[One stage surgical treatment of aortic coarctation associated with bicuspid aortic valve. Report of one case]. / Tratamiento en un tiempo quirúrgico de una coartación aortica asociada a valvulopatía aórtica bicúspide severa. Reporte de un caso.

Percutaneous surgery is the treatment of choice of isolated aortic coarctation in adults However, when there are other heart problems related to aortic coarctation, its surgical management may vary. We report a 41-year-old male presenting with aortic coarctation associated with severe, symptomatic, bicuspid aortic valve lesions and significant left ventricular dysfunction. He underwent open heart surgery for the surgical resolution of these problems. One year after surgery the results are satisfactory with no evidence of postoperative complications and a significant improvement of patient symptoms and left ventricular function.

Validation of the IMPEDE VTE score for prediction of venous thromboembolism in multiple myeloma: a retrospective cohort study.

The IMPEDE VTE score has recently emerged as a novel risk prediction tool for venous thromboembolism (VTE) in multiple myeloma (MM). We retrospectively reviewed 839 patients with newly diagnosed MM between 2010 and 2015 at Cleveland Clinic and included 575 patients in final analysis to validate this score. The c-statistic of the IMPEDE VTE score to predict VTE within 6 months of treatment start was 0·68 (95% CI: 0·61-0·75). The 6-month cumulative incidence of VTE was 5·0% (95% CI: 2·1-7·9) in the low risk group, compared to 12·6% (95% CI: 8·9-16·4%) and 24·1% (95% CI: 12·2-36·1) in the intermediate and high risk groups (P < 0·001 for both). In addition, a higher proportion of patients in the VTE cohort had ECOG performance status of ≥2 as compared to the no VTE cohort (33% vs. 16%, P = 0·001). Other MM characteristics such as stage, immunoglobulin subtype, and cytogenetics were not predictors of VTE. In summary, we have validated the IMPEDE VTE score in our patient cohort and our findings suggest that it can be utilized as a VTE risk stratification tool in prospective studies looking into investigating VTE prophylaxis strategies in MM patients.

Scurvy: A Rare Cause of Anemia.

Scurvy is a rather uncommon disease today, and its symptoms can certainly be exhibited with vitamin C deficiency. Dangerously low levels of the vitamin can cause serious health complications and have been proven to be fatal. We present the case of a 42-year-old female with multiple primary diagnoses: easy bruising and Raynaud's syndrome without gangrene. The purpose of this report is to call attention to the clinical presentation, diagnosis, and treatment of scurvy.

Hemophagocytic Lymphohistiocytosis Associated with Natural T-cell Leukemia.

Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening syndrome of excessive immune activation. It can be triggered by a variety of events that disrupt immune homeostasis, infection being the most common of them. We report a case of a 36-year-old male diagnosed with HLH associated with natural T-cell leukemia. The purpose of this report is to call attention to the clinical presentation, diagnosis, and treatment of HLH.

Cleveland Clinic Imaging Institute's "Commitment to Respect" and Impact on Quality of Care and Patient Satisfaction.

Cleveland Clinic's Imaging Institute implemented a "Commitment to Respect" initiative and survey process in March 2013 with the goal of improving communication and teamwork among employees and, in turn, improving patient satisfaction. Since the rollout of this initiative, we have worked to increase acceptance of the process, improve the survey response, and more fully incorporate results into staff development. Now that we have 4 years of annual data for analysis, we can state based on feedback from caregivers that the process has had a positive effect on relationships between radiologists and frontline clinical staff. The survey identifies behaviors that individuals were not previously aware of, allowing staff members to make changes based on this feedback. Additionally, institute leaders are able to reinforce the respectful behaviors of those scoring well and support the efforts of those whose scores need improvement. Both scenarios are reinforced through the radiologist annual performance review process.

Tratamiento en un tiempo quirúrgico de una coartación aortica asociada a valvulopatía aórtica bicúspide severa. Reporte de un caso / One stage surgical treatment of aortic coarctation associated with bicuspid aortic valve. Report of one case

Percutaneous surgery is the treatment of choice of isolated aortic coarctation in adults However, when there are other heart problems related to aortic coarctation, its surgical management may vary. We report a 41-year-old male presenting with aortic coarctation associated with severe, symptomatic, bicuspid aortic valve lesions and significant left ventricular dysfunction. He underwent open heart surgery for the surgical resolution of these problems. One year after surgery the results are satisfactory with no evidence of postoperative complications and a significant improvement of patient symptoms and left ventricular function.