Utilisation patterns of group O red blood cell transfusion by ABO and D non-identical recipients in large academic hospital.

OBJECTIVES: Several studies have raised concerns that transfusion of O red blood cells (RBCs) to ABO and D non-identical recipients can intensify group O inventory shortages. The aim of this study was to retrospectively analyse particular clinical indications and polices responsible for O RBCs use by ABO and D non-identical recipients, as well as to assess the impact of this practice on the overall utilisation of O RBCs. MATERIAL AND METHODS: Data of all transfused RBCs from 2014 to 2018 were extracted from the comprehensive database of transfusion service. Extracted variables included date of transfusion, ABO and D group of the transfused RBCs and recipients, recipient's demographic, and specific characteristics regarding transfusion requirements. RESULTS: Over a 5-year period, 124,220 RBCs were transfused: 38,962 (31.4%) group O D+ and 9109 (7.3%) group O D-. ABO and D non-identical recipient received 4842 (10.1%) of all administered O RBCs: 2880 (7.4%) of all transfused O D+ and 1962 (21.5%) of all transfused O D- RBCs. The common indications for this practice were: ABO and D mismatched hematopoietic stem cell transplantation (HSCT) (52.5%), infants under the age of 4 months (18.6%), shortage of ABO identical RBCs (9.0%), phenotype-matched RBCs (8,1%), and urgent transfusion (7.2%). CONCLUSIONS: A significant proportion of O RBCs was transfused to ABO and D non-identical recipients, mainly due to transfusion of ABO and D mismatched HSCT recipients. However, the proportion of all transfused RBCs O D+ and especially O D- remained relatively low.

[Syndroma caudae equinae of rare etiology]. / Syndroma caudae equinae zriedkavej etiológie.

The results of treatment patients suffering from syndroma caudae equinae (SCE) are not generally satisfactory. The authors decided to evaluate occurrence according to etiology and permanent consequences after treatment in patients that were treated at the Department of Neurosurgery P. J. Safarik University Hospital in Kosice during 12 years (1996-2007). 95 patients from the 101 members file had SCE caused by disc herniation or spinal stenosis. Rare etiology of SCE was found in the six cases: three had traumatic origin, one spinal epidural abscess, one tumor. SCE developed after surgery of intervetebral disc herniation in one patient. Patients underwent control examination or answered by a questionnaire one year from the beginning of SCE or later. Three patients with traumatic SCE had the moderate residual problems. One patient suffered from intermittent pain, perianogenital hypesthesia had two patients, light motor deficit another one. One patient needs to use increased abdominal pressure for urination. Nobody from this subgroup had sexual difficulties or problems with anal spincters' control. The result of treatment patient with SCE caused by spinal epidural abscess was unfavourable. Permanent pain, perianogenital hypesthesia, hard motor deficit and loss of sexual functions persisted. Patient with oncological SCE had deficit in every traced signs. Similar clinical picture was in a patient with postoperative SCE, but residual deficit was moderate.

Carbon tetrachloride as a thermoporometry liquid probe to study the cross-linking of styrene copolymer networks.

Mesh size distributions (MSDs) of swollen cross-linked styrene copolymer networks have been measured by thermoporometry using CCl(4) as a probe liquid. All numerical relationships required for the calculation of the MSD were established for both the liquid-to-solid and the solid-to-solid thermal transitions of CCl(4) and successfully validated on test samples. It was found that the polymer network, for both thermally and photo-cross-linked materials, was completely built in about 4 h of exposure. A clear correlation was established between the average mesh size of the swollen polymer network on one hand and the benzoyl peroxide groups content and swelling ratio on the other hand.

[Giant retroperitoneal liposarcomas]. / Obrovské liposarkómy retroperitonea.

According to literature liposarcomas account to less than 0.1% of all human tumors, 13% of which are localiced retroperitoneally. Authors describe two cases of giant retroperitoneal liposarcoms treated in their department. CT findings and the course of the disease discussed. Conlusively authors remark of high probability of microscopical residual disease with need of patients' follow up with eventual reoperation and adjuvant radiotherapy.

[Prevention of the anastomosis dehiscence following low anterior rectal resections]. / Prevencia dehiscencie anastomózy po nízkych predných resekciách rekta.

Authors analyse 106 patients that were operated in their department by Dixon's method, in retrospective study. They analyse indications for operations, lesions distance in rectum, endosonographic and CT findings. Basic principles of the operation technique are adequate blood flow, sufficient colon mobilization and tightness of the anastomosis being supplemented with transanal pertubation. Out of early complications anastomosis dehiscence appeared in 6 patients (e.g. 5.6%) out of which 4 were treated conservatively and 2 were being reoperated on (by axial ileostomia and drainage). In discussion different opinions on preoperative preparation, neoadjuvant therapy, presacral drainage, transanal pertubation and other decompressive techniques are anticipated.

Experimental cauda equina compression induces HSP70 synthesis in dog.

The heat shock protein 70 (HSP70) is a key component of the stress response induced by various noxious conditions such as heat, oxygen stress, trauma and infection. In present study we have assessed the consequences of the compression of lower lumbar and sacral nerve roots caused by a multiple cauda equina constrictions (MCEC) on HSP70 immunoreactivity (HSP70-IR) in the dog. Our data indicate that constriction of central processes evokes HSP70 up-regulation in the spinal cord (L7, S1-Co3) as well as in the corresponding dorsal root ganglion cells (DRGs) (L7-S1) two days following injury. A limited number of bipolar or triangular HSP-IR neurons were found in the lateral collateral pathway (LCP) as well as in the pericentral region (lamina X) of the spinal cord. In contrast, a high number of HSP70 exhibiting motoneurons with fine processes appeared in the ventral horn (laminae VIII-IX) of lumbosacral segments. Concomitantly, close to them a few lightly HSP70-positive neuronal somata or cell bodies lacking the HSP70-IR occurred. In the DRGs, HSP70 expression was mildly up-regulated in small and medium-sized neurons and in satellite cells. On the contrary, DRGs from intact or sham-operated dogs did not reveal HSP70 specific neuronal staining. In conclusion, we have demonstrated that the MCEC in dogs mimicking the cauda equina syndrome in clinical settings evokes expression of HSP70 synthesis in specific neurons of the lumbo-sacro-coccygeal spinal cord segments and in small and medium sized neurons of corresponding DRGs. This suggests that HSP70 may play an active role in neuroprotective processes partly by maintaining intracellular protein integrity and preventing the neuronal degeneration in this experimental paradigm.

Effect of spinal cord compression on cyclic 3',5'-guanosine monophosphate in the white matter columns of rabbit.

Changes in the level of cyclic 3',5'-guanosine monophosphate (cGMP) were studied one day after a surgically induced spinal cord constriction performed at the Th7 segment level in the dorsal, lateral and ventral white matter columns and in the non-compartmentalized white matter of Th5-Th6 segments, i.e., above the site of the spinal cord constriction and in Th8-Th9 segments, located below the spinal cord constriction. The midthoracic spinal cord constriction caused a significant decrease in the level of cGMP in the ventral column of Th5-Th6 segments and a significant increase in the lateral column of Th8-Th9 segments. The level of cGMP in the dorsal column, located either rostrally or caudally to the site of the spinal cord injury, remained unchanged. In addition, no significant changes in the level of cGMP were found in the non-compartmentalized white matter of Th5-Th6 and Th8-Th9 segments in response to constriction of the Th7 segment.

[A "dumbell" tumor of the mediastinum--case report]. / "Dumbbell" tumor mediastína--kazuistika.

Tumours situated in the posterior mediastinum and spreading to the spinal canal via the intervertebral opening are described as "dumbbell" tumours. The authors submit the case-history of a 44-year-old patient admitted to the Second Surgical Clinic Pasteur Faculty Hospital, Safarík University Kosice after repeated laminectomy and extirpation of the intraspinally spreading part of a mediastinal tumour. The mediastinal part of the tumour was removed surgically, the histological result was described as a melanotic schwannoma. The postoperative course was without complications, the patient was discharged home in a good condition on the 8th day after the operation. In the conclusion the authors emphasize the necessity to remove the tumour in toto. A one-stage operation in collaboration with a neurosurgeon seems appropriate.

[Modern radiologic diagnosis of prostatic diseases]. / Savremena radioloska dijagnostika oboljenja prostate.

Prostatic pathology presents one of the key elements of morbidity in adult and older males. In developed countries malignant prostatic tumors are the third most common cause of death in males older than 55 years of age. New diagnostic procedures such as transabdominal and transrectal ultrasound, computerized tomography and magnetic resonance enable direct prostatic visualization thus better and more efficient diagnostics. This study offers a review and schedule of diagnostic procedures which enable early detection and classification of prostatic diseases.

[Obstructive ileus--a complication of laparoscopic cholecystectomy]. / Obstrukcný ileus--komplikácia laparoskopickej cholecystektomie.

A 45-year old patient admitted with confirmed calculous pancreatitis underwent the laparoscopic cholecystectomy at the 14th day of the hospitalization. 4 days after the operation he had to be reoperated due to small-bowel-obstruction caused by the herniation of the loop through the supraumbilical port. The small bowel was reduced and plasty of the operative wound was done. Postoperative course was uncomplicated and the patient was discharged from the hospital 6 days after the operation.

[Personal experience with laparoscopic cholecystectomy]. / Nase skúsenosti s laparoskopickou cholecystektomiou.

During the period of 29 months the first 100 laparoscopic cholecystectomies were performed at the Department of Surgery of the Ruzinov Hospital in Bratislava. There were 79 women and 21 men with mean age of 41.5 years (16-67). All operations were modified by the use of only 3 incisions. In 2 patients were the operations converted to open colecystectomy because of perforation of gallbladder in 1 patient because of bleeding. The average operating time was 99.1 minutes (35-225). Intraoperative cholangiography was not carried out in any patient. 2 patients were reoperated because of slipping of the clips from ductus cysticus and 1 patient because of hernia in a scar. All laparoscopic cholecystectomies were planned. The average hospital stay was 5.8 days (3-12). There was no death in our series.

[Ultrasonographic verification of hypertrophic pyloric stenosis]. / Ultrasonografska verifikacija hipertroficne stenoze pilorusa.

In a two-year study on 24 newborn infants, diagnosis of hypertrophic pyloric stenosis (HPS) was intraoperatively confirmed, following preoperative ultrasonography. By means of real time sonography three parameters of the pyloric muscle were measured; the mean length was 19.6 mm, diameter 13.4 mm and the muscle thickness was 5.1 mm.

[Hemophilia from the viewpoint of the neurosurgeon]. / Niekol'ko poznámok k hemofílii a z pohl'adu neurochirurga.

The authors describe a case of cerebral haemorrhage associated with haemophilia A--their own observation, findings and confrontation with data in the literature. They draw attention to the rare incidence of the above complication, discuss the site of haemorrhage and possibilities of treatment.

[Evaluation of radiologic and echosonographic examinations in the detection and confirmation of pleural effusions]. / Evaluacija radioloskih i ehosonografskog pregleda u otkrivanju i potvrdivanju pleuralnih izliva.

In everyday practice, the attention of the radiologists was driven by patients who were admitted for clinical examination for different reasons and in whom pleural effusion was diagnosed by ultrasonography but not on standard radiograms, i.e. patients with strongly suspected pleural effusion standard radiograms could not reveal. Investigations from different aspects and the use of several conventional roentgenological methods were usually sufficient since now in diagnosing most of the cases. This, however, includes prolonged examinations and higher radiation doses received both by patients and by medical staff; besides, all this is not always enough for the effusion to be proven. What is more important, however, is the fact that critical general status of a patient often makes such thorough examination impossible, especially in additional and forced positions. The aim of the authors was to determine, on the basis of its use in everyday practice, to which extent ultrasonography, being a new diagnostic method, can become a routine method and contribute to rationalization of radiodiagnostics for pleural effusions as well as to determine diagnostic algorithm for the detection and confirmation especially of small and smaller pleural effusions.

[Intracranial hemorrhage as a complication of anticoagulation therapy]. / Vnútrolebecné krvácanie ako komplikácia antikoagulacnej liecby.

The authors describe two cases of intracranial haemorrhage as a complication of anticoagulation treatment, and compare their results with those reported in the literature. They analyze risk factors which in conjunction with anticoagulants chuan lead to haemorrhage.

Chronic extradural haematoma of the posterior fossa. Case report.

The authors present the case of extradural haematoma of the posterior fossa in a four-year-old boy who was successfully operated on seventeen days after he had suffered a blow on his occiput. Emphasis is placed on the importance of an early CT scan in a patient showing any clinical signs of possible intracranial pathology following such injury.

[Modern diagnosis of genito-pelvic echinococcosis in women]. / Savremena dijagnostika genito-pelvicne ehinokokoze zene.

From 1927 to 1983, out of 25,388 laparotomies, 10 cases (0.038%), and out of 1,463 vaginal hysterectomies, only one case (0.068%) of genito-pelvic echinococcosis were recorded. Ultrasound (exemplified by a case), and computerized tomography have recently been used for establishing preoperative diagnosis.