Aim: To determine to what extent SpO(2) levels match the ERC targets during the resuscitation of very preterm infants, and how well the SpO(2) is kept within the high and low limits until the infants are transported to the NICU.
Methods: In a single-centre observational study, the SpO(2) and fraction of inspired oxygen (FiO(2)) were collected during the resuscitation of very preterm infants with a gestational age (GA) <= 30 weeks.
Results: A total of 78 infants were included [median (IQR): GA 274/7 (26-286/7) weeks, birth weight 945 g (780-1140)]. During the initial 10
min after birth, large variations in SpO(2) were observed with deviations above the target [median (IQR)] Selleck Cyclosporin A of 4.4% SpO(2) (1.4-6.5), and below the target of 8.2% SpO(2) (2.8-16.0). After
the first 10 min, the SpO(2) levels were respectively above and below the limit for 11% (0-27) and 8% (0-23) of the time.
Conclusion: During the resuscitation of very preterm infants, large deviations of the SpO(2) from the ERC targets are observed. SRT1720 nmr During the first minutes of resuscitation the deviations were likely caused by an inability to control the SpO(2), whereas later deviations were due to weaning, pauses in respiratory support (i.e. intubation) and over exposure to oxygen. Changing the SpO(2) targets to a target range that depicts the acceptable deviation might be helpful in providing better respiratory support. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“In 2009, a new system for staging and classification of malignant melanoma has been proposed by the American Joint Committee on Cancer (AJCC). The AJCC recommends that staging of primary melanoma be based on 3 criteria, namely, thickness, ulceration, and mitotic rate, the latter substituting Clark levels in the previous classification. In melanomas measuring <= 1 mm in thickness, ulceration or finding of single mitotic figure in the dermis defines stage T1b. According to the AJCC, sentinel lymph node dissection should be considered for those melanomas because of a significantly impaired prognosis. As with other prognostic parameters, however, assessment of mitotic rate, with one mitotic HTS assay figure being the cutoff point, is
highly unreliable, and statistics based on such data lack validity. Despite the large database being employed, they may be pseudoscience rather than science.”
“We present two cases of central venous catheterization (CVC) in which an ultrasound-guided in-plane approach was used. Case 1 was a 60-year-old man with acute myelogenous leukemia in whom a right supraclavicular CVC was performed. He had pancytopenia (leukocytes 2,000/mu L; erythrocytes 350 x 10(4)/mu L; platelets 5.6 x 10(4)/mu L), and abnormal coagulability (prothrombin time-international normalized ratio 1.35). A linear array transducer was positioned cephalad to the right clavicle and rotated 30A degrees clockwise. The 21-gauge needle was manipulated from outside of the transducer.