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The first COVID-19 vaccination was given in December 2020 and there is an effort to vaccinate the international population on a massive scale. Common side effects from the vaccine include headache and tiredness. Regional lymphadenopathy has been described in relation to other vaccines. We describe two cases of supraclavicular reactive lymphadenopathy presenting in patients who had the COVID vaccination in the ipsilateral arm. Awareness of this diagnosis is important for patients presenting to the neck lump clinic.  相似文献   
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Context

In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV from a universally fatal disease to a serious chronic illness, warranting discussions between patients and their loved ones about advance care planning (ACP). Evidence is needed on factors associated with patients' likelihood to discuss ACP with loved ones.

Objectives

To further characterize factors associated with successful ACP in PLWHAs with their loved ones, we examined associations between patients having ACP discussions with the need for assistance with personal care, chronic pain, life satisfaction, prior family disagreements over health care decisions, sex, age, and interference in daily routines due to memory problems.

Methods

Data were from the Affirm Care study (N = 370), which examined social and environmental factors associated with health outcomes among PLWHAs and their informal caregivers.

Results

Slightly more than half of respondents discussed ACP with loved ones (57%). In adjusted analysis, higher levels of chronic pain (odds ratio [OR] = 2.09, P = 0.045), needing assistance with personal care (OR = 1.63, P = 0.023), greater life satisfaction (OR = 1.02, P = 0.002), prior family arguments over health care decisions (OR = 2.80, P < 0.001), and female sex (OR = 2.22, P = 0.001) were associated with higher odds of discussing ACP with loved ones, whereas age, drug use, education level, depression, and memory problems were nonsignificant.

Conclusion

These results suggest that interventions to increase ACP among PLWHAs and their loved ones should target males. The findings also suggest PLWHAs with chronic pain, the need for assistance with personal care, and those with a history of prior family arguments over health care decisions may be primed for ACP.  相似文献   
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Since its inception in the early 1980s, the microfracture procedure has been successfully used throughout the body to treat isolated full-thickness cartilage lesions. Although treatment of such injuries can be challenging, and outcomes variable, microfracture has afforded surgeons the ability to treat cartilage lesions in a single-stage fashion at the time of treatment for concomitant injuries. Whereas most research relating to the use of microfracture has focused on managing lesions in the knee, there continues to be interest in applying the same principles in other regions of the body. With the recent enthusiasm and procedural increase in hip arthroscopy and hip preservation procedures, evaluating the use of microfracture in the femoroacetabular joint is the next logical step in establishing treatment principles for cartilage defects in this location. Although we continue to innovate as orthopedic surgeons, and there have been recent declines in ardor for the use of microfracture, this sentiment has arisen only after decades of research and clinical advances. Because of this, continued work will be necessary to understand the limits of the microfracture procedure in hip preservation surgery. Early outcome studies are encouraging and continue to be an important platform on which to lay the foundation for further research and refinement of techniques and indications.  相似文献   
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