Mathiasenhooper6976

We present a rare case of primary colorectal linitis plastica presenting as an acute admission to hospital with a wide range of systemic symptoms, sudden rapid deterioration and subsequent mortality. A postmortem examination revealed a primary linitis plastica of the colon and rectum with diffuse metastatic disease. To our knowledge, this is the first report of primary colorectal linitis plastica presenting as an acute deterioration as a result of extensive metastatic disease.Coronaviruses (CoVs) mainly cause enteric and / or respiratory signs. Mammalian CoVs including COVID-19 (now officially named SARS-CoV-2) belong to either the Alphacoronavirus or Betacoronavirus genera. In birds the majority of the known CoVs belong to the Gammacoronavirus genus, whilst a small number are classified as Deltacoronaviruses. SU5416 solubility dmso Gammacoronaviruses continue to be reported in an increasing number of avian species, generally by detection of viral RNA. Apart from infectious bronchitis virus in chickens, the only avian species in which CoV has been definitively associated with disease are the turkey, pheasant and guinea fowl. Whilst there is strong evidence for recombination between gammacoronaviruses of different avian species, and between betacoronaviruses in different mammals, evidence of recombination between coronaviruses of different genera is lacking. Furthermore, recombination of an apha or betacoronavirus with a gammacoronavirus is extremely unlikely. For recombination to happen, the 2 viruses would need to be present in the same cell of the same animal at the same time; a highly unlikely scenario as they cannot replicate in the same host!INTRODUCTION In the UK, general surgeons must demonstrate competency in emergency general surgery before obtaining a certificate of completion of training. Subsequently, many consultants develop focused elective specialist interests which may not mirror the breadth of procedures encountered during emergency practice. Recent National Emergency Laparotomy Audit analysis found that declared surgeon special interest impacted emergency laparotomy outcomes, which has implications for emergency general surgery service configuration. We sought to establish whether local declared surgeon special interest impacts emergency laparotomy outcomes. METHODS Adult patients having emergency laparotomy were identified from our prospective National Emergency Laparotomy Audit database from May 2016 to May 2019 and categorised as colorectal or oesophagogastric according to operative procedure. Outcomes included 30-day mortality, return to theatre and length of stay. Binomial logistic regression was used to identify any association between declared consultant specialist interest and outcomes. RESULTS Of 600 laparotomies, 358 (58.6%) were classifiable as specialist procedures 287 (80%) colorectal and 71 (20%) oesophagogastric. Discordance between declared specialty and operation undertaken occurred in 25% of procedures. For colorectal emergency laparotomy, there was an increased risk of 30-day mortality when performed by a non-colorectal consultant (unadjusted odds ratio 2.34; 95% confidence interval 1.10-5.00; p = 0.003); however, when adjusted for confounders within multivariate analysis declared surgeon specialty had no impact on mortality, return to theatre or length of stay. CONCLUSION Surgeon-declared specialty does not impact emergency laparotomy outcomes in this cohort of undifferentiated emergency laparotomies. This may reflect the on-call structure at Birmingham Heartlands Hospital, where a colorectal and oesophagogastric consultant are paired on call and provide cross-cover when needed.Objectives To examine rates and correlates of dual cannabis and prescription pain reliever (PPNR) use and misuse among U.S. individuals aged 50+ who reported past-year cannabis use.Methods Using the 2015-2018 National Survey of Drug Use and Health, we examined cannabis nonuse/use and PPNR nonuse/use/misuse among all 35,229 respondents, and then focused on 2,632 past-year cannabis users to examine the risk of PPNR use but no misuse and the risk of PPNR misuse, compared to PPNR nonuse.Results More than one-half of older cannabis users used PPNR in the past year. Multinomial logistic regression results show that the risks of PPNR use/no misuse and PPNR misuse were higher among those who had more chronic medical conditions and a major depressive episode. The risk of PPNR use/no misuse was also associated with high frequency and medical cannabis use. The risk of PPNR misuse was also associated with younger cannabis initiation age and cannabis and other illicit drug use disorders.Conclusions Correlates of dual cannabis and PPNR use/misuse among older adults are poor physical and mental health problems and problematic cannabis use.Clinical Implications Older adults with cannabis and PPNR misuse need access to evidence-based treatment, including medication-assisted treatment when needed.PURPOSE In recent years, work-related musculoskeletal disorders(MSDs) are increasing due to overuse of desktop computer. This investigation was planned to examine musculoskeletal pain in office workers. MATERIALS AND METHODS 362 participants(female50.8%; male49.2%; mean age37.35 ± 8.43years) were included. Sociodemographic factors were recorded. Participants were questioned for their daily working time, computer usage time and years, whether musculoskeletal pain was related to their job or whether pain disturbed their activities of daily living(ADLs). Working postures were observed and pain severity was evaluated with Visual Analog Scale(VAS). RESULTS Participants were found to have more frequently upper back pain(69.6%), neck(66%) and lower back pain(LBP)(64.1%) during the last 12 months. 60.5% of the participants were reported pain after they started work. LBP(32.9%), back(28.2%) and neck(22.9%) pain were found to restrict participants' daily life. We found positive correlations between daily computer use and neck, back, and LBP(r=0.179 p less then 0.001; r=0.166 p=0.002, respectively). CONCLUSIONS Most painful areas of participants using desktop computers were upper back, neck, lower back and shoulder respectively, and the pain in these regions affected ADLs negatively. These pain mostly occurred after current job and these individuals experience more intense pain. Ergonomic approaches could reduce WMSD and make them more independent in ADLs and prevent chronicity.