Background: Hypothermic perfusion is widely used in pediatric cardiac surgery units. The present study evaluated the effects of hypothermia severity on the serum levels of lactate during cardiopulmonary bypass (CPB) in the surgical repair of congenital heart defects in children. Methods: A total of 185 pediatric patients candidated for the elective surgical repair of congenital heart diseases were recruited. The patients’ arterial serum lactate, central venous pressure, diuresis, glucose level, and arterial blood gases were measured and recorded at 4 time points: before CPB, in the cooling stage, in the warming stage, and after CPB and upon admission to the intensive care unit (ICU). Results: The mean age of the patients was 28. 1 ± 19. 6 months. The lactate level was significantly increased more quickly in the patients with hypothermia less than 30 ° C than in those with hypothermia of 30 ° C or greater (P < 0. 001). These 2 groups were significantly different in terms of the duration of CPB (P < 0. 001), the duration of cross-clamping (P < 0. 001), and the volume of the blood filtered (P < 0. 001). No statistically significant difference in the volume of the red blood cell transfused was observed between the 2 groups (P = 0. 12). Conclusions: Deep hypothermia is associated with higher blood lactate levels, which may be associated with poor outcomes during and after CPB. It is recommended that normothermia or mild hypothermia be used during CPB in pediatrics. When the use of deep hypothermia is inevitable, patients should be strictly monitored and screened for adverse outcomes associated with hyperlactatemia.

Background: In COVID-19 pneumonia, chest CT scan plays a crucial role in diagnosing and closely monitoring lung parenchyma. The main reportedly chest CT features of novel coronavirus pneumonia (NCP) have been fully discussed in the literature, but there is still a paucity of reports on uncommon CT manifestations. Case presentation: Herewith, we have reported ten rRT-PCR confirmed COVID-19 patients with CT target signs (bull’, s eye appearance),additionally, we have reviewed previously reported cases. Reviewing the literature, we found eight COVID-19 patients with target sign in the literature. 18 patients were included with a median age of 43. 11 (61%) patients were males. In 87% of patients, the lesions developed within the second-week post symptom onset. These patients mostly experienced an extended hospital stay (median = 10 days), with 53. 8% of cases being admitted in ICU. The in-hospital mortality rate was 23%. Conclusion: Our findings indicate that lesions with a bull’, s eye appearance are not significantly associated with higher mortality in hospitalized COVID-19 patients.

Background: There is no published data on the association between serum biochemical and ultrasonographic markers and adverse pregnancy outcomes. Therefore, the aim of this study was to determine the factors associated with perinatal outcomes in singleton pregnancies using ultrasound and maternal serum markers during the first trimester in Panamanians.Materials and Methods: This was a prospective observational study of 468 first trimester singleton pregnancies conducted over a 7-year period. All women attending a prenatal screening clinic during the study period were informed of the study and the option to participate. Two maternal serum markers, free b-human chorionic gonadotropin (b-hCG) and pregnancy associated plasma protein-A (PAPP-A), and four fetal ultrasound markers, nuchal translucency thickness, nasal bone, flow across the tricuspid valve, and flow in the ductus venosus (DV),were measured by certified maternal fetal medicine specialists. adverse outcomes included miscarriage, major structural defects, genetic disorders, and major fetal cardiac defects.Results: A total of 454 (97%) pregnancies were unaffected. Median maternal age was 31.5 years (range: 18-50). Maternal age was significantly greater in cases of adverse outcome (P=0.007). The number of adverse outcomes associated with an absent or hypoplastic nasal bone, tricuspid valve regurgitation, and abnormal flow in the DV were significantly greater relative to unaffected pregnancies (Ps<0.001). No differences were found in fetal crown-rump length or maternal serum levels of b-hCG or PAPP-A.Conclusion: Abnormal ultrasound markers are associated with adverse outcomes. Women with normal ultrasound and serum markers should be reassured of low risk of adverse pregnancy outcomes.