Aeromedical Decision Making in Internal Jugular Phlebectasia.

BACKGROUND: Internal jugular phlebectasia (IJP) is an uncommon entity with only about 100 reported cases and with very few available cases in the literature. The current case study is about a male trainee fighter pilot incidentally diagnosed to have IJP. With limited literary evidence, it was a complex task to predict the prognosis of IJP and its implications on fighter flying.CASE REPORT: In order to confirm the diagnosis, a preliminary study was carried out to find out the normal and expanded area of the internal jugular vein (IJV) of 30 volunteers. The expanded area of the right IJV of the trainee pilot fell beyond 1 SD of the study population, confirming the diagnosis of IJP in the trainee pilot.DISCUSSION: Aeromedical concerns were the anti-G straining maneuver, positive pressure breathing for G, negative Gz, modified Valsalva maneuver, and rapid decompression. Considering the potential progression of IJP by repeated exposure to aviation stresses, the trainee pilot was re-assigned to helicopters.Khatua SS, Sannigrahi P, Dahiya M, Rastogi P, Raheem A. Aeromedical decision making in internal jugular phlebectasia. Aerosp Med Hum Perform. 2019; 90(2):132-134.

Embryo transfer day does not affect the initial maternal serum ß-hCG levels: A retrospective cohort study.

The aim of this study is to compare the serum ß-hCG values post transfer of a cleavage stage embryo versus a blastocyst stage embryo at equal time intervals post oocyte retrieval (OR) in clinically pregnant patients, and to ascertain a ß-hCG value to predict pregnancy outcomes. This is a retrospective cohort study of 560 women with clinical pregnancy who underwent an embryo transfer performed at either the cleavage stage or the blastocyst stage of embryo development between January 2003 and June 2014 at the Center for Assisted Reproduction (CARE), Singapore General Hospital. The serum ß-hCG level was measured on day 17 post OR. The ß-hCG values were not significantly different in the cleavage stage versus the blastocyst stage embryos (mean±SD: 387±486IU/L D3 vs. 352±268IU/L D5, p=0.96, median value 297 in both groups). Our study suggests that the initial maternal serum ß-hCG values were not affected by the day of transfer of the embryos since assessing the ß-hCG at equivalent points after transfer should not lead to a significant difference assuming the progress and development of the embryos occurred as expected.