Significance of nuchal cord

Perinatal events of 180 babies with nuchal cord (umbilical cord entanglement around foetal neck) over one year have been studied. The incidence of nuchal cord was 5.74% of all hospital deliveries. More than one third (39%) of them had tight nuchal cord (TNC) and 61% had loose nuchal cord (LNC). Babies with TNC were more frequently met with foetal distress (51%), prolonged second stage (11%), non-toxaemic accidental haemorrhage (7%) and operative delivery (56%) when compared to babies with LNC and controls (without nuchal cord). Nearly one fourth (24%) of the babies with TNC were born as small for date, had birth asphyxia (61%) and 8.5% died during perinatal period. Perinatal outcome was adversely affected by TNC in comparison to LNC and controls.     

Four heparin preparations: anti-Xa potentiating effect of heparin after subcutaneous injection

Four different heparin preparations--sodium and calcium salts of the same batch of heparin (mean molecular weight 15,000), low molecular weight sodium heparin (mean m.w. 9,000) and high molecular weight sodium heparin (mean m.w. 22,000) were injected subcutaneously on different days each into 6 healthy young volunteers in a randomized trial. Plasma heparin levels were measured using the anti-Xa assay at 1 hour, 3-4 hours and 6-7 hours after the injection. The highest anti-Xa potentiating effect was obtained after the injection of the low molecular weight sodium heparin (mean 0.381 i.u./ml) at 3-4 hours after the injection. With sodium heparin (m.w. 15,000) the highest values (0.135 i.u./ml) were found at 1 hour. Significantly lower anti-Xa potentiating effect was obtained 1 hour after the injection of calcium heparin and in particular after the injection of high molecular weight heparin (mean values 0.072 i. u./ml and 0.043 i. u./ml respectively). Both these preparations showed an increase from 1 hour after injection to 3-4 hours after injection (mean values 0.082 i. u./ml and 0.057 i. u./ml at 3-4 hours after injection). These results indicate that the salt and the molecular weight of the preparation may strongly influence the degree of anticoagulation achieved after subcutaneous injection.     

Reactivity of the sympathetic-adrenal system in juvenile thyrotoxicosis

In examination of patients with thyrotoxicosis, aged from 14 to 24 years, there was revealed a reduction of the activity of the mediatory link of the sympathico-adrenal ssystem without any connection with age, the severity and duration of the disease, and also with the efficacy of drug therapy. The functional test with insulin in patients with thyrotoxicosis permitted to detect definite reserve possibilities of the adrenergic regulation intensified with increased duration of the disease and with advance of the patient's age, but not with increased severity of the disease. The insulin test offered a possibility of assessing the sympathico-adrenal system reactivity in cases of different degree of the disease compensation.