Hydrophilic Polymers with Potassium Salt and Microporous Polysaccharides for Use as Hemostatic Agents

BACKGROUND Postoperative bleeding can lead to complications such as hematoma, infection, dehiscence, and an unscheduled office visit. Topical hemostatic agents can be used to aid in hemostasis.
OBJECTIVE The objective is to familiarize physicians with topical hemostatic agents—hydrophilic polymers with potassium salts (Urgent QR powder) and microporous polysaccharide hemispheres (Bleed-X).
METHODS Two hemostatic agents, microporous polysaccharide hemospheres and hydrophilic polymers with potassium salt, are discussed. The literature is reviewed.
RESULTS Numerous types of hemostatic agents exist. Topical hemostatic agents are safe, cost-effective, and efficient.
CONCLUSION Microporous polysaccharide hemospheres and hydrophilic polymers with potassium salts can be an adjunct to hemostasis after cautery and ligation. Patients can apply hemostatic agents if they experience any bleeding leading to decreased office visits. Hemostatic agents used intraoperatively shorten bleeding time and enable the physician to use less cautery. Using hemostatic agents can lead to fewer hematomas, infections, and office visits.     

Systemic candidiasis in premature infants

Abstract Four cases of systemic candidiasis in premature infants with different clinical presentations are reported. Diagnosis of the condition can be difficult as clinical manifestations are non-specific and Candida may not be recovered in blood culture. The condition should be suspected in predisposed babies with unabating or deteriorating infections despite appropriate antibiotic therapy. We propose routine microscopic urinary examination for Candida as a screening test for the infection.     

Impact of Interatrial Septum Anatomic Features on Short‐ and Long‐Term Outcomes After Transcatheter Closure of Patent Foramen Ovale: Single Device Type Versus Anatomic‐Driven Device Selection Strategy

Backgrounds

We reported the short‐ and long‐term results of our institutional single center registry Interatrial Septum Interventions Study (ISIS) about the impact of different anatomic characteristics and related device selection in patent foramen ovale (PFO) closure.

Methods

Over a 9 year period (September 2003–September 2012) we prospectively enrolled 340 consecutive patients (mean age 44 ± 15. 5 years, 198 females) who had been referred to our center for PFO catheter‐based closure. The first 105 patients received a single type of device independently from the anatomy (single device strategy). The remaining 235 patients received a different device based on intracardiac echocardiographic study of interatrial septum anatomy (anatomic strategy).

Results

Immediate success rate was 100% in both groups, whereas the rate of immediate complications was 10.4% and 2.5% (P < 0.01) in the single strategy group and anatomic strategy group, respectively. During a mean follow‐up of 59.3 ± 28.9 months, the occlusion rate was 86.6% and 94%, whereas the incidence of recurrences was 1.8% and 0% in the single device strategy group and anatomic strategy group, respectively.

Conclusion

The results from ISIS registry showed that anatomy of interatrial septum associated with PFO is quite complex leading to an increased rate of complications and a slightly lower closure rate if treated with a single device strategy.

     

A “tricky” subarachnoid hemorrhage

To the editor:We report a tricky subarachnoid haemorrhage (SAH).Our patient was a 59-year-old woman with generalized headache for 1 day,which was constricting in nature and rated grade 6/10.Her symptoms were aggravated by lying flat and improved with vomiting.The Glasgow coma scale was full,blood pressure was 142/83 mmHg and pulse 75 beats/min.There was neither neck stiffness nor focal neurological deficit.Fundoscopic examination was normal.She was noted to have hyponatremia (sodium (Na) 122 mmol/L) with serum osmolarity 263 mmol/kg,urine osmolarity 582 mmol/kg,urine Na 117 mmol/L,normal thyroid stimulating hormone and cortisol level.Plain computed tomography (CT) brain was normal (Figure 1A).Lumbar puncture (LP) was performed on day two,and multiple attempts were required.     

Facial approximation: evaluation of dental and facial proportions with height

Background

Fabrication of complete dentures requires the use of certain guidelines which are placed on the bite blocks to assist the clinician to have the maxillary anterior teeth restored to optimal dento-labial relations, in harmony with the overall facial appearance.

Objective

To explore if any relationship exists between dental and facial proportions as well as the height of the individuals.

Methods

Two hundred and four dental students of the Obafemi Awolowo University volunteered to participated in the study. The lower facial height, inter incisal, inter canine, and intercommisure distances, as well as the height of the participants were measured. The data were imputed, analyzed, and reported as simple frequency, means and standard deviations using the SPSS vs 11. Statistical significance was inferred at p<0.05.

Result

The mean values of all the parameters measured were significantly higher in males than females. None of the mean values measured were coincident. However, a significant correlation exists between intercanine and interincisal distances(r=0.8) while a weak but significant negative correlation exists between the intercanine distance and the difference of the intercommisural and intercanine distances (r=−0.4)

Conclusion

The study showed no relationship between intercanine distance, interincisal distance, lower facial height, and the height of the participants with the intercommissural distance. Hence, intercommissural distance may not be used in marking canine line during bite registration procedure. At best, 1.75–2.45 cm should be subtracted from the intercommissural distance to determine the intercanine distance.     

Gastric cytoprotection by amoxycillin in the rat

Abstract Amoxycillin in combination with anti-ulcer agents has been shown to prolong duodenal ulcer remission. While this effect can be related to the eradication of Helicobacter pylori , it is not known if amoxycillin might possess cytoprotective properties. Protection against ethanol-induced gastric mucosal damage by intragastric instillation of amoxycillin suspension (prepared from capsule form) and solution (from injection form, 100% pure amoxycillin), and by intraperitoneal injection of amoxycillin solution was studied using an ex vivo gastric chamber in the rat. Intragastric and intraperitoneal administration of amoxycillin dose-dependently protected the rat gastric mucosa from damage by absolute ethanol. This protection was lost when the rats were pretreated with indomethacin. Gastric mucosal blood flow as measured by laser Doppler flowmetry and gastric acid output were unaffected by amoxycillin. Amoxycillin imparts gastric cytoprotection, and one possible mechanism is by the release of prostaglandins.