Heyde's syndrome: A critical review of the literature.

Heyde's syndrome is an uncommon association between aortic stenosis and gastrointestinal bleeding. Although initially described during the late 1950s, with subsequent reports of a possible link between these disorders, controversy persists regarding the incidence, pathogenesis, and treatment of this syndrome. The main disagreements center on the actual association of aortic stenosis and angiodysplasia, though other controversies include the pathogenesis of Heyde's syndrome, ranging from von Willebrand factor deficiency and age-related degeneration to mucosal ischemia and cholesterol embolization.

Clinical application of a micro multiplane transoesophageal probe in congenital cardiac disease.

Aim: To assess the quality of imaging modalities of a new micro multiplane transoesophageal echocardiogram probe.

Method: This is a prospective study of micro transoesophageal echocardiogram S8-3t probe used at a single institution between 15 December, 2009 and 15 March, 2010. The images were compared with standard paediatric or adult probes where possible.

Three-dimensional electronic spectroscopy of excitons in asymmetric double quantum wells.

We demonstrate three-dimensional (3D) electronic spectroscopy of excitons in a double quantum well system using a three-dimensional phase retrieval algorithm to obtain the phase information that is lost in the measurement of intensities. By extending the analysis of two-dimensional spectroscopy to three dimensions, contributions from different quantum mechanical pathways can be further separated allowing greater insight into the mechanisms responsible for the observed peaks. By examining different slices of the complete three-dimensional spectrum, not only can the relative amplitudes be determined, but the peak shapes can also be analysed to reveal further details of the interactions with the environment and inhomogeneous broadening.

Postoperative bleeding in a patient with normal screening coagulation tests.

A 54-year-old man was brought to the emergency room after a head-on collision. He had multiple fractures in his lower extremities and required immediate surgery. After surgery, the patient had a persistent drop in hemoglobin, hematocrit and platelets despite red blood cell transfusions.

Mapping granular structure in the biological adhesive of Phragmatopoma californica using phase diverse coherent diffractive imaging.

This paper demonstrates the application of the high sensitivity, low radiation dose imaging method recently presented as phase diverse coherent diffraction imaging, to the study of biological and other weakly scattering samples. The method is applied, using X-ray illumination, to quantitative imaging of the granular precursors of underwater adhesive produced by the marine sandcastle worm, Phragmatopoma californica. We are able to observe the internal structure of the adhesive precursors in a number of states.

Using tele-education to train civilian physicians in an area of active conflict: certifying Iraqi physicians in Pediatric Advanced Life Support from the United States.

Years of violence have resulted in a lack of trained health care providers in Iraq. To address this need, International Medical Corps has implemented a national emergency care program for the country. As part of this program, we implemented via tele-education the country's first civilian course in Pediatric Advanced Life Support.

Rosuvastatin therapy does not affect serum MMP-13 or TIMP-1 levels in hypercholesterolemic patients.

Matrix metalloproteinases degrade the collagen content of atherosclerotic plaque and reduce plaque stability. In tissue sections of atherosclerotic plaque, the expression of matrix metalloproteinases is increased. 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) decrease the tissue expression of matrix metalloproteinases-1, -2, -3, and -9 in atheromatous plaque by attenuating the inflammatory process that leads to increased expression.

Experimental characterization of the coherence properties of hard x-ray sources.

The experimental characterization of the coherence properties of hard X-ray sources is reported and discussed. The source is described by its Mutual Optical Intensity (MOI). The coherent-mode decomposition is applied to the MOI described by a Gaussian-Schell model.

Dynamic sample imaging in coherent diffractive imaging.

As the resolution in coherent diffractive imaging improves, interexposure and intraexposure sample dynamics, such as motion, degrade the quality of the reconstructed image. Selecting data sets that include only exposures where tolerably little motion has occurred is an inefficient use of time and flux, especially when detector readout time is significant. We provide an experimental demonstration of an approach in which all images of a data set exhibiting sample motion are combined to improve the quality of a reconstruction.

Real-world lessons from the implementation of a depression screening protocol in acute myocardial infarction patients: implications for the American Heart Association depression screening advisory.

Background: The American Heart Association (AHA) statement has recommended routine screening for depression in coronary artery disease with a 2-stage implementation of the Patient Health Questionnaire (PHQ). Because there is little evidence on feasibility, accuracy, and impact of such a program on depression recognition in coronary patients, the AHA recommendation has met substantial debate and criticism.

Methods And Results: Before the AHA statement was released, the Mid America Heart and Vascular Institute (MAHVI) had implemented a depression screening protocol for patients with acute myocardial infarction that was virtually identical to the AHA recommendations.

Proton pump inhibitors and risk of fracture: a systematic review and meta-analysis of observational studies.

Objectives: Proton pump inhibitors (PPIs) are widely used in several acid-related gastrointestinal disorders. In vivo studies have suggested that gastric suppression by PPIs could result in decreased intestinal calcium absorption. Subsequently, there have been concerns that the chronic use of a PPI is associated with an increased risk of bone fracture.

Prolonged acute care in a 52-year-old man with respiratory failure: lessons learned from 70-day intensive care unit hospitalization.

Purpose: This study was undertaken to record the experiences of a patient who survived prolonged intensive care unit (ICU) care secondary to acute respiratory failure.

Materials And Methods: The patient's medical record was summarized, and the patient was interviewed with audio recording and transcription. He completed several surveys, including the ICU memory tool, the 14-question Posttraumatic Stress Syndrome Questionnaire, the Impact of Event Scale-Revised Questionnaire, and the Hospital Anxiety and Depression Scale Questionnaire.

Potential preventability of spontaneous bacterial peritonitis.

Background: Antibiotic prophylaxis can reduce the incidence of the first episode and recurrent episodes of spontaneous bacterial peritonitis (SBP) in high-risk cirrhotic patients. However, recent data suggest that SBP prophylaxis may be underused. It is unclear how many cases of cirrhosis that develop SBP might actually be prevented with antibiotic prophylaxis.

Nonaffective acute psychoses: uncertainties on the way to DSM-V and ICD-11.

Since the early 20th century, a group of nonaffective psychoses with acute onset and brief duration have been described in different countries under various names, including cycloid psychosis, bouffée délirante, and reactive psychosis. These psychoses share several characteristics, including benign course, greater prevalence in women than men and in developing countries than in industrialized countries, and high prevalence of premorbid psychological and physiologic stressors. However, the variations in names and minute details of symptomatology have overshadowed the basic similarities across these various descriptions.

Ultrafast optical multidimensional spectroscopy without interferometry.

We present here the details of a phase retrieval technique that provides access to multidimensional modalities that are not currently available using existing interferometric techniques. The development of multidimensional optical spectroscopy has facilitated significant insights into electronic processes in physics, chemistry, and biology. The versatility and number of available techniques are, however, significantly limited by the requirement that the detection be interferometric.

Phase-diverse coherent diffractive imaging: high sensitivity with low dose.

This Letter demonstrates that coherent diffractive imaging (CDI), in combination with phase-diversity methods, provides reliable and artefact free high-resolution images. Here, using x rays, experimental results show a threefold improvement in the available image contrast. Furthermore, in conditions requiring low imaging dose, it is demonstrated that phase-diverse CDI provides a factor of 2 improvement in comparison to previous CDI techniques.

Severe tricuspid regurgitation in a patient receiving low-dose cabergoline for the treatment of acromegaly.

Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in PD patients. While cabergoline has been used at much lower doses in patients with hyperprolactinemia, controversy persists as to whether it may cause heart valve disease in this situation. Cabergoline is also used in acromegaly at doses similar to those used in hyperprolactinemia.

Endoscopic removal of multiple duodenum foreign bodies: An unusual occurrence.

Deliberate single foreign body ingestion is a scenario that many gastroenterologists commonly see in psychiatric units and prisons. However, multiple foreign body ingestions, especially located in the duodenum, provide the endoscopist with unique challenges for management and treatment. Although most foreign objects pass spontaneously, one should have a low threshold of intervention for multiple objects, especially those that are wide, sharp and at risk of perforation.

A new approach for structure analysis of two-dimensional membrane protein crystals using X-ray powder diffraction data.

The application of powder diffraction methods to problems in structural biology is generally regarded as intractable because of the large number of unresolved, overlapping X-ray reflections. Here, we use information about unit cell lattice parameters, space group transformations, and chemical composition as a priori information in a bootstrap process that resolves the ambiguities associated with overlapping reflections. The measured ratios of reflections that can be resolved experimentally are used to refine the position, the shape, and the orientation of low-resolution molecular structures within the unit cell, in leading to the resolution of the overlapping reflections.

Acute quadriplegia from hyperkalemia: a case report and literature review.

Background: Hyperkalemia has been described as a rare and under recognized cause of acute quadriplegia.

Case Report: A 52-year-old man with end-stage renal disease presented with ascending quadriplegia and dyspnea for 2 days. He had life-threatening hyperkalemia (9.