Collection and transfusion of blood and blood components in the United States, 1989

To probe recent trends in transfusion practice and their effect on the adequacy of the national blood resource, transfusions and collections in the United States in 1989 were studied, by using data shared by the American Association of Blood Banks, the American Red Cross, and the Council of Community Blood Centers, together with results from a sample survey of the 3600 hospitals that were not members of the national organizations. Statistical methods were used to estimate national activities. The total US supply of blood in 1989 was 14,229,000 units, an increase of 1.2 percent over the supply in 1987. Red cell transfusions were 12,059,000 units. A total of 3,159,000 patients underwent transfusion with whole blood and/or red cells (mean, 3.8 units/patient). Preoperative autologous deposits of 655,000 units by 310,000 patients represented an increase of 65 percent over the level in 1987. However, only 356,000 units (54%) were transfused to the patients who preoperatively deposited them; of the remainder, 13,000 units were crossed over for transfusion to other patients, while 286,000 units were never used. Directed donations, 350,000 units, were provided for 130,000 intended recipients, but only 97,000 units (28%) were transfused to their intended recipients; of the balance, 59,000 units (17%) were crossed over and 194,000 units (55%) were never transfused. Total platelet transfusions were equivalent to 7,258,000 units in 1989, for an increase of 13.7 percent over totals in 1987.     

Journey from conference presentation to peer-reviewed publication: Do ends really meet?

Introduction

The National Conference (NATCON) of Anatomical Society of India (ASI) is the preeminent meeting of anatomists in South-east Asia region. In the present study we undertook a quantitative assessment of the abstracts presented orally in three NATCON of ASI held between 2013 and 2015, with regards to rate of subsequent publication in peer reviewed journals.

An unusual cause of hematuria; primary epiploic appendagitis

INTRODUCTION

Primary epiploic appendagitis (PEA) is self limiting inflammatory disease of colonic epiploic appendices.

PRESENTATION OF CASE

Herein, a 40 years old patient describing abdomino-inguinal pain with clotty hematuria having PEA was presented. At first, the patient was thought to have a primary bladder pathology, but after a meticioulus examination, he found to have PEA and managed by conservative measures.

DISCUSSION

Although PEA does not require surgical intervention, it may mimic other acute abdominal disorders which can be difficult to differentiate. Appendices overlying the sigmoid colon and cecum are more prone to be affected as they are more elongated and wider in size. The patient is usually admitted due to sudden onset of abdominal pain accompanied with fever, abdominal tenderness and leucocytosis.

CONCLUSION

The present case demonstrated that PEA located close to the lower urinary tract especially urinary bladder might present with urinary symptoms such as hematuria. dysuria, pollakuria and inguinal pain.     

Large mucinous neoplasm of the appendix mimicking adnexal mass in a postmenopausal woman

INTRODUCTION

Appendiceal tumors are rare, late-diagnosed neoplasms that may not be differentiated from adnexal masses even by advanced imaging methods and other diagnostic procedures. They may be asymptomatic and remain undiagnosed until surgery.

PRESENTATION OF CASE

We report a case of 81-year-old postmenopausal woman presented with abdominal pain. A magnetic resonance imaging revealed right adnexal mass. Laparotomy was performed and detected a 12 cm × 9 cm mucinous tumoral mass arising in the appendix. An appendectomy and a right hemicolectomy with ileo-transverse anastomosis were performed. Histopathological examination was revealed appendiceal mucinous neoplasm with low malignancy potential.

DISCUSSION

Gastrointestinal tumors such as appendiceal tumors can mimicking adnexal mass. Therefore, appendiceal tumor kept in mind in a patient with diagnosed adnexal mass, especially patient had non-specific clinical symptoms, laboratory and radiologic findings.

CONCLUSION

Gastrointestinal tumors such as appendiceal tumors kept in mind in a patient with diagnosed adnexal mass.     

Evaluation of choroidal thickness using spectral-domain optical coherence tomography in patients with severe obstructive sleep apnea syndrome:a comparative study

AIM: To assess choroidal thickness in patients with severe obstructive sleep apnea syndrome (OSAS) and compare them with healthy controls, using spectral domain optical coherence tomography (OCT).METHODS: In this observational, cross-sectional study, choroidal thicknesses of 23 newly severe OSAS patients and 23 body mass index- age- and sex-matched healthy subjects were measured using a high-speed, high-resolution frequency domain-OCT device (λ=840 nm, 26000 A-scans/s, 5 μm axial resolution). All patients underwent a complete ophthalmic examination before the measurements. OCT measurements were taken at the same time of day (9:00 a.m.), in order to minimize the effects of diurnal variation.CONCLUSION: The decreased choroidal thickness of patients with severe OSAS might be related to the the autonomic disregulation associated with this disease. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and OSAS.     

Congenital glaucoma as an ophthalmic manifestation of Frank–Ter Haar syndrome

We report on a patient with Frank–Ter Haar syndrome that is associated with high intraocular pressures. A 21-day-old male patient was referred to our clinic for surgical treatment of congenital glaucoma. On ophthalmic examination, he had buphthalmos, mild corneal edema and high IOP readings in both eyes. The patient underwent uneventful trabeculotomy surgery, bilaterally. Marked bilateral anterior iris insertion was noted during the surgery. Childhood glaucoma may be associated with Frank–Ter Haar syndrome.     

Neuroarthropathy of the extremities: magnetic resonance imaging features

The objective of this article was to review the magnetic resonance imaging (MRI) findings of four different neuroarthropathic extremities, and discuss the role of MRI in establishing a correct diagnosis. The shoulder, ankle, and knee had predominantly atrophic neuroarthropathic changes, whereas both atrophic and productive changes could be seen in the elbow. Bone marrow edema, suggesting a recent stress fracture, was detected in the elbow and knee. Osteochondral defects, or “detritic” synovitis with effusion, were extensive in all joints but exceptionally profound in the shoulder with amputation-like osteolysis and a total loss of the humeral head. Radiologists may encounter the joint manifestations of neuropathy, which may be confused with various pathologies, including tumor and septic arthritis, before the neurological diagnosis is established. MRI is helpful in detecting the extension of the disease as well as to differentiate chronic Charcot's arthropathy from septic arthritis before radiographic findings suggest the diagnosis.     

A randomized prospective trial of a novel device for measuring perforation size during inlay ‘butterfly’ myringoplasty

Aim

This study introduces a new device to facilitate perforation size measurement during “butterfly” myringoplasty. The purpose of this study is to evaluate the use of ‘otological compass’ on short-term results of inlay cartilaginous ‘butterfly’ tympanoplasty technique in adult patients.

Study design

Prospective, randomized, controlled, blinded.

Patients and methods

This study included 25 patients who underwent inlay cartilage myringoplasty. All operations were performed under general anesthesia by the same surgeon with a microscope-assisted approach. The patients were divided randomly and consecutively into two groups: Group 1 (n = 12) had perforation dimensions and shape measured using the Otologic Compass (OC) and the control group (n = 13) had perforation measured by means of a Fisch elevator. The duration of surgery, number of trials for correct placement of the cartilage graft, results and complications of the surgery were evaluated and compared.

Results

The mean follow-up duration was 6 months. Groups were similar in terms of age and perforation diameters (p > 0.05). Average number of cartilage shaping before satisfactory graft fitting was significantly fewer in the OC group: 1.1 ± 0.3 and 2.2 ± 0.6 trials for OC and control groups, respectively (p < 0.001). Mean duration of preparation and satisfactory graft fitting was 9.6 ± 4.2 minutes in the OC group whereas it was 18.1 ± 5.2 minutes for the control group. Operative duration was significantly shorter in the OC group (p < 0.001). At the end of the follow-up period, successful closure occurred 91.7% and 84.6% patients in the OC and control groups, respectively (p > 0.05). The mean preoperative to postoperative three-tone air-bone gap improved 7.9 dB and 9.0 dB in OC and control groups, respectively (p > 0.05).

Conclusion

This study shows that OC presents as a useful tool that expedites and refines butterfly myringoplasty procedure. The number of cartilage shaping prior to satisfactory graft fitting revealed significantly better results: almost all surgeries in the OC group were complete after a single cartilage shaping attempt.