Donor vigilance data of a blood transfusion service: A multicenter analysis.

BACKGROUND: Donor vigilance is an important part of the quality management system of blood transfusion services. The evaluation of donor side effects helps to improve the donation process and donor compliance. The aim of the present study was to evaluate donor vigilance data in whole blood and plasmapheresis donors of a blood donor service. MATERIALS AND METHODS: Donors fulfilling current national and European eligibility criteria underwent whole blood and plasmapheresis donation (PCS and MCS+ (Haemonetics, Braintree, USA), A 200 (Fenwal, Round Lake, USA). Whole blood was collected at fixed and mobile sites while plasmaphereses were performed at 8 plasma centers. From 2011 to 2013 donor information was provided for gender, age, body weight, height, first and repeat donation. Donors were monitored for venipuncture and circulatory associated side effects. RESULTS: The total incidences of adverse events were 5004 (0.56%) in repeat donors and 2111 (2.78%) in first time donors for whole blood donation and 3323 (1.01%) and 514 (7.96%) for plasmaphereses, respectively. Circulatory associated events were 2679 (0.30%) for whole blood donation and 1624 (0.49%) for plasmaphereses. CONCLUSION: Our donor vigilance data of a blood transfusion service show that whole blood and plasmapheresis are safe with low incidences of adverse events. Repeat donation and age are predictors for low rates of adverse events. On the other hand, first time donation and female gender were associated with higher incidences of adverse events.

[Acoustic-mechanical trauma during cochleostomy: animal experimental studies]. / Akustisch-mechanisches Trauma während einer Cochleostomie: Tierexperimentelle Untersuchungen.

INTRODUCTION: When performing cochlear implant (CI) surgery in ears with residual hearing, cochlear function should be preserved as far as possible. Besides non-traumatic electrode insertion the acoustic-mechanical trauma of the cochleostomy should be minimized. According to experiences from temporal bone preparations the hypothesis that thorough exposition of the endosteal membrane with the drill prior to opening the cochlea might constitute a bigger acoustic mechanical trauma than direct drilling of the inner ear was examined. These experiments were performed in an animal model. MATERIAL AND METHOD: In 12 guinea pigs the cochlear capsule was exposed by opening the bulla under general anesthesia. In 6 animals the fluid-filled cochlea was exposed by careful unilateral abrasion of the bone, whereas on the other ear cochleostomy was performed by direct penetration drilling into the perilymphatic spaces. Hearing tests were performed before and after drilling by measuring evoked brainstem potentials (brainstem electric response audiometry, BERA). In 8 other guinea pig ears abrasive exposition of the cochlea was performed again by only softly touching the otic capsule with the running burr for 10 s. After a hearing test the drilling maneuver was repeated 4 times collectively. Thereby the inner ear was gradually opened from the surface but not deeper into the cochlear lumen. A total of 4 guinea pig ears treated with a single abrasion of 10 s were used as controls. Brain stem measurements were performed accordingly. RESULTS: Hearing loss was lower after a quick direct and deep penetration of the cochlea in comparison to a longer, less invasive opening of the inner ear. Hearing thresholds ascended depending on the duration of the drilling procedure. CONCLUSION: The results support the hypothesis that prolonged drilling of exposed inner ear structures causes more acoustical damage than a direct cochleostomy with the drill.

Heat radiation during caloric vestibular test: thermographic demonstration in temporal bone experiments.

Since Barany's descriptions in 1906, cold and warm irrigations of the external ear canal have been used for unilaterally testing vestibular excitability. The fluid kinetics within the endolymph have been studied thoroughly, whereas relatively few published articles deal with the mechanisms of heat transfer from the external to the internal ear. Even though heat conduction via the bone seemed to be well established in the textbooks, Feldmann and co-workers found heat radiation to be a very important factor. Using a rather uncommon method, we tried to make this heat radiation more apparent: in temporal bone experiments, temperature distribution was followed by thermography. Temporal bone specimens were prepared in such a way that heat distributions became visible after experimental caloric irrigations of the external ear canal. Temperature changes could well be verified by changes in coloration of the 2-dimensional thermograms. Conclusions were drawn from registrations performed in 2 projections, 90 degrees to each other, allowing cautious statements about 3-dimensional distribution. The velocity of heat transfer at the very onset of the reaction can only be explained by radiation, whereas later, other mechanisms, such as conduction via the bone or convection via the middle ear gas, may have some influence. Our results support Feldmann's findings and underline the significance of radiation in the heat transfer mechanism.

How reliable is visual assessment of the electrically elicited stapedius reflex threshold during cochlear implant surgery, compared with tympanometry?

OBJECTIVES: To assess the reliability of visually assessed thresholds of the electrically elicited stapedius reflex, recorded during cochlear implant surgery, compared with intra-operative tympanometric threshold assessment. Intra-operatively recorded electrically elicited stapedius reflex thresholds vary considerably, and differ from those measured post-operatively by means of impedance changes (i.e. using tympanometry). Thus, any confounding effect of different intra-operative techniques and visual assessment inaccuracies should be excluded. METHODS: Both techniques (i.e. visual observation and tympanometry) were performed intra-operatively in six patients, and threshold values were compared. RESULTS: Recorded electrically elicited stapedius reflex thresholds were very similar for both techniques. Visually assessed thresholds were slightly higher in some cases and lower in others, compared with tympanometric thresholds. DISCUSSION: There was almost no difference between reflex thresholds measured with the two different techniques under the same intra-operative conditions. Therefore, we conclude that differences between intra- and post-operative thresholds are not due to the use of different measuring techniques. The main reason for such differences is probably the influence of intra-operative narcotics on reflex thresholds.

[Effects of electromagnetic fields emitted by cellular phone on auditory and vestibular labyrinth]. / Wirkung elektromagnetischer Felder des GSM-Mobilfunksystems auf auditives und vestibuläres Labyrinth und Hirnstamm.

BACKGROUND: It is the subject of this study to investigate the biological effect of the HF radiation produced by the Global System for Mobile Communications-( GSM)-mobile phone on the inner ear with its sensors of the vestibular and auditive systems. METHODS/PATIENTS: Thermographic investigations made on various model materials and on the human temporal bone should show whether mobile phone does induce any increases of temperature which would lead to a relevant stimulus for the auditive and vestibular system or not. We carried out video-nystagmographic recordings of 13 subjects, brainstem electric response audiometry of 24 ears, and recordings of distorsion products of otoacoustic emissions of 20 ears. All tests were made with and without a mobile phone in use. The data was then analyzed for variation patterns in the functional parameters of the hearing and balance system that are subject to the (non)existence of electromagnetic radiation from the mobile phone. RESULTS: The thermographic investigations suggest that the mobile phone does not induce any increases of temperature which would lead to a relevant stimulus for the auditive and vestibular system. Video-nystagmographic recordings under field effect do not furnish any indication of vestibular reactions generated by field effects. Compared with the recording without field, the brainstem electric response audiometry under field effect did not reveal any changes of the parameters investigated, i. e. absolute latency of the peaks I, III, V and the interpeak latency between the peaks I and V. The distorsion products of otoacoustic emissions do not indicate, comparing the three measuring situations, i. e. before field effect, pulsed field and continuous field, any possible impacts of the HF field on the spectrum or levels of emissions for none of the probands. CONCLUSION: The investigations made show that the electromagnetic fields generated in using the mobile phone do not have an effect on the inner ear and auditive system to the colliculus inferior in the brainstem and on the vestibular receptors in the inner ear and the vestibular system.

[Prognostic factors in laryngeal cancer]. / Prognosebestimmende Faktoren des Larynxkarzinoms.

A retrospective analysis of 335 patients with laryngeal and hypopharyngeal cancer from the ENT-Hospital of the Wilhelm-Pieck-University Rostock, who died to December 1986, was made. Adjusted five-year survival rates were in glottic carcinoma 54.2 per cent and supraglottic carcinoma 42.9 per cent. This is significantly higher than in carcinoma of hypopharynx with 15.4 per cent. The following prognostic factors were important for the survival rates of the patients without consideration of the therapy of primary tumor: pTNM-stage, evidence and development of regional metastasis, enlarged stage of the primary tumor at the time of diagnosis; intercurrent diseases; development of distant metastasis and/or second carcinoma; localisation of tumor; primary therapy of regional lymph nodes.

[Thermography of the skin covering a cochlear implant--temperature as an indicator for blood circulation]. / Thermographische Untersuchungen zur Durchblutungssituation der ein Cochlear Implant bedeckenden Haut.

BACKGROUND: Sufficient blood supply of the flap is a significant factor for proper wound healing and lifelong integration of a cochlear implant. Superficial temperature as an indicator of cutaneous blood circulation can be visualized easily by thermography. QUESTION: We examined the correlation between temperature distribution and the anatomic course of defined arteries, the significance of different types of incisions in this regard, and local irritations of skin temperature/blood circulation by the implant itself. MATERIALS AND METHOD: The partially shaved heads of 15 patients were examined by thermography after cochlear implantation, using the Agema thermovision system. RESULT: Temperature distribution of the skin can be closely related to the arterial blood supply. In our group of patients, no significant alterations could be found in the skin covering the implant. Hair growth in the area tested does not allow valid thermographies. DISCUSSION: By the pattern of temperature-distribution/blood circulation some conclusions about typical incisions can be drawn. While most types of incisions respect the patterns of blood circulation, the retroauricular C-incision may cause problems. Postoperative scars can be regarded as places of minor resistance. CONCLUSIONS: Thermography of the skin is an easy method for estimating the blood circulation of the skin above the implant. It is, however, limited to hair-free or shaved skin areas.

[The "ear fever thermometer"--studies of ear thermography]. / Das "Ohr-Fieberthermometer"--Untersuchungen zur Ohrthermographie.

BACKGROUND: Though rarely mentioned in the ENT literature, the "ear thermometer" has become more and more popular in recent years, not only in hospitals but also in households. These instruments are easy to use, and their infrared technology is said to provide precise measurements. The purpose of this study was to verify these claims. PATIENTS AND METHODS: Infrared thermometers were tested in various conditions, and the results were compared. We assessed the effects of "distending" the outer ear canal, different body positions, and irritation of the ear (slight external otitis, hearing aids, otitis media, etc.). We did not specifically test effects of ear wax, as it had sufficiently been studied in pediatric or anesthesiological papers before (almost no effect, except in cases of occlusion of the auditory canal). RESULTS: Using the ear thermometer we found small but statistically significant differences in febrile patients in different body positions. Irritated ears always showed higher temperatures than the normal contralateral ears. The most significant differences were found in persons lying on one side. The "pillow ear" was found 0.7 degree C (average) warmer than the contralateral ear. CONCLUSIONS: Ear thermometers for estimating the body temperature permit easy and fast measurements. However, they include possible sources of measurement error. This study describes possible errors that the therapists should be aware of to avoid misinterpreting the course of a disease.

[Vertigo in suction of open mastoid cavities ("radical surgery cavities")]. / Untersuchungen zum Schwindel beim Absaugen von offenen Mastoidhöhlen ("Radikalhöhlen").

BACKGROUND: Vertigo during suction-cleaning of open mastoid cavities is caused by cold stimulation of the vestibular organ. In clinical and model-experimental measurements we tried to estimate the physical background and the dimension of this temperature drop. METHODS: Using different techniques like thermo-probes, thermovision, or additional model experiments temperature changes during suction were measured in 5 volunteers with open mastoid cavities. These registrations were carried out with special regard to the moisture of the cavity-walls. RESULTS: Distinct temperature changes during suction were observed. In moist cavities superficial temperature decrease was much higher than in dry ones. Using additional model experiments, temperature conduction towards e.g. the horizontal semicircular canal could be simulated. DISCUSSION AND CONCLUSIONS: Among other mechanisms like replacement of sucked-off air by colder air, or taking away warm air close to the cavity walls, effects of evaporative cold seem to be very significant. This could be demonstrated by moistening cavity walls in patients as well as in model experiments. The conclusion to keep the cavity walls as dry as possible is already a clinical demand. In this paper, the physical background and the dimensions of thermal effects during suction-cleaning could be elucidated.