Haemostatic management of extreme challenges to haemostasis in acquired von Willebrand syndrome.

Acquired von Willebrand syndrome (AVWS) is a rare hemorrhagic condition for which very little information is available regarding the management of extreme challenges to Haemostasis. The AVWS is more common in the elderly, who are frequently exposed to invasive procedures and/or chemotherapy. Haematopoietic stem cell transplantation (HSCT) is a situation in which the haemostatic capacity is challenged by severe thrombocytopaenia, chemotherapy-associated mucosal barrier breakdown and the need for invasive procedures. In our report, we present and discuss the haemostatic management of a patient with AVWS who was refractory to Von Willebrand factor concentrate replacement during the course of an autologous HSCT to treat multiple myeloma. Patients with AVWS are frequently exposed to high-risk haemostatic challenges, and additional information about the haemostatic management of these situations is necessary.

Reducing size-dispersion in one-pot aqueous synthesis of maghemite nanoparticles.

Nanosized maghemite-like particles with reduced size-distribution were obtained using a one-pot synthesis route in aqueous medium. Forced hydrolysis of iron ions in ammoniac solution led to the formation of magnetite nanoparticles that were oxidized to maghemite in a hydrothermal digestion step that reduced the polydispersity of nanograins. The prepared nanoparticles were characterized by chemical analysis, X-ray diffractometry, magnetization, Raman spectroscopy and transmission electron microscopy measurements. Data showed that 14 nm-sized particles with polydispersity of about 0.14 were produced and, differently from other procedures, neither additional steps nor toxic reagents were needed to reduce size-dispersion or to oxidize magnetite to maghemite. These facts per se turn such nanodevice into a good potential choice for biomedical applications.

Miniplates in the frontozygomatic region. An anatomic study.

A study of the frontozygomatic region (FZ) to determine an anatomic basis for the use of miniplates in this area was done. Plaster models were obtained from 35 adult skulls and were sectioned at six defined points. Osseous thickness measurements were made perpendicularly to the bone surface. Measurements to determine the risk of penetrating the cranial cavity were also done. The results show that above the FZ suture 5-mm screws should be used. At the two points below the suture, 7-mm screws can be used. The risk of penetrating to the cranial cavity occurs 10 mm above the suture. The diploe thickness at the level of the anterior cranial fossa floor indicates the use of a 7-mm screw at a distance 13.5-18.5 mm from the suture and 5-mm screws above 18.5 mm.

Peritoneal catheter extrusion through the scrotal sac: case report

Peritoneal catheter extrusion throught the scrotal sac: the extrusion of a peritoneal catheter throught the scrotal bolsa following ventriculoperitoneal shunt is unconmmon. The authors report a case of peritoneal catheter extrusion through the scrotal sac a 5-month-old child, with excellent outcome.