Two-staged repair of a giant iliac aneurysm and open repair of a true deep femoral artery aneurysm in Loeys-Dietz syndrome type V: a case report and review of literature.

Background: The syndrome of Loeys-Dietz (LDS) is a rare connective tissue disorder. A classic triad of symptoms is seen: hypertelorism, atypical uvula or clef palate, and multiple tortuous arteries and aneurysms of the aorta and main arterial branches. Mutations in genes involving the transforming growth factor-beta (TGFB) signaling pathway are the cause of this syndrome.

Concerns of older patients and their caregivers in the emergency department.

Background: Older emergency department (ED) patients often have complex problems and severe illnesses with a high risk of adverse outcomes. It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking.

Short-term mortality in older medical emergency patients can be predicted using clinical intuition: A prospective study.

Background: Older emergency department (ED) patients are at risk for adverse outcomes, however, it is hard to predict these. We aimed to assess the discriminatory value of clinical intuition, operationalized as disease perception, self-rated health and first clinical impression, including the 30-day surprise question (SQ: "Would I be surprised if this patient died in the next 30 days" of patients, nurses and physicians. Endpoints used to evaluate the discriminatory value of clinical intuition were short-term (30-day) mortality and other adverse outcomes (intensive/medium care admission, prolonged length of hospital stay, loss of independent living or 30-day readmission).

A Novel Multiplayer Screen-Based Simulation Experience for African Learners Improved Confidence in Management of Postpartum Hemorrhage.

Introduction: Postpartum hemorrhage (PPH) remains a global challenge, affecting thirteen million women each year. In addition, PPH is a leading cause of maternal mortality in Asia and Africa. In the U.

A conundrum: general or neuraxial anesthesia and the use of ROTEM.

We report the use of rotational thromboelastometry (ROTEM) to guide the management of a 29-year-old primigravida at 36weeks' gestation with portal hypertension, esophageal varices, suspected pseudocholinesterase deficiency, and steroid refractory thrombocytopenia presenting to labor and delivery with worsening peripheral edema and new-onset hypertension. A multidisciplinary decision for preoperative platelet transfusion and cesarean delivery under spinal anesthesia was made, guided by ROTEM. A successful cesarean delivery was performed with no bleeding complications.