Status of coral reefs of Little Cayman, Grand Cayman and Cayman Brac, British West Indies in 1999 and 2000. (Part 1: Stony corals and algae)

A benthic assessment of the isolated Cayman Islands was completed at 42 sites. Major changes in the reef community structure were documented by comparison with earlier studies. Acropora palmata and A. cervicornis, once abundant as shallow framework builders, were uncommon. Diseased stony corals were seen in \u3e90% of the study sites, with the highest averages in Little Cayman, especially at Bloody Bay which is one of the most highly regulated marine parks in the Cayman Islands. The Montastraea annularis species complex accounted for two-thirds of the diseased corals which, along with other massive species, were affected largely by white-plague disease. Recent partial-colony mortality was particularly high in Grand Cayman. However, small- to intermediate-sized (M. annularis complex) suggest a strong potential for population regeneration. Algal competition generally did not appear to be a problem for stony corals, and bleaching was insignificant, yet more prevalent, in the deeper (\u3e10 m) sites

Tranexamic Acid Dosing in Craniosynostosis Surgery: A Systematic Review With Meta-Analysis

UNLABELLED: This study aimed to compare operative time, blood loss, and transfusion requirement in patients receiving a high tranexamic acid (TXA) dose of greater than 10 mg/kg versus those receiving a low dose of 10 mg/kg or less. METHODS: PubMed, Cochrane Central, and Embase were queried to perform a systematic review with meta-analysis. Studies reporting outcomes of TXA use in craniosynostosis surgery were included. TXA dosing, operative time, blood loss, and transfusion requirement were the primary outcomes studied. Other variables studied included age and types of craniosynostosis. RESULTS: In total, 398 individuals in the included articles received TXA for craniosynostosis surgery. TXA loading doses ranged from 10 mg/kg to 50 mg/kg. Overall, administration of TXA was not associated with changes in operative time, but was associated with decreased blood loss and transfusion requirement on meta-analysis. Comparison of high dose TXA (\u3e10 mg/kg) versus low dose (10 mg/kg or less) showed no statistical differences in changes in operative time, blood loss, or transfusion requirement. CONCLUSIONS: Overall, TXA reduced blood loss and transfusion requirement in patients undergoing surgery for craniosynostosis. There was no difference in outcomes between high dose and low dose regimens amongst those receiving TXA. Low dose TXA appears adequate to achieve clinical efficacy with a low adverse event rate