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Major surgery is associated with an increased risk of venous thromboembolism, thus the application of mechanical or pharmacologic prophylaxis is recommended. The incidence of venous thromboembolism in patients with inherited platelet disorders undergoing surgical procedures is unknown and no information on the current use and safety of thromboprophylaxis, particularly of low-molecular-weight-heparin in these patients is available. Here we explored the approach to thromboprophylaxis and thrombotic outcomes in inherited platelet disorders patients undergoing surgery at venous thromboembolism-risk participating in the multicenter SPATA study. We evaluated 210 surgical procedures carried out in 155 patients with well-defined forms of inherited platelet disorders (venous thromboembolism-risk: 31% high, 28.6% intermediate, 25.2% low, 15.2% very low). The use of thromboprophylaxis was low (23.3% of procedures), with higher prevalence in orthopedic and gynecological surgeries, and was related to venous thromboembolism-risk. The most frequently employed thromboprophylaxis was mechanical and appeared to be effective, as no patients developed thrombosis, including patients belonging to the highest venous thromboembolism-risk classes. Low-molecular-weight-heparin use was low (10.5%) and it did not influence the incidence of post-surgical bleeding or of antihemorrhagic prohemostatic interventions. Two thromboembolic events were registered, both occurring after high venous thromboembolism-risk procedures in patients who did not receive thromboprophylaxis (4.7%). Our findings suggest that venous thromboembolism incidence is low in patients with inherited platelet disorders undergoing surgery at venous thromboembolism-risk and that it is predicted by the Caprini score. Mechanical thromboprophylaxis may be of benefit in patients with inherited platelet disorders undergoing invasive procedures at venous thromboembolism-risk and low-molecular-weight-heparin should be considered for major surgery. Fil: Paciullo, Francesco. Università di Perugia; Italia Fil: Bury, Loredana. Università di Perugia; Italia Fil: Noris, Patrizia. Universita Degli Studi Di Pavia; Italia Fil: Falcinelli, Emanuela. Università di Perugia; Italia Fil: Melazzini, Federica. Universita Degli Studi Di Pavia.; Italia Fil: Orsini, Sara. Università di Perugia; Italia Fil: Zaninetti, Carlo. Universita Degli Studi Di Pavia.; Italia Fil: Abdul Kadir, Rezan. Haemophilia Centre And Haemostasis Unit, Royal Free Fou; Reino Unido Fil: Obeng Tuudah, Deborah. Haemophilia Centre And Haemostasis Unit, Royal Free Fou; Reino Unido Fil: Heller, Paula Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina Fil: Glembotsky, Ana Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina Fil: Fabris, Fabrizio. Università di Padova; Italia Fil: Rivera, Jose. Universidad de Murcia; España Fil: Lozano, Maria Luisa. Universidad de Murcia; España Fil: Butta, Nora. Hospital Universitario la Paz; España Fil: Favier, Remi. French Reference Centre For Inherited Platelet Disorder; Francia Fil: Cid, Ana Rosa. Hospital Universitario y Politecnico la Fe; España Fil: Fouassier, Marc. French Reference Centre For Inherited Platelet Disorder; Francia Fil: Podda, Gian Marco. Università degli Studi di Milano; Italia Fil: Santoro, Cristina. Università degli studi di Roma "La Sapienza"; Italia Fil: Grandone, Elvira. Casa Sollievo Della Sofferenza,s.giovanni Rotondo; Italia Fil: Henskens, Yvonne. Maastricht University Medical Centre; Países Bajos Fil: Nurden, Paquita. French Reference Centre For Inherited Platelet Disorder; Francia Fil: Zieger, Barbara. Albert Ludwigs University of Freiburg; Alemania Fil: Cuker, Adam. University of Pennsylvania; Estados Unidos Fil: Devreese, Katrien. University of Ghent; Bélgica Fil: Tosetto, Alberto. Hospital San Bortolo; Italia Fil: De Candia, Erica. Istituto Nazionale di Ricovero e Cura a Carattere Scientifico "Saverio de Bellis"; Italia Fil: Dupuis, Arnaud. French Reference Centre For Inherited Platelet Disorder; Francia Fil: Miyazaki, Koji. Kitasato University School Of Medicine; Japón Fil: Othman, Maha. Queens University; Canadá Fil: Gresele, Paolo. Università di Perugia; Italia

Excessive bleeding at surgery is a feared complication in patients with inherited platelet disorders. However, very few studies have evaluated the frequency of surgical bleeding in these hemorrhagic disorders. We performed a worldwide, multicentric, retrospective study to assess the bleeding complications of surgery, the preventive and therapeutic approaches adopted, and their efficacy in patients with inherited platelet disorders: the Surgery in Platelet disorders And Therapeutic Approach (SPATA) study. We rated the outcome of 829 surgical procedures carried out in 423 patients with well-defined forms of inherited platelet disorders: 238 inherited platelet function disorders and 185 inherited platelet number disorders. Frequency of surgical bleeding was high in patients with inherited platelet disorders (19.7%), with a significantly higher bleeding incidence in inherited platelet function disorders (24.8%) than in inherited platelet number disorders (13.4%). The frequency of bleeding varied according to the type of inherited platelet disorder, with biallelic Bernard Soulier syndrome having the highest occurrence (44.4%). Frequency of bleeding was predicted by a pre-operative World Health Organization bleeding score of 2 or higher. Some types of surgery were associated with a higher bleeding incidence, like cardiovascular and urological surgery. The use of pre-operative pro-hemostatic treatments was associated with a lower bleeding frequency in patients with inherited platelet function disorders but not in inherited platelet number disorders. Desmopressin, alone or with antifibrinolytic agents, was the preventive treatment associated with the lowest bleedings. Platelet transfusions were used more frequently in patients at higher bleeding risk. Surgical bleeding risk in inherited platelet disorders is substantial, especially in inherited platelet function disorders, and bleeding history, type of disorder, type of surgery and female sex are associated with higher bleeding frequency. Prophylactic pre-operative pro-hemostatic treatments appear to be required and are associated with a lower bleeding incidence.

Asymptotic method of obtaining restricted open-shell wavefunctions satisfying the correct variational conditions has been extended to excited states. Perturbation theory calculations based on this methodology have been carried out for the correlation energy in the NH2 (B-2(1)) molecule and the vertical excitation energy in BeF (B-2 Sigma(+) --> X-2 Sigma(+)). Our results for NH2 are closely related to known RMP results. Unlike spin-restricted UHF methods however, the proposed scheme deals as do the OPT1, OPT2 and ZAPT theories with the identical spatial parts for the alpha and beta orbitals, which has computational advantages. The results for the excitation energy are in agreement with experimental data. (C) 1998 Elsevier Science B.V. All rights reserved.

Pterins belong to an important group of compounds, acting as inhibitors, sensiziters, enzymes, coenzymes, pigments etc. and together with carotenoids and anthraquinones are responsible for characteristic coloration of bugs. This work was focused on the development of a capillary electrophoretic separation method for the analysis of six pterine derivatives, namely biopterine, neopterine, isoxanthopterine, leukopterine, xanthopterine and erythropterine and on their identification in the real samples. Separation was conducted in an uncoated fused-silica capillary termostated at 30 řC. Separation electrolyte contained boric acid, tris(hydroxymethyl)aminomethane and disodium salt of ethylenediaminetetraacetic acid. The effects of buffer pH, concentration of electrolyte components, separation voltage and wavelength of UV detection on electromigration behavior and detection sensitivity were studied. Under the optimized separation conditions, organic extracts of the three forms of Graphosoma semipunctatum bugs were analyzed.

Remarriage has gained special attention in the past couple of decades from clinicians, researchers, and educators because of the unique issues faced by individuals entering such a relationship. Recognition of these issues increased marriage practitioners' hope that a shift in the social climate had led individuals to prepare for remarriage through various means. This study sought to, one, gain a current perspective on remarriage preparation; two, learn how individuals rate the helpfulness of preparation; and three, note any differences in remarital quality (remarital satisfaction and adjustment) and perceptions of preparedness between individuals who did or did not participate in preparation. Data were analyzed from the Utah Newlywed Study. Results showed that most individuals prepared by talking to others or read ing written information, and most individuals who participated in some form of preparation found it helpful. Despite a high number of participants who reported remarriage preparation as helpful, nonparticipants were more plentiful than participants. The majority of those who did not participate reported preparation as unnecessary. Remarital quality varied based on the preparation form considered. Based on the results, it was suggested that marriage practitioners should do more to increase individuals' views that preparation is valuable, as those who participated generally found it to be helpful.

A proportion of dissolved organic phosphorus (DOP) in soil leachates is readily available for uptake by aquatic organisms and, therefore, can represent a hazard to surface water quality. A study was conducted to characterise DOP in water extracts and soil P fractions of lysimeter soils (pasture before and after, and cultivated soil after leaching to simulate a wet winter-autumn) from a field trial. Data on DOP in drainage waters from the field trial were also generated. In water extracts, used as a surrogate for soil solution and drainage water, 70-90% of the total dissolved P (TDP) concentration was made up of DOP, of which 40% was hydrolysable by phosphatase enzymes. Proportions of hydrolysable DOP to TDP in drainage waters of the field trial were less than in water extracts due to enhanced DRP loss via dung inputs, but still large at 35% of DOP. Analysis of lysimeter soils by sequential fractionation indicated that several organic P fractions changed with land use and due to leaching. Further investigation using NaOH-EDTA extracts and P-31 nuclear magnetic resonance spectroscopy indicated that the greatest changes were a decrease in the concentrations of orthophosphate diester P and an increase in orthophosphate monoester P. This was attributed to mineralization by cultivation and plant roots and also to the leaching of mobile diester P. This study suggests that in such soils with a dynamic soil organic P pool, the concentration of readily bioavailable P in soil solution and drainage waters and the potential to impair surface water quality cannot be determined from the DRP concentration alone. (c) 2005 Elsevier Ltd. All rights reserved.

Asymptotic method of obtaining restricted open-shell wavefunctions satisfying the correct variational conditions has been extended to excited states. Perturbation theory calculations based on this methodology have been carried out for the correlation energy in the NH2 (B-2(1)) molecule and the vertical excitation energy in BeF (B-2 Sigma(+) --> X-2 Sigma(+)). Our results for NH2 are closely related to known RMP results. Unlike spin-restricted UHF methods however, the proposed scheme deals as do the OPT1, OPT2 and ZAPT theories with the identical spatial parts for the alpha and beta orbitals, which has computational advantages. The results for the excitation energy are in agreement with experimental data. (C) 1998 Elsevier Science B.V. All rights reserved.

The formalism for a relativistic open-shell CCSD(T) method is presented and implemented in a computer program, RELCCSD. The code can be used for calculations with 2- or 4-component relativistic reference wave functions and allows a full inclusion of the spin-orbit coupling. The code is interfaced to the MOLFDIR program system, We illustrate its use with nb initio calculations of the fine structure splittings of Cl, FO, ClO, O-2(+), and O-2(-). The triples correction is found to make a large contribution to the Cl atom splitting, which is within 23 cm(-1), of the experimental value. The molecular results are within 4 cm(-1) of the experimental values where these are available, The value for FO is predicted to be -195+/-4 cm(-1), in good agreement with experiment. (C) 1996 American Institute of Physics.