We have previously demonstrated that sickle cell disease (SCD) patients maintain normal global systemic and cerebral oxygen delivery by increasing cardiac output. However, ischemic end‐organ injury remains common suggesting that tissue oxygen delivery may be impaired by microvascular dysregulation or damage. To test this hypothesis, we performed fingertip laser Doppler flowmetry measurements at the base of the nailbed and regional oxygen saturation (rSO2) on the dorsal surface of the same hand. This was done during flow mediated dilation (FMD) studies in 26 chronically transfused SCD, 75 non‐transfused SCD, and 18 control subjects. Chronically transfused SCD patients were studied prior to and following a single transfusion and there was no acute change in rSO2 or perfusion. Laser Doppler estimates of resting perfusion were 76% higher in non‐transfused and 110% higher in transfused SCD patients, compared to control subjects. In contrast, rSO2 was 12 saturation points lower in non‐transfused SCD patients, but normal in the transfused SCD patients. During cuff occlusion, rSO2 declined at the same rate in all subjects suggesting similar intrinsic oxygen consumption rates. Upon cuff release, laser doppler post occlusive hyperemia was blunted in SCD patients in proportion to their resting perfusion values. Transfusion therapy did not improve the hyperemia response. FMD was impaired in SCD subjects but partially ameliorated in transfused SCD subjects. Taken together, non‐transfused SCD subjects demonstrate impaired conduit artery FMD, impaired microcirculatory post‐occlusive hyperemia, and resting hypoxia in the hand despite compensated oxygen delivery, suggesting impaired oxygen supply‐demand matching. Transfusion improves FMD and oxygen supply‐demand matching but not microcirculation hyperemic response.

<b><i>Introduction:</i></b> Postoperative membrane separation is a complication of selective laser photocoagulation of communicating vessels (SLPCV) for the treatment of twin-twin transfusion syndrome (TTTS). <b><i>Objective:</i></b> The aim of this work was to determine whether a quantitative grading system of membrane separation following SLPCV was associated with preterm premature rupture of membranes (PPROM) and preterm delivery (PTD). <b><i>Methods:</i></b> Patients with membrane separation after SLPCV on postoperative day 1 were stratified into greatest width of separation &#x3c;1 cm (Group A) or ≥1 cm (Group B) and compared to patients without separation by the following outcomes: PPROM ≤21 postoperative days, PTD &#x3c;28 gestational weeks, and PTD &#x3c;32 gestational weeks. <b><i>Results:</i></b> Of 654 patients, 123 (18.8%) had membrane separation. Of these, 120 patients were eligible for study and divided into Groups A (<i>n</i> = 91) and B (<i>n</i> = 29). Multiple logistic regression analysis yielded associations with PPROM ≤21 days for Groups B (OR 8.60, 95% CI 3.38–21.90, <i>p</i> &#x3c; 0.0001) and A (OR 2.39, 95% CI 1.05–5.40, <i>p</i> = 0.0369) compared to those without membrane separation. In similar models, Group B was associated with PTD &#x3c;32 weeks (OR 2.41, 95% CI 1.10–5.28, <i>p</i> = 0.0274). <b><i>Conclusion:</i></b> Postoperative membrane separation was associated with an increased risk of PPROM ≤21 days. Membrane separation ≥1 cm had a higher risk of PTD &#x3c;32 weeks.

Our study demonstrated that the increased monocyte counts at recurrence/progression may be a useful biomarker for predicting decreased survival outcome of women with endometrial cancer.

HighlightsSudden cardiac arrest can be a form of carboplatin hypersensitivity reaction.Platinum retreatment and cumulative cycles of ≥ 8 are risk factors.Awareness of the reaction related to carboplatin infusion is necessary.Successful resuscitation with high quality CPR is achievable with trained staffs.