Yde Finnegan (heliumnight5)
Myelopathy is a clinical diagnosis with many causes. A focused history and neurologic exam can help identify a myelopathic syndrome that guides a targeted workup. Though an exact cause may not always be identified, a thoughtful clinical approach can narrow down the differential diagnosis enough to treat the patient. Delayed cord clamping (DCC) and 21 to 30% O resuscitation is recommended for preterm infants but is commonly associated with low pulmonary blood flow (Qp) and hypoxia. 100% O supplementation during DCC for 60 seconds followed by 30% O may increase Qp and oxygen saturation (SpO ). Preterm lambs (125-127 days of gestation) were resuscitated with 100% O with immediate cord clamping (ICC, = 7) or ICC + 30% O , and titrated to target SpO ( = 7) or DCC + 100% O for 60 seconds, which followed by cord clamping and 30% O titration ( = 7). Seven preterm (23-27 weeks of gestation) human infants received continuous positive airway pressure (CPAP) + 100% O for 60 seconds during DCC, cord clamping, and 30% O supplementation after cord clamping. Preterm lambs in the ICC + 100% O group resulted in PaO (77 ± 25 mmHg), SpO (77 ± 11%), and Qp (27 ± 9 mL/kg/min) at 60 seconds. ICC + 30% O led to low Qp (14 ± 3 mL/kg/min), low SpO (43 ± 26%), and PaO (19 ± 7 mmHg). DCC + 100% O leg DCC was associated with SpO2 ≥80% by 5 minutes..Facial surgeries are usually performed with the patient in the supine position; however, it is crucial to predict postoperative results in the upright position. This study aimed to clarify the posture-related morphological changes in the facial soft tissue regarding age and sex, using physical measurements to obtain results in specific linear metric measurements of standard facial features. One hundred healthy volunteers were divided into four groups based on age and sex (25 young men, 25 young women, 25 old men, 25 old women). For all participants, 18 measuring points were marked on the skin along with 18 paired linear measurements, and the angle was measured using a digital sliding caliper and angle meter in both upright and supine positions. In all four groups, the intercanthal width (en-en), binocular width (ex-ex), length of the eye fissure (en-ex), length of the nasal bridge (n-prn), width of the nose (al-al), height of the lower face (sn-gn), vermilion height of the lower lip (sto-li), height of the lower lip (sto-sl), width of the philtrum (cphi-cphi), width of the mouth (ch-ch), and nasolabial angle (NLA) were significantly larger in the supine position than in the upright position. The increase was larger in the older age groups than in the younger age groups. Moreover, the increase was larger in old men than in old women. During facial surgery involving these areas, surgeons should consider the patient's age and sex and understand what facial figuration change would occur depending on posture and change their preoperative design or make minor adjustments during operation in the supine position to increase patient satisfaction.1 ESGE recommends that the initial assessment of patients presenting with acute lower gastrointestinal bleeding should include a history of co-morbidities and medications that promote bleeding; hemodynamic parameters; physical examination (including digital rectal examination); and laboratory markers. A risk score can be used to aid, but should not replace, clinician judgment.Strong recommendation, low quality evidence. 2 ESGE recommends that, in patients presenting with a self-limited bleed and no adverse clinical features, an Oakland score of ≤ 8 points can be used to guide the clinician decision to discharge the patient for outpatient investigation.Strong recommendation, moderate quality evidence. 3 ESGE recommends, in hemodynamically stable patients with acute lower gastrointestinal bleeding and no history of car