Place of the precocious surgical treatment in facial hemangioma

Infantile cutaneous hemangioma is a benign vascular tumour present at 10% of the infants. It forms part of the group of the vascular tumours in the classification of international society for vascular anomalies (ISSVA). Usual surgical attitude is abstention and surgery is proposed only in order to treat sequelae. But some particular situations require early surgery to avoid functional impairment, deformation or growth delay due to the lesion's development. Using our observations, we recall the epidemiology, the physiopathology, the clinical aspects, the particularities of the facial localizations and their treatments. In these localizations the time intervenes like a fourth dimension that is going to modify, to improve or to aggravate the prognosis. Treatment requires a strategy and precocious surgery. We insist on the fact that the dogma of the therapeutic abstention remained true for a majority of children with small size hemangioma and that a precocious surgery must be proposed for some localizations in the face.     

HLA genetic study from United Arab Emirates (UAE), Abu Dhabi

Emiratis belong to the United Arab Emirates (UAE) country. UAE is placed at the East part of the Arabian Peninsula, protruding into the Arabia Gulf and was populated since 130,000 years ago. First humans migrating out of Africa went probably across this territory. HLA-A, -B, -C, -DRB1, -DQB1, -DQA1 were typed in order to obtain HLA profile for clinical, epidemiological and population genetics studies. Twenty different HLA-A, thirty-five HLA-B and twenty-two HLA-C class I alleles were detected; twenty-seven different HLA-DRB1, fourteen HLA-DQB1 and twelve HLA-DQA1 class II alleles were found. Most frequent extended HLA haplotypes are also depicted. People are present in this area since prehistoric ages according to archaeological studies; the “Out of Africa” eastern migration may have affected the present day population composition.     

Enhanced Transitions of Care for Medically Complex Refugees

Background

Between 2015 and 2019, 261,091 refugees were resettled through the U.S. Refugee Admissions Program. Few are chronically ill, but previously these went to emergency rooms upon arrival. We designed a pilot program to anticipate, assess, and safely assume care of chronic health needs and stabilize sick and medically complex refugees upon arrival.

Clinical Operations

Academic internal medicine and pediatrics clinics are linked to the Washington State Refugee Health Program and Refugee Resettlement Agencies. Arriving refugees deemed medically complex through overseas medical evaluation or post-arrival were selected for the program.

Metrics

We reviewed biodata of 2,947 refugees deemed medically complex. We referred five hundred and sixty one (19%) of these for evaluation, and 257 (46%) of referrals received care.

Discussion

Safe transitions of care are standard practice in medical systems. This innovation in Seattle is one example of a system for the safe and cost-effective relocation of refugees with complex illnesses.

     

Utilization of second derivative photoplethysmographic features for myocardial infarction classification

Myocardial infarction (MI) is a common disease that causes morbidity and mortality. The current tools for diagnosing this disease are improving, but still have some limitations. This study utilised the second derivative of photoplethysmography (SDPPG) features to distinguish MI patients from healthy control subjects. The features include amplitude-derived SDPPG features (pulse height, ratio, jerk) and interval-derived SDPPG features (intervals and relative crest time (RCT)). We evaluated 32?MI patients at Pusat Perubatan Universiti Kebangsaan Malaysia and 32 control subjects (all ages 37–87?years). Statistical analysis revealed that the mean amplitude-derived SDPPG features were higher in MI patients than in control subjects. In contrast, the mean interval-derived SDPPG features were lower in MI patients than in the controls. The classifier model of binary logistic regression (Model 7), showed that the combination of SDPPG features that include the pulse height (d-wave), the intervals of “ab”, “ad”, “bc”, “bd”, and “be”, and the RCT of “ad/aa” could be used to classify MI patients with 90.6% accuracy, 93.9% sensitivity and 87.5% specificity at a cut-off value of 0.5 compared with the single features model.     

Analysis of myocardial infarction signals using optical technique

The risk of heart attack or myocardial infarction (MI) may lead to serious consequences in mortality and morbidity. Current MI management in the triage includes non-invasive heart monitoring using an electrocardiogram (ECG) and the cardic biomarker test. This study is designed to explore the potential of photoplethysmography (PPG) as a simple non-invasive device as an alternative method to screen the MI subjects. This study emphasises the usage of second derivative photoplethysmography (SDPPG) intervals as the extracted features to classify the MI subjects. The statistical analysis shows the potential of “a-c” interval and the corrected “a-cC” interval to classify the subject. The sensitivity of the predicted model using “a-c” and “a-cC” is 90.6% and 81.2% and the specificity is 87.5% and 84.4%, respectively.