Post-traumatic pseudoaneurysm of internal mammary artery: a case report

Pseudoaneurysm of the internal mammary artery can be a rare complication of surgery, particularly post-sternotomy, or determined by a direct trauma, usually a stab wound. This report presents a pseudoaneurysm by a stab, diagnosed by chest computed tomography scan performed for hemothorax recurrence. The patient underwent left thoracotomy in third intercostal space; mammary vessels were identified above and below the pseudoaneurysm sac and tied. The postoperative course was uneventful

Effect of Exposure to Small Pharmaceutical Promotional Items on Treatment Preferences

Background: Policy discussions concerning pharmaceutical promotion often assume that small promotional items are unlikely to influence prescribing behavior. Our experiment measures whether exposure to these items results in more favorable attitudes toward marketed products and whether policies that restrict pharmaceutical marketing mitigate this effect. Methods: This is a randomized controlled experiment of 352 third- and fourth-year medical students at two US medical schools with differing policies toward pharmaceutical marketing. Participants assigned to treatment were exposed to small branded promotional items for Lipitor (atorvastatin) without knowledge that the exposure was part of the study. We measured differences in implicit (ie, unconscious) attitudes toward Lipitor and Zocor (simvastatin) in exposed and control groups with the Implicit Association Test (IAT). Self-reported attitudes were also measured, and a follow-up survey was administered measuring attitudes toward marketing. Results: Fourth-year students at the University of Miami Miller School of Medicine exposed to Lipitor promotional items had more favorable implicit attitudes about that brand-name drug compared to the control group (IAT effect: 0.66 vs 0.47; P = .05), while the effect was reversed at the University of Pennsylvania School of Medicine (IAT effect: 0.22 vs 0.52; P = .002) where restrictive policies are in place limiting pharmaceutical marketing (interaction effect: P = .003). No significant effect was observed among third-year students. On a “skepticism” scale, University of Miami students held more favorable attitudes toward pharmaceutical marketing compared to University of Pennsylvania students (0.55 vs 0.42; P Conclusions: Subtle exposure to small pharmaceutical promotional items influences implicit attitudes toward marketed products among medical students. We observed a reversal of this effect in the setting of restrictive policies and more negative school-level attitudes toward marketing

The contributions of family care-givers at end of life: A national post-bereavement census survey of cancer carers' hours of care and expenditures.

BACKGROUND: Family members provide vital care at end of life, enabling patients to remain at home. Such informal care contributes significantly to the economy while supporting patients' preferences and government policy. However, the value of care-givers' contributions is often underestimated or overlooked in evaluations. Without information on the activities and expenditures involved in informal care-giving, it is impossible to provide an accurate assessment of carers' contribution to end-of-life care. AIM: The aim of this study was to investigate the contributions and expenditure of informal, family care-giving in end-of-life cancer care. DESIGN: A national census survey of English cancer carers was conducted. Survey packs were mailed to 5271 people who registered the death of a relative to cancer during 1-16 May 2015. Data were collected on decedents' health and situation, care support given, financial expenditure resulting from care, carer well-being and general background information. RESULTS: In all, 1504 completed surveys were returned (28.5%). Over 90% of respondents reported spending time on care-giving in the last 3 months of the decedent's life, contributing a median 69 h 30 min of care-giving each week. Those who reported details of expenditure (72.5%) spent a median £370 in the last 3 months of the decedent's life. CONCLUSION: Carers contribute a great deal of time and money for day-to-day support and care of patients. This study has yielded a unique, population-level data set of end-of-life care-giving and future analyses will provide estimates of the economic value of family care-givers' contributions

Neonatal cerebral ultrasound: anatomical variants and age-related diseases.

Cerebral ultrasound is a non-invasive imaging technique widely used for the assessment of brain anatomy and diseases in neonates and infants. Indeed, it allows a precise characterization of common variants such as cavum septum pellucidum or diseases like intraventricular hemorrhage. The aim of this pictorial review is to provide a comprehensive overview of the main ultrasound features of the most common cerebral anatomical variants and disorders detectable by cerebral ultrasound using an age-related approach which could support non-subspecialized radiologists

Health related quality of life trajectories and predictors following coronary artery bypass surgery

BACKGROUND: Many studies have demonstrated that health related quality of life (HRQoL) improves, on average, after coronary artery bypass graft surgery (CABGS). However, this average improvement may not be realized for all patients, and it is possible that there are two or more distinctive groups with different, possibly non-linear, trajectories of change over time. Furthermore, little is known about the predictors that are associated with these possible HRQoL trajectories after CABGS. METHODS: 182 patients listed for elective CABGS at The Royal Melbourne Hospital completed a postal battery of questionnaires which included the Short-Form-36 (SF-36), Profile of Mood States (POMS) and the Everyday Functioning Questionnaire (EFQ). These data were collected on average a month before surgery, and at two months and six months after surgery. Socio-demographic and medical characteristics prior to surgery, as well as surgical and post-surgical complications and symptoms were also assessed. Growth curve and growth mixture modelling were used to identify trajectories of HRQoL. RESULTS: For both the physical component summary scale (PCS) and the mental component summary scale (MCS) of the SF-36, two groups of patients with distinct trajectories of HRQoL following surgery could be identified (improvers and non-improvers). A series of logistic regression analyses identified different predictors of group membership for PCS and MCS trajectories. For the PCS the most significant predictors of non-improver membership were lower scores on POMS vigor-activity and higher New York Heart Association dyspnoea class; for the MCS the most significant predictors of non-improver membership were higher scores on POMS depression-dejection and manual occupation. CONCLUSION: It is incorrect to assume that HRQoL will improve in a linear fashion for all patients following CABGS. Nor was there support for a single response trajectory. It is important to identify characteristics of each patient, and those post-operative symptoms that could be possible targets for intervention to improve HRQoL outcomes

Nanoparticles exhibiting self-regulating temperature as innovative agents for Magnetic Fluid Hyperthermia

During the last few years, for therapeutic purposes in oncology, considerable attention has been focused on a method called magnetic fluid hyperthermia (MFH) based on local heating of tumor cells. In this paper, an innovative, promising nanomaterial, M48 composed of iron oxide-based phases has been tested. M48 shows self-regulating temperature due to the observable second order magnetic phase transition from ferromagnetic to paramagnetic state. A specific hydrophilic coating based on both citrate ions and glucose molecules allows high biocompatibility of the nanomaterial in biological matrices and its use in vivo. MFH mediator efficiency is demonstrated in vitro and in vivo in breast cancer cells and tumors, confirming excellent features for biomedical application. The temperature increase, up to the Curie temperature, gives rise to a phase transition from ferromagnetic to paramagnetic state, promoting a shortage of the r2 transversal relaxivity that allows a switch in the contrast in Magnetic Resonance Imaging (MRI). Combining this feature with a competitive high transversal (spin-spin) relaxivity, M48 paves the way for a new class of temperature sensitive T2 relaxing contrast agents. Overall, the results obtained in this study prepare for a more affordable and tunable heating mechanism preventing the damages of the surrounding healthy tissues and, at the same time, allowing monitoring of the temperature reached

The Internist\u27s Post v.1 n.4

Newsletter of the University of Texas Rio Grande Valley School of Medicine - Internal Medicine Residency Program

The Internist\u27s Post v.1 n.7

Newsletter of the University of Texas Rio Grande Valley School of Medicine - Internal Medicine Residency Program

Azobenzenesulfonamide Carbonic Anhydrase Inhibitors as New Weapons to Fight Helicobacter pylori: Synthesis, Bioactivity Evaluation, In Vivo Toxicity, and Computational Studies

Research into novel anti-Helicobacter pylori agents represents an important approach for the identification of new treatments for chronic gastritis and peptic ulcers, which are associated with a high risk of developing gastric carcinoma. In this respect, two series of azobenzenesulfonamides were designed, synthesized, and tested against a large panel of human and bacterial CAs to evaluate their inhibitory activity. In addition, computational studies of the novel primary benzenesulfonamides (4a-j) were performed to predict the putative binding mode to both HpCAs. Then, the antimicrobial activity versus H. pylori of the two series was also studied. The best-in-class compounds were found to be 4c and 4e among the primary azobenzenesulfonamides and 5c and 5f belonging to the secondary azobenzenesulfonamides series, showing themselves to exert a promising anti-H. pylori activity, with MIC values of 4-8 mu g/mL and MBCs between 4 and 16 mu g/mL. Moreover, the evaluation of their toxicity on a G. mellonella larva in vivo model indicated a safe profile for 4c,e and 5c,f. The collected results warrant considering these azobenzenesulfonamides as an interesting starting point for the development of a new class of anti-H. pylori agents

Does coping style mediate the relationship between knowledge and psychosocial outcomes in women with atrial fibrillation?

IntroductionIn patients affected by atrial fibrillation (AF) disease-specific knowledge and coping style may be associated with psychosocial well-being. This study aimed to determine if coping style (problem-focused, emotion-focused, avoidance-focused) mediated the relationship between patient knowledge and three psychosocial outcomes (anxiety, depression and life satisfaction). MethodsIn 2021 a total of 188 women with reported AF, and ages ranging from 18 to 83 years (mean 48.7, sd 15.5 years), completed an online questionnaire consisting of sociodemographic, clinical and AF knowledge questions and psychosocial instruments (Anxiety and depression, the Hospital Anxiety and Depression (HADS) scale; life satisfaction, Satisfaction With Life Scale (SWLS); and coping style (Brief COPE). Using Jamovi statistical software three individual mediational models (for anxiety, depression and life satisfaction) were constructed assessing the direct and indirect relationships between knowledge, coping style and each psychosocial outcome. Age was a covariate in each model. ResultsThe mediation analyses demonstrated significant direct negative associations between AF knowledge and HADS anxiety and depression and positive associations with SWLS. There were also direct associations between each of the three coping styles and the three psychosocial outcomes. There were significant indirect effects of coping style between AF knowledge and each of the three outcomes confirming partial mediation effects.DiscussionThese findings highlight the crucial role of coping style in mediating the association between AF knowledge and psychosocial outcomes. As such, interventions aimed at increasing patient knowledge of AF may be more effective if adaptive problem-solving coping strategies are also demonstrated to these patients. Additionally, modification of maladaptive coping strategies as part of the psychological management of patients with AF is highly recommended