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Purpose: To determine if infants with positional plagiocephaly have limitations of active and passive cervical range of motion measured with simple and reliable methods., Methods: The examiners assessed bilateral active and passive cervical rotations and passive cervical lateral flexion. Cervical assessment was performed twice by 2 different physicians to assess intertester reliability. To assess intratester reliability the first investigator performed a second examination 48 hours after the first one., Results: One-hundred nine subjects were analyzed; 70.7% of the sample had head positional preference on the right, while 29.3% had head positional preference on the left (χ 35.52, P <0.001). Cervical rotations and lateral flexion showed reliable levels of agreement for intra and intertester reliability., Conclusions: The most limited range of motion in infants with positional plagiocephaly was cervical active rotation which affected more than 90% of patients. Passive cervical rotations and lateral flexion were limited in more than 60% of patients.

Background: The aim of this study was to examine the predictive ability of admission neutrophil/lymphocyte ratio (NLR) for predicting amputation in patients with acute limb ischemia who underwent embolectomy., Methods: We retrospectively analyzed the clinical, hematologic, and amputation data of 254 patients who had undergone embolectomy for acute limb ischemia. There were 152 (52%) men and 93 (48%) women, with a mean age of 66.04 ± 13.30 years. The admission NLR was determined by dividing the absolute neutrophil count by the absolute lymphocyte count. The primary end point was determined as amputation and death., Results: The mean duration of follow-up was 26 months. During the follow-up period, there were 18 (7%) amputations within 30 days of surgery and 36 (15%) amputations over a mean follow-up of 26 months. Based on multivariate logistic regression modeling, no arterial back bleeding and preoperative NLR were observed to be independent risk factors for amputation within 30 days of surgery, and no arterial back bleeding and preoperative NLR were observed to be independent risk factors for midterm amputation for the same time period. A NLR of ≥5.2 was taken as the cutoff based upon the receiver operating characteristic. In receiver operating characteristic curve analysis, a NLR ≥5.2 had 83% sensitivity and 63% specificity in predicting amputation within 30 days of surgery and 63% sensitivity and 63% specificity in predicting midterm amputation., Conclusions: An elevated NLR is associated with a poorer limb survival after embolectomy. This simple, inexpensive test may therefore be added to risk stratification of these high-risk patients., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Introduction: Seventy-five percent of primary cardiac tumors are benign, and most are myxomas. Seventy-five percent of myxomas originate from the left atrium, and 2.5% arise from the left ventricle. Heart failure is a rare complication of myxoma., Case: A 54-year-old male patient with chronic obstructive pulmonary disease was admitted to the pulmonology department with a diagnosis of pneumonia and congestive heart failure during hospitalization. An echocardiography evaluation revealed a mobile mass (3.3 cm X 1.2 cm) in the left ventricle. The measured ejection fraction was 22%. Transthoracic and transesophageal echocardiography and magnetic resonance imaging examinations confirmed the presence of a myxoma in the left ventricle. The myxoma was a hanging mass with a stalk on the interventricular septum near the anterior mitral valve annulus. We visualized the gelatinous fragile mass on the septum; we then extracted the myxoma via a transaortic approach with the patient on cardiopulmonary bypass. The patient was discharged 10 days after surgery., Discussion: Myxoma is treated by early surgical resection because of the potential for serious complications. Left ventricular myxomas have been reported to lead to a silent heart failure. This case is important because of its location and the patient's resultant heart failure.