ABO non-identical platelet transfusions, immune platelet refractoriness and platelet support.

ABO-non-identical (ABO-ni) platelets may be another risk factor for immune platelet transfusion refractoriness (i-PTR). We examined the effect of such platelets on i-PTR and subsequent platelet support through retrospective analysis of 17 322 New Zealand patients receiving ≥1 platelets. Immune PTR was defined as PTR with anti-HLA-I/HPA positivity. Univariate and multivariate analyses determined the independent risk factors for i-PTR. One hundred and eighty-eight patients (1.1%) had i-PTR and received more ABO-ni platelets than non-refractory patients (53.2% vs. 29.5%; p < 0.001). More non-O than group O patients had received ABO-ni platelets before i-PTR diagnosis (67.6% vs. 32.5%; p < 0.001). Female sex (p < 0.001), age ≤ 60 years (p = 0.004), haematology patients (p < 0.001) and ≥2 ABO-ni platelets (p < 0.001) were the independent risk factors for i-PTR. More i-PTR patients with anti-HLA-I were non-O compared to group O (90.1% vs. 75.3%; p = 0.007). More with anti-HLA-I + anti-HPA were group O than non-O (24.7% vs. 9.0%; p = 0.003). ABO-ni platelet-exposed i-PTR patients required matched platelets for longer than those receiving only ABO-i platelets (96.5 vs. 59.0 days; p = 0.02). ABO-ni platelets may be a risk factor for i-PTR with dose effect. ABO-i platelets should be considered whenever possible for at-risk patients.

Scalable Generation and Detection of on-Demand W States in Nanophotonic Circuits.

Quantum physics phenomena, entanglement and coherence, are crucial for quantum information protocols, but understanding these in systems with more than two parts is challenging due to increasing complexity. The W state, a multipartite entangled state, is notable for its robustness and benefits in quantum communication. Here, we generate eight-mode on-demand single-photon W states, using nanowire quantum dots and a silicon nitride photonic chip. We demonstrate a reliable and scalable technique for reconstructing the W state in photonic circuits using Fourier and real-space imaging, supported by the Gerchberg-Saxton phase retrieval algorithm. Additionally, we utilize an entanglement witness to distinguish between mixed and entangled states, thereby affirming the entangled nature of our generated state. The study provides a new imaging approach of assessing multipartite entanglement in W states, paving the way for further progress in image processing and Fourier-space analysis techniques for complex quantum systems.

Endoscopic Third Ventriculostomy for Hydrocephalus in Infants: A Single-center Experience.

INTRODUCTION: Hydrocephalus remains one of the more common pathologies managed in pediatric neurosurgery. Endoscopic third ventriculostomy (ETV) has become the procedure of choice for the treatment of hydrocephalus due to aqueductal stenosis with high success rate. It has an advantage over ventriculoperitoneal (VP) shunting, as it enables patients to remain device free. OBJECTIVE: The purpose of this study is to assess the role of ETV in the treatment of hydrocephalus in children under 1 year of age, including preterm low birth weight infants. MATERIALS AND METHODS: A prospective study of 30 infants undergoing ETV in our institution between January 2014 and December 2018 was carried out. There were 25 cases of congenital hydrocephalus with aqueductal stenosis, two cases of Dandy-Walker cyst, two cases of cerebellopontine angle arachnoid cyst, and one case of posttubercular meningitis. ETV success score was calculated preoperatively to evaluate the percentage of success of ETV. RESULTS: The overall success rate was 76.66% (23), with highest success rate of 84% in aqueductal stenosis. The mean age was 6.75 months (range: 1.5-12 months). Five infants were born preterm, four of them required a permanent VP shunt. There were two cases of intraoperative bleeding, four cases of cerebrospinal fluid leak from the wound, and one case of meningitis. CONCLUSION: ETV can be considered a safe and effective modality for the initial treatment of hydrocephalus in full-term normal birth weight infants, while the success of ETV in preterm low birth weight infants need further study of maturity at birth and birth weight as the determinant factors for the success of ETV in this special group.

Clinical spectrum of electrical burns - A prospective study from the developing world.

INTRODUCTION: Electrical burns are devastating, posing development of multiple injuries with high morbidity and mortality. Electrical burn management benefits from a multidisciplinary, multispecialty collaborative approach to improve outcomes. OBJECTIVE: To highlight the clinical spectrum of electrical burns in the developing world, including common etiologies, presentation, intervention, associated injuries, and complications. MATERIALS AND METHODS: A prospective study was conducted from January 2010 to December 2015 that included 78 patients (75 men and 3 women), who presented with a history of electrical burns. Patients were interviewed for detailed clinical history and physical examination. RESULTS: The study comprised 78 patients (high-voltage group: 38.46% and low-voltage group: 61.54%). The most affected age group was the 21-40 year age group. High-voltage injuries were more devastating. The most common complication was septicemia in 24.4% of the patients, which included 43.3% from the high-voltage group. CONCLUSION: Electrical burns affecting young adult men can impose a significant burden in developing countries. Electrical burns, especially due to high voltage, involve multiple organs benefitting from multidisciplinary management and have significant residual sequelae. Public awareness and education and proper training of industry workers remain the best way to minimize the prevalence of electric burns in the developing world.

Hepatitis E virus seroprevalence in three hyperendemic areas: Nepal, Bangladesh and southwest France.

BACKGROUND: Hepatitis E causes a significant burden of disease in developing countries and has recently been increasingly recognized in developed countries. Comparing population anti-hepatitis E virus (HEV) seroprevalence across populations has been difficult. OBJECTIVES: The aim of this study was to compare the anti-HEV IgG seroprevalence in both adults and children in three hyper-endemic areas (Nepal, Bangladesh and southwest France) using a sensitive, commercial anti-HEV IgG assay. STUDY DESIGN: Serum or plasma from adults and children in Nepal (n=498), Bangladesh (n=1,009) and Southwest France (n=1031) were tested for anti-HEV IgG using the Wantai assay. RESULTS: After age-standardization, anti-HEV IgG seroprevalence was 47.1%, 49.8% and 34.0% in Nepal, Bangladesh and southwest France, respectively. There was no difference in seroprevalence by gender in any of the countries. A paucity of infections in children 1-10 years-old was consistently observed (less than 15%) at all 3 locations. CONCLUSIONS: Surprisingly similar high rates of anti-HEV antibodies were detected using a common, sensitive assay. Despite differences in the epidemiology and circulating genotype of HEV in Nepal, Bangladesh and southwest France, this study found more similarities in population seroprevalence than expected.

Gastric bypass for insulin resistance due to lipodystrophy.

We report a 41-year-old woman with severe insulin resistance due to partial lipodystrophy, who was successfully treated with gastric bypass surgery.

Quality of life assessment in patients with inguinal hernia.

BACKGROUND: The natural history of untreated inguinal hernia (IH) is poorly understood. Whether a delay in operative repair of IH leads to excessive physical suffering or significant psychosocial impairment is not known. This study attempts to quantify the morbidity of patients with IH by assessing their quality of life (QOL) while on a waiting list for IH surgery. METHODS: QOL was measured in adult patients with IH who were on the waiting list using a standardized SF-36 questionnaire. Scores were compared with a sample of age-, sex- and comorbidity-matched controls. RESULTS: A total of 143 patients were identified, of which 106 were included in the study. Patients with IH had significantly impaired QOL compared with comorbidity- and demographic-matched controls across all of the domains measured. Subgroup analysis showed an inverse relationship between the size of the IH and the QOL and patients employed in manual work tended to have lower QOL compared with those with sedentary vocations. CONCLUSIONS: In conclusion, we showed that the SF-36 score is a good measure of QOL in this patient group. Those patients on the elective waiting list for repair of IH have a significantly impaired QOL compared with age-, sex- and comorbidity-matched controls.

Isolated dissection of a non-aneurysmal popliteal artery.

Two cases of isolated dissection of a non-aneurysmal, non-atherosclerotic popliteal artery are reported. Isolated dissection of the popliteal artery is a distinct entity that may have far reaching effects on patient's mobility if not adequately treated. This lesion can be seen in non-aneurysmal, non-atherosclerotic vessels and in patients with no predisposing medical causes. It requires a high degree of suspicion for diagnosis because of its rarity. Surgical treatment is the best option and results in a good outcome.