Miracle and Politics Conspirituality along with COVID19

Microscopically, the major findings were widespread platelet-fibrin microthrombi, steatosis, histiocytic hyperplasia in the portal tract, mild lobular inflammation, ischemic-type hepatic necrosis, and zone 3 hemorrhage. Rare megakaryocytes were found in sinusoids. COVID-19 IHC demonstrates positive staining of the histiocytes in the portal tract. Under electron microscopy, histiocyte proliferation is present in the portal tract containing lipid droplets, lysosomes, dilated ribosomal endoplasmic reticulum, microvesicular bodies, and coronavirus. The characteristic findings in the liver of patients with COVID-19 include numerous amounts of platelet-fibrin microthrombi, as well as various degrees of steatosis and histiocytic hyperplasia in the portal tract. Possible mechanisms are also discussed.Hepatocellular adenoma (HCA) is a rare benign liver neoplasm which predominantly occurs in women in the reproductive age group taking oral contraception. see more Since 2002, the terminology HCA has defined an heterogeneous group of neoplastic benign hepatocellular proliferations composed of different subtypes. The genotype-phenotype classification led to the description of 5 well-recognized subtypes based on morphological and immunophenotypical features, that are currently used in practice HNF1A inactivated HCA, inflammatory HCA, β-catenin mutated HCA, sonic hedgehog HCA, and unclassified HCA. The main complications observed in HCAs are bleeding and malignant transformation. Risk of malignant transformation into hepatocellular carcinoma (HCC), more frequent in men, is also dependent to tumor size and HCA subtype, reaching 40% in β-catenin mutated HCA. The distinction of HCA from well-differentiated HCC remains difficult in some cases, leading to the diagnosis of so-called "atypical/borderline HCA". The management of HCA is now based on multidisciplinary approach including clinicians, radiologists, and pathologists integrating gender, tumor size, and HCA subtyping.Oxidative stress, inflammation and neovascularization are the key pathological events that are implicated in human age-related macular degeneration (AMD). There are a limited number of animal models available for evaluating and developing new therapies. Most models represent late exudative or neovascular AMD (nAMD) but there is a relative paucity of models that mimic early events in AMD. The purpose of this study is to characterize the evolution of oxidative stress, inflammation, retinal degeneration and neovascularization in a rat model of AMD, created by subretinal injection of human lipid hydroperoxide (HpODE) that found in the sub-macular region in aged and AMD patients. Subretinal HpODE induced retinal pigment epithelium (RPE) and retinal degeneration resulting in loss of RPE cells, photoreceptors and retinal thinning. RPE degeneration and atrophy were detected by day 5, followed by neural tissue degeneration at day 12 with robust TUNEL positive cells. Western blot analysis confirmed an increase in pro-a 3 weeks via oxidative damage, upregulation of reactive oxygen species and pro-inflammatory genes, pro-apoptotic Bak and pro-angiogenic VEGF upregulation occurs leading to CNV formation. This experimental model of subretinal HpODE is an appropriate model for the study of AMD and provides an important platform for translational and basic research in developing new therapies particularly for early/dry AMD where currently no viable therapies are available.Transapical septal myectomy can be performed for patients with nonobstructive hypertrophic cardiomyopathy (HCM) and diastolic dysfunction to enlarge the left ventricular cavity. The procedure may also include limited shaving of severely hypertrophied papillary muscles. This report illustrates the usefulness of papillary muscle resection to enlarge the left ventricle in a patient with nonobstructive HCM and pre-existing mitral valve prosthesis.
Heparin-induced thrombocytopenia (HIT) is an immune-mediated reaction to heparin that provokes a prothrombotic state and causes a decline in platelet count. Data describing outcomes of HIT after cardiac surgery are limited. This study sought to determine the impact of HIT on short-term outcomes after cardiac surgery.
This was an observational study of cardiac surgeries from 2010 to 2018. Patients with HIT were matched against patients without HIT via 21 nearest neighbor propensity matching. Matching was performed to assess the impact of HIT on operative mortality (STS definition) and thromboembolic events (including deep vein thrombosis, pulmonary embolism, stroke, and/or acute limb ischemia) - the primary outcomes of interest.
Of 11,820 patients undergoing an (STS indexed) cardiac surgery, 131 (1.1%) developed HIT after their index operation. After matching, operative mortality was 21.8% in HIT patients, as compared to 5.3% in non-HIT patients. Thromboembolic events occurred in 29.1% of HIT patients, as compared to 2.9% in non-HIT patients. On sub-analysis, operative mortality was significantly higher for the HIT group without thromboembolic events (16.7%) and the HIT group with thromboembolic events (34.4%), compared to the non-HIT group (5.3%). However, operative mortality was not significantly higher in the HIT group with thromboembolic events, as compared to the HIT group without thromboembolic events, after Bonferroni correction.
Although uncommon, HIT is a highly morbid and potentially lethal complication, which should reinforce the importance of timely recognition and treatment of this adverse outcome.
Although uncommon, HIT is a highly morbid and potentially lethal complication, which should reinforce the importance of timely recognition and treatment of this adverse outcome.
The monthly In-House Hands-On Surgical Training (HOST) program was incorporated into the congenital heart surgery(CHS) curriculum for surgical trainees within our institution. This study evaluated whether there was an improvement and retention of technical skills throughout the curriculum via objective assessment methods.
Twelve 3D-printed surgical heart models were included into the year-long curriculum. The monthly sessions were attended by all trainees and staff surgeons. Proctors demonstrated the operation on a model, which was followed by two attempts by each trainee. Attempts were recorded for objective assessment. On completion of the curriculum trainees repeated four procedures an additional two times following a delay to assess skill retention.
Twelve sessions were completed by 7 trainees within the curriculum. Objective assessments were performed in 7 sessions. Eighty-one percent of trainees' scores improved between the two attempts with a mean improvement of 13%(Attempt 1[HOST-CHS79],Attempt 2[HOST-CHS89],p=<0.