Five-month Follow-up Research Articles

Association between Dietary Salt Intake and Progression in the Gastric Precancerous Process.

Gastric cancer is the third leading cause of cancer mortality worldwide. Studies investigating the effect of salt on gastric cancer have mainly used self-reported measures, which are not as accurate as sodium/creatinine ratios because individuals may not know the amount of salt in their food. Using data from a prospective cohort study, we investigated the effect of salt intake on progression to gastric precancerous lesions. Salt intake was estimated by urinary sodium/creatinine ratios, self-reported frequencies of adding salt to food, and total added table salt. We repeated the analyses among groups with and without Helicobacter pylori infection. We did not observe a positive association between salt intake, measured by urinary sodium/creatinine ratio, and overall progression in the gastric precancerous process (adjusted risk ratio (RR): 0.94; 95% confidence interval (CI) 0.76–1.15). We did observe an association between salt intake and increased risk for progression to dysplasia or gastric cancer overall (RR: 1.32; 95% CI: 0.96–1.81), especially among those who continued to have H. pylori infection at the five-month follow-up (adjusted RR: 1.53; 95% CI: 1.12–2.09), and among those who had persistent H. pylori infection over 12 years (adjusted RR: 1.49; 95% CI: 1.09–2.05). Salt intake may increase the risk of gastric dysplasia or gastric cancer in individuals with H. pylori infection.

Honey-Based Salve and Burdock Leaf Dressings as an Alternative to Surgical Debridement of a Traumatic Wound Eschar.

Objective: Nonviable necrotic eschar is an impedance to wound healing and can ultimately lead to failure of soft tissue coverage in traumatic or high-risk wounds. Topical therapeutic agents can provide a less invasive management alternative to surgical debridement of eschar.Approach: The case of a 40-year-old male with a traumatic right lower extremity amputation complicated by surgical incision ischemic eschar formation is reported. Honey-based salve with burdock leaf dressings was used to noninvasively manage eschar extending over the incision site. Images were obtained for 5 months of follow-up.Results: Five-month follow-up demonstrated complete resolution of eschar and re-epithelialization of skin in the affected region.Innovation: Honey-based salve with burdock leaf dressings shows promise for enhancing healing outcomes in traumatic wounds that develop nonviable eschar.Conclusion: Surgical debridement of an amputation stump with large ischemic eschar was avoided with the use of honey-based salve with burdock leaf dressings.

Myocardial remodeling after kidney transplantation: a case report

BackgroundLupus nephritis (LN) is one of the most common manifestations of systemic lupus erythematosus (SLE) and is often the most serious organ complication and the cause of premature death of such a patient. Most of other organs and systems can be also affected. A typical complication is a cardiovascular involvement leading to the development of heart failure. According to current therapeutic standards, kidney transplantation is the treatment of choice in patients with renal failure in course of LN. On the contrary, a kidney transplantation in a patient with an additional heart disease poses a serious clinical challenge.Case presentationWe present a case of a 49-year-old woman with renal and heart failure following a long-term SLE prepared for kidney transplantation. During the SLE course, the function of the heart and kidneys gradually deteriorated. The patient required the initiation of renal replacement therapy and was dialyzed until a kidney transplantation for 4 years. In the preparation of the patient for the surgical procedure, due to the extremely low ejection fraction, it was decided to include cardioprotective treatment with Levosimendan. The postoperative period was not straightforward but successful. In the monthly and five-month follow-up, a continuous improvement of heart function with normal renal function was noted.ConclusionsKidney transplantation in patients with lupus suffering from heart failure requires the involvement of a team of specialists. Patients with extremely low ejection fraction in the perioperative period should undergo careful hemodynamic supervision in the intensive care unit. Cardioprotective and thus nephroprotective Levosimendan therapy together with optimal fluid and hemodynamic therapy in the peri-transplant period may be a bridge for heart remodeling after kidney transplantation.

The fates of pedicle screws and functional outcomes ina geriatric population following polymethylmethacrylate augmentation fixation for the osteoporotic thoracolumbar and lumbar burst fractures with mean ninety fivemonth follow-up.

Polymethylmethacrylate (PMMA) augmentation is a common method to increase pullout strength fixed for osteoporotic spines. However, few papers evaluated whether these pedicle screws migrated with time and functional outcome in these geriatrics following PMMA-augmented pedicle screw fixation. From March 2006 to September 2008, consecutive 64 patients were retrospectively enrolled. VAS and ODI were used to evaluate functional outcomes. Kyphotic angle at instrumented levels and horizontal and vertical distances (HD and VD) between screw tip and anterior and upper cortexes were evaluated. To avoid bias, we used horizontal and vertical migration index (HMI and VMI) to re-evaluate screw positions with normalization by the mean of superior and inferior endplates or anterior and posterior vertebral body height, respectively. Forty-six patients with 282 PMMA-augmented screws were analyzed with mean follow-up of 95months. Nine patients were further excluded due to bed-ridden at latest follow-up. Twenty-six females and 11 males with mean T score of - 2.7 (range, - 2.6 to - 4.1) and mean age for operation of 77.6 ± 4.3years (range, 65 to 86). The serial HD and kyphotic angle statistically progressed with time. The serial VD did not statistically change with time (p= 0.23), and neither HMI nor VMI (p = 0.772 and 0.631). Pre-operative DEXA results did not correlate with kyphotic angle. Most patients (80.4%) maintained similar functional outcomes at latest follow-up. The incidence of screws loosening was 2.7% of patients and 1.4% of screws, respectively. The overall incidences of systemic post-operative co-morbidities were 24.3% with overall 20.2days for hospitalization. Most patients (80%) remained similar functional outcomes at latest follow-up in spite of kyphosis progression. The incidence of implant failure was not high, but the post-operative systemic co-morbidities were higher, which has to be informed before index surgery.

Longitudinal Effects of Personality on Physical Activity Among College Students: Examining Executive Function as a Potential Moderator.

Objective The purpose of this study was to examine the relationship between personality and physical activity, with a specific focus on whether executive function moderates this relationship. Methods One hundred twenty-six young adults provided complete data at baseline and the five-month follow-up assessment. Executive function was assessed via the parametric Go/No-Go computer task; outcome measures of parametric Go/No-Go were mean reaction time and percent of correct target detection across executive function tasks (simple rule and repeating rule). Personality and moderate-to-vigorous physical activity were assessed via validated questionnaires; one-week test-retest was established on a random sample of the participants, with pedometry employed in the subsample. Results Individuals with a higher baseline conscientiousness personality type had greater five-month follow-up moderate-to-vigorous physical activity (β = 18.5; 95% confidence interval: 5.3, 31.7; p = .006). There was no evidence of an interaction effect for personality trait and executive function on five-month follow-up moderate-to-vigorous physical activity. Conclusion The personality trait conscientiousness was associated with greater moderate-to-vigorous physical activity. However, there was no evidence to suggest that executive function moderates the role between personality and moderate-to-vigorous physical activity. Thus, if confirmed by future work, personality may exert its effects on moderate-to-vigorous physical activity independent of executive function level.

Development and Validation of an Eight-Item Brief Form of the SOAPP-R (SOAPP-8).

Although the Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) has become a widely used screener for aberrant opioid-related behavior in adults, the length of the instrument may limit its utility. The purpose of the current study was to develop a short form of the SOAPP-R by retaining as few items as possible while maximizing predictive accuracy. Participants (N = 555), recruited from pain clinics, completed the 24-item SOAPP-R and participated in a five-month follow-up visit to evaluate aberrant drug-related behaviors. Opioid aberrant-related behavior was determined through self-report, physician report, and urine toxicology screen. The optimal subset of SOAPP-R items to predict aberrant opioid-related behavior was identified empirically by employing the LASSO selection method and the leave-one-out cross-validation (LOOCV) method offered in the GLMSELECT procedure in SAS 9.4 in conjunction with content expertise. Eight items were identified before the selection method stopped. The receiver operating characteristic curve generated from the predicted probabilities from the model produced an area under the curve (AUC) value greater than the AUC value produced by the 24-item SOAPP-R total score and yielded a sensitivity of 0.74 and a specificity of 0.66. These results provide strong preliminary support for the SOAPP-8 as a brief screening tool of aberrant opioid-related behavior in chronic pain patients.

An Uncommon Cause of Acute Abdominal Pain: Primary Epiploic Appendagitis in the Emergency Setting

In the emergency setting, the diagnosis of benign causes of acute abdominal pain can prevent unnecessary medical interventions. To illustrate this point, we report the case of a 28-year-old man who presented to the emer- gency department with symptoms suggestive of acute diverticulitis. Abdominal computed tomography (CT) established, instead, a diagnosis of primary epiploic appendagitis (PEA), which was managed expectantly. The patient’s symptoms resolved within one week of hospital discharge and he remained free of pain at a five-month phone follow-up. Increased awareness of PEA and its self-limited course can help the emergency physician avoid unnecessary imaging studies and expectantly manage this cause of acute abdominal pain.

Variation in Staphylococcus aureus Colonization in Relation to Disease Severity in Adults with Atopic Dermatitis during a Five-month Follow-up.

The aim of this study was to monitor Staphylococcus aureus colonization and disease severity in adults with atopic dermatitis (AD) during 5 months. Twenty-one patients attended 3 visits each for severity SCORing of Atopic Dermatitis (SCORAD) assessment, quantitative cultures from the skin and conventional cultures from the anterior nares, tonsils and perineum. S. aureus isolates were typed for strain identity with pulsed-field gel electrophoresis (PFGE). Seventy-one percent of patients were colonized with S. aureus on lesional skin at least once. Density (colony-forming units (CFU)/cm2) was higher on lesional skin than on non-lesional skin (p < 0.05). Density on lesional skin and number of colonized body sites were positively correlated with SCORAD (p = 0.0003 and p = 0.007, respectively). Persistent carriers of the same strain on lesional skin had higher mean SCORAD index than intermittent/non-carriers (36.3 and 17.1, respectively, p = 0.002). The results show a temporal correlation between several aspects of S. aureus colonization and disease severity in AD raising the question of the importance of this in pathogenesis and treatment.

Bilateral Anterior Ischaemic Optic Neuropathy in a Child on Continuous Peritoneal Dialysis: Case report and literature review

Non-arteritic anterior ischaemic optic neuropathy (NAION) is a serious complication of continuous peritoneal dialysis (CPD) which can lead to poor vision and blindness. We report a five-year-old girl who had undergone a bilateral nephrectomy at the age of one year and was on home CPD. She was referred to the Paediatric Ophthalmology Unit of Sultan Qaboos University Hospital, Muscat, Oman, in 2013 with acute bilateral vision loss, preceded by a three-day history of poor oral intake. At presentation, the patient had severe systemic hypotension. An ophthalmological examination revealed severe bilateral visual impairment and NAION. She was treated with intravenous methylprednisolone and normal saline boluses. At a five-month follow-up, the visual acuity of the right eye had improved but vision in the left eye remained the same. Acute bilateral blindness due to NAION while on CPD is a rare condition in childhood. Paediatricians should be aware of this complication in order to ensure prompt management.

Robot-Assisted Ureteroileal Reimplantation for Postcystectomy Anastomotic Stricture

Introduction and Objectives: Ureteroileal anastomatic strictures after robot-assisted radical cystectomy (RARC) occur at a rate of 4% to 9% and pose a challenge in management. Although open surgical repair remains the standard treatment for anastomotic strictures, we present a case of effective postcystectomy robot-assisted laparoscopic ureteroileal reimplantation. Materials and Methods: Our patient is a 65-year-old woman with high-grade muscle-invasive urothelial carcinoma who underwent RARC and intracorporeal ileal conduit urinary diversion. Three months postoperatively, the patient developed recurrent urinary tract infections that necessitated hospital admission for left pyelonephritis. CT scan displayed left hydronephrosis and hydroureter. Antegrade nephrostogram revealed a complete ureteroileal anastomatic stricture, with confirmed severe obstruction on MAG-3 renal scan and left differential renal function of 16%. After failure of endoscopic dilation, the patient underwent exploratory laparoscopy and robot-assisted left ureteral reimplantation. Laparoscopic ports were placed similarly to RARC. We performed a lysis of adhesions and identified the proximal end of the ileal conduit, where the distal ureters were identified among significant fibrosis. We isolated each ureter separately and mobilized the left ureter posterior to the sigmoid colon using sharp dissection. We incised into the proximal end of the ileal conduit and confirmed identification of the left ureter through the protruding preplaced stent. We then ligated the distal most aspect of the left ureter after a frozen section confirmed no recurrence of tumor and advanced a guidewire through the conduit into the left distal ureter and renal pelvis. The ureter was spatulated and we completed a new left ureteroileal anastomosis over a Double-J stent using two running 4-0 Vicryl sutures. Results: Our operative time was just under 4 hours with an estimated blood loss of 100 mL. Jackson–Pratt (JP) drain was maintained until discharge on postoperative day 4. There were no intraoperative or postoperative complications. Five-month follow-up revealed marked improvement of left hydronephrosis on renal ultrasound and absence of obstruction on MAG-3 renal scan with a t½ of 8 minutes. Left renal function stabilized at 19%. Conclusions: Robot-assisted ureteral reimplantation for management of postcystectomy ureteroileal anastomatic stricture is feasible and safe in experienced hands. No competing financial interests exist. Runtime of video: 7 mins 56 secs

Multimodal endovascular treatment for traumatic carotid-cavernous fistula

ObjectiveTo present our experience in treating traumatic carotid-cavernous fistula (TCCF) by multimodal endovascular treatment. MethodsThe management of 28 patients with TCCF between January 2004 and October 2012 in our hospital was retrospectively analyzed. According to imaging charateristics, 24 cases were categorized into Type I, 3 Type II and 1 Type III. Totally 30 endovascular treatments were performed: Type I TCCFs were obliterated via transvenous approach (7/25), or transarterial approach (18/25) including 6 by detachable balloon occlusion, 6 by microcoil embolization, 3 by Hyperglide balloon-assisted coil embolization and 3 by a combination of detachable balloon and coil embolization. Two patients were treated with closure of internal carotid artery (ICA). Type II TCCFs were treated with transvenous embolotherapy (2/3) or carotid artery compression therapy (1/3). The Type III patient underwent detachable balloon embolization. ResultsImmediate postoperative angiography showed recovery in 26 cases. One recurrent TCCF was found 2 weeks after detachable balloon embolization, and then re-obliterated by transarterial coils. Reexamination found balloon deflation and fistula recanalization in 1 patient one month after combination of detachable balloons and coil embolization, which was cured by a second treatment via transvenous approach. The immediate angiography revealed residual blood flow in 4 patients. Among them, 2 patients with delayed symptoms at follow-up needed a second treatment, 1 patient recovered after carotid artery compression therapy, and the remaining patient’s symptoms disappeared on digital subtraction angiography at five-month follow-up. CT angiography revealed anterior communicating artery aneurysm in the patient who was treated with closure of ICA 4 years later. ConclusionAccording to results of images, characteristics of the fistula and type of drainage, proper treatment approach and embolic material can maximally heal pathological changes, retain the ipsilateral ICA patency and reduce long-term complications.

Reducing eating disorder risk factors: A pilot effectiveness trial of a train-the-trainer approach to dissemination and implementation.

Impediments limit dissemination and implementation of evidence-based interventions (EBIs), including lack of sufficient training. One strategy to increase implementation of EBIs is the train-the-trainer (TTT) model. The Body Project is a peer-led body image program that reduces eating disorder (ED) risk factors. This study examined the effectiveness of a TTT model at reducing risk factors in Body Project participants. Specifically, this study examined whether a master trainer could train a novice trainer to train undergraduate peer leaders to administer the Body Project such that individuals who received the Body Project (i.e., participants) would evidence comparable outcomes to previous trials. We hypothesized that participants would evidence reductions in ED risk factors, with effect sizes similar to previous trials. Utilizing a TTT model, a master trainer trained a novice trainer to train undergraduate peer leaders to administer the Body Project to undergraduate women. Undergraduate women aged 18 years or older who received the Body Project intervention participated in the trial and completed measures at baseline, post-treatment, and five-month follow-up. Primary outcomes included body dissatisfaction, thin ideal internalization, negative affect, and ED pathology. Participants demonstrated significant reductions in thin ideal internalization, ED pathology and body dissatisfaction at post-treatment and 5-month follow-up. At 5 months, using three different strategies for managing missing data, effect sizes were larger or comparable to earlier trials for 3 out of 4 variables. Results support a TTT model for Body Project implementation and the importance of utilizing sensitivity analyses for longitudinal datasets with missing data.

Impact of Smoking Cessation on Subsequent Pain Intensity Among Chronically Ill Veterans Enrolled in a Smoking Cessation Trial

ContextPrior cross-sectional studies have reported greater pain intensity among persistent smokers compared with nonsmokers or former smokers; yet, few prospective studies have examined how smoking abstinence affects pain intensity. ObjectivesTo determine the impact of smoking cessation on subsequent pain intensity in smokers with chronic illness enrolled in a smoking cessation trial. MethodsWe recruited veteran smokers with chronic illness (heart disease, cancer, chronic obstructive pulmonary disease, diabetes, or hypertension) for a randomized controlled smoking cessation trial and prospectively examined pain intensity and smoking status. Participants (n = 380) were asked to rate their pain in the past week from 0 to 10 at baseline and the five-month follow-up. The primary outcome measure was self-reported pain intensity at the five-month follow-up survey. Self-reported smoking status was categorized as an abstainer if patients reported no cigarettes in the seven days before the follow-up survey. ResultsIn unadjusted analyses, abstainers reported significantly lower pain levels at the five-month follow-up compared with patients who continued to smoke (parameter estimate = −1.07; 95% CI = −1.77, −0.36). In multivariable modeling, abstaining from cigarettes was not associated with subsequent pain intensity at five-month follow-up (parameter estimate = −0.27; 95% CI = −0.79, 0.25). ConclusionParticipants who were classified as abstainers did not report significantly different levels of pain intensity than patients who continued to smoke. Future studies should expand on our findings and monitor pain intensity in smoking cessation trials. Trial RegistrationClinicalTrials.govNCT00448344.

The enabling effect of social support on vaccination uptake via self-efficacy and planning

Purpose: In the context of worksite influenza vaccination programmes, social support, action planning and perceived self-efficacy were examined as predictors of participation. Mechanisms among these predictors were analysed by applying the enabling effect model to vaccination. Moreover, this model was extended by the inclusion of planning. Methods: In a large German company, a survey on influenza vaccination was launched with 200 employees taking part in the five-month follow-up. Using regression procedures, a sequential mediation model was examined, leading from social support via self-efficacy and planning to vaccination behaviour. Results: The three predictors jointly accounted for 47% of the vaccination participation variance. The enabling effect model was confirmed, highlighting how social support may promote self-efficacy beliefs. Further analysis yielded the extended model, revealing planning as a mediator between self-efficacy and subsequent behaviour while the indirect path from social support via self-efficacy to behaviour remained. Conclusions: Multiple step mediation analysis underscored the relevance of social support and self-efficacy. It also revealed planning as a proximal factor that may facilitate participation in a worksite influenza vaccination programme.

TCT-346 Clinical Impact of Five-month Follow-up Glycosylated Hemoglobin on Cardiovascular Outcomes in Diabetic Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Diabetes mellitus is known as a strong predictive factor of adverse cardiovascular event after ST-segment elevation myocardial infarction (STEMI). Recently, glycosylated hemoglobin (HbA1c) reflecting serum glucose control within 8 to 12 weeks, is studied to investigate relationship with major

A cluster-randomized trial of mass drug administration with a gametocytocidal drug combination to interrupt malaria transmission in a low endemic area in Tanzania.

BackgroundEffective mass drug administration (MDA) with anti-malarial drugs can clear the human infectious reservoir for malaria and thereby interrupt malaria transmission. The likelihood of success of MDA depends on the intensity and seasonality of malaria transmission, the efficacy of the intervention in rapidly clearing all malaria parasite stages and the degree to which symptomatic and asymptomatic parasite carriers participate in the intervention. The impact of MDA with the gametocytocidal drug combination sulphadoxine-pyrimethamine (SP) plus artesunate (AS) plus primaquine (PQ, single dose 0.75 mg/kg) on malaria transmission was determined in an area of very low and seasonal malaria transmission in northern Tanzania.MethodsIn a cluster-randomized trial in four villages in Lower Moshi, Tanzania, eight clusters (1,110 individuals; cluster size 47- 209) were randomized to observed treatment with SP+AS+PQ and eight clusters (2,347 individuals, cluster size 55- 737) to treatment with placebo over three days. Intervention and control clusters were 1km apart; households that were located between clusters were treated as buffer zones where all individuals received SP+AS+PQ but were not selected for the evaluation. Passive case detection was done for the entire cohort and active case detection in 149 children aged 1-10 year from the intervention arm and 143 from the control arm. Four cross-sectional surveys assessed parasite carriage by microscopy and molecular methods during a five-month follow-up period.ResultsThe coverage rate in the intervention arm was 93.0% (1,117/1,201). Parasite prevalence by molecular detection methods was 2.2-2.7% prior to the intervention and undetectable during follow-up in both the control and intervention clusters. None of the slides collected during cross-sectional surveys had microscopically detectable parasite densities. Three clinical malaria episodes occurred in the intervention (n = 1) and control clusters (n = 2).ConclusionsThis study illustrates the possibility to achieve high coverage with a three-day intervention but also the difficulty in defining suitable outcome measures to evaluate interventions in areas of very low malaria transmission intensity. The decline in transmission intensity prior to the intervention made it impossible to assess the impact of MDA in the chosen study setting.Trial RegistrationClinicalTrials.gov: NCT00509015

Differences in Pre-licensure Interprofessional Learning: Classroom Versus Practice Settings

AbstractBackground: Health Canada and Cochrane reviews indicate a need for rigorous outcome testing following interprofessional learning, particularly in practice settings. This led to research questioning whether knowledge, attitudes, perceptions, values, and skills regarding collaborative patient care improve after interprofessional learning in classroom and practice settings based on the degree of exposure to interprofessional learning compared to a control group.Methods and Findings: Pre-licensure students from seven health-profession programs were assigned to three groups: Control (no intervention), Education (classroom-based interprofessional learning), and Full-Participant (classroom-based and practice-based interprofessional learning). They were later surveyed to assess outcomes. Immersion at an interprofessional practice setting had a greater impact on scores than classroom-based interprofessional education. Both interventions significantly improved attitudes, perceptions, knowledge, and skills related to interprofessional collaboration. Only immersion improved the perceived importance of sharing leadership. Changes after the education intervention persisted at five-month follow-up.Conclusions: Interprofessional learning in classroom and practice settings positively impacted participants' knowledge, attitudes, perceptions and values, and skills regarding interprofessional teamwork. Use of a longitudinal study with a control group provided evidence that pre-licensure interprofessional learning would increase awareness of the need to collaborate. Findings encourage longerterm study of how interprofessional learning in various settings could improve how future practitioners approach patient care.

Mindfulness-Based Stress Reduction Versus Pharmacotherapy for Chronic Primary Insomnia: A Randomized Controlled Clinical Trial

The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia. A randomized controlled trial was conducted. The study was conducted at a university health center. Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT). Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions. The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only). Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.

Can economic-psychological parameters predict successful smoking cessation?

This paper conducts a five-month follow-up survey of 608 Japanese adults who just started smoking cessation within the previous month, and measures economic-psychological parameters such as the time preference rate and risk aversion coefficient using a conjoint analysis. We reach two main conclusions. First, cessation successes are more risk-averse than cessation failures, both at the starting and finishing points of the survey. Furthermore, between the two points, the time preference rates decrease for cessation successes, while the values increase for cessation failures. Second, we find that along with individual characteristics, economic-psychological parameters are important predictors of successful cessation.

Spontaneous recanalization of internal carotid artery occlusion

We present a case of spontaneous recanalization of the internal carotid artery (ICA) that occurred in a 51-year-old male patient. The occlusion of the right ICA was asymptomatic and was detected incidentally during imaging of the opposite carotid artery. The patient underwent neuroradiologic analysis and a tapered, flame-like occlusion suggestive of the right ICA dissection was detected. One month later, a carotid Doppler ultrasound demonstrated patent right carotid artery with normal spectral flow. Five-month follow-up showed that the ICA remained patent.