the incidence of bile duct injuries is very low.

Experiences with and needs for aftercare following the death of a loved one in the ICU: a mixed-methods study among bereaved relatives

BackgroundBereaved relatives of intensive care unit (ICU) patients are at increased risk of psychological complaints. Aftercare might help them cope with processing the ICU admission and their loved one’s death. There is little (qualitative) evidence on how bereaved relatives experience aftercare. Also, the COVID-19 pandemic likely impacted aftercare provision. We aim to examine how many relatives in Dutch ICUs received aftercare before and during the pandemic and to qualitatively describe their experiences and needs regarding aftercare.MethodsA mixed-methods study among relatives of patients who died in an ICU before or during the COVID-19 pandemic. Bereaved relatives in six ICUs completed a questionnaire (n = 90), including two items on aftercare. These were analyzed using descriptive statistics and Chi-squared tests. Subsequently, both relatives that received and relatives that did not receive aftercare were interviewed about their experiences and needs regarding aftercare. The interviews were thematically analyzed.ResultsAfter the passing of a loved one, 44% of the relatives were asked by a healthcare professional from the hospital how they were doing, and 26% had had a follow-up conversation. Both happened more often during the first wave of the pandemic than during the second wave or before the pandemic. The most common reason for not having had a follow-up conversation was not knowing about this option (44%), followed by not feeling a need (26%). Regarding the latter, interviewed relatives explained that this would not revive their loved one or that they had already discussed everything they wanted. Relatives who wanted a follow-up conversation, wanted this because this would help them realize the severity of their loved one’s illness, to exchange personal experiences, and/or to thank the ICU team. Those with a follow-up conversation said that they had reviewed the medical course of the admission and/or discussed their (mental) well-being.ConclusionsICU healthcare professionals may play a vital role in addressing aftercare needs by asking relatives how they are doing in the weeks following the death of their loved one and offering them a follow-up conversation with an ICU physician. We recommend to include aftercare for bereaved relatives in ICU guidelines.

(011) Exploring Pretending Orgasm and Sexual Satisfaction Among Egyptian Women: A Cross-Sectional Survey Study

Abstract Introduction Research on sexual satisfaction, especially orgasm, has focused on North American and Western contexts. Studies show women frequently pretend during PVI to end activity or avoid consequences. Reasons vary from emotional communication to mate deception, not always related to sexual dysfunctions. Sociosexuality may influence behaviors, with casual sex individuals less likely to fake orgasms for positive feedback. Limited research on non-Western societies, especially Egypt, prompted this study to explore prevalence and reasons for pretending orgasm among Egyptian women, investigating correlations with sexual orientation, sexual violence history, dysfunction, and family size. Objective 1. Prevalence of faking orgasm in Egyptian adults. 2. Reasons for faking orgasm in Egyptian women. 3. Correlations with sexual orientation, violence history, dysfunction, and family size. 4. Insights into sexual scripts in Egyptian society. Methods This cross-sectional survey investigates reasons for faking orgasm in Egyptian women. A convenience sample of women aged 18 and above was recruited through social media, community centers, and universities. Data collection occurred between [December 2020] and [February 2021], with participants providing informed consent for the online survey. The survey includes 51 questions on pretending orgasm and a structured interview for demographic information. Participants rated reasons on a Likert scale, and quantitative data will be analyzed using descriptive and inferential statistics to identify prevailing motives. Results In the survey of 626 Egyptian women: •38.6% (242 women) reported pretending orgasm during sexual encounters. •Common reasons for pretending included: wanting to end sexual activity (55.9%–350 women), avoiding negative consequences (66.6%–417 women), and pleasing their partner (55.9%–350 women). •Sociosexuality played a role, with 38.3% (240 women) of those interested in casual sex less likely to fake orgasms for positive feedback. •96.2% (602 women) identified as heterosexual, 1% (6 women) as homosexual, and 2.9% (18 women) as bisexual. •85.2% (534 women) were married, 6.4% (40 women) divorced, 2.6% (16 women) separated, and 5.7% (36 women) in a relationship. •91.8% (575 women) belonged to small families, and 8.2% (51 women) to big families. •14.1% (88 women) had multiple sexual partners, and 16.5% (103 women) suffered from psychological dysfunction. •43.2% (271 women) engaged in sexual relationships more than once a week, 26.9% (168 women) once a week, and 17.6% (110 women) once a month. •32.6% (204 women) were sexually satisfied, 9.6% (60 women) were not satisfied, and 7% (44 women) were neutral. •45.5% (285 women) had a history of sexual harassment, and 27.6% (173 women) had a history of Female Genital Mutilation (FMG). Conclusions The study reveals a prevalent practice of pretending orgasm among Egyptian women (38.6%). Reasons for pretending vary, with a significant percentage aiming to end sexual activity (55.9%), avoid negative consequences (66.6%), and please partners (55.9%). Sociosexuality plays a role, with 38.3% of those interested in casual sex less likely to fake orgasms for positive feedback. Findings emphasize open communication for sexual satisfaction and relationship well-being. Limitations include self-report bias and limited generalizability. Future research should explore diverse contexts and long-term effects on relationship satisfaction. Addressing complexities is vital for healthy relationships among Egyptian women. Disclosure No.

Firearm Access and Gun Violence Exposure Among American Indian or Alaska Native and Black Adults

American Indian or Alaska Native and Black adults experience elevated rates of firearm injury and death, but both groups are severely underrepresented in research on firearm exposure and behaviors. To explore geodemographic differences in firearm behaviors and violence exposure among American Indian or Alaska Native and Black adults in the US. In this survey study, nationally representative samples of American Indian or Alaska Native and/or Black adults recruited from KnowledgePanel were surveyed cross-sectionally. Surveys were administered online between April 12 and May 4, 2023. Firearm access, storage, and carrying behaviors and lifetime firearm violence exposure were the primary outcomes. Demographic factors such as age, geographic location, and political affiliation were considered. Data were weighted to geodemographic distributions from the US Census Bureau's 2022 Current Population Survey. Of 3542 participants, 527 (14.9%) were American Indian or Alaska Native (280 [53.1%] female) and 3015 (85.1%) were Black (1646 [54.6%] female). Both groups exhibited high firearm access rates (American Indian or Alaska Native adults: 238 [45.4%; 95% CI, 39.4%-51.7%]; Black adults: 909 [30.4%; 95% CI, 28.0%-32.9%]), predominantly owning handguns for home protection. The groups demonstrated similar firearm storage patterns, and a substantial proportion endorsed always or almost always carrying firearms outside the home (American Indian or Alaska Native adults: 18.9%; Black adults: 15.2%). Self-protection was a common reason for carrying a firearm (American Indian or Alaska Native adults: 104 [84.9%; 95% CI, 74.1%-91.7%]; Black adults: 350 [88.3%; 95% CI, 82.3%-92.4%]), and a minority of participants cited lack of faith in the police (American Indian or Alaska Native adults: 19 [15.2%; 95% CI, 8.2%-26.7%]; Black adults: 61 [15.4%; 95% CI, 10.3%-21.2%]), indicating potential shifts in public safety dynamics. In this survey study of American Indian or Alaska Native and Black US adults, a substantial percentage of both groups reported living in homes with firearms, storing firearms loaded and unlocked, frequently carrying firearms outside the home, and having been exposed directly and indirectly to gun violence. These findings underscore the need for nuanced public health campaigns and policies and highlight challenges for law enforcement in contexts of racial disparities and changing legal frameworks.

SENKRON SIKIŞTIRMA DÖNÜŞÜMÜ VE DERİN ÖĞRENME KULLANILARAK FOTOPLETİSMOGRAFİ TABANLI KAN BASINCI KESTİRİMİ

Cardiovascular diseases are one of the deadliest health problems. Hypertension is the most common reason for cardiovascular diseases. Keeping the blood pressure (BP) level under control is the only way to protect against the deadly results of hypertension. Therefore, monitoring BP regularly makes it possible to detect dangerous conditions in patients with hypertension. With the rapid developments in computers and sensor technologies, it is becoming possible to monitor BP levels continuously by using photoplethysmogram (PPG) signals. This work presents a non-invasive BP prediction method using one channel PPG signal. We employed the Synchrosqueezing Transform to obtain Time-Frequency (TF) images of the PPG signals. The TF images were used to feed a pre-trained deep neural network. We estimated the BP levels inside the 5-second intervals. Our method estimates BP levels with a mean error (ME) of 0.2148 mmHg and -0.0370 mmHg in the systolic and diastolic blood pressure (SBP and DBP) respectively. The ME values of our method are in the applicable levels. The standard deviation (SD) of our method is 5.0642 mmHg for DBP and 10.9904 mmHg for SBP. The upper limit specified by the AAMI is 8 mmHg. Also, our method is coherent with grades A and B according to the BHS standard.

Nursing applicants’ desire to work in nursing and related factors: a cross-sectional study

Background The desire to work in the nursing profession has recently been identified as an important aspect to consider in the selection process of nursing students but very little is known about nursing applicants’ or students’ desire to work in nursing. Aims The study aimed to describe and explain the desire of undergraduate nursing applicants to work in nursing. Design A cross-sectional study design. Methods The Desire to Work in Nursing Instrument was used to collect the data. All nursing applicants (N = 974) who took part in an entrance examination organised in six Universities in October 2018 were eligible to participate. Eight Hundred and Forty-one applicants (response rate 86%, 102 males) participated in the study. Statistical analysis included the use of descriptive statistics and linear regression was used to assess if dependent variables explained the observed outcomes. Results A strong desire to work in nursing was demonstrated in all the four areas. The most common reason to desire this work was suitability to nursing and the nature of work, and the least common was the career opportunities. Gender, previous education, and a realistic image best explain the desire. Conclusions The assessment of desire to work in nursing may assist career choice of nursing applicants, and may enhance recruitment and retention in nursing education. Applicants need to be more aware of the career development possibilities. Further studies are needed to investigate if the desire to work in nursing is different to men than to women to inform recruitment strategies.

Emergency coronary artery bypass surgery after chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry

BackgroundEmergency coronary artery bypass surgery (eCABG) is a serious complication of chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI). MethodsWe examined the incidence and outcomes eCABG among 14,512 CTO PCIs performed between 2012 and 2023 in a large multicenter registry. ResultsThe incidence of eCABG was 0.12% (n = 17). Mean age was 68 ± 6 years and 69% of the patients were men. The most common reason for eCABG was coronary perforation (70.6%). eCABG patients had larger target vessel diameter (3.36 ± 0.50 vs. 2.90 ± 0.52; p = 0.003), were more likely to have moderate/severe calcification (85.7% vs. 45.8%; p = 0.006), side branch at the proximal cap (91.7% vs. 55.4%; p = 0.025), and balloon undilatable lesions (50% vs. 7.4%; p = 0.001) and to have undergone retrograde crossing (64.7% vs. 30.8%, p = 0.006). eCABG cases had lower technical (35.3% vs. 86.7%; p < 0.001) and procedural (35.3% vs. 86.7%; p < 0.001) success and higher in-hospital mortality (35.3% vs. 0.4%; p < 0.001), coronary perforation (70.6% vs. 4.6%; p < 0.001), pericardiocentesis (47.1% vs. 0.8%; p < 0.001), and major bleeding (11.8% vs. 0.5%; p < 0.001). ConclusionsThe incidence of eCABG after CTO PCI was 0.12% and associated with high in-hospital mortality (35%). Coronary perforation was the most common reason for eCABG.

A multidisciplinary diagnostic centre for early detection of cancer in patients with non-specific symptoms: a service evaluation

Background/Aims Symptoms of malignancy are often vague and non-specific, leading to delayed diagnosis and treatment. The multidisciplinary diagnostic centre was established in 2017 to facilitate the shortest and safest route to detecting cancer in such cases. This study aimed to evaluate the service model and work towards a business case for more widespread adoption of the multidisciplinary diagnostic centre service. Methods Data from all patients managed by the service from 2017–21 were collected contemporaneously. After 51 months, service data were examined against the aims of the service, focusing on patient demographic characteristics, main reasons for referral, main diagnostic tests performed, patient outcomes and time from referral to discharge. Results Between 2 February 2017 and 30 April 2021, 899 patients were referred to the centre. Weight loss was the most common reason for referral. During this period, 96 (10.7%) patients were diagnosed with a cancer. Of these diagnoses, 42.9% were made within 28 days of referral, improving to 60.6% in the final year of the service evaluation. Conclusions The multidisciplinary diagnostic centre demonstrates the importance and potential of having a dedicated referral pathway for patients presenting with vague, concerning symptoms.

Clinical and Epidemiological Characteristics of a Contingent of Elderly Patients Treated in the Somatopsychiatric Department of a Multi-Field Hospital

Background: comorbidity of somatic and mental pathology is the most common reason that complicates the provision of medical care to the elderly even under the conditions of a specialized somatopsychiatric department (SPD) of a multi-field hospital, which dictates the need for further study of the clinical and epidemiological features of these patients population.The aim of the study was to investigate the clinical and epidemiological characteristics of a contingent of elderly patients treated over a year in SPD of a multi-field hospital in comparison with similar data from a psychiatric hospital. The objectives of the study were to analyze the demographic structure of this contingent, the distribution of various types (categories) of somatic and mental pathology, routes of admission, time and outcomes of treatment in SPD of a multidisciplinary hospital.Materials and methods: the research material was the medical documentation of a sample of patients treated during 2019 in the SPD of the City Clinical Hospital № 1 named after. N.I. Pirogov of the Moscow Department of Health Protection (the total number of patients treated was 3379 people, of which 1456 were aged 65 and older). To conduct a comparative analysis, we used data from an epidemiological study in a psychiatric hospital (City Psychiatric Hospital № 13 of the Moscow Department of Health Protection), conducted in the same 2019 year.Results: it was established that in the SPD of a multi-field hospital, care is provided to a heterogeneous (demographic and clinical-diagnostic) group of patients, predominantly of late age (65 years and older). The most common diagnosis is dementia of various origins, complicated by severe somatic pathology (acute or associated with decompensation of a chronic somatic disease).Conclusion: elderly and senile patients make up more than half of the contingent of patients treated in the SPD of a multidisciplinary hospital. Significant differences were revealed in the SPD diagnostic distribution of young-middle-aged and elderly patients. Special features of the gender and age distribution of patients in the indicated age groups were established. Data were obtained on a higher mortality rate for those aged 65 years and older. The presence of problems in providing care to patients of older age groups in SPD determines the need for its improvement. For this purpose, it is advisable to consider the issue of creating a model of SPD of geriatric profile in a multi-field hospital to provide emergency psychiatric and somatic care to elderly patients.

An Analysis of Participant Preferences Regarding Virtual Versus In-person Format of Orthopaedic Surgery Educational Materials in Low- and Middle-Income Countries.

The University of California, San Francisco Institute for Global Orthopaedics and Traumatology Surgical Management and Reconstructive Training (SMART) course has instructed orthopaedic surgeons from low-resource countries on soft-tissue reconstruction. Before the COVID-19 pandemic, the course was conducted in-person; however, it was transitioned to a virtual format during the pandemic. The aim of this study was to determine participant preferences regarding a virtual or in-person SMART course format. Survey data were collected via e-mail after each SMART course using RedCap or Qualtrics. Statistical analyses were conducted using Stata. There were 247 survey respondents from 44 countries representing all world regions, with Africa (125, 51%) the most represented. Of those who attended both an in-person and virtual course, most (82%) preferred the in-person format. In addition, all measured course outcomes were significantly better for participants attending the in-person course. The most common reason for not attending an in-person course was the cost of travel (38, 51%). This study demonstrated a preference toward in-person learning for the SMART course. In addition, those surgeons participating in the in-person course endorsed increased positive outcomes from the course. Increased emphasis should be placed on in-person surgical skills training for low-resource surgeons.

A Cross-Sectional Study Examining the Behavioral Patterns and Attitudes of First - and Second-Year Medical College Students in West Bengal, India, Regarding Self-Medication

BACKGROUND&#x0D; Self-medication is a pervasive habit, and drug abuse is a severe problem. Since medical students are future doctors, they give it a unique significance. The study's objectives were to assess the practice, knowledge, and attitudes of first- and second-year medical students at a medical college in West Bengal, India, about self-medication.&#x0D; METHODS&#x0D; The study was conducted in Nilratan Sircar Medical College and Hospital, Kolkata, West Bengal. In 2021, medical students across the colleges of West Bengal conducted cross-sectional research using questionnaires. Upon being informed of the objectives and design of the study, first- and second-year MBBS students willingly agreed to participate.&#x0D; RESULTS&#x0D; In this study, 91.50% of medical students practiced self-medication. The common indication for self-medication was fever (89.2%) and headache (69.6%). Previous prescriptions for the same illness (68.87%) were the main source of information for self-medication. Common reasons for self-medication were urgency (53.33%) and quick relief (50%). Over-the-counter (88.14%) drugs were the most common sources of medications. The common preferred system of self-medication was allopathic (92.5%). The percentage of discontinuation (58.1%) of self-medication was more. The majority of them favoured oral (96.67%) media.&#x0D; CONCLUSIONS&#x0D; It was determined that more than half of the student population self-medicated for a wide range of ailments; the cause may be the increased public awareness of drugs brought on by the availability of information via books, the internet, and over-the-counter medications from pharmacists. Therefore, it is crucial to stop students from self-medicating to prevent the emergence of drug habits, resistance, and drug interactions.

Similar rates of reoperation for neuroma after transtibial amputations with and without targeted muscle reinnervation.

To compare the rates of revision surgery for symptomatic neuromas in patients undergoing primary transtibial amputations with and without targeted muscle reinnervation (TMR). Retrospective cohort study. Level I trauma hospital and tertiary military medical center. Adult patients undergoing transtibial amputations with and without TMR. Transtibial amputation with targeted muscle reinnervation. Reoperation for symptomatic neuroma. During the study period, there were 112 primary transtibial amputations performed, 29 with TMR and 83 without TMR. Over the same period, there were 51 revision transtibial amputations performed, including 23 (21%) in the patients undergoing primary transtibial amputation at the study institution. The most common indications for revision surgery were wound breakdown/dehiscence (42%, n = 25), followed by symptomatic neuroma 18% (n = 9/51) and infection/osteomyelitis (17%, n = 10) as the most common indications. However, of the patients undergoing primary amputation at the study's institution, there was no difference in reoperation rates for neuroma when comparing the TMR group (3.6%, n = 1/28) and no TMR group (4.0%, n = 3/75) (P = 0.97). Symptomatic neuroma is one of the most common reasons for revision amputation; however, this study was unable to demonstrate a difference in revision surgery rates for neuroma for patients undergoing primary transtibial amputation with or without targeted muscle reinnervation. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Clinical practice guidelines in prehospital pain management for paramedics: a systematic review protocol.

The purpose of this review is to examine prehospital pain management clinical practice guidelines (CPGs) to identify recommendations that can be adopted or adapted into paramedic clinical practice. An additional aim is to consider the methodological quality of these CPGs and the recommendations within them. Quality, evidence-based CPGs support clinicians and optimize patient care. However, not all CPGs meet rigorous evidence-based standards, and some may be misleading. As pain is a common reason for patients to access ambulance services, the evaluation of pain management CPGs, their quality, and whether their recommendations can be adopted or adapted into practice is required to increase understanding in this area. We will include CPGs for pain management intended for prehospital services in civilian communities. CPGs in English published from 2017, and containing clear recommendations addressing pain of any cause will be considered for inclusion. This review will combine methodologies, including the PICAR framework (population, intervention, comparison, attributes of eligible CPGs, recommendation characteristics) by Johnston et al. , and the JBI umbrella and scoping review methodologies. The search strategy will cover 12 databases, including PubMed, Embase, and specific CPG databases (eg, GIN Library). Additionally, Google Scholar and Google will be searched, and prehospital organizations without regular publications will be contacted. The AGREE II and AGREE-REX tools will be used to assess the methodological rigor and clinical credibility of the CPGs. The characteristics of both CPGs and the recommendations will be extracted and discussed in the review. PROSPERO CRD42022352951.

Reasons for past abortions among women in treatment for opioid use disorder.

The main reasons women in the general population seek abortion are financial, timing, and partner-related reasons. While women with opioid use disorder (OUD) appear to use abortion services more than women in the general population, reasons for abortion in this group have not been examined to our knowledge. Female patients aged 18-50 years in OUD treatment at 22 randomly selected facilities in Michigan were surveyed. The survey included items assessing reproductive health history. Women who reported having one or more abortions were asked to think back to that time and their reasons for choosing abortion. Twenty potential reasons and a write-in option were offered; women could endorse as many as applied. Of 260 women surveyed, 84 reported having an abortion. Of these, most (77.4%) reported multiple reasons for having an abortion. The most common reasons for having an abortion were not having money to take care of a baby (54.8%), feeling too young to have a child and not feeling ready to be a mother (both 42.9%), not loving the father and other partner-related concerns (25.0%-32.1%), and having concerns about the effects of their drug use (28.6%). No combination of reasons for abortion emerged as more prevalent than any other. Like women in the general population, women in treatment for OUD had not only abortions because of financial, timing, and partner-related reasons but also concerns about the effects of their drug use. These results underscore the multiple and often interrelated reasons that lead women to seek abortion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Anti-Staphylococcus aureus effects of natural antimicrobial peptides and the underlying mechanisms.

Staphylococcus aureus can cause localized infections such as abscesses and pneumonia, as well as systemic infections such as bacteremia and sepsis. Especially, methicillin-resistant S. aureus often presents multidrug resistance, which becomes a major clinical challenge. One of the most common reasons for methicillin-resistant S. aureus antibiotic resistance is the presence of biofilms. Natural antimicrobial peptides derived from different species have shown effectiveness in combating S. aureus biofilms. In this review, we summarize the inhibitory activity of antimicrobial peptides against S. aureus planktonic cells and biofilms. We also summarize the possible inhibitory mechanisms, involving cell adhesion inhibition, membrane fracture, biofilm disruption and DNA disruption. We believe this can provide the basis for further research against S. aureus biofilm-associated infections.

Risk factors of emergency department visits following elective cervical and lumbar surgical procedures: a multi-institution analysis from the Michigan Spine Surgery Improvement Collaborative.

Emergency department visits 90 days after elective spinal surgery are relatively common, with rates ranging from 9% to 29%. Emergency visits are very costly, so their reduction is of importance. This study's objective was to evaluate the reasons for emergency department visits and determine potentially modifiable risk factors. This study retrospectively reviewed data queried from the Michigan Spine Surgery Improvement Collaborative (MSSIC) registry from July 2020 to November 2021. MSSIC is a multicenter (28-hospital) registry of patients undergoing cervical and lumbar degenerative spinal surgery. Adult patients treated for elective cervical and/or lumbar spine surgery for degenerative pathology (spondylosis, intervertebral disc disease, low-grade spondylolisthesis) were included. Emergency department visits within 90 days of surgery (outcome measure) were analyzed utilizing univariate and multivariate regression analyses. Of 16,224 patients, 2024 (12.5%) presented to the emergency department during the study period, most commonly for pain related to spinal surgery (31.5%), abdominal problems (15.8%), and pain unrelated to the spinal surgery (12.8%). On multivariate analysis, age (per 5-year increase) (relative risk [RR] 0.94, 95% CI 0.92-0.95), college education (RR 0.82, 95% CI 0.69-0.96), private insurance (RR 0.79, 95% CI 0.70-0.89), and preoperative ambulation status (RR 0.88, 95% CI 0.79-0.97) were associated with decreased emergency visits. Conversely, Black race (RR 1.30, 95% CI 1.13-1.51), current diabetes (RR 1.13, 95% CI 1.01-1.26), history of deep venous thromboembolism (RR 1.28, 95% CI 1.16-1.43), history of depression (RR 1.13, 95% CI 1.03-1.25), history of anxiety (RR 1.32, 95% CI 1.19-1.46), history of osteoporosis (RR 1.21, 95% CI 1.09-1.34), history of chronic obstructive pulmonary disease (RR 1.19, 95% CI 1.06-1.34), American Society of Anesthesiologists class > II (RR 1.18, 95% CI 1.08-1.29), and length of stay > 3 days (RR 1.29, 95% CI 1.16-1.44) were associated with increased emergency visits. The most common reasons for emergency department visits were surgical pain, abdominal dysfunction, and pain unrelated to index spinal surgery. Increased focus on postoperative pain management and bowel regimen can potentially reduce emergency visits. The risks of diabetes, history of osteoporosis, depression, and anxiety are areas for additional preoperative screening.

Physician Leaders’ Role in the Finances of Strategy

Physician leaders frequently shrink from involving themselves in the finances of organizational strategy. The most common reasons include, “It’s not my area of expertise,” “Better to leave that to the finance department,” or “I don’t even understand the language spoken, so I can’t be of help.” However, their voice is important to the financial planning process for complex ambulatory services and their overall success.

An evaluation of primary immunization coverage among 12-23 months children in an urban area of western Maharashtra: a community based cross sectional study

Background: Infectious diseases are major cause of morbidity and mortality in children. One of the most cost effective and easy methods for the child survival is immunization. Objective was to determine the immunization coverage and find out the various factors and its reasons for partial or non-immunization of child. Methods: A cross-sectional study was carried out for the assessment of immunization coverage in the field practice area of the urban health training center using WHO 30×7 clusters sampling method during March 2021 to October 2022. A total of seven children aged 12-23 months were interviewed from each cluster on pretested, predesigned schedule, thus giving us the sample size of 210. Chi square test was applied for statistical analysis. Results: A total of 210 children aged 12-23 months were included in the study. It was found that 158 (75.24%) of the children were found to be fully immunized. While 49 (23.34%) and 3 (1.42%) nonimmunized respectively. Most common reason for partial and non-immunization of children was found to be obstacles and lack of motivation on the part of parents. There is only statistically significant association between education of mothers and immunization status of children. Conclusions: Increasing the knowledge and understanding of the caretakers of the young children abouts the essentiality and benefits of routine immunization would be a strong step forward in achieving the goals.