Health-related Internet use and treatment adherence: A transdiagnostic comparison of outpatients with major depressive disorder and schizophrenia.

Treatment adherence is relevant for clinical and economic outcome in affective disorders as well as psychosis. Knowledge concerning the disease and its treatment might influence patients' willingness to follow the health-care providers' recommendations and mutual decision-making. In the current study, we investigated how Internet surfing for health-related issues and attitude toward the relevance of the online information impact treatment adherence in major depressive disorder (MDD) and schizophrenia (SZ). A total of 83 outpatients (59 MDD, 24 SZ) participated in a survey. A multiple linear regression model with "exposure," "attitude," "diagnosis," and their interaction as regressors was significant predictive of medication-adherence rating scores, R2 = .179; 95% CI [0.00, 0.32]. In the MDD group only, more extended exposure to Internet surfing for health-related issues and attribution of higher personal relevance were associated with poorer medication adherence at a statistical trend level, p = .060 and p = .077, respectively. In both groups, being female as well as higher age and intelligence were associated with favorable adherence, p = .003, p = .044, and p = .039, respectively. Considering the limitations (e.g., small sample size), our findings add to previously published data contributing to a better understanding of how Internet use may impact treatment adherence in MDD and schizophrenia.

A unique case of thrombosed giant popliteal aneurysm.

We report a unique case of a giant, thrombosed, and ruptured popliteal aneurysm measuring 13.8 cm x 14.0 cm x 14.0 cm in a 93-year-old man. The patient is a hypertensive smoker with asymptomatic swelling behind the knee for several years who developed pain in the swelling with ecchymosis for 2 weeks before presentation. Despite rupture of the aneurysm, this patient exhibited no ischemic symptoms. The patient underwent emergency surgery in which most of the aneurysmal sac was excised and because of satisfactory collateral circulation, the proximal and distal popliteal artery was suture-ligated. Remarkably, the patient did not require a bypass graft and at follow up is pain-free and ambulating with no clinical signs or symptoms of ischemia. This case is unique in several ways: (1) to our knowledge, this is the largest popliteal aneurysm compared with any case that has been documented in the literature, (2) this is also the oldest reported age ever associated with a popliteal aneurysm, and (3) exclusion suture ligation proximally and distally has resulted in an exceptional outcome.

Electronic submission of resident work hours: a convenient way of exchange of information.

The purpose of this protocol is to assess how residents can document their work hours in a convenient and objective way; to find an efficient, secure, quick, and reproducible way of communication between house staff and residency administrators regarding work hours data; and to fulfill the requirements of the Accreditation Council for Graduate Medical Education and other monitoring bodies regarding work hours documentation. This electronic work hours submission protocol is based on the Microsoft Excel system. The data is submitted via e-mail to the residency coordinators. The work hours sheet recognizes the time spent by the residents in various categories such as patient care, off hours, off days, vacations, outpatient clinic time, on-site rest time, and education time. Calculations are done automatically in the work sheet and results are shown graphically. We found electronic submission of work hours as a more convenient, secure, objective, efficient, and reproducible way of communication than the paper submission forms. Each resident can now easily be tracked for the time he/she spends in various categories. The data will be used to assess how more efficiently residents can spend their time. It also fulfills the documentation requirements of different monitoring bodies.