Role of Interventional Radiology in the Management of Non-aortic Thoracic Trauma.

Trauma remains a leading cause of death for all age groups, and nearly two-thirds of these individuals suffer thoracic trauma. Due to the various types of injuries, including vascular and nonvascular, interventional radiology plays a major role in the acute and chronic management of the thoracic trauma patient. Interventional radiologists are critical members in the multidisciplinary team focusing on treatment of the patient with thoracic injury.

The Challenges in Diagnosis and Management of Acquired Thrombotic Thrombocytopenic Purpura: Consensus Report from Three Gulf Countries.

Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare hematological emergency characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, and multiorgan failure due to autoimmune-mediated deficiency in ADAMTS-13 activity. Currently, plasma exchange, with or without steroids, is the frontline option for the management of aTTP. The treatment should be started promptly once the disorder is clinically suspected.

Validity of Random Triglyceride Levels in Infants Receiving Parenteral Nutrition.

Intravenous lipid emulsions (IL) are an important part of parenteral nutrition (PN) to meet essential fatty acid (EFA) requirements and metabolic demands of neonates and preterm infants. Some critically-ill neonates may not metabolize IL effectively which can lead to hypertriglyceridemia. Risks associated with this include increased pulmonary vascular resistance, displaced bilirubins, and platelet or macrophage dysfunction.

A Retrospective Review Following the Addition of Clonidine to a Neonatal Abstinence Syndrome Treatment Algorithm.

To investigate the outcomes associated with the implementation of a neonatal abstinence syndrome (NAS) treatment algorithm utilizing dual therapy with morphine sulfate and clonidine in a level four neonatal intensive care unit (NICU). A cohort of neonates (≥35 weeks gestation) born at an academic tertiary medical center between January 1, 2015 and December 31, 2018 who were diagnosed with NAS were retrospectively evaluated following the implementation of a new NAS treatment algorithm. Neonates were categorized in two groups based on if they were treated pre- or post-implementation of the protocol.

Genetic Characterization of a Model Ciliopathy: Bardet-Biedl Syndrome.

Bardet-Biedl syndrome (BBS) is a rare ciliopathy affecting multiple organ systems. Patients with BBS are usually diagnosed later in childhood when clinical features of the disease become apparent. In this article, we presented a case of BBS discovered by whole genome sequencing in a newborn with heterotaxy, duodenal atresia, and complex congenital heart disease.

Prophylactic inhibition of NF-κB expression in microglia leads to attenuation of hypoxic ischemic injury of the immature brain.

Background: Periventricular leukomalacia (PVL), a devastating brain injury affecting premature infants, is the most common cause of cerebral palsy. PVL is caused by hypoxia ischemia (HI) and is characterized by white matter necrotic lesions, microglial activation, upregulation of NF-κB, and neuronal death. The microglia is the main cell involved in PVL pathogenesis.

Caudal Regression Syndrome.

Caudal Regression Syndrome (CRS) or Caudal dysgenesis syndrome (CDS) is characterized by maldevelopment of the caudal half of the body with variable involvement of the gastrointestinal, genitourinary, skeletal, and nervous systems. CRS affects 1-3 newborn infants per 100,000 live births. The prevalence in infants of diabetic mothers is reported at 1 in 350 live births which includes all the variants.

A Truncating Variant of as a Cause of Escobar Syndrome: A Multiple Pterygium Syndrome Subtype.

Escobar syndrome is a milder variant of multiple pterygium syndrome characterized by pterygia, scoliosis, and multiple congenital contractures. It is most frequently due to a genetic variant in , which encodes the γ-subunit of the nicotinic acetylcholine receptor. Though the subunit is considered a "fetal" form and transitions to the "adult" ε-subunit by 33 weeks' gestation, the pathogenic musculoskeletal effects during fetal development render children with this condition permanently affected.

Unique Case of Congenital Duodenal Atresia and a Choledochal Cyst and the Hypothesis of Their Embryological Evolution.

The concomitant occurrence of duodenal atresia (DA) and a choledochal cyst (CC) has rarely been reported. Knowledge of both the presentation and management of this rare co-occurrence is imperative in avoiding potential complications and sequelae, such as biliary metaplasia. Herein we describe a female infant born at 32 weeks gestational age who was diagnosed with duodenal atresia and annular pancreas postnatally, who had subsequent findings of malrotation and a choledochal cyst, as seen from contrast imaging.

Unusual ureteric duplication abnormality in a child with pelvoureteric junction obstruction.

A 5-year-old girl underwent an elective left pyeloplasty for pelvoureteric junction obstruction (PUJO). At laparoscopy, two ureters were seen to be draining a left duplex kidney, with a PUJO of the lower moiety. Interestingly, however, the upper moiety ureter was bifurcating to drain both upper and lower moiety as well.

The Shanfield anastomosis revisited: Its applications and early outcome.

Background: Shanfield first described a simple ureteric implantation technique involving a U-stitch anchoring the spatulated end of the transplant ureter to the interior of the intact bladder through a small stab wound. We present an extrapolation of this principle to Mitrofanoff channels and native ureteric reimplantations and further extend it to a laparoscopic approach in some.

Methods: A retrospective case-note reviewing the Shanfield ureteric reimplantation in fifteen children between October 2014 and May 2017 was performed.

Paediatric penetrating thoraco-abdominal injury: role of minimallly invasive surgery.

We report two cases of penetrating thoraco-abdominal injuries who presented to our trauma centre. One with stab to lower left chest and the other one had pallet injury to right upper abdomen. The clinical presentation, radiological investigations and operative intervention are reviewed.

Nonlinearity of cationic aromatic amine sorption to aluminosilicates and soils: role of intermolecular cation-π interactions.

Through the study of substituted anilines and benzylamines, we demonstrated that cooperative cation-π, π-π, and van der Waals interactions can increase aromatic cationic amine sorption to Na/Ca-montmorillonite well beyond the extent expected by cation exchange alone. Cationic amines exhibiting cooperative interactions displayed nonlinear S-shaped isotherms and increased affinity for the sorbent at low surface coverage; parallel cation exchange and cooperative interactions were noted above a sorption threshold of 0.3-2.

Central venous catheters in the left-sided superior vena cava: clinical implications.

Aim: Left-sided superior vena cava (LSVC) is a congenital venous anomaly with an incidence of about 0.3%, and which is sometimes discovered during vascular intervention [Le Cat. Histoire de l'acadroyale des sciences .

Second-generation antipsychotics cause a rapid switch to fat oxidation that is required for survival in C57BL/6J mice.

Some second-generation antipsychotics (SGAs) increase insulin resistance and fat oxidation, but counter intuitively they do not activate lipolysis. This seems unsustainable for meeting energy demands. Here, we measured dose-dependent effects of SGAs on rates of oxygen consumption (VO2), respiratory exchange ratio (RER), and physical activity in C57BL/6J mice.

The testicular regression syndrome--do remnants require routine excision?

Aim: Excision of testicular remnants is debatable in the scenario where hypoplastic vas and vessels can be seen entering a closed internal ring during laparoscopy for impalpable testes. We aimed to establish how frequently excised remnants have identifiable testicular tissue and, hence, malignant potential.

Methods: This study is a retrospective review of all excised testicular remnants in children with impalpable testis.

Troponin estimation identifies myocardial infarction patients with different characteristics.

Objective: To investigate the impact of new myocardial infarction definition based on troponin, the rate of myocardial infarction diagnosis, patients characteristics, and short-term prognosis.

Methods: We enrolled 1,255 consecutive myocardial infarction patients from the Kuwait Registry of Acute Coronary Syndromes from December 2003 to May 2004. Two patient groups were identified, those diagnosed with elevated creatine kinase-MB (CK group) and those diagnosed with elevated troponin with normal CK-MB (Troponin group).

A registry of acute myocardial infarction in Kuwait: Patient characteristics and practice patterns.

Background: Coronary artery disease is the leading cause of death in Kuwait, yet data about patient characteristics and practice patterns are lacking.

Objectives: To establish a registry of all acute myocardial infarction (AMI) cases admitted to the general hospitals in Kuwait, so that the characteristics and management patterns of patients with AMI could be accurately determined.

Methods: For six consecutive months, all patients with AMI admitted to the coronary care units of the five participating hospitals were prospectively included in the registry.

Patient characteristics and practice patterns in the treatment of acute myocardial infarction in Kuwait: a pilot study.

Objectives: To determine the characteristics, management and outcomes of patients with acute myocardial infarction (AMI) admitted to the general hospitals and to assess the feasibility of establishing a registry for AMI in Kuwait.

Subjects And Methods: We prospectively included 111 consecutive patients (94 males and 17 females, mean age 55 years) admitted to the coronary care units of the five participating hospitals during May 2000. The subjects all had a final diagnosis of AMI.