Necrotizing soft tissue infection of the breast during COVID-19 pandemic.
BREAST; ABDOMINAL wall; COVID-19 pandemic; NECROTIZING fasciitis; SOFT tissue infections; TOBACCO use
Necrotizing soft tissue infection has been historically recognized as a severe, rapidly spreading soft tissue infection associated with a very high risk of mortality. Cases of primary necrotizing fasciitis of the breast are rarely described but often fatal. We present a case of necrotizing soft tissue infection of the right breast extending to the anterior abdominal wall in a 39-year-old obese female, with a history of tobacco use. The patient presented 10 days after symptom onset due to concerns and anxiety related to COVID-19 exposure. This delay allowed for further extension and smoldering of the breast infection. The treatment of this aggressive disease process begins with early diagnosis, where a high index of suspicion is vital. Once diagnosed, the treatment regimen should be composed of emergent surgical debridement, which can include breast salvage debridement or total mastectomy, in addition to antibiotic therapy.
Kamagate N; DeVito R
Case Reports in Surgery
2020
1905-07
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journalArticle
<a href="http://doi.org/10.1155/2020/8876475" target="_blank" rel="noreferrer noopener">10.1155/2020/8876475</a>
Examining The Relationships Between Posttraumatic Stress Disorder Symptoms, Positive Smoking Outcome Expectancies, And Cigarette Smoking In People With Substance Use Disorders: A Multiple Mediator Model
abuse treatment; anxiety disorders; Cigarette smoking; consequences questionnaire; daily smokers; fagerstrom test; negative affect; nicotine dependence; Positive smoking outcome expectancies; posttraumatic stress disorder (PTSD); psychiatric-disorders; Psychology; scale ces-d; Substance Abuse; Substance use disorder (SUD); tobacco use
Cigarette smoking is highly prevalent in people with substance use disorders (SUDs) and is associated with significant physical health problems. Posttraumatic stress disorder (PTSD) is also highly associated with both SUDs and cigarette smoking and may serve as a barrier to smoking cessation efforts. In addition, people with PTSD are more likely to hold positive smoking outcome expectancies (i.e., beliefs that smoking cigarettes results in positive outcomes); these beliefs may contribute to cigarette smoking in people with SUDs experiencing PTSD symptoms. The present study examined the relationship between PTSD symptoms and typical daily cigarette smoking/cigarette dependence symptoms in a sample of 227 trauma-exposed current smokers with SUDs (59.9% male, 89.4% Caucasian) seeking detoxification treatment services. Additionally, the indirect effects of multiple types of positive smoking outcome expectancies on these relationships were examined. Participants completed questionnaires assessing PTSD symptoms, positive smoking outcome expectancies, cigarette consumption, and cigarette dependence symptoms. Results indicated that PTSD symptoms were not directly related to cigarette consumption or cigarette dependence symptoms. However, negative affect reduction outcome expectancies were shown to have a significant indirect effect between PTSD symptoms and cigarette consumption, while negative affect reduction, boredom reduction, and taste-sensorimotor manipulation outcome expectancies were all found to have significant indirect effects between PTSD symptoms and cigarette dependence symptoms. The indirect effect involving negative affect reduction outcome expectancies was statistically larger than that of taste sensorimotor manipulation outcome expectancies, while negative affect reduction and boredom reduction outcome expectancies were comparable in magnitude. These results suggest that expectancies that smoking can manage negative affective experiences are related to cigarette smoking in people with SUDs experiencing PTSD symptoms and suggest that effective smoking cessation treatments should take into account these expectancies. (C) 2013 Elsevier Ltd. All rights reserved.
Hruska B; Bernier J; Kenner F; Kenne D R; Boros A P; Richardson C J; Delahanty D L
Addictive Behaviors
2014
2014-01
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.addbeh.2013.10.002" target="_blank" rel="noreferrer noopener">10.1016/j.addbeh.2013.10.002</a>