All patients

who developed a complication after a penetrating injury required intervention for the management of the complication.

Conclusion: Selective reimaging of renal injuries based on clinical and laboratory criteria seems to be safe regardless of injury mechanism or management. High-grade penetrating injuries undergoing operative intervention should carry the highest degree of vigilance and lowest threshold for repeat imaging.”
“We are reporting the successful surgical treatment of a 23-year-old female with a giant right coronary artery to coronary sinus fistula. This woman had find more complaints of chest pain and dyspnea on exertion for few months. Transthoracic echocardiography (TTE) showed a large tortuous right coronary artery and a dilated coronary sinus. Preoperative multi-detector computed tomography (MDCT) coronary angiography and cardiac catheterization confirmed the diagnosis of a right coronary artery to coronary sinus fistula. The patient underwent surgical closure of the fistula and division of the communication between the right coronary artery and the coronary sinus with the use

of cardiopulmonary bypass. The patient was discharged home on postoperative day 5 and at one-year follow-up is symptom-free. (c) 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.”
“AimsTo examine whether early onset of tobacco or alcohol use, and continued use of tobacco or alcohol in early adolescence, are related to a higher LY411575 mw KU57788 likelihood of developing a cannabis use disorder during adolescence.

Design and settingData were used from four consecutive assessment waves of the TRacking Adolescents’ Individual Lives Survey (TRAILS), a general Dutch population study. TRAILS is an ongoing longitudinal study that will follow the same group of adolescents from the ages of 10 to 24 years.

ParticipantsThe sample consisted of 1108 (58%

female) adolescents (mean ages at the four assessment waves are 11.09, 13.56, 16.27 and 19.05 years, respectively)

MeasurementsCannabis use disorders were assessed using the Composite International Diagnostic Interview 3.0 (CIDI). Adolescent tobacco and alcohol use were assessed using self-report questionnaires.

FindingsEarly-onset tobacco use [odds ratio (OR)=1.82, confidence interval (CI)=1.05-3.14, P<0.05], but not early-onset alcohol use (OR=1.33, CI=0.84-2.12, P>0.05), was associated with a higher likelihood of developing a cannabis use disorder. Similarly, adolescents who reported continued use of tobacco (OR=2.47, CI=1.02-5.98, P<0.05), but not continued use of alcohol (OR=1.71, CI=0.87-3.38, P>0.05), were more likely to develop a cannabis use disorder.

ConclusionsEarly-onset and continued tobacco use appear to predict the development of a cannabis use disorder in adolescence, whereas early onset and continued alcohol use do not.