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Recent years have brought new, highly effective systemic treatments to clinical practice, which can be used to treat patients with locally advanced or metastatic skin cancers. Using these regimens in neoadjuvant strategy influences surgical treatment by facilitating surgical resection, avoiding extensive resections with complex reconstructions and even omitting surgery in some cases. Integrating systemic therapy with surgery is ongoing and requires novel quality measures of surgical treatment to capture the clinical benefits of multidisciplinary strategies better. The Textbook Outcome (TO) is a novel measure of surgical quality, which captures the short-term outcomes of surgery and reflects long-term survival. Textbook Outcomes match a particular type of surgery, are intuitive to interpret, and may be widely applied in surgical oncology and general surgery. Therefore, this review aims to describe recent findings on neoadjuvant skin cancer treatment and their implications for surgical proceedings in the context of Textbook Outcomes. [ABSTRACT FROM AUTHOR]

Resiliency theory might provide a conceptual framework for understanding why adverse substance-related consequences vary considerably among young adults using psychoactive substances. Protective behavioral strategies (PBS) are behaviors that reduce substance use and related consequences. Despite such suggestions, to date no research has explicitly treated PBS as resilience factors. The purpose of this study was to examine compensatory and protective models of resilience among young adults using various substances. Data were obtained from an online questionnaire distributed through online social networks. Participants were Polish young adults (18–30 years old; M = 22, SD = 3.6; about 30% female and 1.3% non-binary; N = 7253), who reported using substances, other than alcohol or nicotine, in the last 12 months. After controlling for sociodemographics, hierarchical regression analyses of both substance-related harms and SUDs indicated the main effects of risk and protective factors, and the interaction between substance use and PBS. The models explained about 50% and 52% of the dependent variables variance, respectively. The results of this cross-sectional study provide support for both compensatory and protective models of resilience. This presents a rationale for recognizing PBS use as resilience factors that help young adults reduce substance-related harms. Theoretical discussion and practical implications are provided. [ABSTRACT FROM AUTHOR]

Background: Neoadjuvant–adjuvant therapy for locally advanced or potentially resectable metastatic melanoma was expected to improve operability and clinical outcomes over upfront surgery and adjuvant treatment only. Methods: Forty‐seven consecutive patients were treated with neoadjuvant–adjuvant BRAF inhibitors (BRAFi)/MEK inhibitors (MEKi) and surgery. Results: Twelve (26%) patients achieved a pathological complete response and 10 (21%) patients achieved a near‐complete response. In the whole group, median recurrence‐free survival was 19.4 months and median distant metastasis‐free survival (mDMFS) was 21.9 months. In patients with a pathological complete response (pCR)/near‐pCR median recurrence‐free survival (RFS) and distant metastasis‐free survival (DMFS) were significantly longer than in patients with minor pathological response with hazard ratio (HR) = 0.37 (p =.005) for RFS and HR = 0.33 (p =.002) for DMFS. After median follow‐up of 52.5 months, median progression‐free survival since BRAFi/MEKi therapy initiation was 25.1 months. The median time‐to‐treatment‐failure since initiation of neoadjuvant therapy was 22.2 months and was significantly longer in patients with pCR/near‐pCR (HR = 0.45; p =.022). Neoadjuvant therapy did not result in any new specific complications of surgery. After 48 months, RFS and overall survival were 36.3% and 64.8% or 20% and 37.4% in patients with pCR/near‐pCR and pathological partial response/pathological nonresponse, respectively. Conclusions: The authors confirmed that BRAFi/MEKi combination is an effective and safe regimen in the perioperative treatment of stage III/IV melanoma. Major pathological response to neoadjuvant treatment is a surrogate marker of recurrence including DMFS in these patients. Plain Language Summary: Our study presents a large comprehensive analysis of neoadjuvant‐adjuvant systemic therapy in patients diagnosed with marginally resectable stage III or IV melanoma.Neoadjuvant therapy effectively reduced the volume of the disease, which facilitated subsequent surgical resection.After median follow‐up of 52.5 months, median progression‐free survival since therapy initiation was 25.1 months. Twelve patients had complete pathological response and 10 patients had a near‐complete pathological response—and together they had median recurrence‐free survival and distant metastasis‐free survival significantly longer than in patients with pathological partial response or nonresponse.Complete/near‐complete pathological response to neoadjuvant treatment is a surrogate marker of recurrence‐free, including distant metastasis‐free, survival in these patients. The results of this real‐world study indicated that BRAF/MEK‐targeted therapy is effective in neoadjuvant treatment of patients with marginally resectable stage III or IV melanoma, facilitating surgical resection. The level of pathological response to the neoadjuvant treatment is a prognostic factor for disease recurrence (as well for overall survival), and relapses were most often seen in the central nervous system. [ABSTRACT FROM AUTHOR]

Copyright of Alcoholism & Drug Addiction / Alkoholizm i Narkomania is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: This study examined the prevalence of medicine use for headache, stomachache, difficulties in getting to sleep, nervousness, depression and lack of energy among 15- to 16-year-old students; the relationship between medicine use and students' health status; and the relationship between medicine and nicotine, illegal drug, and alcohol use. Methods: Data were collected from a random sample of ninth-grade students attending Warsaw middle schools (N = 722, 47% females). The self-administered anonymous questionnaire was completed during school lessons. Findings: For a period of 1 month, 52% of the students used medicines for headache and 41% for stomachache at least 1-2 times. The most prevalent pain relievers were over-the-counter medicines based on paracetamol, ibuprofen and drotaverine. A smaller proportion of students (10-13%) used herbal agents to address mental health problems, including difficulties in getting to sleep, nervousness and bad mood. Girls were more likely to use pain relievers and medicines for nervousness. The results of logistic regression showed that after controlling for gender, all variables related to health status increased risk of medicine use for mental health problems. Cigarette smoking was associated with medicine use for headache. No association was found, however, between medicine use and use of alcohol and illicit drugs. This may suggest that medicine use and consumption of other psychoactive substances constitute two distinct phenomena. (Contains 5 tables.)

This study, conducted every 4 years since 1984, is aimed at monitoring alcohol, tobacco, tranquillizers and illegal drug-use trends among 15-year-olds from Warsaw. The self-report data are taken from a representative sample of students attending schools in three districts of Warsaw (sample size ranged from 1461 to 3918 in the different study waves). Between late 1980s and mid-1990s a significant increase in youth substance use, including alcohol, cigarettes and illegal drugs, has been documented. The most recent results (from 2000 to 2004) indicated stabilization in alcohol and illegal drug use and decrease in tobacco use. The trend in the use of tranquillizers/sleeping pills was relatively stable over the past 16 years. However, changes in adolescent substance use differ across gender. While boys as a group became more restrained in substance use, girls remained at the same level or continued to show increasing trends (e.g. in getting drunk). These differences reflect changes in young female risky behaviours. (Contains 8 tables, 1 figure and 1 note.)

Copyright of Alcoholism & Drug Addiction / Alkoholizm i Narkomania is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)