Evaluation of Vaping Cessation Infographics among E-cigarette Users: A Cross-sectional, Mixed-methods Study

Introduction: This rise in vaping has become a significant public health concern. This mixed-methods study aims to assess the impact of vaping cessation infographics on different cessation motivation and gather feedback regarding how the infographic could be further improved. Methods: Current e-cigarette users completed an online cross-sectional survey in January 2022 through Prolific®. Participants evaluated a vaping cessation infographic. Eligible participants were adults aged 19-64 years, US residents, fluent in English, and current e-cigarette users. Participants completed a questionnaire with questions regarding demographics, e-cigarette use, and assessment of the liking of infographics. Poisson regressions were conducted to assess the associations between infographic liking and perceived vaping cessation importance, readiness, and commitment. The open-ended feedback provided in the online survey on the infographic was assessed using content analysis. Results: Among 361 participants who were presented with the cessation infographic, 85.9% of them rated the infographic favorably. The liking of the cessation infographic (e.g. excellent vs fair/poor) was associated with greater perceived quit importance (incidence rate ratio, IRR=2.0, p\u3c0001, quit commitment (IRR=1.6, p=0.005), and readiness to quit (IRR=1.9, p=0.001). The analysis of open-ended feedback resulted in several themes. Participants appreciated the detailed coping strategies, ease of understanding and accessibility, timelines and expectations, support and encouragement, comprehensive information, youth-focused content, and visual and structural appeals. Areas identified for improvement included health information and risks, design and presentation, target audience and content, support and resources, and user engagement. Conclusions: This study highlights the need for tailored vaping cessation interventions. The infographic presented in this study resonated more with African American and Hispanic participants, who reported higher favorability than White participants

Primary Apocrine Adenocarcinoma of the Vulva: A Report of a Rare Case

Primary apocrine adenocarcinoma of the vulva is a rare and aggressive malignancy that typically presents as an irregular vulvar lesion with associated dermatologic changes. Diagnosis can be challenging due to significant clinical and histopathologic overlap with other vulvar adenocarcinomas as well as metastatic disease. We present the case of a 63-year-old postmenopausal woman diagnosed with primary apocrine adenocarcinoma of the vulva. The patient’s prior history of breast cancer created a diagnostic dilemma, as it was initially unclear whether the lesion represented metastatic breast carcinoma or a primary vulvar malignancy. Histopathologic evaluation with immunohistochemical analysis demonstrated strong androgen receptor positivity, negative estrogen receptor and progesterone receptor staining, strong GCDFP-15 positivity, and strong CK7 positivity. This profile supported the diagnosis of primary vulvar apocrine adenocarcinoma, allowing for appropriate surgical management and successful excision of the lesion. This case highlights the diagnostic complexity of vulvar adenocarcinomas and underscores the importance of systematic clinicopathologic evaluation, particularly in patients with a history of malignancy

A Rapidly Progressing Lower Extremity Soft Tissue Sarcoma in an Adolescent Patient

Soft tissue sarcomas (STSs) are rare malignant tumors of mesenchymal origin with heterogeneous histologic subtypes and variable clinical behavior. Although STSs most commonly arise in the extremities, rapidly progressive sarcomas involving the distal lower extremity in adolescents have not been well documented. We report a case of an STS in a previously healthy adolescent female whose initial presentation was presumed to be a muscle strain. Over a three-month period, her symptoms worsened with progressive enlargement of a calf mass and development of widespread metastatic disease. This case highlights the importance of maintaining suspicion for malignancy in rapidly enlarging soft tissue masses, with timely referral to specialized sarcoma centers for further evaluation

Gastric Volvulus as a Rare Sequelae of a Hiatal Hernia: A Case Report and Review of the Literature

Gastric volvulus is a rare but potentially life-threatening complication of a hiatal hernia that can result in gastric ischemia or necrosis if not promptly recognized and treated. A 51-year-old man presented with several hours of severe nausea, vomiting, and chest pain. Physical examination was notable for signs of acute distress, and the patient reported dark-colored emesis. Initial laboratory evaluation demonstrated leukocytosis and elevated serum lactate levels. Computed tomography of the chest and abdomen revealed a large hiatal hernia with herniation of the majority of the stomach into the thoracic cavity and findings concerning for mesoaxial gastric volvulus. Esophagogastroduodenoscopy demonstrated ischemic changes involving the gastric cardia. Given concern for gastric ischemia, the patient underwent urgent surgical intervention, including reduction of the hiatal hernia, cruroplasty reinforced with bio-synthetic mesh, and gastropexy to prevent re-torsion. The patient tolerated the procedure without intraoperative complications and demonstrated clinical improvement postoperatively, with resolution of symptoms and stabilization of laboratory abnormalities. This case highlights the importance of early recognition of gastric volvulus as a complication of a hiatal hernia and underscores the role of prompt imaging and surgical intervention to prevent gastric ischemia and necrosis