Effect of exchange blood transfusion on oxygen saturation of neonates with severe neonatal jaundice by pulse oximetry

Objective: To determine if there was any difference in SpO2 readings during exchange blood transfusion (EBT).Methods: A prospective cross-sectional study of neonates with severe neonatal jaundice requiring EBT was conducted. Oxygen saturation was recorded before, immediately and 15 minutes after EBT by using a pulse oximeter. Results: This study included 30 neonates with 20 males and 10 females. The age ranged from 1 to 12 days with a mean of (5.4 ± 2.9) days. Pre-EBT SpO2 ranged from 90％ to 98％ with a mean value of (94.3 ± 2.2)％; SpO2 in the end of EBT ranged from 85％ to 99％ with a mean value of (94.1 ± 3.2)％; SpO2 at 15 minutes after EBT ranged from 77％ to 99％ with a mean value of (94.8 ± 4.1)％. There was no significant difference between SpO2 values at onset of EBT and either immediately or 15 minutes after EBT (P=0.770 and 0.422, respectively). SpO2 showed no significant difference between neonates who were infused with blood of different storage times (<24 h or ≥24 h) at the onset of EBT (P=0.584), immediately (P>0.999) and 15 minutes after EBT (P=0.887). Besides, SpO2 values were compariable in neonates with hematocrit <45％ or ≥45％ at the onset of EBT (P=0.284), immediately (P=0.118) and 15 minutes after EBT (P=0.868). Conclusions: EBT does not affect SpO2 in neonates.     

Does severe obstructive sleep apnea syndrome alter retrobulbar blood flow? A color Doppler ultrasound study

Purpose

To evaluate extraocular orbital vessels with color Doppler ultrasound (CDU) and investigate the effects of severe obstructive sleep apnea (OSA) on retrobulbar blood flow.

Methods

Between February 2014 and September 2015, 30 patients with severe OSA (apnea–hypopnea index (AHI) > 30) and 28 controls were prospectively included in this study. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer, and CDU was used to evaluate the retrobulbar vessels.

Results

The mean AHI score for the OSA group was 63.2 ± 21.5 per hour. The IOP values were significantly higher in the severe OSA group (p < 0.05). The central retinal artery peak systolic velocity (PSV) (p < 0.05) and end-diastolic velocity (EDV) (p < 0.02), and the ophthalmic artery (OA) PSV and EDV, were found to be significantly lower in the OSA group (p < 0.05).

Conclusion

Severe OSA causes an increase in IOP and a decrease in flow velocity in the retrobulbar circulation.

     

The independent association of plateletcrit with long-term outcomes in patients undergoing primary percutaneous coronary intervention

Purpose

Platelets play a key role in the genesis of thrombosis. Plateletcrit (PCT) provides complete information on total platelet mass. The relationship between PCT values and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary angioplasty is not known. We sought to determine the effect of PCT values on the outcomes of primary angioplasty for STEMI.

Methods

Overall, 2572 consecutive STEMI patients (mean age, 56.6 ± 11.8 years) undergoing primary percutaneous coronary intervention were enrolled retrospectively into the present study. Plateletcrit at admission was measured as part of the automated complete blood count. Patients were classified into 2 groups: high PCT (> 0.237, n = 852) and nonhigh PCT (< 0.237, n = 1720). Clinical characteristics and in-hospital and long-term (median, 21 months) outcomes of primary angioplasty were analyzed.

Results

A higher in-hospital shock rate was observed among patients with high PCT values compared with those with nonhigh PCT values (6.5 vs 3.8%, respectively; P = .003). The long-term cardiovascular prognosis was worse for patients with high PCT values (Kaplan-Meier, log-rank test; P = .007). We used Cox proportional hazard models to examine the association between PCT and adverse clinical outcomes. High PCT values were also an independent predictor of cardiovascular mortality (hazard ratio, 1.85; 95% confidence interval, 1.061-3.22; P = .03).

Conclusion

High PCT values on admission are independently associated with long-term adverse outcomes in patients with STEMI who undergo primary angioplasty.     

Spindle cell lipoma of the hypopharynx

Objective: We report a rare case of a spindle cell lipoma with atypical clinical course.Case report: A 51 year old female patient referred to our clinic with feeling of mass in the throat she had had for two years. The patient described difficulty in swallowing. Indirect laryngoscopy did not reveal any masses at bilateral pyriform sinuses, and the mucosa had a natural appearance. However, a mass with a stalk was detected in the side of the mouth when the patient retched. Endoscopic monitoring of the mass revealed its origin to be the left sinus pyriformis. No pathological structures could be detected in the indirect laryngoscopy taken after the patient gulped again. The mass was shown by magnetic resonance imaging to extend into the esophagus. It was removed using suspension microlaryngoscopy. Postoperative control revealed a complete healing at the excision site. Immunohistochemical examination for pathological diagnosis indicated a spindle cell lipoma.Conclusions: Laryngeal and hypopharyngeal lipomas are rare forms of benign laryngeal neoplasms. Their asymptomatic course makes diagnosis difficult. The patient is presented here with related clinical and pathological features.     

Morphological study of some hypothalamic centers in rats after deafferentation of the mediobasal hypothalamus

The volume of the nuclei and nucleoli of certain hypothalamic centers (SON, PVN, SCN, AN, VMN) was determined in control rats and in rats after deafferentation of the mediobasal hypothalamus. Sex differences were found in the parvocellular formations of the control animals: The volumes of nuclei and nucleoli of neurons of AN and VMN, and also of the nucleolus of SCN neurons were larger in females than in males. After deafferentation of the mediobasal hypothalamus the volume of the cell nuclei was increased, especially in hypothalamic formations located outside the isolated zone. This increase was more clearly defined in rats constantly in a state of estrus after the operation. Statistically significant differences between volumes of both nuclei and nucleoli of the cells in subgroups of rats with permanent estrus and with permanent diestrus were found only in the case of SCN. No such differences were found for AN, despite the considerable difference in the constant of luteinizing hormone in the pituitary of the same rats. It is suggested that gonadotropin releasing factors are not produced by the cells of AN and that control over the succession of phases of the sex cycle may be exerted by SCN.Laboratory of Neuroendocrinology, I. M. Sechenov Institute of Evolutionary Physiology and Biochemistry, Leningrad. (Presented by Academician of the Academy of Medical Sciences of the USSR V. N. Chernigovskii.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 89, No. 3, pp. 352–354, March, 1980.