Effect of fluctuation of oxygenation and time spent in the target range on retinopathy of prematurity in extremely low birth weight infants.

BACKGROUND: The association between saturation of peripheral oxygenation (SpO2) fluctuation and severity of retinopathy of prematurity (ROP) is well elucidated in extremely low birth weight (ELBW) infants. Time spent in the Target range of SpO2 is also associated with the severity of ROP. METHODS: In a prospective observational study, the SpO2 of all ELBW infants admitted to our unit were monitored for the first four weeks of life, and averaged every minute for analysis. The percent time spent at SpO2 <90%, 90-95%, and >95% and weekly SpO2 fluctuations [as SpO2 coefficient of variation (CoV)] were calculated. RESULTS: During the study period 21 infants had moderate to severe ROP and 35 infants served as controls. Infants with moderate to severe ROP were smaller and younger than their controls [676±124 grams vs. 796±148 grams (p < 0.001); and 24.0±1.0 weeks vs. 25.0±1.7 weeks (p < 0.001) respectively]. There were no significant differences in time spent in the 90-95% range between groups (p = 0.66). However there was a significant increase in weekly SpO2 CoV in infants with moderate to severe ROP vs. controls (p = 0.007). CONCLUSION: In ELBW infants, there was an association between SpO2 fluctuation during the first four weeks of life and severity of ROP, although, no association was established with time spent in the target range of SpO2.

[Personal experiences with Minitrol]. / Nase zkusenosti s Minitrolem.

PIP: Minitrol (.5 mg megestrol acetate) is an oral contraceptive preparation whose effect is directed toward a lower level than hypothalamic-hypophysial-ovarian preparations, and it does not affect the neurohormonal regulation of the cycle. 28 women participated in the experiment, taking Minitrol for 1-8 months. 122 cycles were examined. Acne and increased hair loss were experienced, believed to be due to relatively strong antiestrogen effects of the preparation. Of the 122 cycles, 68% fluctuated between 26-32 days, 6% were longer and 26% shorter. In 10% of the cases, intermenstrual bleeding occurred. In 1 woman whose cycle was irregular, an endometrial polyp was found. For a certain number of women, the .5 mg dosage is too strong, and its effect exceeds the desired contraceptive level as well as disturbs ovarian activity. For the group of women for which the preparation is too strong, a capsule with lesser content is recommended, as this contraceptive substance is highly suitable to young women.^ieng

[Changes in the biochemical properties of cervical mucus occurring during the use of minitabled-based contraception (author's transl)]. / Zmeny biochemických vlastností cervikálního hlenu v prubehu uzívání minitabletové antikoncepce

PIP: 31 women were administered a modified mintablet contraceptive, consisting of .3 mg of norethisterone for an average of 10.6 months. During this period changes in the cervical mucus were analyzed. Changes in the protein fractions were revealed, which were characterized by a widening of the spectrum of albumins in the area of globulins and some special fractions. These changes, elicited by the contraceptive effect of the gestagen preparation, were confirmed in comparison to a control group through a permeation test.^ieng

[Ultrastructure of endometrium during low-dose gestagenic anticonception (author's transl)]. / Ultrastruktura endometria pri nízkodávkované gestagenní antikoncepci

PIP: 31 women (average age, 26 years) were administered a modified low dosage gestagen contraceptive, containing .3 of norethisterone for an average period of 10.6 months. Changes in the ultrastructure of the endometrium were studied throughout this period. Changes in both parts of the ultrastructure, the fibrose and epithelial parts, were revealed in comparison to material taken before use of the preparation. Changes in the stromata cells were particularly of a gestagenic character. Epithelial cells also demonstrated a particularly gestagenic stimulation.^ieng

[Choice of contraception in various periods of the woman's life]. / Volba antikoncepcní metody v ruzném obodobí zivota zeny.

PIP: All contraceptives must be considered not only for their effectiveness but for their side effects as well. The classical contraceptives such as the diaphragm and locally applied chemical preparations can only cause local irritations, but hormonal preparations and IUDs can have much more serious side effects. As long as the kind of complications that can result from a given contraceptive are known, the possibility of problems occurring each time a device is prescribed can be calculated. All complications considered, hormones and IUDs are not recommended. If there is a desire for more pregnancies later, discontinuance of the pill for a 3-month period after 1 year of use is recommended to allow the endometrium to regenerate. IUDs are recommended only for women who no longer wish to have children, and they are never to be used immediately after an abortion or bith. It is necessary to consider each patient individually and above all select the type of contraception that will least interfer with the successful planning of her parenthood.^ieng