Leakage of ruptured silicone breast implants through abdominal laparoscopic port sites: A rare complication following transabdominoplasty breast augmentation.

Background: Abdominoplasty and breast augmentation are two of the most commonly performed aesthetic procedures in the UK. When performed as a combined procedure, separate inframammary and abdominoplasty incisions are most frequently used. Transabdominoplasty breast augmentation, performed via a single abdominoplasty incision is also described.

Rare presentation of Fabry disease as 'burnt-out' hypertrophic cardiomyopathy.

We herein report the case of a 53-year-old man who was historically diagnosed with hypertrophic cardiomyopathy (HCM) and was lost to follow-up, before presenting with end-stage heart failure. This was initially suspected as dilated cardiomyopathy and then 'burnt-out phase' of HCM but subsequently the underlying diagnosis was Fabry disease. Fabry disease is an uncommon lysosomal-storage disease due to reduced or absent activity of the alpha-galactosidase A enzyme.

Quantification of Posterior Risk Related to Intrapartum FIGO 2015 Criteria for Cardiotocography in the Second Stage of Labor.

Introduction: Intrapartum cardiotocography (CTG) was used for several decades to detect a stressed fetus so that delivery can be expedited to prevent birth asphyxia. The main aim of the study was to calculate the risk of neonatal acidemia (pH ≤ 7.10) according to duration of the 2nd stage of labor and occurrence of the International Federation of Gynecology and Obstetrics (FIGO) 2015 CTG classification parameters.

Psychological effect of COVID-19 on medical health-care workers.

Objective: To review the psychological Effect of COVID-19 on medical health-care workers.

Conclusions: Social support is a cornerstone in facing COVID-19 and uplifting the spirits of both patients and their doctors along with the whole medical staff dealing with the pandemic.

Percutaneous Device Closure of Paravalvular Leak: Combined Experience From the United Kingdom and Ireland.

Background: Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery.

Methods: All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry.

Deceptive potassium and magnesium measurements.

Potassium and magnesium are important circulating cations and are predominantly intracellular elements. Only a small fraction of these elements is present in extracellular fluids including blood (∼1%). Measurement of the concentration of such small fractions in blood is commonly used to assess and reflect their body content levels.

Accessory mitral valve tissue: appearance on cardiac computed tomography.

Accessory mitral valve tissue is an uncommon congenital malformation and a rare cause of left ventricular outflow tract obstruction. Although echocardiography provides a "gold standard" for evaluation of valves, the high temporal and spatial resolutions of computed tomography technology makes it useful in the assessment of valvular structure and function.

Probabilistic Bayesian reasoning can help identifying potentially wrong immunoassays results in clinical practice: even when they appear 'not-unreasonable'.

Background: Immunoassays are susceptible to analytical interferences including from endogenous immunoglobulin antibodies at a rate of ∼0.4% to 4%. Hundreds of millions of immunoassay tests (>10 millions in the UK alone) are performed yearly worldwide for measurements of an array of large and small moieties such as proteins, hormones, tumour markers, rheumatoid factor, troponin, small peptides, steroids and drugs.

The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for "normal" results.

Background: A major use of serum magnesium measurements in clinical practice is to identify patients with deficiency. However, numerous studies have shown that magnesium deficiency is common and may be present in over 10% of hospitalized patients, as well as in the general population. An important cause for under diagnosis of deficiency is that serum magnesium, the most commonly used test, can be normal despite negative body stores.

Vulnerable atherosclerotic plaque metalloproteinases and foam cell phenotypes.

Plaque rupture underlies most myocardial infarctions. Plaques vulnerable to rupture have thin fibrous caps, an excess of macrophages over vascular smooth muscle cells, large lipid cores, and depletion of collagen and other matrix proteins form the cap and lipid core. Production of matrix metalloproteinases from macrophages is prominent in human plaques, and studies in genetically modified mice imply a causative role for metalloproteinases in plaque vulnerability.

Low tissue inhibitor of metalloproteinases 3 and high matrix metalloproteinase 14 levels defines a subpopulation of highly invasive foam-cell macrophages.

Objective: An excess of metalloproteinases (MMPs) over tissue inhibitors of metalloproteinases (TIMPs) may favor atherosclerotic plaque rupture. We compared TIMP levels in nonfoamy and foam-cell macrophages (FCM) generated in vivo.

Methods And Results: In vivo generated rabbit FCM exhibited 84% reduced TIMP-3 protein compared to nonfoamy macrophages, and immunocytochemistry revealed a TIMP-3 negative subset (28%).

Analysis of complications following surgical treatment of benign parotid disease.

Background: The objective of the study was to study the incidence of, and risk factors for developing complications following parotidectomy for benign disease, to improve preoperative patient counselling and better inform future surgical management.

Methods: An 11-year retrospective review of 162 parotidectomies for benign disease, collecting and analysing data about presentation, investigations, surgical treatment, postoperative facial nerve function, Frey's syndrome and other surgical complications.

Results: The mean age at presentation was 58 years.

Erroneous laboratory results: what clinicians need to know.

Laboratory tests such as 'conventional biochemistry' are analytically robust and trusted, however, some common tests performed by immunoassays, eg thyroid function tests, are inherently more prone to analytical interference, giving rise to incorrect results. Interfering antibodies capable of causing potentially misleading results in immunoassay varied from about 0.4% to 4%.

Genomics of foam cells and nonfoamy macrophages from rabbits identifies arginase-I as a differential regulator of nitric oxide production.

Objective: Conversion of macrophages to foam cells is a critical step in the initiation and progression of atherosclerosis. We sought to identify genes differentially regulated in foam cells, since these are likely to include new targets for intervention.

Methods And Results: We used suppression subtraction hybridization to compare foam cells and nonfoamy macrophages isolated from subcutaneous granulomas of rabbits fed a cholesterol-rich or normal chow diet and confirmed upregulation of 3 genes, including matrix metalloproteinase-12 (mRNA 2.

Long-term outcome of skull base surgery with microvascular reconstruction for malignant disease.

Background: Successful resection of malignant skull base disease depends implicitly on the ability to reconstruct the resulting defects in the craniovisceral diaphragm, to support neural structures, and to prevent ascending intracranial infections. Microsurgery reliably achieves these objectives and has increased the scope of curative oncologic surgery. The authors assessed the reconstructive results and the long-term oncologic outcome of patients having skull base surgery with free tissue transfer.