Prevalence and antimicrobial resistance patterns of Salmonella isolated from poultry farms in southeastern United States

Salmonella spp. are among the most common foodborne pathogens, and increase in the occurrence of antimicrobial drug-resistant Salmonella poses a severe risk to public health. The main objective of this study was to determine changes in Salmonella prevalence and their antimicrobial resistance on poultry farms following recommendations to changes in biosecurity practices. Four poultry farms were sampled by collecting cloacal swabs, drag swabs, and litter samples prior to recommended biosecurity changes (March-April) and post recommendations (October-November). Prevalence of Salmonella was 3 to 4% during pre-recommendations, while the prevalence was higher (P > 0.05), ranging from 5 to 14% during post recommendations. Higher Salmonella prevalence was observed for pre- and post-recommendation phases by sample type in cloacal and drag samples -5% for farm 1, drag swab -6% on farm 2, cloacal swab -6% for farm 3, and drag swab -17% on farm 4. The PCR confirmed Salmonella were serotyped and tested for antimicrobial resistance. Six serotypes of Salmonella were identified with S. Enteritidis (52%) being the most prevalent, followed by S. Berta (38%), S. Mbandaka (7%), S. Typhimurium (2%), S. Kentucky (0.4%), and S. Tennessee (0.4%). A total of 7% isolates exhibited resistance to at least one of the 8 antimicrobials. Higher resistance was observed for tetracycline, streptomycin, and nalidixic acid. A single isolate of S. Mbandaka exhibited multidrug resistance to tetracycline, amoxicillin/clavulanic acid, and ampicillin. Based on these prevalence results, it can be inferred that, irrespective of implementation of improved biosecurity practices, seasonal variation can cause changes in the prevalence of Salmonella on the farms. Resistance to clinically important antimicrobials used to treat salmonellosis is a concern to public health.

Pubic lice infestation in man from Mhow, Madhya Pradesh

Worldwide, 2-10% of human population is infested with pubic lice which are mostly found in the hair of pubic area, occasionally under the armpits, in the beard or mustache and on the eyebrows and eyelashes. They are usually transmitted through sexual contact or through toilet seats and bedding material. A twenty-year-old boy suffering from severe itching in the genital region during night hours submitted the lice for their identification in Department of Veterinary Parasitology, College of Veterinary Science and Animal Husbandry, Mhow. These lice were identified as Phthirus pubis.

Sclerosing polycystic adenosis of the oral cavity

Minor salivary glands are ubiquitous in the oral cavity, and related diseases are often indolent and asymptomatic. We describe the unusual features of sclerosing polycystic adenosis, and its similarities to more sinister conditions of the minor salivary glands. Its importance is currently uncertain and research points to a pathogenesis that is neoplastic, which can create ambiguity. Sclerosing polycystic adenosis is a newly-discovered condition that merits further discussion and research to evaluate its full impact.

Harmonic Generation from Neutral Manganese Atoms in the Vicinity of the Giant Autoionization Resonance

High harmonics from laser-ablated plumes are mostly generated from ionic species. We demonstrate that with ultrashort infrared (∼1.82  μm) driving lasers, high harmonics from laser-ablated manganese are predominantly generated from neutral atoms, a transition metal atom with an ionization potential of 7.4 eV. Our results open the possibility to advance laser-ablation technique to study the dynamics of neutral atoms of low ionization potential. Moreover, as manganese contains giant autoionizing resonance, intense and broadband high harmonics have been demonstrated from this resonance at energies from 49 to 53 eV. This opens the possibility to generate intense attosecond pulses directly from the giant resonances, as well as to study these resonances using high-harmonic spectroscopy.

Prediction and prevention of small-for-gestational-age neonates: evidence from SPREE and ASPRE

OBJECTIVES

To examine the effect of first-trimester screening for pre-eclampsia (PE) on the prediction of delivering a small-for-gestational-age (SGA) neonate and the effect of prophylactic use of aspirin on the prevention of SGA.

METHODS

The data for this study were derived from two multicenter studies. In SPREE, we investigated the performance of screening for PE by a combination of maternal characteristics and biomarkers at 11-13 weeks' gestation. In ASPRE, women with a singleton pregnancy identified by combined screening as being at high risk for preterm PE (> 1 in 100) participated in a trial of aspirin (150 mg/day from 11-14 until 36 weeks' gestation) compared to placebo. In this study, we used the data from the ASPRE trial to estimate the effect of aspirin on the incidence of SGA with birth weight < 10^th , < 5^th and < 3^rd percentile for gestational age. We also used the data from SPREE to estimate the proportion of SGA in the pregnancies with a risk for preterm PE of > 1 in 100.

RESULTS

In SPREE, screening for preterm PE by a combination of maternal factors, mean arterial pressure, uterine artery pulsatility index and serum placental growth factor identified a high-risk group that contained about 46% of SGA neonates < 10^th percentile born at < 37 weeks' gestation (preterm) and 56% of those born at < 32 weeks (early); the overall screen-positive rate was 12.2% (2014 of 16 451 pregnancies). In the ASPRE trial, use of aspirin reduced the overall incidence of SGA < 10^th percentile by about 40% in babies born at < 37 weeks' gestation and by about 70% in babies born at < 32 weeks; in babies born at ≥ 37 weeks, aspirin did not have a significant effect on incidence of SGA. The aspirin-related decrease in incidence of SGA was mainly due to its incidence decreasing in pregnancies with PE, for which the decrease was about 70% in babies born at < 37 weeks' gestation and about 90% in babies born at < 32 weeks. On the basis of these results, it was estimated that first-trimester screening for preterm PE and use of aspirin in the high-risk group would potentially reduce the incidence of preterm and early SGA by about 20% and 40%, respectively.

CONCLUSION

First-trimester screening for PE by the combined test identifies a high proportion of cases of preterm SGA that can be prevented by the prophylactic use of aspirin. © 2018 Crown copyright. Ultrasound in Obstetrics & Gynecology © 2018 ISUOG.

Tele-evidence: A videoconferencing tool as a viable alternative to physical appearance of doctors for the judicial summons

Introduction:

The role of physicians often extends beyond provision of direct patient care and includes appearance in courts as professional or expert witnesses to give their testimony in various legal cases. This often consumes precious time and resources of the doctors and the hospitals. This study was taken up to evaluate the present system of the physical appearance of the doctors to various courts and compare it with the videoconferencing mode of giving testimony (tele-evidence).

Materials and Methods:

Available records of summons and vehicles used were analyzed to calculate the cost involved and man-hours consumed in honoring the court summons. Telemedicine facility, available in our institute, was used for conducting tele-evidence with selected courts of the two states as a pilot, which was later expanded. A survey was also done to assess the experience of the physicians with physical appearance and videoconferencing using structured questionnaire after approval from the Institute's Ethics Committee. Likert scale of 0–10 points was used to measure satisfaction.

Results:

There was 43% drop in the monthly mileage of vehicles, 49% reduction in the fuel cost per month, and 28% savings in terms of time consumed for court duties. Satisfaction score for parameters of time consumed, physical strain, mental strain, communication with Honorable Judges, and overall experience was 87% through tele-evidence as compared to 31% with physical appearance.

Conclusion:

Tele-evidence is an acceptable and implementable mode of testifying and has led to tremendous resource savings in our tertiary care setting. The model needs to be replicated for deliverance of justice and is in consonance with Government's push toward Digital India.

ASPRE trial: incidence of preterm pre-eclampsia in patients fulfilling ACOG and NICE criteria according to risk by FMF algorithm

OBJECTIVE

To report the incidence of preterm pre-eclampsia (PE) in women who are screen positive according to the criteria of the National Institute for Health and Care Excellence (NICE) and the American College of Obstetricians and Gynecologists (ACOG), and compare the incidence with that in those who are screen positive or screen negative by The Fetal Medicine Foundation (FMF) algorithm.

METHODS

This was a secondary analysis of data from the ASPRE study. The study population consisted of women with singleton pregnancy who underwent prospective screening for preterm PE by means of the FMF algorithm, which combines maternal factors and biomarkers at 11-13 weeks' gestation. The incidence of preterm PE in women fulfilling the NICE and ACOG criteria was estimated; in these patients the incidence of preterm PE was then calculated in those who were screen negative relative to those who were screen positive by the FMF algorithm.

RESULTS

A total of 34 573 women with singleton pregnancy delivering at ≥ 24 weeks' gestation underwent prospective screening for preterm PE, of which 239 (0.7%) cases developed preterm PE. At least one of the ACOG criteria was fulfilled in 22 287 (64.5%) pregnancies and the incidence of preterm PE was 0.97% (95% CI, 0.85-1.11%); in the subgroup that was screen positive by the FMF algorithm the incidence of preterm PE was 4.80% (95% CI, 4.14-5.55%), and in those that were screen negative it was 0.25% (95% CI, 0.18-0.33%), with a relative incidence in FMF screen negative to FMF screen positive of 0.051 (95% CI, 0.037-0.071). In 1392 (4.0%) pregnancies, at least one of the NICE high-risk criteria was fulfilled, and in this group the incidence of preterm PE was 5.17% (95% CI, 4.13-6.46%); in the subgroups of screen positive and screen negative by the FMF algorithm, the incidence of preterm PE was 8.71% (95% CI, 6.93-10.89%) and 0.65% (95% CI, 0.25-1.67%), respectively, and the relative incidence was 0.075 (95% CI, 0.028-0.205). In 2360 (6.8%) pregnancies fulfilling at least two of the NICE moderate-risk criteria, the incidence of preterm PE was 1.74% (95% CI, 1.28-2.35%); in the subgroups of screen positive and screen negative by the FMF algorithm the incidence was 4.91% (95% CI, 3.54-6.79%) and 0.42% (95% CI, 0.20-0.86%), respectively, and the relative incidence was 0.085 (95% CI, 0.038-0.192).

CONCLUSION

In women who are screen positive for preterm PE by the ACOG or NICE criteria but screen negative by the FMF algorithm, the risk of preterm PE is reduced to within or below background levels. The results provide further evidence to support the personalized risk-based screening method that combines maternal factors and biomarkers. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

The good, the bad, and the ugly of luminex donor-specific crossmatch

The presence of donor-specific antibodies directed against human leukocyte antigen significantly influences renal transplant because of antibody-mediated rejection. We performed the screening of pre-renal transplant patients for preformed anti-HLA antibodies using anti-human globulin augmented-complement-dependent lymphocytotoxicity crossmatch (AHG-CDCXm), luminex donor-specific crossmatch (LumXm) and HLA antibody screening. Seven hundred and fifty-four patients were assessed for LumXm. HLA antibody screening was possible in 325 out of 754 cases. All the three investigations viz. CDCXm, HLA antibody screening and LumXm was performed in 325 patients. All CDCXm positive patients (10/325, 3.08%) were also positive with LumXm and HLA antibody screen whereas 14 cases (4.31%) with CDCXm negative were positive with luminex-based assays. LumXm and HLA antibody screening were both positive in 24 (7.38%) cases, LumXm and HLA antibody screening were both negative in 275 (84.63%) cases and LumXm negative and HLA antibody screening was positive in 22 (6.76%) cases. However, there were four cases (1.23%) which were positive in LumXm in spite of being negative in HLA antibody testing. Single Antigen Bead (SAB) assay was performed in all patients positive for HLA antibody test. We suggest that LumXm is a useful and sensitive technique for the detection of anti-HLA antibodies in pre-transplant renal patients. However, other measures such as luminex antibody screen, SAB assay, history of the donor, and the class of antibodies involved should be taken into consideration for pre-transplant work up of renal patients.

High and long-term von Willebrand factor expression after Sleeping Beauty transposon-mediated gene therapy in a mouse model of severe von Willebrand disease

Essentials von Willebrand disease (VWD) is the most common inherited bleeding disorder. Gene therapy for VWD offers long-term therapy for VWD patients. Transposons efficiently integrate the large von Willebrand factor (VWF) cDNA in mice. Liver-directed transposons support sustained VWF expression with suboptimal multimerization.

SUMMARY

Background Type 3 von Willebrand disease (VWD) is characterized by complete absence of von Willebrand factor (VWF). Current therapy is limited to treatment with exogenous VWF/FVIII products, which only provide a short-term solution. Gene therapy offers the potential for a long-term treatment for VWD. Objectives To develop an integrative Sleeping Beauty (SB) transposon-mediated VWF gene transfer approach in a preclinical mouse model of severe VWD. Methods We established a robust platform for sustained transgene murine VWF (mVWF) expression in the liver of Vwf-/- mice by combining a liver-specific promoter with a sandwich transposon design and the SB100X transposase via hydrodynamic gene delivery. Results The sandwich SB transposon was suitable to deliver the full-length mVWF cDNA (8.4 kb) and supported supra-physiological expression that remained stable for up to 1.5 years after gene transfer. The sandwich vector stayed episomal (~60 weeks) or integrated in the host genome, respectively, in the absence or presence of the transposase. Transgene integration was confirmed using carbon tetrachloride-induced liver regeneration. Analysis of integration sites by high-throughput analysis revealed random integration of the sandwich vector. Although the SB vector supported long-term expression of supra-physiological VWF levels, the bleeding phenotype was not corrected in all mice. Long-term expression of VWF by hepatocytes resulted in relatively reduced amounts of high-molecular-weight multimers, potentially limiting its hemostatic efficacy. Conclusions Although this integrative platform for VWF gene transfer is an important milestone of VWD gene therapy, cell type-specific targeting is yet to be achieved.

Pre-freezing Treatment with Butylated Hydroxytoluene and Cholesterol-loaded Methyl-β-cyclodextrin Improves Quality of Cryopreserved Boar Semen

BACKGROUND

Pre-freezing treatment of boar sperm with additives improves the quality of post-thaw sperms.

OBJECTIVES

The study aimed to determine the efficacy of butylated hydroxy-toluene (BHT) and cholesterol-loaded methyl-β-cyclodextrin (CLC) for the improvement of the frozen-thawed boar sperm quality.

METHODS

Split samples of 30 ejaculates from six boars were cryopreserved in lactose-egg yolk-glycerol extender containing BHT (0.2 mM), CLC (5 mg/ 200-240 x 10⁶ sperm) or BHT (0.2 mM) plus CLC (5 mg per 200-240 x 10⁶ sperm). Semen samples were evaluated for motility, membrane integrity, acrosomal status, mitochondrial membrane potential (MMP), DNA integrity and lipid peroxidation after equilibration and after freezing.

RESULTS

The addition of BHT and CLC into the extender significantly improved (P<0.05) plasma membrane integrity and decreased (P<0.05) lipid peroxidation after freezing. Post-thaw motility and live intact acrosome were significantly (P<0.05) higher in the extenders with BHT or BHT plus CLC. The post-thaw MMP of viable spermatozoa and DNA integrity were not affected. BHT plus CLC showed a significant (P<0.05) improvement on motility as compared to BHT and CLC alone.

CONCLUSION

Treatment of boar spermatozoa with BHT and CLC improved post-thaw sperm quality.

Effect of Reduced Glutathione, Water Soluble Vitamin E Analogue and Butylated Hydroxytoluene on the Post Thaw Characteristics of Boar Spermatozoa

BACKGROUND

Antioxidant in freezing extender of boar semen improved post thaw sperm function.

OBJECTIVE

The study compared the effects of reduced glutathione (GSH), water soluble vitamin E analogue Trolox and butylated hydroxytoluene (BHT) on quality of cryopreserved boar spermatozoa.

MATERIALS AND METHODS

Using split sample technique three different antioxidants namely, GSH (1 mM), vitamin E (0.2 mM) and BHT (0.2 mM) were added to the freezing medium of lactose-egg yolk-glycerol extender, and samples were frozen using controlled freezing rate of 40°C/min from -6 to -140°C. Samples were evaluated for sperm motility, acrosomal status, plasma membrane integrity, mitochondrial membrane potential, lipid peroxidation and sperm DNA integrity after equilibration and after freezing.

RESULTS

The supplementation of GSH, vitamin E and BHT resulted in significantly higher post thaw motility, live intact acrosome and plasma membrane intact sperm. The incidence of post thaw sperm lipid peroxidation was significantly reduced after addition of antioxidants. However, antioxidants treatment neither significantly improved mitochondrial membrane potential of live sperm sub-population nor sperm DNA integrity after freezing. There was no significant difference of the post thaw sperm characteristics among three antioxidants. Protective effect of GSH, vitamin E and BHT are comparable on cryopreserved boar spermatozoa.

The catalase gene promoter and 5'-untranslated region variants lead to altered gene expression and enzyme activity in vitiligo

BACKGROUND

Oxidative stress is considered to be the initial event in the course of vitiligo. The enzyme catalase (CAT) is mainly involved in cellular defence against oxidizing agents through detoxifying H₂ O₂ .

OBJECTIVES

The aims were (i) to assess erythrocyte CAT enzyme activity and lipid peroxidation (LPO) levels as well as CAT mRNA expression in skin and blood; (ii) to investigate CAT gene promoter rs7943316, rs1001179, 5'-untranslated region rs1049982, and exon (rs17886350, rs11032709, rs17880442, rs35677492) polymorphisms; and (iii) to perform genotype/haplotype-phenotype correlation analyses in patients with vitiligo and controls from Gujarat.

METHODS

CAT activity and LPO levels were measured spectrophotometrically. CAT mRNA levels were estimated using real-time polymerase chain reaction (PCR) by the SYBR Green method. Single-nucleotide polymorphism genotyping was performed using PCR-restriction fragment length polymorphism and amplification-refractory mutation system-PCR analyses.

RESULTS

Patients with vitiligo showed significantly decreased CAT mRNA expression in lesional and nonlesional skin and in blood, with reduced CAT activity compared with that of controls. CAT -89A/T and -20T/C polymorphisms were significantly associated with patients, especially with active and generalized vitiligo, whereas no association was observed for -262G/A and exon polymorphisms. The A_-262 T_-89 C_-20 haplotype with variant alleles was found to be associated with 6·4-fold risk of vitiligo. Genotype/haplotype-phenotype correlation analyses revealed that individuals with susceptible genotypes/haplotype for CAT -89A/T and -20T/C polymorphisms showed significantly decreased CAT mRNA/activity, and only -89A/T polymorphisms showed significantly increased LPO levels compared with wild-type genotypes/haplotype.

CONCLUSIONS

The present study proposes the crucial role of CAT and its allelic variants in oxidative stress-mediated pathogenesis of vitiligo.

Ion implantation for deterministic single atom devices

We demonstrate a capability of deterministic doping at the single atom level using a combination of direct write focused ion beam and solid-state ion detectors. The focused ion beam system can position a single ion to within 35 nm of a targeted location and the detection system is sensitive to single low energy heavy ions. This platform can be used to deterministically fabricate single atom devices in materials where the nanostructure and ion detectors can be integrated, including donor-based qubits in Si and color centers in diamond.

Spectrum of Malignant Skin Lesion in Patients attending Nepalgunj Medical College and Teaching Hospital

IntroductionClinical diagnosis of dermatological manifestation of neoplastic skin lesion can pose a diagnostic difficulty at times. Histopathological diagnosis is mandatory for accurate characterization of disease entity for proper and timely management of cases.ObjectiveThe aim of this study was to analyze malignant tumor of skin with respect to age, sex, clinical features and histopathological features and to evaluate the accuracy of clinical diagnosis with histopathological correlation.MethodologyThis is hospital based cross-sectional study conducted at Nepalgunj Medical College and Teaching Hospital, Kohalpur from February 2010 to January 2011. A total of 70 histopathological specimens of skin biopsies were studied and correlated with the clinical diagnosis. The data was entered into Microsoft  office excel and analyzed using statistical package for social sciences (SPSS 17.0).ResultsMalignant tumor of skin constituted 21.4% of total cases. In malignant tumor, most common sites were head and neck regions followed by lower limb with keratinocytic tumors being in the majority. Most of the specimens (65.7%) were obtained as excisional biopsies.  Seven cases diagnosed as benign lesions clinically, turned out to be malignant on histopathological examination. Out of 13 cases in which clinical diagnosis was of malignancy, only 8 turned out to be malignant, thus for malignant lesions, the clinical diagnosis had a sensitivity of 53.3%, specificity of 90.9% and a positive predictive value of 61.5%.ConclusionsSquamous cell carcinoma was the most common malignant tumor in this study and histopathological correlation significantly modifies the overall management in dermatological disorders where clinical diagnoses are equivocal.Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, Page: 156-161

Effect of monthly high-dose vitamin D on bone density in community-dwelling older adults substudy of a randomized controlled trial

BACKGROUND

Severe vitamin D deficiency causes osteomalacia, yet trials of vitamin D supplementation in the community have not on average demonstrated benefit to bone mineral density (BMD) or fracture risk in adults.

OBJECTIVE

To determine whether monthly high-dose vitamin D supplementation influences BMD in the general population and in those with low 25-hydroxyvitamin D levels.

METHODS

Two-year substudy of a trial in older community-resident adults. A total of 452 participants were randomized to receive monthly doses of vitamin D3 100 000 IU, or placebo. The primary end-point was change in lumbar spine BMD. Exploratory analyses to identify thresholds of baseline 25-hydroxyvitamin D for vitamin D effects on BMD were prespecified.

RESULTS

Intention-to-treat analyses showed no significant treatment effect in the lumbar spine (between-groups difference 0.0071 g cm^-2 , 95%CI: -0.0012, 0.0154) or total body but BMD loss at both hip sites was significantly attenuated by ~1/2% over 2 years. There was a significant interaction between baseline 25-hydroxyvitamin D and treatment effect (P = 0.04). With baseline 25-hydroxyvitamin D ≤ 30 nmol L^-1 (n = 46), there were between-groups BMD changes at the spine and femoral sites of ~2%, significant in the spine and femoral neck, but there was no effect on total body BMD. When baseline 25-hydroxyvitamin D was >30 nmol L^-1 , differences were ~1/2% and significant only at the total hip.

CONCLUSIONS

This substudy finds no clinically important benefit to BMD from untargeted vitamin D supplementation of older, community-dwelling adults. Exploratory analyses suggest meaningful benefit in those with baseline 25-hydroxyvitamin D ≤ 30 nmol L^-1 . This represents a significant step towards a trial-based definition of vitamin D deficiency for bone health in older adults.

αv integrins on mesenchymal cells regulate skeletal and cardiac muscle fibrosis

Mesenchymal cells expressing platelet-derived growth factor receptor beta (PDGFRβ) are known to be important in fibrosis of organs such as the liver and kidney. Here we show that PDGFRβ+ cells contribute to skeletal muscle and cardiac fibrosis via a mechanism that depends on αv integrins. Mice in which αv integrin is depleted in PDGFRβ+ cells are protected from cardiotoxin and laceration-induced skeletal muscle fibrosis and angiotensin II-induced cardiac fibrosis. In addition, a small-molecule inhibitor of αv integrins attenuates fibrosis, even when pre-established, in both skeletal and cardiac muscle, and improves skeletal muscle function. αv integrin blockade also reduces TGFβ activation in primary human skeletal muscle and cardiac PDGFRβ+ cells, suggesting that αv integrin inhibitors may be effective for the treatment and prevention of a broad range of muscle fibroses.

ASPRE trial: performance of screening for preterm pre-eclampsia

OBJECTIVE

To examine the performance of screening for preterm and term pre-eclampsia (PE) in the study population participating in the ASPRE (Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention) trial.

METHODS

This was a prospective first-trimester multicenter study on screening for preterm PE in 26 941 singleton pregnancies by means of an algorithm that combines maternal factors, mean arterial pressure, uterine artery pulsatility index and maternal serum pregnancy-associated plasma protein-A and placental growth factor at 11-13 weeks' gestation. Eligible women with an estimated risk for preterm PE of > 1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg per day) vs placebo from 11-14 until 36 weeks' gestation, which showed that, in the aspirin group, the incidence of preterm PE was reduced by 62%. In the screened population, the detection rates (DRs) and false-positive rates (FPRs) for delivery with PE < 37 and ≥ 37 weeks were estimated after adjustment for the effect of aspirin in those receiving this treatment. We excluded 1144 (4.2%) pregnancies because of loss to follow-up or study withdrawal (n = 716), miscarriage (n = 243) or termination (n = 185).

RESULTS

The study population of 25 797 pregnancies included 180 (0.7%) cases of preterm PE, 450 (1.7%) of term PE and 25 167 (97.6%) without PE. In combined first-trimester screening for preterm PE with a risk cut-off of 1 in 100, the DR was 76.7% (138/180) for preterm PE and 43.1% (194/450) for term PE, at screen-positive rate of 10.5% (2707/25 797) and FPR of 9.2% (2375/25 797).

CONCLUSION

The performance of screening in the ASPRE study was comparable with that of a study of approximately 60 000 singleton pregnancies used for development of the algorithm; in that study, combined screening detected 76.6% of cases of preterm PE and 38.3% of term PE at a FPR of 10%. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Blood Components Load in Post-operative Neurosurgical Patients Suspected with Disseminated Intravascular Coagulation

Neurosurgical patients with suspected DIC receive large amount of transfusion support in form of red cell concentrates (RCC), platelet rich plasma (PRP) and fresh frozen plasma (FFP). However, there are very few studies which have studied the effect of blood components load in the outcome of the patient. We conducted a prospective observational study on 61 post operative neurosurgery patients suspected with DIC and had at least one deranged haemostatic parameter namely platelet count, prothrombin time, partial thromboplastin time and thrombin time. Their blood components load was co-related with the outcome and with the hemostatic derangements. Twenty-eight patients died in our study group. 19/28 died patients had DIC. The red cell load was significantly more in patients who died compared to those who were alive (p = 0.041). On the other hand, load of PRP as well as FFP was significantly different between the patients who were alive and dead. This difference was further heightened when the DIC deaths were compared with the other patients. This is especially true for FFP transfusion which was significantly higher in DIC deaths (p = 0.006). Also, the number of FFPs received by neurosurgical patients suspected with DIC was significantly more in patients >2 coagulation abnormalities (p = 0.008). However, no correlation was found between PRP and RCC received and number of coagulation abnormalities present. To conclude, the load of FFP was maximum in patients with DIC deaths and the load of RCC was associated with overall mortality.