BACKGROUND
Use of universally ABO‐compatible group AB plasma for trauma resuscitation can be challenging due to supply limitations. Many centers are now using group A plasma during the initial ...resuscitation of traumatically injured patients. This study was undertaken to evaluate the impact of this practice on mortality and hospital length of stay (LOS).
STUDY DESIGN AND METHODS
Seventeen trauma centers using group A plasma in trauma patients of unknown ABO group participated in this study. Eligible patients were group A, B, and AB trauma patients who received at least 1 unit of group A plasma. Data collected included patient sex, age, mechanism of injury, Trauma Injury Severity Score (TRISS) probability of survival, and number of blood products transfused. The main outcome of this study was in‐hospital mortality differences between group B and AB patients compared to group A patients. Data on early mortality (≤24 hr) and hospital LOS were also collected.
RESULTS
There were 354 B and AB patients and 809 A patients. The two study groups were comparable in terms of age, sex, TRISS probability of survival, and total number of blood products transfused. The use of group A plasma during the initial resuscitation of traumatically injured patients of unknown ABO group was not associated with increased in‐hospital mortality, early mortality, or hospital LOS for group B and AB patients compared to group A patients.
CONCLUSION
These results support the practice of issuing thawed group A plasma for the initial resuscitation of trauma patients of unknown ABO group.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Leung Ping Kwan brought as much talent and inspiration to the writing of his short stories as he did to his poems. ‘I have drawn on magical realism to explore the absurdity of Hong Kong,’ he wrote of ...the story ‘See Mun and the Dragon’ (1975) in which we find him using a simple, clipped style. The later story ‘Drowned Souls’ (2007) was written in a more symbolic, lyrical and more complex manner. Although the two stories are separated by over thirty years, and are in many ways so very different, dragons play a prominent part in both. The dragon has always been a fascinating creature, a complex embodiment of the timeless soul of China, symbol of the universal power of the imagination, of the creative energy and transformative possibilities of the Tao. Both of these enchanting stories are anchored in the author’s idea of freedom and liberation.
Introduction
The primary objective of this study was to assess response to plasma exchange (PLEX) in myasthenia gravis (MG) patients with and without autoantibodies (Ab) to acetylcholine receptor ...(AChR) or muscle‐specific kinase (MuSK). Analysis was also done to determine if correlation existed between sex, early or late onset MG, thymoma, or thymectomy and response to PLEX.
Materials and Methods
Data was analyzed on 58 consecutive MG patients treated with PLEX. Responses were categorized as complete response, clinical improvement requiring maintenance PLEX, or no/minimal response to PLEX.
Results
Eighty‐eight percent (51/58) of patients were Ab‐positive; 44 had AChR and 7 had MuSK Ab. Complete response was seen in 26 patients (24 Ab+), 24 remain on maintenance PLEX (19 Ab+), and 2 had no/minimal response (both AChR Ab+). Ab status (P = 0.43), AChR Ab (P = 0.10), MuSK Ab (P = 0.45), early onset MG (P = 0.63), thymoma (P = 0.46), and thymectomy (P = 0.16) were not significantly associated with outcome. Patient sex did show significant association with outcome (P = 0.01), with men more likely to have complete response and women more likely to require maintenance. Late onset MG is significantly associated with higher likelihood of complete response (P = 0.03). Antibody titers declined after PLEX in 83% of patients with complete response, in whom pre‐ and post‐PLEX titers were available (n = 6).
Conclusions
In conclusion, our study showed 96% response rate to PLEX in MG; however, only patient gender and late onset MG were significantly associated with treatment response.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
This study is a narrative analysis of fathers' experiences in having a child with intellectual disability in Hong Kong. The study explored the fathers' subjective interpretation of their lived ...experiences. It included their reactions in having the special child, their experience of parenting the child, and the meaning derived from the experience. The cultural and contextual factors that had influenced their interpretation of their experience were also explored. Fifteen fathers who had a child aged 12 to 16 with mild grade intellectual disability participated in the study. Each of them was invited to attend two in-depth interviews with the duration of about two hours each. These 15 fathers were of diversified backgrounds and each of them had their unique story, but they also shared similar experiences in parenting their special child. Generally they shared common characteristics of adhering to the values of traditional Chinese males, while at the same time they also adopted some of the western ways of taking up the roles of a husband and a father. During the interviews, they were able to disclose their long suppressed feelings and reveal their struggles in overcoming the various difficulties in fathering the child. They had pains and sorrows, but they also experienced joy and pride in being the father of a special child. In the course of parenting they showed gradual acceptance of having the child but they also came to understand that their child would be their life-long burden. From the stories three common pairs of themes emerged: external locus of control vs. internal locus of control, sense of responsibility vs. love and concern, and humiliation vs. pride. These themes reflected how the fathers interpreted their life, their relationship with the child and their view of self. The findings also showed that the fathers' gradual change from the arrival of the child to age 16 could be demarcated into three stages. The initial stage was filled with feelings of helplessness. The second stage was when their child settled with schooling and they became more stable and positive. The third stage was the stage when the child stepped into adolescence and they began to face their aging process. They began to be aware that they could not take care of their child forever and became anxious and worried about the child's future. From the findings, the social beliefs, values and traditional practices, social context, and personal characteristics were found to be significant factors influencing these fathers' interpretation of their experience in having a child with intellectual disability. The stories of these fathers have provided rich materials for more in-depth understanding of these fathers who had a child with intellectual disability. Based on the findings, recommendations are made to policy-makers, service planners and practitioners of related disciplines in providing more appropriate services to give support and assistance to fathers and those families with a child with intellectual disability, and also in building up an inclusive society.
We present the first optical spectroscopy of five confirmed (or strong candidate) redback millisecond pulsar binaries, obtaining complete radial velocity curves for each companion star. The ...properties of these millisecond pulsar binaries with low-mass, hydrogen-rich companions are discussed in the context of the 14 confirmed and 10 candidate field redbacks. We find that the neutron stars in redbacks have a median mass of 1.78 0.09 M with a dispersion of = 0.21 0.09. Neutron stars with masses in excess of 2 M are consistent with, but not firmly demanded by, current observations. Redback companions have median masses of 0.36 0.04 M with a scatter of = 0.15 0.04 M , and a tail possibly extending up to 0.7-0.9 M . Candidate redbacks tend to have higher companion masses than confirmed redbacks, suggesting a possible selection bias against the detection of radio pulsations in these more massive candidate systems. The distribution of companion masses between redbacks and the less massive black widows continues to be strongly bimodal, which is an important constraint on evolutionary models for these systems. Among redbacks, the median efficiency of converting the pulsar spin-down energy to γ-ray luminosity is ∼10%.
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