We report a case of atypical hemolytic uremic syndrome (aHUS) that occurred after childbirth in a patient with a history of numerous recurrent episodes of TMA with nephrotic proteinuria and impaired ...renal function. At 33 weeks of the first spontaneous pregnancy, proteinuria up to 0.8 g/l was first registered, at 38 weeks she was hospitalized with proteinuria, reaching a maximum of 13 g/l, she was delivered promptly, after which progressive thrombocytopenia was noted over the next few days (up to 44×10
/l) and anemia and severe arterial hypertension, which could not be corrected by several groups of antihypertensive drugs. Initiated plasma therapy had no effect. After exclusion of all other causes of TMA, therapy with eculizumab was initiated, which made it possible to quickly and completely stop the phenomena of TMA. The presented observation demonstrates the successful treatment of recurrent course of aHUS with eculizumab with the achievement of complete recovery of kidney function in a patient with a homozygous mutation in the
gene. It is worth noting the importance of genetic research even in those situations where clinically aHUS is beyond doubt.
Nonmonotonic variation with collision energy (sqrts_{NN}) of the moments of the net-baryon number distribution in heavy-ion collisions, related to the correlation length and the susceptibilities of ...the system, is suggested as a signature for the quantum chromodynamics critical point. We report the first evidence of a nonmonotonic variation in the kurtosis times variance of the net-proton number (proxy for net-baryon number) distribution as a function of sqrts_{NN} with 3.1 σ significance for head-on (central) gold-on-gold (Au+Au) collisions measured solenoidal tracker at Relativistic Heavy Ion Collider. Data in noncentral Au+Au collisions and models of heavy-ion collisions without a critical point show a monotonic variation as a function of sqrts_{NN}.
The Breit-Wheeler process which produces matter and antimatter from photon collisions is experimentally investigated through the observation of 6085 exclusive electron-positron pairs in ...ultraperipheral Au + Au collisions at √sNN = 200 GeV . The measurements reveal a large fourth-order angular modulation of cos 4 Δ ϕ = ( 16.8 ± 2.5 ) % and smooth invariant mass distribution absent of vector mesons ( ϕ , ω , and ρ ) at the experimental limit of ≤ 0.2 % of the observed yields. The differential cross section as a function of e+ e− pair transverse momentum P⊥ peaks at low value with √⟨P⊥2 ⟩ = 38.1 ± 0.9 MeV and displays a significant centrality dependence. These features are consistent with QED calculations for the collision of linearly polarized photons quantized from the extremely strong electromagnetic fields generated by the highly charged Au nuclei at ultrarelativistic speed. The experimental results have implications for vacuum birefringence and for mapping the magnetic field which is important for emergent QCD phenomena.
Objective of the study. Optimization of transfusion support of abdominal delivery in pregnant women at risk of obstetric haemorrhage using monitored management of haemostasis disorders.Study ...materials. The study group consisted of 24 women of 23-47 years old with abnormal placental invasion (API) and bleeding during caesarean section at a gestational age of 32-36 weeks. Group 1 consisted of 14 patients, who were injected with tranexamic acid as part of combined therapy; Group 2 consisted of 10 women, who were injected with aminomethylbenzoic acid as part of combined therapy.Results. All patients received instrumental autoerythrocyte reinfusion. Three patients of Group 1 (21.4%) with refractory bleeding received recombinant coagulation factor VIIa (Coagil, Russia) at a dose of 60 pg/kg body weight (average dose 6.6 ± 1.4 mg), adecrease in bleeding was observed, the operative treatment was completed in the form of metroplasty. In the early stages of bleeding, eight patients were injected with a prothrombin complex concentrate of 600-1,200 IU before administration of fresh-frozen plasma (FFP), which allowed to reduce the volume of donor FFP in these patients. The study of hemostasis showed a very high inverse relationship between extent of blood loss and fibrinogen level in the groups of patients.Conclusion. The use of factor VIIa in refractory major obstetric haemorrhage (MOH) in patients with API allows to reduce the blood loss, perform metroplasty, and preserve the woman’s fertility. Patient blood management (PCM) in pregnant women with API makes it possible to conduct organ-preserving treatment in 91.7% of women.
The chiral magnetic effect (CME) refers to charge separation along a strong magnetic field due to imbalanced chirality of quarks in local parity and charge-parity violating domains in quantum ...chromodynamics. The experimental measurement of the charge separation is made difficult by the presence of a major background from elliptic azimuthal anisotropy. This background and the CME signal have different sensitivities to the spectator and participant planes, and could thus be determined by measurements with respect to these planes. We report such measurements in Au+Au collisions at a nucleon-nucleon center-of-mass energy of 200 GeV at the Relativistic Heavy-Ion Collider. It is found that the charge separation, with the flow background removed, is consistent with zero in peripheral (large impact parameter) collisions. Some indication of finite CME signals is seen with a significance of 1–3 standard deviations in mid-central (intermediate impact parameter) collisions. Furthermore, significant residual background effects may, however, still be present.
We report precision measurements of hypernuclei $^3_ΛH$ and $^4_ΛH$ lifetimes obtained from Au + Au collisions at $\sqrt{sNN}$ = 3.0 GeV and 7.2 GeV collected by the STAR experiment at the ...Relativistic Heavy Ion Collider, and the first measurement of $^3_ΛH$ and $^4_ΛH$ midrapidity yields in Au + Au collisions at $\sqrt{sNN}$ = 3.0 GeV. $^3_ΛH$ and $^4_ΛH$, being the two simplest bound states composed of hyperons and nucleons, are cornerstones in the field of hypernuclear physics. Their lifetimes are measured to be 221 ± 15 (stat) ± 19 (syst) ps for $^3_ΛH$ and 218 ± 6 (stat) ± 13 (syst) ps for $^4_ΛH$. The pT-integrated yields of $^3_ΛH$ and $^4_ΛH$ are presented in different centrality and rapidity intervals. It is observed that the shape of the rapidity distribution of $4_ΛH$ is different for 0%–10% and 10%–50% centrality collisions. Thermal model calculations, using the canonical ensemble for strangeness, describes the $^3_ΛH$ yield well, while underestimating the $^4_ΛH$ yield. Transport models, combining baryonic mean-field and coalescence (jam) or utilizing dynamical cluster formation via baryonic interactions (phqmd) for light nuclei and hypernuclei production, approximately describe the measured $^3_ΛH$ and $^4_ΛH$ yields. Our measurements provide means to precisely assess our understanding of the fundamental baryonic interactions with strange quarks, which can impact our understanding of more complicated systems involving hyperons, such as the interior of neutron stars or exotic hypernuclei.
The STAR Collaboration reports measurements of back-to-back azimuthal correlations of di-π0s produced at forward pseudorapidities (2.6<η<4.0) in p+p, p+Al, and p+Au collisions at a center-of-mass ...energy of 200 GeV. We observe a clear suppression of the correlated yields of back-to-back π0 pairs in p+Al and p+Au collisions compared to the p+p data. The observed suppression of back-to-back pairs as a function of transverse momentum suggests nonlinear gluon dynamics arising at high parton densities. Furthermore, the larger suppression found in p+Au relative to p+Al collisions exhibits a dependence of the saturation scale $Q^{2}_{s}$ on the mass number A . A linear scaling of the suppression with A1/3 is observed with a slope of -0.09±0.01.
One of the primary goals of nuclear physics is to understand the force between nucleons, which is a necessary step for understanding the structure of nuclei and how nuclei interact with each other. ...Rutherford discovered the atomic nucleus in 1911, and the large body of knowledge about the nuclear force that has since been acquired was derived from studies made on nucleons or nuclei. Although antinuclei up to antihelium-4 have been discovered and their masses measured, little is known directly about the nuclear force between antinucleons. Here, we study antiproton pair correlations among data collected by the STAR experiment at the Relativistic Heavy Ion Collider (RHIC), where gold ions are collided with a centre-of-mass energy of 200 gigaelectronvolts per nucleon pair. Antiprotons are abundantly produced in such collisions, thus making it feasible to study details of the antiproton-antiproton interaction. By applying a technique similar to Hanbury Brown and Twiss intensity interferometry, we show that the force between two antiprotons is attractive. In addition, we report two key parameters that characterize the corresponding strong interaction: the scattering length and the effective range of the interaction. Our measured parameters are consistent within errors with the corresponding values for proton-proton interactions. Our results provide direct information on the interaction between two antiprotons, one of the simplest systems of antinucleons, and so are fundamental to understanding the structure of more-complex antinuclei and their properties.
We report on the W and Z/γ∗ differential and total cross sections as well as the W+/W− and (W+ + W−)/(Z/γ∗) cross section ratios measured by the STAR experiment at RHIC in p + p collisions at √s = ...500 GeV and 510 GeV. The cross sections and their ratios are sensitive to quark and antiquark parton distribution functions. In particular, at leading order, the W cross section ratio is sensitive to the d/u ratio. These measurements were taken at high Q2 ∼ M2W, M2Z and can serve as input into global analyses to provide constraints on the sea quark distributions. The results presented here combine three STAR datasets from 2011, 2012, and 2013, accumulating an integrated luminosity of 350 pb−1. We also assess the expected impact that our W+ / W− cross section ratios will have on various quark distributions, and find sensitivity to the u − d and d/u distributions.
Placenta accreta is one of the most severe anomalies of attachment, due to the high risk of massive bleeding. At present, the paradigm of organ-preserving delivery is laid. The implementation of this ...tactic is possible in the context of the introduction into the obstetric practice of patient blood management (PBM).
Objective:
to evaluate the effectiveness of blood preservation methods in the management and delivery of pregnant women with placenta placenta accrete.
Materials and methods:
The study group consisted of 59 pregnant women with placenta accreta in age from 20 to 40 years old (32,43 ± 5,05), who were examined in «Scientific Medical Research Center of Obstetrics”. Clinical, special (ultrasound and magnetic pelvic magnetic resonance imaging) and laboratory methods were used. A program of preparation for delivery was developed using the principles of the PBM: treating anemia at the preoperative stage; a multidisciplinary operating team was prepared (two obstetricians, a surgeon, anesthesiologist and resuscitator, anesthetist, transfusionist, physician, who provides work for Cell Saver, laboratory assistant). Operational tactics included a bottom cesarean section using one of the methods of surgical prevention and arrest of bleeding - bilateral ligation of the internal iliac arteries (1st group) (19 women), temporary stop of blood flow in common iliac artery by means of vascular clamps Satinsky (18 patients – 2ndgroup); bilateral overlay of turnstile harnesses on the base of the wide ligaments and the cervical-neck area, supplemented by a controlled balloon tamponade of the uterus (22 patients – 3rd d group). The operation was carried out under conditions of intraoperative reinfusion of autoerythrocytes on the apparatus “Cell-Saver 5”, donor FFP and erythrocyte component, tranexam preparations, rFVIIa (KoagilVII) were administered. In 80% of women, operations were performed under combined spinal-epidural anesthesia.
Results:
the lowest blood loss was detected in the 3rd group with compression complex hemostasis: 1286 ± 510 ml. Accordingly, the volumes of infusion and transfusion therapy were also the smallest in this group. The volume of reinfused autoerythrocytes ranged from 260 ml to 1420 ml and averaged 801,7 ± 414,18 ml with a hematocrit of 55-60%. Donor erythrocytes were transfused to only 27 patients in an average volume of 785,1 ± 134,2 ml. rFVIIa (Koagil) was administered to four patients: three from the first group and one from the second group: a significant decrease in the speed and volume of bleeding was noted, and he performed an organ-sparing operation. Hysterectomy was performed on five women (8,77%). In the postoperative period was carried out antianemic therapy. The hospital stay averaged 7,9 ± 1,8 days.
Conclusion:
The special role in the management and delivery of pregnant with placenta accreta plays the use of various PBM techniques , which include rational therapy of preoperative and postoperative anemia with modern iron preparations, rational surgical tactics, red blood cell autotransfusion, use of modern hemostatic agents and blood substitutes. A comprehensive multidisciplinary approach to this problem allows reducing blood loss, minimizing the volume of donor blood components and implementing organ-preserving tactics in a significant number of women.
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