Demographics and Reported Symptoms Associated With Marijuana Use Among Adolescents and Young Adults.

Purpose Marijuana use has been increasing in the adolescent population. Our objective was to examine the prevalence of marijuana use among a sample of adolescents and young adults, determine an association with risk-taking behaviors, identify reported medical symptoms, and delineate common beliefs about marijuana use. Methods A questionnaire was administered to a sample of patients aged between 12 and 23 years old presenting to the emergency department of Penn State Hershey Medical Center, Hershey, Pennsylvania. Data were stratified by marijuana users and non-users, and further stratified by traditional (vape, pipe, edibles) and non-traditional (oils/concentrates, topical creams) use. Results The analysis was based on 200 questionnaires. Thirty-nine percent (n=78) reported marijuana use. Marijuana users were more likely to report previous sexual intercourse (79.5% vs. 32.8%; p=<0.0001), as well as the use of alcohol (50.0% vs. 10.7%; p=<0.0001), cigarettes (41% vs. 8.2%; p=<0.0001), prescription pain medications (20.5% vs. 4.1%; p=0.002), and cocaine (14.1% vs. 0.8%; p=0.0017). Users more likely reported texting while driving (41.0% vs. 13.1%; p=0.005) and experienced physical or electronic victimization due to bullying (43.6% vs. 19.7%; p=0.002). Users were more likely to report gastroesophageal reflux disease (GERD), attention deficit disorder (ADD), anxiety, and depression. The most common symptoms associated with marijuana use were anxiety (65.4%), headache (61.6%), nausea/vomiting (53.8%), cough (51.3%), and abdominal pain (47.4%). Sixty-nine percent of respondents believed marijuana was "safer than other drugs". Conclusion Based on our sample, we identified risk-taking behaviors, medical symptoms, and beliefs associated with marijuana use. Healthcare professionals may use these data to provide screening and anticipatory guidance to adolescents who use marijuana and consider marijuana use in their differential diagnosis.

Aortoiliac: Covered, Uncovered, CERAB as It Relates to Peripheral Arterial Disease.

Peripheral arterial disease (PAD) affects over 200 million worldwide and is the leading cause of major limb amputation, with individuals suffering from PAD being at three times greater risk of dying compared with matched controls. TASC-II guidelines provide a consensus on the management of PAD based on the collaboration between international vascular specialties. These guidelines previously outlined open surgery as the gold standard for treatment of aortoiliac disease and PAD as it has demonstrated consistent long-term results. However, this approach is also associated with high perioperative mortality, especially when compared with endovascular techniques. With recent developments in endovascular technology, user technique, and experience, this approach has become more widely used as primary intervention for aortoiliac disease. One of these novel techniques includes covered endovascular reconstruction of the aortic bifurcation, which has demonstrated excellent technical success and improved primary and secondary patency rates with follow-up. The aim of this review is to compare the efficacy of these approaches to the treatment of aortoiliac disease and demonstrate the benefits of the shift toward an endovascular-first approach to treatment of this disease, regardless of lesion complexity or severity.

Depiction of Sexual Harassment in Medical Television Shows.

Background and objective Medical television (TV) shows are known to exaggerate medical scenarios, including relationships among/between medical staff and patients. Unfortunately, sexual harassment occurs within the medical and nursing profession. The objective of this study was to analyze the depiction of sexual harassment in eight popular medical TV shows. Methods The first 10 episodes of the first season of eight popular medical TV shows (St. Elsewhere, ER, Scrubs, Private Practice, Grey's Anatomy, Nurse Jackie, The Good Doctor, and The Resident) were viewed and coded by two reviewers. The data abstracted included demographics of those involved in the sexual harassment and examples of sexual harassment depicted. Results The analysis was based on 62 instances of sexual harassment. The victim of sexual harassment was female in 77% (49/62) of instances. The most common relationships depicted pertaining to the acts of sexual harassment were attending physicians toward attending physicians (12/62, 19.3%), interns toward interns (8/62, 12.9%), attending physicians towards interns (7/62, 11.2%), and patients toward attending physicians (5/62, 8.1%). The most common examples of sexual harassment portrayed were telling sexual anecdotes/jokes (23/62, 37.1%), inappropriate touching (12/62, 19.4%), and making sexual comments about appearance, such as body parts or clothes (12/62, 19.4%). Conclusion Based on our analysis of medical TV shows, instances of sexual harassment occurred most commonly between attending physicians, and most of them were associated with sexual anecdotes/jokes. Medical and nursing professionals may draw on relevant instances from medical TV shows to discuss how to recognize and deal with sexual harassment in the workplace in order to promote a safe and nurturing environment devoid of harassment.

Social relationships in rehabilitation and their impact on positive outcomes among amputees with lower limb loss at Walter Reed National Military Medical Center.

OBJECTIVE: To explore how the social context of the clinic influenced the way former patients with lower limb loss in the Military Advanced Training Center at Walter Reed National Military Medical Center evaluated their outcomes. DESIGN: Cross-sectional phenomenological-based interviews and observations. PATIENTS: Twenty individuals with lower limb amputation were recruited from a multidisciplinary military treatment programme for patients with lower-extremity traumatic limb-loss injured in Afghanistan or Iraq. METHODS: Lightly structured interviews were conducted either in person or over the telephone with former patients and clinical care-providers. Where possible, observation was conducted in conjunction with the interviews. The research team used content analysis of the data, consistent with ethnographic methods. RESULTS: Analysis of the therapeutic effect of social relationships developed in the clinical rehabilitation programme identified 3 areas of significance: enduring relationships with key care-providers, access to treatment team by patients, and peer support among patients. CONCLUSION: The social component of service delivery influences patients' outcomes from clinical care. These results could be translated across healthcare settings to improve patient outcomes.