“
“Purpose of study To describe a simple and reliable method of intra-operative localisation of thoracic spine in a single surgical setting.

Summary of background Intra-operative localisation of thoracic spine levels can be difficult due to anatomical constraints, such as scapular shadow, patient’s size and poor bone quality. This is particularly true in cases of thoracic discectomies in which the vertebral bodies appear normal. There are several methods described in recent literature to address this. Many of them require a separate procedure which was performed often the previous day. We report a technique which addresses the issue

of localising thoracic level intra-operatively.

Materials and methods After induction of general anaesthesia, selleck compound the patient was placed prone and the pedicle of interest was identified using fluoroscopy. A K-wire was then inserted percutaneously

into this pedicle under image guidance [confirmed in the antero-posterior (AP) and lateral views]. The wire was then cut close to the skin after bending it. The patient was now positioned laterally and the intended procedure performed through an anterior trans-thoracic approach. The ‘K’ wire PLX4032 order was removed at the end of the procedure.

Results and conclusion We routinely used this technique in all our thoracic discectomies (four cases in 2 years). There were no intra-operative complications. This method is simple, avoids the patient undergoing two procedures and requires no more ability than placing an implant in the pedicle under fluoroscopy. Placing the ‘K’ wire into a fixed point like the pedicle facilitates rapid intra-operative viewing of the level of interest and is removed easily at the conclusion of surgery.”
“Argatroban was used as the anticoagulant during cardiopulmonary bypass (CPB) in a patient with heparin-induced thrombocytopenia (HIT) type II undergoing mitral valve replacement. Dosage was reduced

because of preoperative congestive liver disorder. Perioperative coagulability was poor, and, ultimately, failure of hemostasis led to a fatal outcome. Although argatroban use as an anticoagulant for HIT is reported, the optimal dose has not been established. During IWR-1-endo long-term CPB, increasing the total dosage may extend anticoagulant ability, leading to dose dependence. Because no antagonist for argatroban”
“Since 1988, the American Society for Clinical Pathology (ASCP) has conducted surveys to determine the extent and distribution of workforce shortages within the nation’s clinical laboratories. This confidential survey has been administered every 2 years and has served as a source of information for academic, government, and industry labor analysts. Results from past surveys show that laboratory medicine is a rapidly evolving field.