This review will discuss aspects of some of the more recent techn

This review will discuss aspects of some of the more recent techniques, including sperm DNA-damage tests, intracytoplasmic morphologically selected sperm injection, amino acid and metabolomics profiling, preimplantation genetic screening and time-lapse imaging, and those that may have substantial impacts check details on the field of reproductive

medicine in the future including artificial gametes, ovarian transplantation and gene therapy. RBMOnline (c) 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“P>The incidence of unanticipated difficult or failed airway in otherwise healthy children is rare, and routine airway management in pediatric patients is easy in experienced hands. However, difficulties with airway management find more in healthy children are not infrequent in nonpediatric anesthetists and are a main reason for pediatric anesthesia-related morbidity and mortality. Clear concepts and strategies are, therefore, required to maintain oxygenation and ventilation in children. Several complicated algorithms for the management of the unanticipated difficult adult and pediatric

airway have been proposed, but a simple structured algorithm for the pediatric patient with unanticipated difficult airway is missing. This paper proposes a simple step-wise algorithm for the unexpected difficult pediatric airway based on an adult Difficult Airway Society (DAS) protocol, discusses Cytoskeletal Signaling inhibitor the role of recently introduced airway devices, and suggests a content of a pediatric airway trolley. It is intended as an easy to memorize and a practical guide for the anesthetist only occasionally involved in pediatric anesthesia care as well as a call to stimulate discussion about the management of the unanticipated difficult pediatric airway.”
“IVF and embryo transfer for the treatment of human infertility has now resulted in the birth of over 4 million babies. The technique did not arise as a quantum event but was built on the

efforts of many earlier workers in the fields of reproductive endocrinology and development. One should remember the famous saying of Isaac Newton: ‘If I have seen further than most, it is because I have stood on the shoulder’s of giants’. Ethical and moral issues have always arisen when investigators study early mammalian development, particularly human development. This paper documents these earlier studies and also draws attention to the ethical and moral arguments that inevitably arose. RBMOnline (c) 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”

To describe our experience in the anesthetic management of pediatric patients who have undergone left cardiac sympathetic denervation (LCSD) for congenital long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT).

Additional covariates included demographics and co-morbidities

Additional covariates included demographics and co-morbidities.

Results. Of the

5,549 (97.3%) eligible participants, 1,991 (35.9%) reported pain of moderate intensity or greater, and 1,028 (18.5%) were cognitively impaired. Among cognitively impaired participants, moderate or greater pain report was associated with functional impairment odds ratio (OR) = 1.74 (1.15, 2.62; P<0.01), depressed mood OR = 1.69 (1.18, 2.44; P<0.01), and lower self-rated health OR = 2.35 (1.69, 3.30; P<0.01). Among cognitively intact participants, pain report was similarly associated with functional impairment OR = 1.40 (1.20,1.63); JPH203 price P<0.01), depressed mood OR = 1.88 (1.59,2.23; P<0.01), and lower self-rated health OR = 2.34 (1.94,2.82; P<0.01).

Conclusions. Pain self-report in both cognitively intact and impaired community-dwelling persons is associated with a similar multidimensional experience. These findings confirm the need for comprehensive evaluation of pain and related outcomes in all older adults, with selleck inhibitor appropriate pharmacologic and nonpharmacologic management.”
“Positron emission tomography (PET) images usually suffer from poor signal-to-noise ratio (SNR) due to the high level of noise and low spatial resolution, which adversely affect its performance for lesion detection and quantification. The complementary information present in high-resolution anatomical images from multi-modality imaging systems could

potentially be used to improve the ability to detect and/or quantify lesions. However, previous methods that use anatomical priors usually require matched organ/lesion boundaries. In this study, we investigated the use of anatomical information to suppress noise in PET images while preserving

both quantitative accuracy and the amplitude of prominent signals that do ICG-001 ic50 not have corresponding boundaries on computerized tomography (CT). The proposed approach was realized through a postreconstruction filter based on the nonlocal means (NLM) filter, which reduces noise by computing the weighted average of voxels based on the similarity measurement between patches of voxels within the image. Anatomical knowledge obtained from CT was incorporated to constrain the similarity measurement within a subset of voxels. In contrast to other methods that use anatomical priors, the actual number of neighboring voxels and weights used for smoothing were determined from a robust measurement on PET images within the subset. Thus, the proposed approach can be robust to signal mismatches between PET and CT. A 3-D search scheme was also investigated for the volumetric PET/CT data. The proposed anatomically guided median nonlocal means filter (AMNLM) was first evaluated using a computer phantom and a physical phantom to simulate realistic but challenging situations where small lesions are located in homogeneous regions, which can be detected on PET but not on CT.

Fifty-seven percent of the prediction models were presented and e

Fifty-seven percent of the prediction models were presented and evaluated as simplified scoring systems. Sixteen percent of articles failed to report the number of outcome events in the

validation datasets. Fifty-four percent of studies made no explicit mention of missing data. Sixty-seven percent did not report evaluating model calibration whilst most studies evaluated model discrimination. It was often unclear whether the reported PND-1186 performance measures were for the full regression model or for the simplified models.

Conclusions: The vast majority of studies describing some form of external validation of a multivariable prediction model were poorly reported with key details frequently not presented. The validation studies were characterised by poor design, inappropriate handling and acknowledgement of missing data and one of the most key performance measures of prediction models i.e.

calibration often omitted from the publication. It may therefore not be surprising that an overwhelming majority of developed prediction models are not used in practice, when there is a dearth of well-conducted and clearly reported (external validation) studies describing their performance on independent participant data.”
“OBJECTIVES: To estimate the probability of survival and to evaluate risk factors for death in a cohort of persons living with human immunodeficiency virus (PLHIV) Napabucasin research buy who had started tuberculosis (TB) treatment. METHODS: A prospective cohort study was conducted between June 2007 and December 2009 with HIV-infected patients who had started anti-tuberculosis CH5424802 mw treatment in the State of

Pernambuco, Brazil. Survival data were analysed using the Kaplan-Meier estimator, the log-rank test and the Cox model. Hazard ratios and their respective 95%CIs were estimated.

RESULTS: Of a cohort of 2310 HIV-positive individuals, 333 patients who had commenced treatment for TB were analysed. The mortality rate was 5.25 per 10 000 person-years (95%CI 4.15-6.63). The probability of survival at 30 months was 74%. Risk factors for death in the study population were being female, age >= 30 years, having anaemia, not using highly active antiretroviral therapy (HAART) during treatment for TB and disseminated TB. Protective factors for death were a CD4 lymphocyte count >200 cells/mm(3) and treatment for TB having started in an out-patient clinic.

CONCLUSIONS: The use of HAART can prevent deaths among HIV-TB patients, corroborating the efficacy of starting HAART early in individuals with TB.”
“Although gene-environment interactions are known to significantly influence psychopathology related disease states, only few animal models cover both the genetic background and environmental manipulations.

009) and the proximal tibial vein (P = 005) in males than female

009) and the proximal tibial vein (P = .005) in males than females, while no differences were observed in the clinical manifestations between

the 2 sexes in UEDVT patients. Our study is able to give a broad perspective of the prevalence data of UEDVT and LLDVT in the city of Mumbai of approximately 5 million population served by this hospital. We conclude that the topology of thrombosis in deep vein thrombosis (DVT) patients in India is different from that of the Western countries.”
“Phenol-formaldehyde microcapsules with linseed oil as an active agent were produced by applying Cyclosporin A in situ polymerization method. The anticorrosion and self-healing efficiency of the synthesized materials were studied. Characteristics of these synthesized capsules were studied by Fourier transform infrared spectroscopy, and surface morphology was analyzed by using scanning electron microscope. Controllable particle size was estimated at different rpm of stirrer and particle size was checked under microscope and also by using particle size analyzer. The anticorrosion performance of encapsulated microcapsules coated with epoxy resin was carried out in 5% NaCl aqueous solution.

The effectiveness of linseed oil filled microcapsules was investigated for healing the cracks generated in paint films or coatings. It was found that the cracks were successfully healed when selleck products LB-100 mouse linseed oil was released from ruptured microcapsules. Further, linseed oil-healed area was found to prevent effectively the corrosion of the substrate in immersion studies. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 119: 2911-2916, 2011″
“The aim of this study was to detect the prevalence of the polymorphisms of growth arrest-specific gene 6 (Gas6; Gas6 c. 834 vertical bar 7G > A) in patients with sticky platelet syndrome (SPS). Sticky platelet syndrome is a hereditary, autosomal dominant thrombophilia characterized by platelet hyperaggregation after low concentrations of platelet inducers-adenosine diphosphate (ADP) and epinephrine (EPI). The

cause of SPS still remains unknown, but in recent years it was suggested that Gas6 protein may have a potential role in the pathogenesis of SPS. To assess the Gas6 polymorphisms (Gas6 c. 834 + 7G > A), 128 patients with SPS were included in the study and examined by polymerase chain reaction (PCR) method. GG genotype was detected in 63 (49.2%) patients, GA genotype in 53 (41.4%) patients, and AA genotype in 12 (9.4%) patients. The results in controls did not differ significantly compared to patients with SPS. Our findings did not prove allele A to be less associated with thrombosis and that “”prothrombotic”" allele G may be associated with higher risk of thrombosis. We cannot support the idea that Gas6 protein and Gas6 polymorphisms may be associated with thrombosis in SPS.

Nine patients were

Nine patients were VX-809 supplier included, but only six patients improved under goal-directed therapy and subsequently underwent liver transplantation. All six patients recovered quickly from infection; five patients recovered without sequelae and

one patient died because of late complications. We propose that in patients with chronic liver disease and active pneumonia transplantation is a treatment option that should not hastily be abandoned.”
“La0.7Sr0.3MnO3 (LSMO) thin films with a thickness d of 10, 20, 60, and 100 nm were grown on 20-nm-thick SrTiO3-buffered (100) silicon substrates by a reactive molecular beam epitaxy. For all samples, x-ray diffraction (XRD) revealed an excellent epitaxy with in-plane cubic [100] and [010] axes of LSMO.

The XRD measured values of the out-of-plane lattice parameter suggest that the strain state does not vary significantly from sample to sample. A super conducting quantum interference device reveals that the room temperature magnetization at saturation increases with d and nearly reaches the bulk value for d = 100 nm; the Curie temperature ranges in the 320-350 K interval, to compare to 360 K in the bulk. Ferromagnetic resonance (FMR) in cavity (at 9.5 selleck GHz) and microstrip FMR used to investigate the dynamic magnetic properties, revealed a fourfold anisotropy showing its easy axes along the [110] and [1 (1) over bar0] directions. In the thickest samples (d > 20 nm), the FMR spectra present two distinct resonant modes. This splitting is presumably due to the simultaneous presence of two different magnetic phases. (C) 2011 American Institute of Physics. [doi:10.1063/1.3565422]“
“Purpose: To evaluate stand-alone performance of computer-aided detection (CAD) for colorectal polyps of 6 mm or larger at computed Rabusertib nmr tomographic (CT) colonography in a large asymptomatic screening


Materials and Methods: In this retrospective, institutional review board-approved, HIPAA-compliant study, a CAD software system was applied to screening CT colonography in 1638 women and 1408 men (mean age, 56.9 years) evaluated at a single medical center between March 2006 and December 2008. All participants underwent cathartic preparation with stool tagging; electronic cleansing was not used. The reference standard consisted of interpretation by experienced radiologists in all cases. This interpretation was further refined for the subset of cases with positive findings by using subsequent colonoscopic or CT colonographic confirmation, as well as retrospective expert localization of polyps with CT colonography. This test set was not involved in training the CAD system. The Fisher exact test was used to evaluate significance; 95% confidence intervals (CIs) were obtained by using the exact method. Results: Per-patient CAD sensitivities were 93.8% (350 of 373; 95% CI: 90.9%, 96.1%) and 96.5% (137 of 142; 95% CI: 92.0%, 98.8%) at 6-and 10-mm threshold sizes, respectively.

The surgery was uneventful, and postoperative imaging confirmed t

The surgery was uneventful, and postoperative imaging confirmed that the electrode was positioned properly. She developed episodic vertigo 10 to 14 days after the implant surgery,

THZ1 Cell Cycle inhibitor which failed to improve with aggressive vestibular rehabilitation therapy. Plugging of the round window for possible perilymphatic fistula did not relieve her symptoms.

Intervention: Right transcanal labyrinthectomy supplemented by filling the vestibule with gentamicin-soaked Gelfoam and then a customized vestibular rehabilitation program.

Main Outcome Measure: Comparison of vestibular symptoms and cochlear implant performance before and after transcanal labyrinthectomy.

Results: The patient had immediate relief of symptoms, and the function of the cochlear implant was not adversely affected.

Conclusion: Transcanal labyrinthectomy may be an effective method to ablate the vestibular end organ after unilateral cochlear implantation. It can offer relief of disabling vertigo without adversely affecting the performance of the implant.”
“Dendritic cells (DCs) are potent antigen-presenting cells that are central to the regulation, maturation, and maintenance of the cellular immune response against cancer. In contrast, CD4(+)CD25(+) regulatory T cells (Tregs) play a central role in self-tolerance and

suppress antitumor immunity. In this study, we investigated the clinical significance of mature CD83(+) DCs and Foxp3(+) Tregs in the primary tumor and regional lymph nodes from find more the viewpoint of the two opposing players in the immune responses.

We investigated, immunohistochemically, the density of CD83(+) DCs and Foxp3(+) Tregs in primary lesions of gastric cancer (n = 123), as well as in regional lymph nodes with (n = 40) or without metastasis (n = 40).

Decreased density

of CD83(+) BAY 73-4506 molecular weight DCs and increased density of Foxp3(+) Tregs were observed in the primary tumor and metastatic lymph nodes. Density was significantly correlated with certain clinicopathological features. Poor prognosis was observed in patients with a low density of CD83(+) DCs and a high density of Foxp3(+) Tregs in primary lesions. For patients with metastatic lymph nodes, the density of CD83(+) DCs in negative lymph nodes was found to be an independent prognostic factor by multivariate analysis.

The density of CD83(+) DCs and Foxp3(+) Tregs was inversely correlated with tumor progression and reflected the prognosis of gastric cancer.”
“Eucalyptus globulus Labill. (Myrtaceae) is a commercially important natural resource mainly used by pulp and paper industry due to its higher quality cellulosic fibres and for the production of medicinally important essential oil. After the coppicing of trees for the former use, it is not used by the essential oil industries for a long time resulting in a loss of economy. Based on this fact, an attempt has been made to practice its simultaneous use for the two different sectors.

The damage to OEC in pgr5 mutants was relatively smaller and thus

The damage to OEC in pgr5 mutants was relatively smaller and thus their PSII complexes were more heat tolerant. P700 oxidation-reduction kinetics following heat-stress revealed that photosystem I (PSI) complexes remained oxidizable either with 10-ms multiple turn-over flashes or far-red illumination but the complementary cyclic electron flow around PSI (CEF) was abolished in both mutants. With further increase in incubation temperature, CEF was fully suppressed even in WT. Thus, P700 turn-over was not enhanced following thermal stress. Furthermore, the experimental data predicts the onset of pseudocyclic electron transport with molecular oxygen as terminal acceptor in crr2-2 and pgr5 HM781-36B chemical structure mutants but not in

wild type Arabidopsis subjected to severe thermal-stress. (C) 2010 Elsevier Masson SAS. All rights reserved.”
“A lack of deceased human donor livers leads to a significant mortality in patients with acute-on-chronic or acute (fulminant) liver failure or with primary non-function of an allograft. Genetically engineered pigs could provide livers that might bridge the patient to allotransplantation. CCI-779 mouse Orthotopic liver transplantation in baboons using livers from alpha 1,3-galactosyltransferase gene-knockout (GTKO) pigs (n = 2) or from GTKO pigs transgenic for CD46 (n = 8) were carried out with a clinically acceptable immunosuppressive regimen. Six of 10 baboons survived for 4-7 days. In all cases, liver function was adequate, as evidenced by tests of detoxification, protein synthesis, complement activity and coagulation parameters. The major problem that prevented more prolonged survival beyond 7 days was

a profound thrombocytopenia that developed within 1 h after reperfusion, ultimately resulting in spontaneous hemorrhage at various sites. We postulate that this is associated with the expression of tissue factor VS-6063 supplier on platelets after contact with pig endothelium, resulting in platelet and platelet-peripheral blood mononuclear cell(s) aggregation and deposition of aggregates in the liver graft, though we were unable to confirm this conclusively. If this problem can be resolved, we would anticipate that a pig liver could provide a period during which a patient in liver failure could be successfully bridged to allotransplantation.”
“Background: Parasitaemia, the percentage of infected erythrocytes, is used to measure progress of experimental Plasmodium infection in infected hosts. The most widely used technique for parasitaemia determination is manual microscopic enumeration of Giemsa-stained blood films. This process is onerous, time consuming and relies on the expertise of the experimenter giving rise to person-to-person variability. Here the development of image-analysis software, named Plasmodium AutoCount, which can automatically generate parasitaemia values from Plasmodium-infected blood smears, is reported.

“L-Glutamate elicits the umami taste sensation, now recogn

“L-Glutamate elicits the umami taste sensation, now recognized as a fifth distinct taste quality. A characteristic feature of umami taste is its potentiation by 5′-ribonucleotides such as guanosine-5′-monophosphate and inosine 5′-monophosphate, which also elicit the umami taste on their own. Recent data suggest that multiple G protein-coupled receptors contribute to umami taste. This review will focus on events downstream of the umami taste receptors. Ligand

binding leads to G beta gamma activation of phospholipase C beta 2, which produces the second messengers inositol trisphosphate and diacylglycerol. Inositol trisphosphate binds to the type III inositol trisphosphate receptor, which causes the release of Ca(2+) from intracellular

stores and Ca(2+)-dependent activation of a monovalent-selective cation channel, TRPM5. TRPM5 is believed to depolarize taste GSK621 nmr cells, which leads to the release of ATP, which activates ionotropic purinergic receptors on gustatory afferent nerve fibers. This model is supported by knockout of the relevant signaling effectors as well as physiologic studies of isolated taste cells. Concomitant with the molecular studies, physiologic studies show that L-glutamate elicits increases in intracellular Ca(2+) in isolated taste cells and that the source of the Ca(2+) is release from intracellular stores. Both Ga gustducin and Ga transducin are involved in umami signaling, because the knockout NVP-BSK805 manufacturer of either subunit compromises responses to umami stimuli. Both alpha-gustducin and alpha-transducin activate phosphodiesterases to decrease intracellular cAMP. The target of cAMP in umami transduction is not known, but membrane-permeant analogs of cAMP antagonize electrophysiologic responses to umami stimuli in isolated taste cells, which suggests that cAMP may have a modulatory role in umami signaling. Am J Clin Nutr 2009; 90 (suppl): 753S-5S.”
“Biobased nanocomposites were manufactured through the melt intercalation of nanoclays and starch esters synthesized at the Fraunhofer Institute for Applied Polymer

Research (TAP) from high amylose starch. Starch acetates (SAs) and starch propionates (SPs) were tested in combination with glycerol triacetate (triacetin) as a plasticizer for concentrations up to 30 and 20 wt %, respectively, see more with different types of organomodified and unmodified montmorillonites (MMTs). The mechanical properties of injection-molded test bars were determined by a tensile experiment giving the strength, modulus, and elongation of the composites. X-ray diffraction (XRD) analysis and transmission electron microscopy (TEM) were used to study clay dispersion and intercalation/exfoliation. Dynamic mechanical analysis was used to track the temperature dependence of the storage modulus and tan delta behavior of the starch/clay hybrid. Because they were the best performing compositions, SP with 5 wt % plasticizer and SA with 20 wt % plasticizer were filled with 5 wt % nanoclay.

The initial growth process of CNWs was investigated with and With

The initial growth process of CNWs was investigated with and Without O(2) gas addition to a C(2)F(6) capacitively Coupled plasma with H radical injection. In the case of the CNW synthesis without the addition of O(2) gas, scanning electron microscopy (SEM). transmission electron microscopy, x-ray photoelectron spectroscopy (XPS). and Raman spectroscopy revealed that a 10-nm-thick interface layer composed of nanoislands wits formed selleck on a Si substrate approximately I min

prior to CNW formation. In contrast. with O(2) gas addition. SEM and XPS revealed that an interface layer was not formed and that CNWs were grown directly from nanoislands. Moreover. Raman spectroscopy suggested that the interface layer was composed of amorphous Fludarabine clinical trial carbon and that O(2) gas addition during CNW growth is effective for achieving a high graphitization of CNWs. Therefore. O(2) gas addition has the effect of reducing the amorphicity and disorder of CNWs and controlling CNW nucleation. (C) 2009 American Institute of Physics. [doi:10.1063/1.3253734]“
“Background-Familial history is a strong risk factor for coronary

artery disease (CAD), especially for early-onset myocardial infarction (MI). Several genes and chromosomal regions have been implicated in the genetic cause of coronary artery disease/MI, mostly through the discovery of familial mutations implicated in hyper-/hypocholesterolemia by linkage studies and single nucleotide polymorphisms by genome-wide association studies. Except for a few examples (eg, PCSK9), the role of low-frequency genetic variation (minor allele frequency [ MAF]) approximate to 0.1%-5% on MI/coronary artery disease predisposition has not been extensively investigated.

Methods and Results-We selected 68 candidate genes and sequenced their exons (394 kb) in 500 early-onset MI cases and 500 matched controls, all of French-Canadian ancestry, using solution-based

capture in pools of nonindexed DNA samples. In these regions, we identified 1852 single nucleotide variants (695 novel) and captured 85% of the variants with MAF >= 1% found by the 1000 PLX4032 supplier Genomes Project in Europe-ancestry individuals. Using gene-based association testing, we prioritized for follow-up 29 low-frequency variants in 8 genes and attempted to genotype them for replication in 1594 MI cases and 2988 controls from 2 French-Canadian panels. Our pilot association analysis of low-frequency variants in 68 candidate genes did not identify genes with large effect on MI risk in French Canadians.

Conclusions-We have optimized a strategy, applicable to all complex diseases and traits, to discover efficiently and cost-effectively DNA sequence variants in large populations. Resequencing endeavors to find low-frequency variants implicated in common human diseases are likely to require very large sample size. (Circ Cardiovasc Genet. 2012;5:547-554.

The domestic cat is a model for both wild felids and human resear

The domestic cat is a model for both wild felids and human research. The aim of this study was to evaluate the effect of different vitrification protocols applied to feline oocytes at different maturational stages on the preservation

of oocyte viability and integrity of subcellular structures. The vitrification solutions consisted of 20% ethylene glycol, 20% DMSO, 20% FCS, and 1.5m Trehalose with and without 10% Ficoll PM-70. Markers for cell viability (PI/FDA), cytoskeleton organization (Anti-a-TubulinFITC SU5402 in vivo antibody, Phalloidin-TRITC), as well as nuclear configuration (DAPI) were used for evaluation of vitrified-warmed oocytes. Our results show that 52% and 41% of live mature and immature oocytes, respectively and until 32% of microtubules, 28% of nuclear configuration and 36% of microfilaments in the normal pattern can be obtained with protocol described in this paper. According to our data, Ficoll PM-70 essentially improves the oocytes survival upon vitrification.”
“Asthma exacerbation and other respiratory symptoms are associated with exposure to air pollution. Since environment affects gene methylation,

it is hypothesized that asthmatic responses to pollution are mediated through methylation. Materials & methods: We study the possibility that airborne particulate matter affects gene methylation in the asthma pathway. We measured methylation array data in clinic visits of 141 subjects from the Normative Aging Study. Black carbon and sulfate measures from a central monitoring site were recorded and 30-day 4SC-202 clinical trial averages AZD2014 in vitro were calculated for each clinic visit. Gene-specific methylation scores were calculated for the genes in the asthma pathway, and the association between the methylation in the asthma pathway and the pollution measures was analyzed using sparse Canonical Correlation Analysis. Results: The analysis found that exposures to black carbon and sulfate were significantly

associated with the methylation pattern in the asthma pathway (p-values 0.05 and 0.02, accordingly). Specific genes that contributed to this association were identified. Conclusion: These results suggest that the effect of air pollution on asthmatic and respiratory responses may be mediated through gene methylation.”
“Objectives. To describe a series of complex fetal anemia cases, detail the appropriate investigations and management, and review the literature.

Methods. Four cases of non-red cell alloimmunization or infective cases of fetal anemia are presented.

Results. Of the four cases presented, one was a neonatal death, one pregnancy was terminated, one case was diagnosed with Diamond Blackfan anemia, and one case was due to recurrent feto-maternal hemorrhages despite negative Kleihauer tests.

Conclusions. Non-alloimmune causes of fetal anemia can be difficult to manage. Some cases require repeated and frequent intrauterine transfusions.