ABO Blood Group Is a Predictor for the Development of Venous Thromboembolism After Total Joint Arthroplasty.

BACKGROUND: The study's purpose was to determine if there is an association between ABO blood group and the development of symptomatic venous thromboembolism (VTE) after total joint arthroplasty (TJA). METHODS: A total of 28,025 patients who underwent primary TJA at a single health care system from 2000 to 2014 were retrospectively reviewed from electronic records. Patients who experienced a symptomatic VTE were identified. A multivariate regression model adjusted for known potential risk factors, including age, gender, body mass index, surgery type, previous VTE, smokers, rheumatologic diseases, malignancy, hypercoagulable state, and VTE prophylaxis, was developed to test the association of ABO blood group and postoperative VTE. Separate multivariate regressions were performed for total knee arthroplasty and total hip arthroplasty, specifically looking at pulmonary embolism. RESULTS: The risk of symptomatic VTE after TJA was increased in AB blood group patients (odds ratio = 1.4; P = .03). Furthermore, the risk of pulmonary embolism was increased after total knee arthroplasty in AB blood group patients (odds ratio = 2.24; P = .001) but not after total hip arthroplasty (P = .742). CONCLUSION: AB blood group increased the risk of VTE after TJA. Patient's ABO blood group should be considered in terms of risk stratification and selection of appropriate postoperative VTE prophylaxis.

A method for measuring the intelligibility of uninterrupted, continuous speech.

Speech-in-noise tests commonly use short, discrete sentences as representative samples of everyday speech. These tests cannot, however, fully represent the added demands of understanding ongoing, linguistically complex speech. Using a new monitoring method to measure the intelligibility of continuous speech and a standard trial-by-trial, speech-in-noise test the effects of target duration and linguistic complexity were examined. For a group of older hearing-impaired listeners, significantly higher speech reception thresholds were found for continuous, complex speech targets than for syntactically simple sentences. The results highlight the need to sample speech intelligibility in a variety of everyday speech-in-noise scenarios.

Macrophage Activation Syndrome Presents as Initial Manifestation of Lupus in an Adult Female.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the immune system erroneously attacking healthy tissues and organs. SLE has a wide variety of clinical presentations. The signs and symptoms of SLE are very well-known, though rare presentations could occur that require early clinical attention. Macrophage activation syndrome (MAS) is a severe and life-threatening condition in which the immune system becomes overactive, leading to the excessive stimulation and proliferation of immune cells. MAS can occur as a primary immune disorder, which is not very common. It can also happen secondary to a wide variety of pathological conditions, which include infections, malignancies, autoimmune, and rheumatologic disorders. In rare cases, SLE can present with overlapping features of MAS, further complicating the clinical picture, and may require specialized management. Early recognition and intervention of this overlap are essential for improving outcomes, as delayed diagnosis and treatment can lead to significant morbidity and mortality. Here, we present a case of a young adult female who was diagnosed with SLE with the initial presentation of MAS in the form of fever, splenomegaly, cytopenia, and hemophagocytosis.

A Unique Arc of Bühler Variant Connecting the Arteries of the Foregut, Midgut, and Hindgut and Its Surgical Significance.

This case report presents a rare variation of the arc of Bühler (AOB) in a cadaver during the abdominal dissection assignment in the Ross Anatomy Lab at William Carey University College of Osteopathic Medicine. The AOB is a patent anastomotic channel between the celiac trunk and the superior mesenteric artery independent of the gastroduodenal artery and dorsal pancreatic artery. This report describes in detail a complex and extensive branching pattern of a unique AOB variant. Our findings contribute to the limited literature on this condition and emphasize the importance of thorough knowledge of vascular variations to avoid potential complications during surgical procedures.

Variations in the slope of the psychometric functions for speech intelligibility: a systematic survey.

Although many studies have looked at the effects of different listening conditions on the intelligibility of speech, their analyses have often concentrated on changes to a single value on the psychometric function, namely, the threshold. Far less commonly has the slope of the psychometric function, that is, the rate at which intelligibility changes with level, been considered. The slope of the function is crucial because it is the slope, rather than the threshold, that determines the improvement in intelligibility caused by any given improvement in signal-to-noise ratio by, for instance, a hearing aid. The aim of the current study was to systematically survey and reanalyze the psychometric function data available in the literature in an attempt to quantify the range of slope changes across studies and to identify listening conditions that affect the slope of the psychometric function. The data for 885 individual psychometric functions, taken from 139 different studies, were fitted with a common logistic equation from which the slope was calculated. Large variations in slope across studies were found, with slope values ranging from as shallow as 1% per dB to as steep as 44% per dB (median = 6.6% per dB), suggesting that the perceptual benefit offered by an improvement in signal-to-noise ratio depends greatly on listening environment. The type and number of maskers used were found to be major factors on the value of the slope of the psychometric function while other minor effects of target predictability, target corpus, and target/masker similarity were also found.