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Safety concerns may be a perceived barrier to implementation of home transfusion, however current published data suggests serious adverse reactions are rare. Cost-effectiveness data for home transfusion are very limited and a key area for future research. Home transfusion has the potential to benefit from newer technologies, such as portable/remote monitoring and electronic patient identifiers.Abdominal pain is a common presenting complaint to the Emergency Department (ED). Often, rare etiologies can be discovered in the work up of this common complaint. Here we present the case of an adolescent female who presented with abdominal pain and was found to have obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) or Herlyn-Werner-Wunderlich Syndrome. A 12 year old female with known renal agenesis presented with 5 days of left sided abdominal pain that then developed into right lower quadrant pain. She had regular menses for the last 2 years. Ultrasound (US) showed a fluid collection in the lower uterine segment and a complex cystic structure anterior to the uterus. Magnetic resonance imaging (MRI) showed the patient to have didelphys uterus with "severe dilatation of the cervix/vaginal canal… extending from the right uterine horn" and left-sided ovarian and Fallopian tube torsion. She was taken to the operating room where she underwent vaginal septum excision and a left salpingo-oopherectomy. OHVIRA includes the triad of obstructed hemivagina, uterine didelphys, and ipsilateral renal agenesis. This occurs due to embryologic arrest of the mullerian and mesonephric ducts at 8 weeks of gestation. Most abnormalities are right sided which leads to right lower abdominal and pelvic pain approximately 4 months post-menarche. Diagnosis of OHVIRA is made utilizing US and CT scans. MRI can also be useful to further delineate specific anatomy. It is important for the emergency physician to be aware of this entity as most patients don't present to care until acute, severe symptoms develop. This makes it more likely for them to seek care in the ED as opposed to the outpatient setting.

Patients' post-operative wellbeing determines the impact andeffectiveness of breast reshaping and reconstruction procedures. CC-115 cell line The aim of the study was to evaluate and compare four different types of breast reconstruction bilateral therapeutic mammaplasty, DIEP flap, ELD with immediate lipomodelling and implant-based reconstruction using BREAST-Q.

Patients who underwent breast reconstruction by one of the above-mentioned methods were identified from a retrospective register and sent BREAST-Q questionnaires. Univariate and multivariate analysis of BREAST-Q scores and clinical characteristics were performed for identifying trends between and within groups.

A total of 240 patients were identified with a response rate of 57%. Patients receiving implants were statistically less satisfied with breast reconstruction (mean 57%) and tended to be younger with lower BMI in comparison to other groups. There were no statistical differences in psychosocial wellbeing or patient experience between groups. Despite the fact that clinically these groups were heterogeneous, satisfaction with breast was similar in the remaining three autologous groups (range 70-75%). Detailed analysis and interpretation of quality-of-life scores, clinical differences and trends identified in the multivariate analysis along with nuances between surgical techniques used in our unit for breast reshaping and reconstruction, have been performed.

The most important goal of breast reconstruction is to restore patients' quality of life and satisfaction with breast. Identifying factors which can potentially predict poor outcomes will improve the informed consent process and patient selection.

The most important goal of breast reconstruction is to restore patients' quality of life and satisfaction with breast. Identifying factors which can potentially predict poor outcomes will improve the informed consent process and patient selection.

Micropigmentation is a well-recognised option for nipple-areola complex reconstruction, as part of the breast reconstruction pathway for patients following mastectomy. As a part of delayed breast reconstruction, this treatment was put on hold during the COVID-19 pandemic.

To assessthe views of patients regarding micropigmentation in response to the COVID-19 pandemic, and whether their attitudes to seeking out this part of the reconstructive journey had been altered.

A questionnaire undertaken with 53 patients between August & September 2020 attending the Micropigmentation clinic.

81.1% of patients reported COVID-19 had not impacted their decision, with a similar proportion happy to proceed with the treatment at the time of questioning.

The results highlight the importance of nipple-areola complexto our patients' reconstructive journey.

The results highlight the importance of nipple-areola complex to our patients' reconstructive journey.

To examine associations between reports of sensitive health behaviors and the provision of time alone by a clinician during adolescent well visits.

Data were collected from 547 adolescents who completed a well visit at one of eight clinics. Adjusted mixed logistic regression was used to examine whether reports of sexual behavior, substance use, disordered eating, mental health concerns, and demographic characteristics were associated with time alone.

Sexual behavior was found to be significantly associated with time alone, while substance use, disordered eating, a positive depression screen, and suicidal ideation were not. Older adolescents and males were more likely to report time alone, while race/ethnicity had no association with time alone.

Clinicians may be prioritizing time alone for behavioral concerns differently than for other sensitive behaviors.

Clinicians may be prioritizing time alone for behavioral concerns differently than for other sensitive behaviors.

This article describes the selection of priority indicators for adolescent (10-19years) health measurement proposed by the Global Action for Measurement of Adolescent health advisory group and partners, building on previous work identifying 33 core measurement areas and mapping 413 indicators across these areas.

The indicator selection process considered inputs from a broad range of stakeholders through a structured four-step approach (1) definition of selection criteria and indicator scoring; (2) development of a draft list of indicators with metadata; (3) collection of public feedback through a survey; and (4) review of the feedback and finalization of the indicator list. As a part of the process, measurement gaps were also identified.

Fifty-two priority indicators were identified, including 36 core indicators considered to be most important for measuring the health of all adolescents, one alternative indicator for settings where measuring the core indicator is not feasible, and 15 additional indicators for settings where further detail on a topic would add value. Of these indicators, 17 (33%) measure health behaviors and risks, 16 (31%) health outcomes and conditions, eight (15%) health determinants, five (10%) systems performance and interventions, four (8%) policies, programmes, laws, and two (4%) subjective well-being.

A consensus list of priority indicators with metadata covering the most important health issues for adolescents was developed with structured inputs from a broad range of stakeholders. This list will now be pilot tested to assess the feasibility of indicator data collection to inform global, regional, national, and sub-national monitoring.

A consensus list of priority indicators with metadata covering the most important health issues for adolescents was developed with structured inputs from a broad range of stakeholders. This list will now be pilot tested to assess the feasibility of indicator data collection to inform global, regional, national, and sub-national monitoring.

Experiencing racial discrimination in everyday life can have lasting detrimental effects on Black American youth. Conduct problems are one of the consequences of discriminatory experiences. The present study examined whether the effects of discrimination on conduct problems vary by the levels of ethnic-racial socialization youth experience.

A sample of 472 Black American youth provided five waves of survey data from ages 11-15 (June 2013 - December 2017). We tested the moderating effect of different types of ethnic-racial socialization (preparation for bias, cultural socialization, promotion of mistrust) on the association between discrimination and conduct problems using logistic regression analyses.

We found that cultural socialization significantly moderates the effects of racial discrimination on conduct problems. Promotion of mistrust was directly associated with increased risk for conduct problems.

Findings suggest that high levels of cultural socialization are beneficial to mitigate the effect of discrimination on conduct problems. Promotion of mistrust needs to be avoided but future research is warranted to investigate if promotion of mistrust can be helpful to youth in certain contexts.

Findings suggest that high levels of cultural socialization are beneficial to mitigate the effect of discrimination on conduct problems. Promotion of mistrust needs to be avoided but future research is warranted to investigate if promotion of mistrust can be helpful to youth in certain contexts.Major vascular complications after transcatheter aortic valve replacement (TAVR) are a pertinent issue and associated with increased morbidity and mortality. We herein describe a case of acute limb ischemia following the administration of protamine sulfate (PS) that was administered to mitigate a bleeding complication post-failure of a vascular access closure device. PS should be used cautiously for the prevention or management of bleeding-site complications following TAVR. The patient described in this case has consented to having his case described in this manuscript.

Intravascular lithotripsy (IVL) has been well characterized as a safe and effective method for plaque modification in the treatment of de-novo, calcific coronary artery disease. In-stent restenosis (ISR) remains a major challenge in coronary revascularization, especially "multilayer" ISR. The use of IVL in ISR remains off-label and has been described in case reports and small case series. We report the single-center experience using IVL for the treatment of ISR, including multilayer ISR.

This was a retrospective single-center study. All intracoronary percutaneous interventions requiring lithotripsy use, between May 2021 and December 2021, were reviewed. We selected only the cases involving IVL use for the treatment of in-stent restenosis. Baseline characteristics of patients were obtained from chart review. Procedural details and outcomes were obtained from reports and from a detailed review of procedural images.

A total of 13 ISR lesions were treated with IVL, of which 5 were in cases of multilayer ISR. Procedural success was observed in 11 lesions. Three patients had recurrent angina during a mean follow-up of 133 days. None of the patients had hard outcomes of myocardial infarction or cardiac death during the follow-up period.

IVL is feasible and safe for ISR treatment including multilayer ISR. IVL is associated with good immediate procedural success, and a low rate of short-term adverse outcomes.

IVL is feasible and safe for ISR treatment including multilayer ISR. IVL is associated with good immediate procedural success, and a low rate of short-term adverse outcomes.