No abstract

These results allow for identification of blood uses that are susceptible to improvement, help appraise the expected yield of blood safety measures, and will assist in planning the future blood supply.

A procedure to take into account the nongenetic relationship between maternal effects in adjacent generations is presented. It considers a correlation between maternal environments provided by a dam and its daughters (lambda). The dispersion structure of the maternal animal model was modified to include a correlation matrix (E) that relates the maternal permanent environmental effects. The structures of the E matrix and its inverse (E(-1)) are described. Both matrices are completely defined by the correlation coefficient lambda. An algorithm to compute these matrices from pedigree information was also developed. Furthermore, a Bayesian analysis of this model including the lambda parameter was developed using Gibbs sampling, with Metropolis steps for the nonstandard conditional distributions. With simulated data, the proposed model reduced the bias in all estimates of dispersion parameters when an antagonism between the maternal effects received by a daughter and its future maternal environment existed. This model also provides an estimate of the environmental relationship between the maternal effects of dams and daughters by the lambda parameter. The same Bayesian analysis was also carried out with weaning weight data of the Bruna dels Pirineus breed. The posterior means (standard deviation) of (co)variance ratios were .214 (.081) for direct heritability (h2d), .107 (.033) for maternal heritability (h2m), .047 (.020) for the proportion of variance due to maternal environmental effects (c2m), and -.034 (.043) for the genetic correlation between direct and maternal effects (r(dm)). The posterior mean of lambda parameter was -.190, and 76% of its marginal posterior distribution took negative values. As occurred with simulated data, considering the maternal environmental correlation in the analysis implied higher h2m estimates, lower c2m and h2d estimates, and less negative values for the marginal posterior distribution of r(dm). These results were considered as evidence of the environmental antagonism between maternal effects provided by a dam and its daughters to weaning weight of their progeny in the Bruna dels Pirineus breed.

Summary.A female patient with delayed haemolytic transfusion reaction due to anti-M antibody is described. Diagnosis was based on laboratory evidence of haemolysis and on characteristic serological findings. Anti-M was detected in the recipient's serum 7 d after the last transfusion episode. This alloantibody had not been present in the pretransfusion serum. In addition, the direct antiglobulin test was positive on post-transfusion testing and the implicated antibody was eluted from post-transfused red cells.Delayed haemolytic transfusion reactions have long been recognized as a potencial hazard of transfusion therapy, but such cases due to anti-M are extremely rare.

To assess potential differences in epidemiology and management of patients admitted with influenza infection in the intensive care unit (ICU) during the first post-pandemic influenza period. Observational prospective study comparing September 2009-January 2010 with September 2010-January 2011. Variables captured: demographics, co-morbidities, physiological parameters, outcomes and management. Analysis was performed using SPSS v. 13.0; significance was set at p 0.5. Data from 53 patients, 38 adults (age, median 41.5 years; interquartile range (IQR) 32.8-51.3) and 15 children (age, median 2 years, IQR 0.5-9) are presented. Vaccination rates were 0% and 4.3% during the first and second periods, respectively. Differences postpandemic were: 100% of episodes developed after December compared with 16.7% in the 2009 season. Younger children were affected (median age 0.8 years (IQR 0.3-4.8) vs 7 years (IQR 1.25-11.5), p 0.05) and influenza B caused 8.7% of ICU admissions. Influenza A (H1N1) 2009 and respiratory syncytial virus epidemics occurred simultaneously (42.8% of children) and bacterial co-infections doubled (from 10% to 21.7%); the prevalence of co-infections (viral or bacterial) increased from 10% to 39.1% (OR 5.8, 95% CI 1.3-24.8). Respiratory syndromes without chest X-ray opacities reflecting exacerbation of asthma or chronic obstructive pulmonary disease, bronchitis or bronchiolitis increased (from 6.9% to 39.1%, p<0.05) and pneumonia decreased (from 83.3% to 56.5%, p <0.05). Primary viral pneumonia predominated among ICU admissions. Postpandemic ICU influenza developed later, with some cases of influenza B, more frequent bacterial and viral co-infections and more patients with severe acute respiratory infection with normal chest X-ray. Increasing vaccination rates among risk-group individuals is warranted to prevent ICU admission and death.