U.S. Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts.

U.S. military veterans have been heavily impacted by the opioid overdose crisis, with drug overdose mortality rates increasing by 53% from 2010-2019. Risk for overdose among veterans is complex and influenced by ongoing interaction among physiological/biological, psychological, and socio-structural factors. A thorough understanding of opioid-related overdose among veterans, one that goes beyond simple pharmacological determinism, must examine the interplay of pain, pain treatment, and stress, as well as psychological and social experiences-before, during, and after military service. Comprehensive efforts to tackle the overdose crisis among veterans require interventions that address each of these dimensions. Promising interventions include widespread naloxone distribution and increased provision of low-threshold wrap-around services, including medications for opioid use disorder (MOUD) and holistic/complementary approaches. Interventions that are delivered by peers - individuals who share key experiential or sociodemographic characteristics with the population being served - may be ideally suited to address many of the barriers to opioid-related risk mitigation common among veterans. Community care models could be beneficial for the large proportion of veterans who are not connected to the Veterans Health Administration and for veterans who, for various reasons including mental health problems and the avoidance of stigma, are socially isolated or reluctant to use traditional substance use services. Interventions need to be tailored in such a way that they reach those more socially isolated veterans who may not have access to naloxone or the social support to help them in overdose situations. It is important to incorporate the perspectives and voices of veterans with lived experience of substance use into the design and implementation of new overdose prevention resources and strategies to meet the needs of this population. Key messagesU.S. military veterans have been heavily impacted by the opioid overdose crisis, with drug overdose mortality rates increasing by 53% from 2010-2019.The risks for overdose that veterans face need to be understood as resulting from an ongoing interaction among biological/physiological, psychological, and social/structural factors.Addressing drug overdose in the veteran population requires accessible and non-judgemental, low threshold, wraparound, and holistic solutions that recognise the complex aetiology of overdose risk for veterans.

Incidencia de tumores cerebrales en el Hospital Infantil Dr. Arturo Grullón 1988-1992 / Incidence of brain tumors in Infantil Hospital Dr Arturo Grullón 1988-1992

Se trata de un estudio retrospectivo en que se revisaron 20 casos de pacientes ingresados en el Hospital Dr. Arturo Grullón, en Santiago, R. D., con diagnóstico de tumor cerebral y que por reporte de patología correspondieron 7 casos a craneofaringioma (35//), 4 casos a meduloblastoma (20//), 3 casos a ependimoma (15//), 3 casos a glioma (15//), 2 casos a astrocitoma (10//) y 1 caso desconocido (5//). El sexo mas afectado fue el masculino con 12 casos (60//). La edad mas frecuente de aparición de 10 a 15 años y las complicaciones mas frecuentes fueron hidrocefalia, estrabismo, epilepsia, perdida de la visión. La mortalidad fue de 40//. Algunos casos murieron pocos días despues de diagnósticados y otros varios meses despues

Hernia diafragmática congénita : reporte de un caso / Congenital diaphragmatic hernia: one case report

Se presenta un caso de hernia diafragmática congénita (foramen de Bochdalek) en un paciente masculino de 4 años de edad, caracterizado por dificultad respiratoria marcada, que se diagnosticó por estudio radiográfico, confirmado posteriormente por una intervención quirúrgica

Hernia deslizante : reporte de un caso / Sliding hiatal hernia: a case report

Se trata de un lactante menor de 6 meses de edad que fue ingresada en el hospital Dr. Arturo Grullón de Santiago y cuyo diagnóstico de ingreso fue D/C Testículo feminizante derecho. Los hallazgos intrahoperatorios fueron una hernia deslizante, cuyos componentes fue Tuba uterina, ovario y útero. Lactante, Testículo feminizante, hernia deslizante