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Neonatal Hypoglycemia: A Continuing Debate in Definition and Management

References 1. Bonacruz GL, Arnold JD, Leslie GI, Wyndham L, Koumantakis G. Survey of the definition and screening of neonatal hypoglycaemia in Australia. J Paediatr Child Health. 1996; 32(4): 299-301. 2. Cornblath M, Hawdon JM, Williams AF, Aynsley- Green A, Ward-Platt MP, Schwartz R, Kalhan SC. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000; 105(5): 1141-1145. 3. Deshpande S, Ward Platt M. The investigation and management of neonatal hypoglycaemia

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Retinal Complications in Diabetes Mellitus: Importance of Screening and Management

Retinopathy Management Guidelines. Expert Rev Ophthalmol. 2012; 7(5): 417-39. Available from: http://www.medscape.com/viewarticle/775150 7. Diabetes Health Center: Do Diabetics Need Yearly Eye Exams? Study: Once Every 3 Years May Be Enough for Some. Available from: http://diabetes.webmd.com/news/20030116/dodiabetics- need-yearly-eye-exams 8. American Academy of Ophthalmology: Preferred Practice Pattern Guidelines: Diabetic Retinopathy PPP - Updated Oct 2012. Available from: http://one.aao.org/CE/PracticeGuidelines/PPP_Conte nt.aspx?cid=d0c853d3-219f-487b-a524- 326ab3

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Congenital Hydronephrosis: Disease or Condition?

References 1. Tripp BM, Homsy YL. Neonatal hydronephrosis-the controversy and management. Pediatr Nephrol. 1995; 9: 503–9. 2. Flashner SC, King LR. Ureteropelvic junction. In: Kelalis PP, King LR, Belman AB. Clinical pediatric urology. Philadelphia; W. B. Saunders, 1992; 693–723. 3. Homsy YL, Williot P, Danais S. Transitional neonatal hydronephrosis: fact or fantasy? J Urol. 1986; 136: 339–41. 4. Thomas DFM. Fetal uropathy. Br J Urol. 1990; 66: 225–31. 5. Koff SA, Hayden LJ, Cirulli C, Shore R. Pathophysiology of ureteropelvic junction: experimental

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Special Conditions in Venous Thrombembolism – Case Series

increases risk for venous thromboembolism. J Am Soc Nephrol. 2008 Jan; 19(1): 135–40. 8. Mulder FI, Candeloro M, Kamphuisen PW, Di Nisio M, Bossuyt PM, Guman N, Smit K, Büller HR, van Es N; CAT prediction collaborators; CAT-prediction collaborators. The Khorana score for prediction of venous thromboembolism in cancer patients: a systematic review and meta-analysis. Haematologica. 2019 Jan 3. pii: haematol.2018.209114. doi: 10.3324/haematol.2018.209114. 9. 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. (2014). European Heart

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Treatment of Acetabular Defects with Porous Metal Augments in Revision Hip Surgery

Abstract

Porous metal augments have been used successfully for management of large acetabular defects during revision hip arthroplasty. This study analyzes and compares the clinical and radiographic outcomes of porous metal augments in cemented and uncemented acetabular revisions, all performed at the same institution. In the period 2015-2017, 36 patients with 37 large acetabular defects were treated with porous metal augments in cemented and uncemented acetabular revisions. Postoperatively, patients were monitored for two years on average period of 24-36 months.

Acetabular augments were used when preoperative and intraoperative findings indicated the presence of large acetabular defects that can hinder the stability of the revision implants. We used lateral approach, 36 mm femoral head, and cementless or cemented acetabular cup depending on local bone quality. Postoperatively, all patients followed total hip arthroplasty precautions, with weight bearing as tolerated regimen with use of crutches during 6 weeks after surgery. The follow-up was radiological and clinical. We used HHS. At a mean follow-up of two years (range 24-36 months) one patient had reinfection and one patient had infection. None of the patients shown signs of aseptic augment or acetabular cup loosening. Porous metal augments show comparable excellent radiographic and clinical short-term outcomes, when combined with cemented or uncemented cups in revision hip arthroplasty. They allow good bone ingrowth, adequate implant contact and good stability. Complications were related to infection and not related to the augments itself.

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Minimalistic Approach for Transcatheter Aortic Valve Implantation (TAVI): Open Vascular Vs. Fully Percutaneous Approach

REFERENCES 1. Leon MB, Smith CR, Mack M, et al. Transcatheter aorticvalve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010; 363: 1597–607. 2. Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011; 364: 2187–98. 3. Nishimura RA, Otto CM, Bonow RO et al. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart

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Is Opioid-Free General Anesthesia More Superior for Postoperative Pain Versus Opioid General Anesthesia in Laparoscopic Cholecystectomy?

management of pain after ambulatory surgery. Anesthe Analg 2002; 94 (3): 577–85. 5. Alam MS, Hoque HW, Saifullah M, Ali MO. Port site and intraperitoneal infiltration of local anesthetics in the reduction of postoperative pain after laparoscopic cholecystectomy. Med Today 2009; 22: 24–28. 6. Harless M, Depp C, Collins S, Hewer I. Role of Esmolol and Perioperative Analgesia and Anesthesia: A Literature Review. AANA journal. 2015; 83 (3): 167–77. 7. Ramaswamy S, Wilson JA, Colvin L. Non-opioid-based adjuvant analgesia in perioperative care. Continuing

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Association of Systemic Inflammatory Response Syndrome with Bacteremia in Patients with Sepsis

: 801–10. 9. Leth RA, Forman BE, Kristensen B. Predicting bloodstream infection via systemic inflammatory response syndrome or biochemistry. J Emerg Med 2013; 44: 550–7. 10. Jones GR, Lowes JA. The systemic inflammatory response syndrome as a predictor of bacteraemia and outcome from sepsis. Q J Med 1996; 89: 515–22. 11. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013; 41: 580–637. 12. Vincent JL, et al. The SOFA (Sepsis

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Some Psychological Aspects of T1DM in Children and Adolescents

References 1. Achenbach TM. Manual for the child behavior checklist (4-18) and 1991 Profile, Burlington, VT: University of Vermont, Department of Psychiatry. 1991. 2. Alvarado-Martel D, Velasco R, Sánchez-Hernández R, Carrillo A, Nóvoa F, Wägner A. Quality of life and type 1 diabetes: a study assessing patients’ perceptions and self-management needs. World J Diabetes. 2015; 6(3): 527-533. 3. Bozinovski S, Martinovska C, Bozinovska L, Pop-Jordanova N. Expert system with fuzzy logic in analysis of the personality

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Ischaemia-Driven Optimal Therapeutic Approach in Asymptomatic Patients with High Cardiovascular Risk: The Value of Clinical, Laboratory and Myocardial Spect Imaging Findings

Abstract

Background: We wanted to evaluate the presense of myocardial ischaemia in asymptomatic patients with high cardiovascular risk, the influencing clinical and laboratory factors and the impact of ischaemia on final management decision.

Material and methods: We evaluated 60 asymptomatic patients with high CV risk, who underwent SPECT myo-cardial perfusion imaging (MPI) for detection of suspected CAD. We used the 17 segment model for quantitative and semiquantitative scan perfusion and function analysis using perfusion scores. All patients had full blood laboratory analyses including lipid values, presence of albuminuria, rest and stress ECG. Logistic regression analysis was used to assess the impact of clinical and laboratory parameters on myocardial ischaemia prevalence.

Results: Stress-inducible ischaemia was found in 19 pts (33%), fixed defects were found in 13% and mixed defects in 9% of cases. The average ischaemia amount was 10%. Mild ischaemia was found in 12 patients (64%) - summed stress score (SDS) < 4, moderate ischaemia in 5 patients (26%) - SDS 5-7 and severely abnormal scans in 2 patients (10%) - SDS > 7. Severe ischaemia was only related to the duration of diabetes. Six pts with severe ischaemia had ST depression > 2 mm on stress study, and a higher wall motion index and LVEF fall > 5% during stress study (p < 0.01). Stepwise logistic regression analysis for prediction of stress-induced ischaemia showed OR 2.4 (95% CI 1.7?3.6) for stress-induced ECG changes and OR 3.9 for presence of DM over 10y (95% CI 2.3?6.6). Seven patients with ischaemia > 10%, were referred for coronary angiography.

Conclusions: MPI is a valuable method for preclinical assessment of myocardial ischaemia in patients with high CV risk, which can improve prognosis and guide treatment decision.

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