Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Non-destructive lock-picking of a historical treasure chest by means of X-ray computed tomography

An innovative approach to a non-destructive lock mechanism examination by means of X-ray computed tomography (CT) was involved in a careful opening of a locked 19(th)century chest missing the key, as an interdisciplinary cooperation with the restorers. In regard of the exploration and conservation of such locked objects, their opening is important to the restorers. However, the opening may be complicated, if not impossible, without damaging the object when the key is missing. Moreover, the historical locks might be equipped with protective mechanisms. Despite the exceeding dimensions and the weight of the steel chest, a CT analysis was performed, which enabled a detailed exploration of the lock based on a system of levers and bolts handled by a single key, located in a case on the inside of the chest lid, including the dimensions essential for manufacturing of a new key copy. Moreover, two secret protective mechanisms were revealed, as well as all the damages of the object

Laterální mezitělová fúze na bederní páteři provedena na prasečím modelu s biologicky resorbovatelným keramicko/biopolymerním hybridním implantátem obohaceným o hyperstabilní růstový faktor fibroblastů 2

An experimental animal study was designed to investigate the intervertebral fusion efficiency and safety of a bioresorbable ceramic/biopolymer hybrid implant enriched with FGF2-STAB(R) in comparison with a tricortical bone autograft used as a gold standard. Twenty-four experimental pigs underwent L2/3 discectomy with implantation of either the tricortical iliac crest bone autograft or the bioresorbable hybrid implant (BHI) followed by lateral intervertebral fixation. The quality of spinal fusion was assessed by micro-computed tomography (micro-CT), biomechanical testing, and histological examination at both 8 and 16 weeks after the surgery.Experimentální studie na zvířatech byla navržena tak, aby zkoumala účinnost a bezpečnost meziobratlové fúze a biologicky resorbovatelného hybridního implantátu z keramiky/biopolymeru obohaceného o FGF2-STAB (R) ve srovnání s trikortikálním kostním autograftem používaným jako zlatý standard. Dvacet čtyři experimentálních prasat podstoupilo discektomii L2/3 s implantací buď trikortikálního autograftu kosti kyčelní, nebo bioresorbovatelného hybridního implantátu (BHI) s následnou laterální intervertebrální fixací. Kvalita spinální fúze byla hodnocena mikropočítačovou tomografií (mikro-CT), biomechanickým testováním a histologickým vyšetřením v 8. a 16. týdnu po operaci

The neurochemical profile quantified by in vivo 1H NMR spectroscopy.

Proton NMR spectroscopy is emerging from translational and preclinical neuroscience research as an important tool for evidence based diagnosis and therapy monitoring. It provides biomarkers that offer fingerprints of neurological disorders even in cases where a lesion is not yet observed in MR images. The collection of molecules used as cerebral biomarkers that are detectable by (1)H NMR spectroscopy define the so-called "neurochemical profile". The non-invasive quality of this technique makes it suitable not only for diagnostic purposes but also for therapy monitoring paralleling an eventual neuroprotection. The application of (1)H NMR spectroscopy in basic and translational neuroscience research is discussed here