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63, 95% CI 2.56-5.15; p<0.001), living with family (OR 0.64, 95% CI 0.41-9.96; p=0.033), and eating more fruit (≥3 pieces/day, OR 2.30, 95% CI 1.61-3.27; p<0.001).

These findings highlight the high consumption and low degree of awareness of UPF among consumers based mainly on food composition.

These findings highlight the high consumption and low degree of awareness of UPF among consumers based mainly on food composition.

The Face is the most frequent localization for cutaneous carcinoma. The nose accounts for about 30% of these tumors. Nose tissue loss repair has to pursue 3 types of objectives carcinologic, aesthetic and functional. The aim of this article is to identify a decision tree to guide the choice of surgical reconstruction technique based on localization and size of the defect.

We performed a retrospective analysis in Angers' CHU from 2013 to 2019 including 229 patients referred for cutaneous tumors excision in need of reconstruction. We analyzed the type of reconstruction, size of the tissue loss and localization of the defect in terms of nose aesthetic subunits.

Among the 229 patients included, the most frequent localization was nose tip (32%). 44% of patients were reconstructed with skin grafts or composite graft, 56% with flaps (48% local flaps and 4% association of both methods). Limited central resections of nose tip were reconstructed with skingraft. The Rybka flap and bilobed flap were the preferred choice for lateral reconstruction of nose tip. Largest tip defects were reconstructed using Rieger flap or forehead flap. The dorsum was often reconstructed with local flap glabellar on the upper part, Rieger on the lower part. Lateral side was perfectly reconstructed with island flap. Nose wings needed framework composite graft was the judicious choice in case of limited tissue loss whereas forehead flap with framework or Schmid-Meyer flap were chosen for larger defects.

Our past experience in nasal reconstruction has provided us with an original decision tree to guide surgeons in choosing the right reconstruction technique according to the size and localization of the defect.

Our past experience in nasal reconstruction has provided us with an original decision tree to guide surgeons in choosing the right reconstruction technique according to the size and localization of the defect.

Extravasation of chemotherapeutic agents is a common complication in cancer centers. In severe cases involving large tissue necrosis, surgery may be needed to resect necrotic tissues and to cover the exposed areas.

A 71 years old women was referred to our unit two month after extravasation of epirubicin from an implanted port-a-cath with a large chemonecrosis of the anterior chest wall. She presented an evolutive tissue necrosis extending from the upper anterior thoracic region to the right breast. Surgical debridements and negative wound pressure therapy were necessary in order to obtain clean areas. The final chest wall defect was covered using a Muscle Sparing Latissimus Dorsi pedicled flap. This surgical management have permitted a satisfying wound healing and functional recovery without any complication.

Chemotherapeutics' extravasations can be a severe complication of oncologic treatment and have to be discussed between oncologists and plastic surgeons to find the most effective and suitable solution with consideration of the specificities of cancer therapy. In chest wall skin defect, the use of muscle sparing latissimus dorsi pedicled flap is a robust solution with low morbidity of the donor site.

Chemotherapeutics' extravasations can be a severe complication of oncologic treatment and have to be discussed between oncologists and plastic surgeons to find the most effective and suitable solution with consideration of the specificities of cancer therapy. In chest wall skin defect, the use of muscle sparing latissimus dorsi pedicled flap is a robust solution with low morbidity of the donor site.

Healthcare organizations increasingly are screening patients for social needs (e.g., food, housing) and referring them to community resources. This systematic mixed studies review assesses how studies evaluate social needs resource connections and identifies patient- and caregiver-reported factors that may inhibit or facilitate resource connections.

Investigators searched PubMed and CINAHL for articles published from October 2015 to December 2020 and used dual review to determine inclusion based on a priori selection criteria. Data related to study design, setting, population of interest, intervention, and outcomes were abstracted. Articles' quality was assessed using the Mixed Methods Appraisal Tool. Data analysis was conducted in 2021.

The search identified 34 articles from 32 studies. The authors created a taxonomy of quantitative resource connection measures with 4 categories whether participants made contact with resources, received resources, had their social needs addressed, or rated some aspect ion measures be explicitly defined and focus on whether participants received new resources and whether their social needs were addressed.

Health disparities negatively impact the lives of patients and are a product of the social categorization of medicine. In dismantling the systemic racism and biases that create health disparities, health equity curricula can be implemented that improve resident physician awareness and competency in caring for patients from vulnerable populations.

The objective of this study is to assess the impact of a resident-led health equity curriculum on the self-efficacy of family medicine residents in caring for vulnerable populations and managing challenging patient scenarios.

The Health Equity Leadership Concentration (HELC) curriculum was implemented in the fall of 2019. Residents self-selected their participation in the concentration and completed pre- and 6-month post- implementation surveys on self-efficacy. Deidentified survey data were analyzed with α = 0.05 significance level.

Eight residents of 26 residents self-selected to participate (30%) with pre- and post- implementation survey response rates of 100% and 87.5% (HELC) and 66.7% and 88% (general residents). A significant increase in self-efficacy was observed in caring for the uninsured (p=0.007), LGBTQ (P=0.047), and Immigrant (p=0.04) populations and managing food insecurity (p=0.01) after 6 months in the HELC curriculum. No significant increases were seen in the general resident curriculum. HELC residents had a significant increase in self-efficacy in caring for the Medicaid population (p=0.048) in comparison with the general residents.

The HELC was successful in increasing self-efficacy in caring for vulnerable populations and managing challenging patient scenarios at 6-months. Further evaluation is needed for generalizability and determination of true statistical significance.

The HELC was successful in increasing self-efficacy in caring for vulnerable populations and managing challenging patient scenarios at 6-months. Further evaluation is needed for generalizability and determination of true statistical significance.Traumatic brain injury (TBI) related mental disorder has been hypothesized in the literature before 1969 as the etiology of schizophrenia. TBI has been described as a complex of multiple genetic factors and interacting non-genetic factor influence. Most research on non-genetic factors has focused on the period from conception through childhood. Thus far, there is no evidence suggestive of schizophrenic features for individuals without family history of mental health disorder following TBI in adulthood. Hence, we present these case series of three different TBI related schizophrenia with no past psychiatric history nor positive family psychiatric background. Though there are scientific reports suggesting association between TBI and schizophrenia, most of the links are either based on pre-teen exposure to TBI or positive family history of mental illness. Discussed in line of current literature, this case series adds to the body of evidence on adult TBI related schizophrenia in individuals with no family history of mental health disorder.The year 2020 opened the eyes of many to the structures of racism that persist in our country. As the visceral urgency of those galvanizing moments fade, organizations must move beyond releasing supportive statements and determining how they can live up to their stated values. To truly support Black lives, academic medical centers (AMCs) must commit to critically examine and improve the manner in which daily practices, culture, and context uplift Black students, health care professionals, and patients to achieve health equity. One step is to create a culture that is willing to listen and improve when people express discomfort or report mistreatment in order to retain people who are underrepresented in medicine (URiM) in a welcoming environment. Academic centers should address microaggressions to create a safe work and learning atmosphere. Then, ensure that faculty, trainees, and staff represent the demographics of the communities in which institutions are situated. Recruiting and retaining an inclusive health care workforce must be systematic and intentional to achieve representation. Studies have shown that racial and ethnic concordance between providers and patients improves patient satisfaction and health outcomes. Further, business studies have shown that racially diverse leadership teams outperform teams that are more homogenous. Diversity benefits colleagues, learners, and patients by considering different perspectives and improving problem solving. Additionally, AMCss should teach about structural racism as a social determinant of health to raise awareness of a common cause of health disparities and understand why patients of color may distrust the medical system. Furthermore, academic centers should work with local leaders to assess needs and provide community benefits and advocate for policies that meet those needs. While there are some challenges in starting these conversations in our institutions, changing the status quo is necessary to achieve health equity for all.

Evaluate racial and ethnic representation in clinical trials compared to the disease burden for diabetic retinopathy (DR) and diabetic macular edema (DME) within the United States (US). Diabetic retinopathy (DR) is currently the leading cause of blindness in American adults, affecting over 7.7 million individuals and disproportionately affecting Black Americans. Selleck 5'-N-Ethylcarboxamidoadenosine Black patients represent 38.3±16.5% of DME within the US population while White patients represented 44.6±18.3% of the DME population in the US.

All completed interventional clinical trials involving the conditions "Macular Edema" or "Diabetic Retinopathy" between 2001 and 2020. Excluded studies had fewer than 50 participants, terminated early, did not have published results, or involved locations outside the US.

Twenty-five clinical trials were included in this review. In National Institute of Health (NIH) and industry-sponsored clinical trials for DME, the proportion of Black patients was 12.6±3.3% (p<0.05) and 8.6±2.9% (p<0.05), respectively.