False positive retroaortic left circumflex coronary artery in a patient with atrial septal defect

Retroaortic course of coronary artery is a relative contraindication for device closure of an atrial septal defect. In this brief report, we demonstrate, for the first time, inferior aortic recess mimicking retroaortic left circumflex coronary artery in a patient with atrial septal defect. This distinction is important to avoid spurious diagnosis of anomalous coronary artery denying patient a chance of nonsurgical closure of atrial septal defect.     

Unruptured sinus of Valsalva aneurysm mimicking as right atrial tumor

Sinus of Valsalva aneurysm is a rare congenital cardiac abnormality and is usually diagnosed when it ruptures. An asymptomatic 55‐year‐old male of unruptured sinus of Valsalva aneurysm of noncoronary cusp was on medical follow‐up. At 2‐year follow‐up, there was thrombus formation in the aneurysm, mimicking right atrium tumor on 2D transthoracic echocardiography. Cardiac computed tomography showed filling defect in the aneurysm suggestive of thrombus. Considering the high risk of systemic emboli surgery was performed, and aneurysm was repaired with Dacron patch.     

Translation and validation of the Canadian diabetes risk assessment questionnaire in China

Objectives

To adapt the Canadian Diabetes Risk Assessment Questionnaire for the Chinese population and to evaluate its psychometric properties.

Design and Sample

A cross‐sectional study was conducted with a convenience sample of 194 individuals aged 35–74 years from October 2014 to April 2015.

Methods

The Canadian Diabetes Risk Assessment Questionnaire was adapted and translated for the Chinese population. Test–retest reliability was conducted to measure stability. Criterion and convergent validity of the adapted questionnaire were assessed using 2‐hr 75 g oral glucose tolerance tests and the Finnish Diabetes Risk Scores, respectively. Sensitivity and specificity were evaluated to establish its predictive validity.

Results

The test–retest reliability was 0.988. Adequate validity of the adapted questionnaire was demonstrated by positive correlations found between the scores and 2‐hr 75 g oral glucose tolerance tests (r = .343, p < .001) and with the Finnish Diabetes Risk Scores (r = .738, p < .001). The area under receiver operating characteristic curve was 0.705 (95% CI .632, .778), demonstrating moderate diagnostic value at a cutoff score of 30. The sensitivity was 73%, with a positive predictive value of 57% and negative predictive value of 78%.

Conclusions

Our results provided evidence supporting the translation consistency, content validity, convergent validity, criterion validity, sensitivity, and specificity of the translated Canadian Diabetes Risk Assessment Questionnaire with minor modifications. This paper provides clinical, practical, and methodological information on how to adapt a diabetes risk calculator between cultures for public health nurses.     

Working Without a Net: Leukemia and Lymphoma Survivors’ Perspectives on Care Delivery at End-of-Treatment and Beyond

This study explored survivors’ perspectives on care delivery and supportive care needs during reentry. Fifty-one individual interviews were conducted with adult leukemia and lymphoma survivors, 3 to 48 months from treatment cessation. Survivors reported poor continuity of care across the patient–survivor transition, difficulty finding appropriate information/services, lack of preparation, lack of support for survivorship issues, and inadequate or poorly timed follow-up as factors contributing to adjustment difficulties at end of treatment and beyond. Improved care coordination is needed after active treatment, including use of an exit interview and delivery of services that are more congruent and better timed to meet ongoing and emergent survivorship needs.     

The management of hypotension in the neonatal intensive care unit

Hypotension in the first few days of a pre-term baby's life is not an uncommon event. This paper will define hypotension and give the reader a clear understanding of how blood pressure is maintained in the first few days of life. It will provide information on the physiology of cardiac output (CO), and blood pressure (BP) regulation in the newborn infant. An appreciation of this physiology is essential to effectively administer and manage the commonly used pharmacological agents ‘inotropes’ in the Neonatal Intensive Care Unit (NICU).     

Open sutureless lumbar hernia repair using a ‘memory ring’ patch

Various techniques have been used to repair lumbar hernias. We describe here a sutureless repair with a flat ‘memory ring’ patch performed as a day case.