Prospective observational cohort study of the association between antiplatelet therapy, bleeding and thrombosis in patients with coronary stents undergoing noncardiac surgery.

Background: The perioperative management of antiplatelet therapy in noncardiac surgery patients who have undergone previous percutaneous coronary intervention (PCI) remains a dilemma. Continuing dual antiplatelet therapy (DAPT) may carry a risk of bleeding, while stopping antiplatelet therapy may increase the risk of perioperative major adverse cardiovascular events (MACE).

Methods: Occurrence of Bleeding and Thrombosis during Antiplatelet Therapy In Non-Cardiac Surgery (OBTAIN) was an international prospective multicentre cohort study of perioperative antiplatelet treatment, MACE, and serious bleeding in noncardiac surgery.

A case of check-rein deformities of the great and lesser toes treated through exploration at the midfoot.

We present the case of a twenty-two year old man who presented to the orthopaedic clinic complaining of clawing of his great toe. Further examination revealed clawing of the lesser toes and surgical scarring to the fibula and tibia. A history of previous operative fixation for lower limb trauma was described.

Analysis of a data-fusion system for continuous vital sign monitoring in an emergency department.

Objective: The aim of the study was to evaluate the ability of a data-fusion patient status index (PSI) to detect patient deterioration in the emergency department (ED) in comparison with track-and-trigger (T&T).

Materials And Methods: A single-centre observational cohort study was conducted in a medium-sized teaching hospital ED. Vital sign data and any documented T&T scores (paper T&T) were collected from adults attending the resuscitation room, majors or observation ward.

22-year longitudinal study of repetitive colonoscopy in patients with a family history of colorectal cancer.

Introduction: We report the outcomes of a long-term surveillance programme for individuals with a family history of colorectal cancer.

Methods: The details of patients undergoing a colonoscopy having been referred on the basis of family history of colorectal cancer were entered prospectively into a database. Further colonoscopy was arranged on the basis of the findings.

Managing chondrosarcoma of the epiglottis: a case report.

Laryngeal chondrosarcomas are a very rare malignancy with less than 150 cases reported in the literature. Of these, the epiglottis is the most unusual primary neoplastic subsite. Uncertainties arise owing to the extremely rare nature of the condition with regard to treatment and investigation for metastases in overtly low grade cases.

The effect of anesthetic technique on recovery after orthognathic surgery: a retrospective audit.

We audited the recovery characteristics of 51 patients who had undergone orthognathic maxillofacial surgery at a single center. Patients whose anesthesia had been maintained with intravenous propofol and remifentanil (n  =  21) had significantly higher pain scores during the first 4 hours after surgery than those whose anesthesia was maintained with volatile inhalational agents and longer-acting opioids (n  =  30) (P  =  .016).

Thy3 cytology: what to do next?

Introduction: Cytological analysis of thyroid fine needle aspiration (FNA) is aided by the 'Thy' classification. However, there is often confusion surrounding the management of patients with a Thy3 classification. A subdivision of Thy3 has been created to help reduce this dilemma but its use within the UK appears to by infrequent.

Closure of minor wounds with tissue adhesive.

This article provides basic information on safe and effective wound closure using tissue adhesive. Although it is intended for staff who are new to emergency care, it can be used by more experienced staff as a refresher or teaching aid.

Epididymo-orchitis as a presenting feature of relapsing polychondritis: a case report.

Relapsing polychondritis (RP) is a rare multisystem disease. It is characterized by recurrent inflammation of cartilaginous structures including the ears, nose, tracheo-bronchial tree and peripheral joints. Proteoglycan-rich structures such as the heart, eyes and blood vessels can also be affected.

Amyloidosis presenting as bilateral transudative pleural effusions with normal cardiac investigations: a case report.

A 66-year-old man with a diagnosis of monoclonal gammopathy of unknown significance was referred for investigation of bilateral transudative pleural effusions by the cardiology team. Echocardiography, myocardial perfusion scanning and left heart catheterisation were all normal or non diagnostic. Given significant occupational asbestos exposure in his twenties he underwent thoracoscopic pleural biopsy.