Interactions between programmable shunt valves and the iPad 3 with Smart Cover.

INTRODUCTION: In patients with programmable CSF shunt valves, the risk of unintentional valve adjustment associated with the environmental magnetic influence is ever present. We tested whether the iPad 3 with Smart Cover is capable of changing the setting of individual programmable valves ex vivo using direct fluoroscopic visualization. METHODS: The following valves were tested: Strata NSC Adjustable Pressure Valve, Strata NSC Burr Hole Valve, Strata II small valve, Sophysa Polaris model SPV, Aesculap valve proGAV, and Codman Certas Programmable Valve. The left front edge of the iPad 3 with Smart Cover was found to have the strongest magnetic flux, measuring approximately 1,200 G and was moved linearly directly over the tested valve and then parallel to the first path at approximately 30 cm/s. Also, this area was rotated once at varying distances above the valve at approximately 1 rad/s. RESULTS: Almost all shunt valves were immune to reprogramming by the iPad 3 at varying distances (including direct contact) except for the Strata II small valve, where rotating the peak flux location 4 mm above the valve changed the valve pressure settings every time. CONCLUSIONS: The iPad 3 can change pressure settings of the Strata II small valve at a distance comparable to the thickness of certain regions of the scalp. Although the specific rotational motion described here may be uncommon in real life, it is nevertheless recommended that children with hydrocephalus, caregivers, educators, and therapists are informed of the now-apparent risks of close contact with this increasingly popular technology.

The novel HLA-B*51:01:83 allele was identified by next-generation sequencing.

HLA-B*51:01:83 differs from HLA-B*51:01:01:01 by one single nucleotide substitutions in exon 5.

Hyperacute stabilization (<12 hours) for polytrauma patients with unstable spinal fractures.

BACKGROUND: The objective of this study is to validate the safety of hyperacute stabilization. METHODS: Patient demographics, American Spinal Injury Association (ASIA) grade on initial evaluation and serial follow up grades, hospital length of stay, Intensive Care Unit length of stay, intraoperative blood loss, postoperative length of stay, comorbidities, Injury Severity Score and complications of recumbency were recorded. RESULTS: Corroborating previous studies, our study shows polytrauma patients undergoing a hyperacute stabilization of a spinal fracture displayed a trend towards better neurological outcome and decreased hospital stays while having a similar complication rate to those operated on in a delayed fashion. CONCLUSIONS: Hyperacute stabilization can be associated with improved ASIA grades even in complete injuries.

Chemoenzymatic synthesis of the sialyl Lewis X glycan and its derivatives.

A combination of recombinant FKP and alpha-(1-->3)-fucosyltransferase allows the facile synthesis of the sialyl Lewis X tetrasaccharide glycan and its derivatives in excellent yield. In this system, the universal fucosyl donor, guanidine 5'-diphosphate-beta-L-fucose (GDP-fucose), or its analogues can be generated in situ by cofactor recycling using pyruvate kinase.