Platelet transfusions in adult patients with particular reference to patients undergoing surgery.

Descriptive information on platelet (PLT) recipients, particularly during surgery, is limited. A description of the current epidemiology of PLT-transfused patients is required to optimize platelet transfusion care and to follow trends in PLT use. In 2004 and 2005, information was combined from several computerized medical systems. Participating hospitals (9 hospital districts of 21) handled approximately 64% of annual Finnish hospital admissions. A total of 6321 adult patients were transfused with 37,761 PLT products. Most PLT products (43.1%) were transfused to patients suffering from haematological malignancies. Only 1.0% of all surgical patients received PLTs (53.8% of PLT recipients and 35.8% of transfused PLTs). The most common single operation connected with PLT transfusion was coronary artery bypass while 27.1% of surgery-related PLTs were given to patients having an operation involving the digestive system or spleen. Only 36.4% of all PLT-transfused (operated and conservatively treated) patients were discharged directly home; in-hospital mortality was 9.5%. PLTs were given 40 products per 1000 hospital admissions requiring an operation in 2004, and 38 products in 2005. Perioperative PLT use is slightly decreasing in adult patients. As a single-operation type, coronary artery bypass patients receive most of the PLT products and have experienced no decline in PLT use over the years. Overall, PLT recipients have high in-hospital mortality.

Effect of chronic ethanol diet on expression of gonadotropin genes in the male rat.

The present study elucidates further the defect in the function of hypothalamic-pituitary-gonadal axis in the male rat after a 6% ethanol diet for 5 weeks. The body, testis, prostate and seminal vesicle weights of the ethanol-treated animals did not differ from those of the pair-fed controls. However, the weights of the ethanol and pair-fed groups were significantly lower than in untreated controls (P less than .001). The pituitary luteinizing hormone beta mRNA level of ethanol-treated rats was significantly higher (P less than .05) but the follicle-stimulating hormone beta mRNA level was lower (P less than .05) than those of the diet control group. Additionally, the follicle-stimulating hormone beta mRNA level of the diet controls was higher than that of the untreated controls (P less than .05). There were no significant differences in the levels of common-alpha subunit or prolactin mRNA between the groups. The serum and testicular testosterone concentrations of the ethanol and diet control groups did not differ, but both were significantly lower than in untreated controls (P less than .01). The serum luteinizing hormone of ethanol rats was significantly higher than that of diet controls (P less than .01), but the pituitary luteinizing hormone, the serum and pituitary follicle-stimulating hormone and the prolactin of ethanol and diet control animals did not differ.

Birth injuries: incidence and predisposing factors.

The incidence of birth-associated major injuries among 14.265 live born infants during seven years is presented. The occurrence of major trauma was 3.16% or 441 injuries in 437 children. The most usual injury was fracture of the clavicle, which occurred in 3.0%, after that brachial plexus injury with occurrence of 0.11%, and fracture of long bones with 0.03%. In addition to that there was one child with facial nerve palsy. Four children had two birth injuries each. The most important causes of brachial plexus injury were macrosomia and shoulder dystocia. Eight of 16 children with brachial plexus injury had shoulder dystocia and six of 16 macrosomia. The frequency of macrosomia in our material of 14.265 children was 4.7%, which is much higher than earlier reports by other authors.

Effects of chronic ethanol diet on pituitary-testicular function of the rat.

We studied the effects of a 6% ethanol liquid diet administered for 5 wk on the pituitary-gonadal function of adult male rats. Because ethanol is known to reduce body weight, we used sucrose-fed animals as controls. No significant differences in body, testis, or prostate weights were found between the rats exposed to ethanol and their sucrose-fed controls at the end of the 5-week treatment. Seminal vesicle weights decreased significantly (p less than 0.05) in the ethanol-treated group. Serum and testicular testosterone concentrations were significantly reduced in the ethanol-treated group, to 43.6% and 48.3% of levels in the sucrose-fed controls, respectively (p less than 0.05). Serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels of the ethanol-treated rats were 37.9% and 41.3%, respectively, of those of the sucrose-fed controls (p less than 0.01-0.05). The pituitary levels of these hormones were similar to those of controls, but the ratios of pituitary LH and FSH to their serum levels were clearly increased after ethanol exposure, to 492% and 206.1%, respectively (p less than 0.05). In contrast, pituitary prolactin (PRL) of the ethanol-treated rats was decreased to 40.2% (p less than 0.01) of sucrose-fed controls. Testicular content of LH receptors was significantly reduced (to 77.0% of controls; p less than 0.01), but content of FSH receptors was slightly increased by the ethanol diet (to 121.5% of sucrose-fed controls; p less than 0.05). No ethanol-associated changes were apparent in testicular PRL and gonadotropin-releasing hormone (GnRH) receptors or in pituitary GnRH receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Intestinal blind pouch- and blind loop- syndrome in children operated previously for congenital duodenal obstruction.

A follow-up study of 27 children operated for congenital duodenal obstruction (CDO) in the years 1953--71 is presented. Nine children belonged to the intrinsic and 18 children to the extrinsic group of CDO. A total of 7 retrocolic, isoperistaltic, side-to-side duodeno-jejunostomy, 7 Ladd's operation, 8 duodenolysis, 2 reduction of midgut volvulus, 2 duodenostomy a.m. Morton and one gastro-jejunostomy were performed at the age of 1 day--15 years. The clinical and radiological examinations were performed 3--21 years (mean 10 years 2 months) after these operations. In 3 cases there was a moderate duodenal dilatation, but reoperation was not necessary. During the follow-up period, one boy, now aged 8 years, developed a blind pouch-syndrome in the I portion of the duodenum containing a 5 x 5 cm phytobezoar 4 1/2 years after duodeno-jejunostomy. The frequency of blind pouch-syndrome after duodeno-jejunostomy was thus 1:7 or 14%. One girl, now aged 9 years, developed a blind loop-syndrome in the ileocaecal segment 3 months after side-to-side ileotransversostomy, which was performed from adhesion-obstruction after duodenolysis for malrotation I and CDO. Both the blind pouch- and the blind loop-deformation were resected and the children recovered well. To avoid blind-pouch- and blind loop-deformations in the intestines, the anastomosis must be made wide enough, and especially in the surgery of the jejuno-ileo-colic region an end-to-end anastomosis is preferable.

Intestinal blind pouch- and blind loop-syndrome in children operated previously for congenital duodenal obstruction.

A follow-up study of 27 children operated for congenital duodenal obstruction (CDO) in years 1953-71 is presented. Nine children belonged to the intrinsic and 18 children to the extrinsic group of CDO. A total of 7 retrocolic, isoperistaltic, side-to-side duodeno-jejunostomy, 7 Ladd's operation, 8 duodenolysis, 2 reduction of midgut volvulus, 2 duodenostomy a.m. Morton and one gastro-jejunostomy were performed at the age of 1 day-15 years. The clinical and radiological examinations were performed 3-21 years (mean 10 years 2 months) after these operations. In 3 cases there was a moderate duodenal dilation, but reoperation was not necessary. During the follow-up period, one boy, now aged 8 years, developed a blind pouch-syndrome in the I portion of the duodenum containing a 5 X 5 cm phytobezoar 4 1/2 years after duodeno-jejunostomy. The frequency of blind pouch-syndrome after duodeno-jejunostomy was thus 1:7 or 14%. One girl, now aged 9 years, developed a blind loop-syndrome in the ileocaecal segment 3 months after side-to-side ileotransversostomy, which was performed from adhesion-obstruction after duodenolysis for malrotation I and CDO. Both the blind pouch- and the blind loop-deformation were resected and the children recovered well. To avoid blind pouch- and blind loop-deformations in the intestines, the anastomosis must be made wide enough, and especially in the surgery of the jejuno-ileo-colic region an end-to-end anastomosis is preferable.