ABSTRACT
The prevalence of cannabis usage is increasing worldwide, including among both Indigenous and non-Indigenous Australians. The long-term effects of cannabis use on the lungs are well-known. However, the acute adverse effects on the lungs are sparsely reported. There are different ways in which cannabis can be inhaled, such as smoking or through a water vaporizing method known as a "bong." An improvised innovative bong device that is commonly used in Northern Australia, called a "bucket bong," uses water and air pressure to assist in cannabis inhalation. In this report, we describe three patients from remote and rural Northern Australian communities presenting with near-life-threatening events (acute pneumonitis and massive pneumothorax) immediately after the use of cannabis via bucket bong.
Subject(s)
Cannabis , Humans , Northern Territory/epidemiology , Cannabis/adverse effects , Smoking , WaterABSTRACT
Background: MRI-guided fusion biopsy is increasingly utilized over systematic 12-core biopsy for men with MRI-visible prostate lesions. Patients and Methods: Patients with MRI visible lesions who underwent MRI-guided fusion and systematic 12-core biopsy from 2016-2020 in the Intermountain Healthcare (IHC) system were consecutively analyzed. This was in the setting of a continuous quality assurance initiative among the reading radiologists. Primary outcome was prostate cancer (PCa) detection defined by Gleason grade group (GGG) 1 or higher. Clinically significant cancer (CSC) was defined as GGG 2 or higher. Patients were stratified by biopsy date, 2016-2017 and 2018-2021, and lesions were stratified by PI-RADS v2 category. Results: A total of 184 patients with 324 MRI-detectable lesions underwent both biopsy modalities in the IHC system from 2016 to 2021. CSC was detected in 23.5% of MRI-guided fusion biopsies. Comparing PI-RAD v2 categories 1-3 to categories 4-5, rate of CSC was 10% and 42% respectively. MRI-guided fusion and systematic 12-core biopsies were concordant for PCa in 77% of men and CSC in 83%. MRI-guided fusion biopsy detected PCa in 26/103 and CSC in 20/131 men in whom systematic 12-core biopsy was negative. Systematic 12-core biopsy detected PCa in 17/94 and CSC in 11/122 men in whom MRI-guided fusion was negative. Conclusions: Omitting MRI-guided fusion or systematic 12-core biopsy would have resulted in underdiagnosis of CSC in 11% or 6% of patients respectively. Combining biopsies increased detection rate of CSC. This was in the setting of a continuous quality assurance program at a large community-based hospital.
ABSTRACT
Soldiers' treatment in medical hold has been controversial due in part to a series of articles that appeared in the popular press. The purpose of this study was to explore soldiers' satisfaction as an indicator of the quality of health and treatment care received while in medical hold at Womack Army Medical Center (Fort Bragg, North Carolina). Data came from a survey of 17 questions that was administered on a point prevalence date and analyzed using descriptive statistics. A total of 47 of 164 soldiers on medical hold on March 1, 2007 responded. The overall patient satisfaction averaged 81.57%, based on a 5-point Likert rating scale for the soldier case sample. However, the survey also showed areas where Womack can improve.
