Implementing an HL7 version 3 modeling tool from an Ecore model.

One of the main challenges of achieving interoperability using the HL7 V3 healthcare standard is the lack of clear definition and supporting tools for modeling, testing, and conformance checking. Currently, the knowledge defining the modeling is scattered around in MIF schemas, tools and specifications or simply with the domain experts. Modeling core HL7 concepts, constraints, and semantic relationships in Ecore/EMF encapsulates the domain-specific knowledge in a transparent way while unifying Java, XML, and UML in an abstract, high-level representation. Moreover, persisting and versioning the core HL7 concepts as a single Ecore context allows modelers and implementers to create, edit and validate message models against a single modeling context. The solution discussed in this paper is implemented in the new HL7 Static Model Designer as an extensible toolset integrated as a standalone Eclipse RCP application.

Antibiotics in the management of aggressive periodontitis.

Aggressive periodontitis, although not rare, is a fairly unknown condition. Little is known about its optimal management. While majority of patients with common forms of periodontal disease respond predictably well to conventional therapy (oral hygiene instructions (OHI), non-surgical debridement, surgery, and Supportive Periodontal therapy (SPT)), patients diagnosed with aggressive form of periodontal disease often do not respond predictably/favorably to conventional therapy owing to its complex multi-factorial etiology. Protocols for treating aggressive periodontitis are largely empirical. There is compelling evidence that adjunctive antibiotic treatment frequently results in more favorable clinical response than conventional therapy alone. This article mainly focuses on the role of adjunct use of pharmacological agents in improving the prognosis and treatment outcome of aggressive periodontitis patients.

Use of extraperitoneal iliac artery endarterectomy in the endovascular era.

Although iliac artery (IA) endarterectomy has largely been replaced by bypass and endovascular options, open endarterectomy continues to play an important role in selected patterns of occlusive disease. The objective of this report is to present a contemporary clinical series of patients having undergone IA endarterectomy. Specifically, we define patterns of disease amenable to open endarterectomy and provide an updated technical note of this procedure. A retrospective study on 23 patients with IA occlusions unsuitable for radiologic intervention (TransAtlantic Inter-Societal Consensus [TASC] C and D lesions) underwent extraperitoneal IA endarterectomy. Twenty-five primary IA endarterectomies were performed. Of these, five required more extensive endarterectomy, three of the distal aorta and two of the contralateral IA. Sixteen of the 25 endarterectomies required common femoral artery endarterectomy and 6 required iliofemoral bypass. The average follow-up was 26 months. Procedure-related mortality occurred in one patient (4.3%). Within 4 months, one patient underwent an aortofemoral bypass and two patients required major amputation. Primary patency rates were 96% at 3 months and 88% at 1, 2, and 3 years. This series shows that in selected patterns of aortoiliac occlusive disease, endarterectomy remains an important alternative to consider.