The Relationship Between Preoperative Hemoglobin Concentration, Use of Hospital Resources, and Outcomes in Cardiac Surgery.

Objectives: Preoperative anemia is an established risk factor associated with adverse perioperative outcomes after cardiac surgery. However, limited information exists regarding the relationship between preoperative hemoglobin concentration and outcomes. The aim of this study was to investigate how outcomes are affected by preoperative hemoglobin concentration in a cohort of patients undergoing cardiac surgery.

Musculoskeletal manifestations of the antiphospholipid syndrome.

The scope of clinical and laboratory manifestations of the antiphospholipid syndrome (APS) has increased dramatically since its discovery in 1983, where any organ system can be involved. Musculoskeletal complications are consistently reported in APS patients, not only causing morbidity and mortality, but also affecting their quality of life. We reviewed all English papers on APS involvement in the musculoskeletal system using Google Scholar and Pubmed; all reports are summarized in a table in this review.

Relationship between maxillary central incisor proportions and facial proportions.

Statement Of Problem: No universally accepted parameter exists for selecting maxillary central incisors (MCIs) relative to facial proportions.

Purpose: The purpose of this prospective clinical study was to determine the relationship between MCIs and facial height and width in adults, intersex differences, and measurement differences between right and left MCI.

Material And Methods: A prospective study was undertaken of 149 dental students (F:76; M:73) aged between 18 and 30 years.

CD126 and Targeted Therapy with Tocilizumab in Chronic Lymphocytic Leukemia.

Purpose: IL6 promotes tumor growth and signal transduction via both its membrane-bound (CD126) and soluble receptors (sCD126). We aimed to study whether the levels of CD126 expression in chronic lymphocytic leukemic (CLL) cells can predict in vitro and in vivo treatment response.

Experimental Design: The levels of membrane-bound CD126 expression were determined on freshly isolated CLL B cells (n = 58) using flow cytometry.

A critical appraisal of point-of-care coagulation testing in critically ill patients.

Derangement of the coagulation system is a common phenomenon in critically ill patients, who may present with severe bleeding and/or conditions associated with a prothrombotic state. Monitoring of this coagulopathy can be performed with conventional coagulation assays; however, point-of-care tests have become increasingly attractive, because not only do they yield a more rapid result than clinical laboratory testing, but they may also provide a more complete picture of the condition of the hemostatic system. There are many potential areas of study and applications of point-of-care hemostatic testing in critical care, including patients who present with massive blood loss, patients with a hypercoagulable state (such as in disseminated intravascular coagulation), and monitoring of antiplatelet treatment for acute arterial thrombosis, mostly acute coronary syndromes.

Infection is the major trigger of hemophagocytic syndrome in adult patients treated with biological therapies.

Introduction: Hemophagocytic syndromes (hemophagocytic lymphohistiocytosis, HLH) are characterized by a wide range of etiologies, symptoms, and outcomes, but have a common etiopathogenic pathway leading to organ damage: an excessive inflammatory response. Biological therapies have been proposed as a therapeutic option for refractory HLH, but have also been related to the development of HLH in severe immunosuppressed patients.

Objectives And Methods: The purpose of this study was to analyze the clinical characteristics and outcomes of adult patients who developed HLH after receiving biological therapies.

Improved Construction of Auricular Prosthesis by Digital Technologies.

Implant-retained auricular prostheses are a successful prosthetic treatment option for patients who are missing their ear(s) due to trauma, oncology, or birth defects. The prosthetic ear is aesthetically pleasing, composed of natural looking anatomical contours, shape, and texture along with good color that blends with surrounding existing skin. These outcomes can be optimized by the integration of digital technologies in the construction process.

Google-driven search for big data in autoimmune geoepidemiology: analysis of 394,827 patients with systemic autoimmune diseases.

Systemic autoimmune diseases (SADs) are a significant cause of morbidity and mortality worldwide, although their epidemiological profile varies significantly country by country. We explored the potential of the Google search engine to collect and merge large series (>1000 patients) of SADs reported in the Pubmed library, with the aim of obtaining a high-definition geoepidemiological picture of each disease. We collected data from 394,827 patients with SADs.

The current place of tranexamic acid in the management of bleeding.

There has been an explosion of interest in the ability of tranexamic acid to reduce morbidity and mortality in surgical and traumatic bleeding. Tranexamic acid has been shown to reduce mortality due to traumatic bleeding by a third, without apparent safety issues. It is now clearly established that intravenous tranexamic acid reduces blood loss in patients with surgical bleeding and the need for transfusion.

Spontaneous epidural spinal haematoma in children caused by vascular malformations.

Purpose: The occurrence of spinal epidural haematoma of 'spontaneous' origin in adults is a well-documented entity, though it is rare in children. In the literature to date, there are few cases of this kind of spontaneous haematoma proven to be due to an underlying vascular abnormality.

Method: Retrospective review of two cases of children under 15 years of age with spontaneous epidural spinal haematoma.

Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors.

Aims: Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasive measures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different available methods of measurement.

Correction of facial and mandibular asymmetry using a computer aided design/computer aided manufacturing prefabricated titanium implant.

Patients with significant craniofacial asymmetry may have functional problems associated with their occlusion and aesthetic concerns related to the imbalance in soft and hard tissue profiles. This report details a case of facial asymmetry secondary to left mandible angle deficiency due to undergoing previous radiotherapy. We describe the correction of the bony deformity using computer aided design/computer aided manufacturing custom-made titanium onlay using novel direct metal laser sintering.

Adult haemophagocytic syndrome.

Haemophagocytic syndromes (haemophagocytic lymphohistiocytosis) have a wide range of causes, symptoms, and outcomes, but all lead to a hyperinflammatory response and organ damage--mainly reported in paediatric patients, but reports of adult presentation are increasing. Analysis of the genetic and molecular pathophysiology of these syndromes have improved the understanding of the crosstalk between lymphocytes and histiocytes and their regulatoty mechanisms. Clinical presentations with a broad differential diagnosis, and often life-threatening outcome, complicate the management, which might include supportive intensive care, immunosuppressive and biological treatments, or haemopoietic stem cell transplantation.

Evaluation of multidimensional COPD-related subjective fatigue following a pulmonary rehabilitation programme.

Introduction: Subjective fatigue has been recognised as an important, multi-component symptom in COPD. Pulmonary Rehabilitation (PR) improves fatigue component of the Chronic Respiratory Questionnaire, a quality of life (QoL) measure. However, it is not clear if all fatigue dimensions are affected equally.

Salient social cues are prioritized in autism spectrum disorders despite overall decrease in social attention.

Diminished social attention is often considered to be a central deficit in autism spectrum disorders (ASDs). We further investigate this hypothesis by measuring the distracting power of social and non-social stimuli in the context of a Stroop task among children with ASD and typically developing controls (TDCs). Our results show that Stroop interference increases with social versus non-social distracters in TDCs, whereas the opposite pattern occurs in ASD.

Perceived stress and self-esteem mediate the effects of work-related stress on depression.

The aim of the present study was to investigate the impact of perceived stress and self-esteem on work-related stress and depression. Two hundred and eighty-four Korean nurses participated in the study. The participants completed four questionnaires, including the Korean short version of the occupational stress scale, the perceived stress scale, the Rosenberg self-esteem scale and the Beck depression inventory.

Recent advances in reconstructive oral and maxillofacial surgery.

Reconstruction within the head and neck is challenging. Defects can be anatomically complex and may already be compromised by scarring, inflammation, and infection. Tissue grafts and vascularised flaps (either pedicled or free) bring healthy tissue to a compromised wound for optimal healing and are the current gold standard for the repair of such defects, but disadvantages are their limited availability, the difficulty of shaping the flap to fit the defect and, most importantly, donor site morbidity.

Prenatal diagnosis and management of a craniofacial glioma detected at 20 weeks' gestation. Case report and review of the literature.

Foetal imaging and anomaly detection is advancing at a rapid rate. As a result, detection of foetal craniofacial abnormalities is increasing. Ultrasound and magnetic resonance imaging are currently the imaging modalities most commonly used.

Moving inwards, moving outwards, moving upwards: the role of spirituality during the early stages of breast cancer.

The paper reflects on a study which explored the role of spirituality in the lives of women during the first year after being diagnosed with breast cancer. The study utilised a qualitative method (hermeneutic phenomenology) designed to provide rich and thick understanding of women's experiences of breast cancer and to explore possible ways in which spirituality may, or may not, be beneficial in enabling coping and enhancing quality of life. The paper draws on the thinking of David Hay and Viktor Frankl to develop a model of spirituality that includes, but is not defined by, religion and that has the possibility to facilitate effective empirical enquiry.

Ethnic differences in aortic pulse wave velocity occur in the descending aorta and may be related to vitamin D.

We studied aortic pulse wave velocity (aPWV), a predictor of cardiovascular events independent of blood pressure, in a multiethnic sample of British men, to investigate the roles for blood levels of vitamin D and aldosterone in total and regional aortic stiffness. Total aPWV was estimated noninvasively by the Arteriograph device (aPWV(AG)) in 198 men, with its length measure calibrated by magnetic resonance. PWVs over the aortic arch and descending aorta were measured by magnetic resonance in a subsample (n=47).

The neurobiology of Meditation and its clinical effectiveness in psychiatric disorders.

This paper reviews the evidence for changes of Meditation on body and brain physiology and for clinical effectiveness in disorders of psychiatry. The aim of Meditation is to reduce or eliminate irrelevant thought processes through training of internalised attention, thought to lead to physical and mental relaxation, stress reduction, psycho-emotional stability and enhanced concentration. Physiological evidence shows a reduction with Meditation of stress-related autonomic and endocrine measures, while neuroimaging studies demonstrate the functional up-regulation of brain regions of affect regulation and attention control.