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Objectives: To determine the incidence and types of ophthalmic complications associated with maxillofacial trauma over a period of 24 months.Methods: An institutional prospective study was conducted on 62 patients presenting with maxillofacial trauma to study the correlation between facial trauma and ophthalmic complications.Results: Road traffic accidents were reported to be the primary etiologic factor for most trauma cases studied. Zygomaticomaxillary complex (ZMC) fracture was associated with more ophthalmic complications while fractures involving the orbital rims and walls were associated with severe complications.Conclusions: Maxillofacial trauma, particularly those associated with midface, including ZMC fracture, Le Fort II, Le Fort III, and naso-orbito-ethmoidal fractures, can commonly cause ophthalmic complications and blindness in rare cases. Hence, every patient with maxillofacial trauma should undergo an ophthalmic examination and should be placed under close observation for necessary treatment when required.

We have confirmed that there is a link between upper and lower airway inflammation and that this is not limited to patients with asthma. The process is associated with systemic inflammation as evidenced by increased blood eosinophils but appears to be independent of IgE.

We describe the case of a 67-year-old female patient presenting with constitutional symptoms and rapid decline. Two bone marrow core biopsies were performed, with spindled cells identified and thought to represent marrow involvement by systemic mastocytosis on the first biopsy. A diagnosis of metastatic vascular malignancy with sarcomatoid features was favored on the second core biopsy. The patient rapidly deteriorated and passed away. The post-mortem examination revealed a splenic angiosarcoma with metastasis to the liver and bone marrow. Splenic angiosarcoma is a rare, aggressive entity, with bone marrow metastasis even more uncommon. This report perceives this as a diagnostic consideration on bone marrow biopsies with spindled cells and explores the diagnostic dilemma and overlapping features of systemic mastocytosis and angiosarcoma.

Miniaturization in High Throughput Screening (HTS) is perceived as essential by pharmaceutical screening laboratories to accommodate the enormous increase in compounds and targets over the past few years. The two primary goals are to increase throughput while decreasing costs. The ability to perform primary screening assays in high-density micro-well plates at volumes of 1-2µl will accelerate the early stages of drug discovery. Ultra-HTS (uHTS) assays require an accurate and reliable means of fluid handling in the submicroliter volume range. This relates to the design of instrumentation for dispensing fluids, as well as assay plates. Fluid handling has been a major obstacle to the full implementation of miniaturized assays. This report focuses on current approaches to submicroliter fluid handling in high-density multi-well plates.

Background: Increased pulse pressure (PP) is an independent risk factor for cardiovascular disease (CVD) morbidity and mortality in men and women. Increased PP has also been shown to be a stronger predictor of CVD mortality, than systolic (S), diastolic (D), or mean blood pressure (BP). Changes in PP amplitude are also associated with other metabolic syndrome components. PP is increased in obesity and increases at a greater rate in patients with diabetes mellitus (DM); and may contribute to the risk and "opinion" that labels DM-CVD-risk as equivalent to previous myocardial infarction. The purpose of this study is to determine whether the metabolic marker, Hemoglobin A1c (A1c), during the early stage of DM development is also associated with a readily available clinical vascular marker, PP. Such an observation may provide an opportunity to detect and start preventive treatment earlier and provide a possible path to begin investigating the mechanisms of hypertensive-diabetic CVD. Methodology: Complete baseline metabolic panels and 24-hour ambulatory BP (AMBP) recordings were obtained on 102 African Americans, 65.9% females, aged 40-90 years, and with Stage-I hypertension. Participants were categorized in two groups according to A1c < 5.7 or A1c ≥5.7. T-test was used to examine difference in BP levels between the two groups. In addition, we examine the independent effect of A1c levels on PP in a linear regression model that adjusts for age and BMI. Results: There were 61 non-diabetic subjects with A1c <5.7, and 41 pre-diabetics or diabetics with A1c ≥5.7. Results showed no significant difference in SBP between the groups (126.2±15.2 mmHg versus 127±16.6mmHg, p=0.70). However, DBP was significantly lower in the group with an HbA1c ≥ 5.7, (75.3±11.3 versus 67.9±10.4mmHg, p<0.03). This resulted in a significantly higher PP in the A1c≥5.7 group, (50.9±10.6 versus 59.0±14.8, p<0.03). Regression analysis showed independent association of PP with A1c (β=5.84, p=0.026) after adjusting for age and BMI. Conclusion: There was an association between A1c levels and changes in PP even in the early stages of DM. This suggests that changes in vascular health, as reflected in increase in PP, may start earlier than previously appreciated.

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4629 Background: Seizures are frequently found in patients with autoimmune diseases such as lupus and APS. Recent publications concluded that APLAs are associated with seizures and their presence results in more poor control. Conversely, the presence of auto-antibodies directed against different targets, including APLA, voltage-gated potassium channels, c-aminobutyric acid B receptor, GAD, and others, have been identified in up to 20% of newly-diagnosed epilepsy patients and there is increasing evidence of their pathogenic role. Objective: We sought to evaluate the relationship between epilepsy and antiphospholipid antibodies (APLA) and/or antiphospholipid antibody syndrome (APS). This was done by means of a systematic review of the literature. We sought to answer four questions: 1) Are epilepsy and seizure disorders more prevalent among pts. with aPLAS/aPLAs?; 2) Is aPLAS more prevalent among patients with epilepsy or seizure disorders?; 3) In those with seizure disorders, is there a heightened prevalence of aPLAs?; 4) Does the presence and titre of aPLAs determine the severity and/or frequency of seizures, in these patients? Design/Methods: We conducted a systematic review to evaluate the relationship between APLA (including anticardiolipin Ab, anti beta-2-glycoprotein-1 Ab, and lupus anticoagulant) and epilepsy. We searched MEDLINE, EMBASE, Healthstar, the Cochrane library, LILACS, Scopus and grey literature. We included cohort, case-control, and cross-sectional studies studying the prevalence of epilepsy in patients with APS and/or +APLA, the prevalence of +APLA and/or APS in patients with epilepsy, and the severity of the seizures in patients with +APLA and/or APS. Results: The search retrieved 837 relevant references and 79 were retrieved for full review. We included in the final review 24 studies (19 case-control, 3 cohort and 2 cross-sectional). In 3 cohorts, including 1585 patients with APS, the frequency of epilepsy ranged between 3.4 and 8.5%. In 16 case-control studies, including 3893 patients, the OR for +APLA and/or APS in patients with epilepsy ranged from 0.60 to 13.3 in individual studies. In 2 case-control studies, including 804 patients, the OR for epilepsy in patients with +APLA and/or APS ranged from 0.83 to 2.82 in individual studies. An OR or RR could be calculated in only 17 studies, and within this group, twelve positive and five negative studies were identified. No meta-analysis was conducted due to the high heterogeneity of designs. In 4 studies, an association was found between +APLA and seizure frequency and severity. In positive studies there was no correlation between +APLA, epilepsy and cerebral ischemia. Conclusions: We conclude that +APLA/APS might be related with higher risk and severity of epilepsy, however further studies using accepted consensus definitions for APLA positivity, more stringent methodology and appropriate subgroup analysis are needed. Disclosures: Lazo-Langner: Pfizer: Honoraria; Leo Pharma: Honoraria.