Effects of Placental Transfusion on Late Preterm Infants Admitted to a Mother-Baby Unit.

OBJECTIVE: Well-appearing late preterm infants admitted to a mother baby unit may benefit from either delayed cord clamping (DCC) or umbilical cord milking (UCM). However, there are concerns of adverse effects of increased blood volume such as polycythemia and hyperbilirubinemia. The purpose of this study is to examine the short-term effects of placental transfusion on late preterm infants born between 350/7 and 366/7 weeks of gestation. STUDY DESIGN: In this pre- and postimplementation retrospective cohort study, we compared late preterm infants who received placental transfusion (161 infants, DCC/UCM group) during a 2-year period after guideline implementation (postimplementation period: August 1, 2017, to July 31, 2019) to infants who had immediate cord clamping (118 infants, ICC group) born during a 2-year period before implementation (preimplementation period: August 1, 2015, to July 31, 2017). RESULTS: The mean hematocrit after birth was significantly higher in the DCC/UCM group. Fewer infants had a hematocrit <40% after birth in the DCC/UCM group compared with the ICC group. The incidence of hyperbilirubinemia needing phototherapy, neonatal intensive care unit (NICU) admissions, or readmissions to the hospital for phototherapy was similar between the groups. Fewer infants in the DCC/UCM group were admitted to the NICU primarily for respiratory distress. Symptomatic polycythemia did not occur in either group. Median hospital length of stay was 3 days for both groups. CONCLUSION: Placental transfusion (DCC or UCM) in late preterm infants admitted to a mother baby unit was not associated with increased incidence of hyperbilirubinemia needing phototherapy, symptomatic polycythemia, NICU admissions, or readmissions to the hospital for phototherapy. KEY POINTS: · Placental transfusion was feasible in late preterm infants.. · Placental transfusion resulted in higher mean hematocrit after birth.. · Placental transfusion did not increase the need for phototherapy.. · Fewer admissions to the NICU for respiratory distress were noted in the placental transfusion group..

The relationship of body mass index on patient reported outcomes after platelet-rich plasma versus microfragmented adipose tissue for knee osteoarthritis: A secondary analysis of a randomized controlled trial.

OBJECTIVE: Body mass index (BMI) is known to contribute to outcomes for patients with knee OA. Furthermore, BMI influences the protein expression of orthobiologic treatments like platelet-rich plasma (PRP) and microfragmented adipose tissue (MFAT). We performed a secondary analysis of the association of BMI with PROs for patients with knee OA who received either PRP or MFAT injections. METHODS: Seventy-one patients with knee OA were randomized to receive a single ultrasound-guided injection of PRP or MFAT. PRP was created from 180cc of anti-coagulated blood and processed using a double-spin, buffy-coat concentration system. MFAT was created using autologous lipoaspirate that was processed according to minimal manipulation guidelines. PROs, and osteoarthritis outcome scores (KOOS) were tracked for 12-months. RESULTS: Forty-nine patients (PRP=23, MFAT=26) completed 12-month follow-up. KOOS- Quality of life and activity of daily living subscores were inversely correlated (both p < 0.05) with BMI in the MFAT but not PRPgroup. KOOS-Pain and Sport subscores showed a trend towards inverse correlation with BMI in the MFAT group (p = 0.07 and p = 0.06, respectively), but not PRP.Conclusion: BMI was negatively associated with PROs in patients who received MFAT injections for knee OA, but not for patients receiving PRP.

Abdominal ectopic pregnancy.

Abdominal pregnancy is a rare form of ectopic pregnancy with high morbidity and mortality. There are a limited number of case reports of abdominal ectopic pregnancies. We present a case of a 29-year-old woman who presented to her obstetrician at 17 weeks' gestation with abdominal pain. A sonogram and confirmatory magnetic resonance imaging demonstrated an abdominal ectopic pregnancy. The patient underwent exploratory laparotomy with removal of the ectopic pregnancy. Our case presents an opportunity to discuss a rare form of ectopic pregnancy and the importance of proper diagnosis and treatment to reduce morbidity and mortality.

Calcific tendonitis of the flexor pollicis longus tendon at the thumb interphalangeal joint in childhood.

In rare instances, calcific tendonitis may manifest in the pediatric population as inflammatory calcium hydroxyapatite deposition. To our knowledge, there have been no previous case reports involving the flexor pollicis longus tendon at the thumb interphalangeal joint. We present a 9-year-old boy with a painful mass at the right thumb interphalangeal joint. Initial radiographs revealed a 7-mm ovoid calcific mass along the volar soft tissues of the thumb interphalangeal joint. Subsequent ultrasound and magnetic resonance findings further confirmed calcification with surrounding edema. Because the pain was limiting the patient's school activities, his family elected for excisional biopsy of the calcific mass. Pathology ultimately revealed prominent dystrophic calcifications with surrounding granulomatous inflammation, consistent with calcific tendonitis.

Pregnancy-related emergencies: Profile and outcome.

BACKGROUND: National efforts to reduce maternal mortality with respect to community services have primarily focused on upgrading transportation infrastructure and formalizing training for care providers. There is, however, a paucity of baseline data on the profile and outcomes of pregnant women presenting to the Emergency Department (ED) in India. METHODS: This retrospective study enrolled all pregnant women presenting to a large tertiary medical care center in India, between November 2016 and November 2017. RESULTS: There were 696 ED visits by pregnant women during the study period. The mean age was 26.85 (SD: 4.88) years. Pregnant women in the first trimester contributed to 50.8% of all visits, and 54% being multigravida. The most common presenting complaints were bleeding/spotting per vaginum (PV) (38.2%) and abdominal pain (37.6%) followed by fever (21.6%) and vomiting (21.5%). Obstetric causes contributed to 53.2% of the ED visits, while nonobstetric causes amounted to 43.2%. Over a third (39.7%) required hospital admission. Of these patients, 73% delivered in CMC with live births amounting to 62.3% while 3.5% ended in fetal deaths. The miscarriages rate was as high as 28%. More than half (51.1%) of the deliveries were by normal vaginal delivery. There were no maternal deaths during the time of admission. CONCLUSIONS: Our study sheds new light on the profile of emergency visits among pregnant patients and their relationship to the outcome of pregnancy. First trimester visits were most common with complaints of bleeding PV and abdominal pain. This could explain the high rate of miscarriages among this population.