Background Neonatal abstinence syndrome (NAS) is common, expensive, and hurts opioid addicted women and their families. Current treatments do not sufficiently address comorbid addictions, especially tobacco use, among pregnant buprenorphine-maintained women. Methods 25 consecutive admissions of pregnant, opioid addicted women were treated with buprenorphine maintenance and a novel intervention for pregnant opioid addicted patients, Drug Use Targeted Therapy (DUST). DUST entails a combination of informing women about the impact of various drugs on their fetus, discussing the woman’s thinking about these consequences of drug use, and varying the frequency of psychotherapy; increasing if addictive drugs are used and decreasing if the woman wishes when drug use is stopped. Results 20/25 remained in treatment until delivery. All 20 women were using addictive drugs at admission. None were planned pregnancies. There was a high prevalence of emotional, physical or sexual abuse, criminal behavior, comorbid psychiatric disorders, and chronic pain. Nineteen stopped all addictive drugs. NAS was present for 5 out of 19 newborns with a duration of hospitalization from 4 to 6 days. Conclusions This preliminary open-label case series found that pregnant buprenorphine maintained women can stop tobacco. What has sometimes been termed “neonatal opioid abstinence syndrome” may most accurately be termed, “neonatal opioid/tobacco abstinence syndrome.” If the treatment effectively addresses tobacco use, other addictive drugs are rarely used. DUST resulted in a 95% quit rate for addictive drugs. Pilot data on this new intervention is limited; a case series that does not have a corresponding control group.

Three-dimensional (3D), two-dimensional (2D) ultrasound and saline infusion sonography (SIS) are beneficial tools in diagnosing congenital uterine anomalies. This article illustrates six various case scenarios based on 3D ultrasound images in order to review the concepts of ultrasound diagnosis of congenital uterine anomalies and apply it to the presented case studies. These cases scenarios educate the reader on arcuate uterus, septate uterus, bicornuate uterus, didelphic uterus, uterus duplex and unicornuate uterus. This article also presents the sequence of embryologic events leading to the congenital uterine anomalies. The role of 3D ultrasound in diagnosis and treatment of congenital uterine anomalies is presented, along with its advantages over 2D ultrasound, SIS, X-ray hysterosalpingography, magnetic resonance imaging, hysteroscopy and laparoscopy. The effects of hysteroscopic metroplasty on fertility are also illustrated and discussed. After this case-based discussion is completed, the readers will be able to make a differential diagnosis of the different types of congenital uterine anomalies.

Background: Agitation is a significant challenge to mental healthcare. This project aims to examine the effects of implementing an interactive mental flexibility group to decrease incidences of agitation in the inpatient psychiatric population during nursing shift change.Methods: This observational study, conducted on the acute inpatient psychiatric unit of an academic hospital in Central NY, USA. This 23-bed unit admits psychiatric patients from the E.D. and local hospitals. The art-based interactive group was implemented during the critical period of nursing shift change, which is known for having an increased agitation due to caregiver changes. We tracked group attendance, incidences of agitation, and as-needed medication administration for agitation. We administered a Likert-type scale to rate emotions before and after each session.Results: We observed a dramatic decrease in as needed medications for agitation 1 month prior to group (n = 576) compared to 3 months during group (n = 120). The new group constitutes a significant decrease in agitation incidents. Patients indicated an increase in happiness (mean = 0.46, SD = 0.978), decrease in sadness (mean = 0.44, SD = 1.078), and decrease in anger (mean = 1.15, SD = 1.984).Conclusions: Our project indicates that the patients and staff well receive interactive group sessions in an acute psychiatric unit. The group sessions helped to decrease agitation and medication administration.Future directions: We recommend the utilization of interactive mental flexibility groups on acute psychiatric units to promote emotional regulation, especially during nursing shift change.