This study aimed to evaluate the antithrombotic efficacy between bivalirudin and unfractionated heparin (UFH) on radial artery thrombosis (RAT) during transradial coronary intervention (TRI) by optical coherence tomography (OCT). We consecutively reviewed a total of 307 patients who underwent radial artery OCT inspection after TRI in our centre from October 2017 to January 2019; afterwards, 211 screened patients were divided into the UFH group (  = 144) and the bivalirudin group (  = 67) according to their anticoagulation strategy during TRI. The thrombosis in the radial artery was observed in 51 cases (24.17%) with a median thrombus volume of 0.054 mm (0.024, 0.334) and median thrombus score of 7 (4, 15). Thrombus occurred in 28 cases in the bivalirudin group with an incidence of 41.8%, which was significantly higher than that in the UFH group (  = 23, 16.0%, < 0.001). This difference was even more remarkable after propensity score matching (bivalirudin group  = 22, 42.3% vs. UHF group  = 11, 13.9%, < 0.001). Multivariate logistic analysis revealed that bivalirudin increased the RAT risk by 3.872 times (95% CI 2.006-8.354, < 0.001) after adjustment for the other predictors. In this present study, the use of bivalirudin was associated with a higher risk of RAT than UFH. It highlighted UFH should be a more considerable choice to prevent radial artery access thrombosis in TRI.In this present study, the use of bivalirudin was associated with a higher risk of RAT than UFH. It highlighted UFH should be a more considerable choice to prevent radial artery access thrombosis in TRI.Understanding polymorphism in chiral systems for drug manufacturing is essential to avoid undesired therapeutic effects. Generally, polymorphism is studied through changes in temperature and solution concentration. A less common approach is the application of pressure. The goal of this work is to investigate the effect of pressure on levetiracetam (pure enantiomer) and etiracetam (racemic compound). Anisotropic compressions of levetiracetam and etiracetam are observed to 5.26 and 6.29 GPa, respectively. The most compressible direction for both was identified to be perpendicular to the layers of the structure. Raman spectroscopy and an analysis of intermolecular interactions suggest subtle phase transitions in levetiracetam (∼2 GPa) and etiracetam (∼1.5 GPa). The stability of etiracetam increases with respect to levetiracetam on compression; hence, the chiral resolution of this system is unfavorable using pressure. This work contributes to the ongoing efforts in understanding the stability of chiral systems.Background The relationship between the 2019 novel coronavirus (COVID-19) and pneumothorax is not yet established. As of June 2020, few cases of nonintubated patients developing pneumothorax had been documented. Case Report We present the case of an elderly patient with COVID-19 pneumonia that resulted in a prolonged hospital course because of pneumothorax complication. The patient did not develop severe symptoms and did not require intubation. Conclusion This case report should aid clinicians assessing patients with COVID-19 pneumonia.Background Hip fracture is a common orthopedic condition that leads to many hospitalizations each year. Intertrochanteric femur fractures are commonly treated with cephalomedullary nail fixation. Superior gluteal artery bleed is a rare complication of cephalomedullary nail fixation, especially when the trochanteric approach is used. Case Report A 63-year-old male presented to the emergency department with a right intertrochanteric femur fracture after a fall from standing height. Cephalomedullary nail fixation was performed without any complications during the operation. The patient's postoperative course was complicated by decreasing hemoglobin levels despite blood transfusions. Superior gluteal artery bleed with a large hematoma was discovered on postoperative day 4. The bleed was embolized, and the patient was stabilized and discharged. Conclusion We found only 1 published report of a superior gluteal artery bleed associated with nail placement. During the operative procedure, guidewire placement requires careful consideration because of the risk of vascular damage. Superior gluteal artery injury, although rare, should be considered in patients with unstable hemoglobin levels after nail placement.Background New neurologic deficits after spine surgery occur in less than 1% of cases. A particularly rare complication is white cord syndrome, a neurologic deterioration in the absence of obvious perioperative injury with concurrent hyperintense signal change on T2-weighted magnetic resonance imaging. The pathophysiologic mechanism is hypothesized to be an ischemia-reperfusion injury after the decompression of a chronically ischemic cord. Case Report A 63-year-old male underwent posterior cervical decompression and fusion for severe cervical stenosis and myelopathy. During the procedure, intraoperative neurophysiologic monitoring signals were lost. The patient developed acute postoperative tetraplegia attributed to white cord syndrome. Motor and sensory deficits improved after intravenous dexamethasone and intensive physical therapy. Conclusion The pathophysiology of white cord syndrome is unclear, and intraoperative anesthetic management strategies to prevent this syndrome are unknown. This case serves to educate perioperative physicians to suspect this rare syndrome, encourage research into its pathophysiology, and guide clinicians in formulating therapeutic regimens.Background Myiasis is a disease caused by the infestation of human tissue by the larval stage of various flies. It has been identified in sub-Saharan Africa and in tropical parts of the Americas. Cases have also been identified among travelers returning to the United States. Infestations may involve any part of the body, including the scalp, and open wounds may become infected with these larvae. selleckchem The primary cause of wound myiasis in the western hemisphere is Cochliomyia hominivorax. Case Report We present a case of wound myiasis in an adult Haitian male with a persistent wound for 2 years. To our knowledge, only 1 other report of wound myiasis in Haiti caused by C hominivorax has been published. Conclusion Wound myiasis can occur in many tropical regions of the world, including Haiti. Because of the prevalence of global travel, clinicians should be familiar with the condition's diagnosis and management.