Highly sensitized (HS) anti-human leukocyte antigens (HLA) patients awaiting kidney transplantation benefit from specific allocation programs. Serological monitoring at 3-month intervals is recommended to prevent unexpected positive crossmatch (XM), but this strategy is not evidence-based. Therefore, we assessed its relevance when using single-antigen flow bead (SAFB) and screening flow bead (SFB) assays.

We included 166 HS patients awaiting a transplant and assessed their SAFB profile during the year preceding their inclusion. Anti-HLA antibodies were evaluated by SAFB assay and compared within patients as serum pairs, at 3, 6, and 9 months. We assessed the performance of SFB for detecting changes in SAFB profiles with 35 serum pairs.

On comparing 354, 218, and 107 serum pairs at 3, 6 and 9 months, respectively, only 0.6%, 0.7%, and 1% of all antigens tested exceeded for the first time the unacceptable antigen threshold (mean fluorescence intensity≥2000) in the most recent sample. Irrespective of the follow-up period, the calculated panel-reactive antibodies increased by a mean of 1%, and there was no significant increase in the proportion of donors at risk for positivity of flow- and/or complement-dependent cytotoxicity XM. The SFB did not accurately detect the variations of SAFB profiles.

Changes in HS patient profiles are anecdotal and show little association with transplant access or risk for positive XM. Less frequent monitoring in HS patients should be considered to improve cost-effectiveness without affecting transplant safety.

Changes in HS patient profiles are anecdotal and show little association with transplant access or risk for positive XM. Less frequent monitoring in HS patients should be considered to improve cost-effectiveness without affecting transplant safety.

The study aimed to determine whether the addition of cognitive impairment, depression, or both, to the assessment of physical frailty (PF) is associated with the risk of lung transplant (LTX) waitlist mortality.

Since March 2013, all patients referred for LTX evaluation underwent PF assessment. Cognition was assessed using the Montreal Cognitive Assessment and depression assessed using the Depression in Medical Illness questionnaire. We assessed the association of 4 composite frailty measures PF ≥3 of 5 = frail, cognitive frailty (CogF ≥ 3 of 6 = frail), depressive frailty (DepF ≥ 3 of 6 = frail), and combined frailty (ComF ≥ 3 of 7 = frail) with waitlist mortality.

The prevalence of PF was 78 (22%), CogF 100 (28%), DepF 105 (29%), and ComF 124 (34%). Waitlist survival in the non-PF group was 94% ± 2% versus 71% ± 7% in the PF group (p < 0.001). Cox proportional hazards regression analysis demonstrated that PF (Adjusted HR, 4.88; 95% CI, 2.06 – 11.56), mild cognitive impairment (Adjusted HR, 3.03; 95% CI, 1.05 – 8.78) and hypoalbuminemia (Adjusted HR, 0.89; 95% CI, 0.82 – 0.97) were independent predictors of waitlist mortality. There was no significant difference in the area under the curve of the 4 frailty measures.

The addition of cognitive function and depression variables to the PF assessment increased the number of patients classified as frail. However, the addition of these variables, does not strengthen the association with LTX waitlist mortality compared to the PF measure.

The addition of cognitive function and depression variables to the PF assessment increased the number of patients classified as frail. However, the addition of these variables, does not strengthen the association with LTX waitlist mortality compared to the PF measure.The success of percutaneous fixation of non or minimally displaced scaphoid waist fractures is reliant on optimal placement of the screw. This can be challenging for surgeons to achieve, potentially involving a large volume of intraoperative imaging, and surgical time. Mixed reality (MR) is a new technology that allows the projection of holographic imagery within the surgeon’s field of vision intraoperatively. This imagery can include surgical planning data and 3D reconstructions of a patient’s anatomy that can be used in order to aid the surgeon in achieving accuracy. We describe a technique for how this novel technology might be used in the future to fix scaphoid fractures-MR assisted percutaneous scaphoid fixation. This is done using cadaveric modeling. MR assisted percutaneous scaphoid fixation may have the potential to aid surgeons in achieving an optimal guidewire placement with the ability to reduce surgical time and radiation exposure.The purpose of this study was to investigate the possible effect of Thurston-Holland fragment (THF) size on the development of premature physeal closure (PPC) in distal tibia type 2 epiphyseal injuries. Fifty-eight fractures in 57 patients with a minimum follow-up period of 12 months were included. For statistical analysis, sex and age of the patient, number of reduction attempts, percentage of THF base relative to physis length on anteroposterior or lateral radiograph, maximal initial and postreduction displacement amount, presence of accompanying fibula fracture and trauma mechanism were evaluated. PPC was observed in 12 fractures (20.7%). An increased amount of initial displacement, increased number of reduction attempts and passing the physis with three Kirschner wires were determined as statistically significant factors for PPC occurrence (P = 0.011, 0.011 and 0.005, respectively). The THF percentage was not found to be an important factor for the occurrence of PPC. In males, THF size was less than 50% more frequently than that in females (P = 0.013). THF size had no significant effect on PPC occurrence after distal tibial epiphyseal fractures.

Cerebral palsy in children, which is the result of a nonprogressing damage to the central nervous system, causes motor and posture disorders that change with age. The level of child activity correlates with the hip dislocation risk. It most often affects nonwalking patients and those with tetraparesis or oblique pelvis. The aim of the study was to assess the effectiveness and clinical value of Dega pelvic osteotomy with accompanying directional femoral bone osteotomy after minimum of 20 years from surgery of patients with cerebral palsy.

The conducted research was retrospective and concerned the children operated at our Hospital. The assessment was carried out in 346 children with spastic hip during the years 1993-2000. The inclusion criteria were applied unilateral dislocation of the hip, the observation period of at least 20 years, pelvic osteotomy by Dega method and combined with varus derotation femur osteotomy.

The analysis involved fifteen patients. check details The follow-up period was minimum 20 years (20-27 years).