Pulseless Electrical Activity and Perioperative Cardiac Arrest Due to Undiagnosed and Asymptomatic Hypothyroidism During Outpatient Surgery in an Adolescent.

Commonly identified risk factors for perioperative cardiac arrest in pediatric-aged patients include cardiac surgery, younger age, comorbid conditions including pulmonary hypertension and cyanotic congenital heart disease, and emergency surgery. Although medication-related etiologies formerly predominated, the elimination of halothane from anesthetic care has resulted in a shift in etiology to hemodynamic events related to blood loss or hyperkalemia associated with the rapid administration of blood products. Rarely, cardiac arrest can be sudden and unexpected without an identified pre-existing etiology in an otherwise apparently healthy patient.

The Rationale for Treating the Nodule in Dupuytren's Disease.

Background: Dupuytren's disease encompasses a spectrum of fibroblastic disorders from the presence of 1-2 nodules in the palm of a hand with no joint contracture to grotesque, crippling and disabling deformities of hands. Over the last 50 years, many enlightening studies have been forthcoming, which, through techniques of histopathology, biochemistry, tissue culture, and electron microscopy, have shed pearls of light on various aspects of the disease process.

Methods: A comprehensive review of the literature on Dupuytren's disease was undertaken, stringing together results from numerous studies to establish a table of events and their location in the development of the disease.

An evaluation of the impact of apheresis platelets used in the setting of massively transfused trauma patients.

Introduction: Trauma is a major cause of morbidity and mortality worldwide. Of patients arriving to trauma centers, patients requiring massive transfusion (MT, >or=10 units in 24 hours) are a small patient subset but are at the highest risk of mortality. Transfusion of appropriate ratios of blood products to such patients has recently been an area of interest to both the civilian and military medical community.

Optical density values correlate with the clinical probability of heparin induced thrombocytopenia.

Introduction: Heparin induced thrombocytopenia is a clinicopathologic syndrome that may result in severe thrombotic sequelae without prompt diagnosis and treatment. A clinical scoring system to assess the pre-test probability of heparin-induced thrombocytopenia, the 4 T's, has been reported to correlate with the serotonin release assay.

Materials And Methods: We performed a single-center, retrospective study correlating the 4 T's score with the commercial heparin-PF4 ELISA.

Indications for early fresh frozen plasma, cryoprecipitate, and platelet transfusion in trauma.

Background: Massive blood transfusion can be lifesaving in the treatment of severe trauma. Guidelines for the use of non-RBC blood components in the early phase of trauma resuscitation are largely based on extensions of expert recommendations for general surgery.

Methods: The logic and evidence for the use of plasma, platelets, and cryoprecipitate early in the course of massive transfusion for trauma were reviewed.