Atypical hemolytic uremic syndrome (aHUS) represents a complement-mediated thrombotic microangiopathy (TMA) characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ damage, most frequently affecting the kidneys. Although infection is a well-recognized precipitant, extensive skin involvement is uncommon. Here, we describe a 14-year-old boy who developed aHUS following Rhinovirus/Enterovirus infection. He was found to have anemia, thrombocytopenia, acute kidney injury, hematuria, and proteinuria, and peripheral smear examination demonstrated schistocytes. Complement evaluation showed reduced C3 and factor I concentrations, increased soluble C5b-9, and preserved ADAMTS13 activity. Investigations for Shiga toxin-producing Escherichia coli, systemic autoimmune disease, and alternative infectious etiologies were negative. Even with eculizumab, corticosteroids, therapeutic plasma exchange (TPE), and continuous renal replacement therapy (CRRT), his condition progressed to petechiae, ecchymoses, hemorrhagic bullae, and necrotic lesions of the axilla, neck, and back. Since the necrotic areas failed to heal and were accompanied by continued platelet consumption and a heightened risk of infection, surgical debridement and wound closure were undertaken after the platelet count reached 81 × 10^9/L. Histopathologic analysis of the excised tissue confirmed cutaneous thrombotic microangiopathy with microvascular thrombosis. Following the procedure, platelet count, hemoglobin, and complement C3 returned to normal, and the wound healed without complication. At subsequent follow-up, the scars were supple and level, with no sensory deficit or functional limitation. This report expands the range of infectious triggers associated with aHUS and demonstrates that persistent necrotic cutaneous thrombotic microangiopathy may necessitate prompt surgical management in addition to complement inhibition and supportive treatment.

Advanced biomedical analyses require simultaneous quantification of multiple entities (cells, proteins, viruses, vesicles, …) calling for a multiplexed and compact biosensor. Label-free approaches giving access to the kinetic of interaction between key molecules are solid candidates for these analyses, but they currently lack either robustness for field use, multiplexing ability, or specificity. In this contribution, we report on the development of a new type of device that merges advantages of microsystem-based integrated solutions and performance of quartz acoustic wave biosensors. We have fabricated an acoustic wave biosensor composed of multiple independent detection units, each equipped with a specific surface biointerface for the selective detection and quantification of target analytes. The implementation of reflector structures on each sensing unit enables effective wave confinement, allowing for multiplexed measurements without compromising the performance of individual units. This technology relies on commercially available quartz and silicon wafers. To demonstrate the usefulness of our approach, we developed a proof-of-concept biosensor for the assessment of primary hemostasis. This assessment is based on monitoring the adhesion of platelets on functionalized surfaces during the sequence of events that leads to primary hemostasis. The biosensor directly takes whole blood and allows real-time measurement of resonance frequency and dissipation factor of 3 sensing units placed in a row. We have then characterized the specificity, repeatability, cross-talk, and sensitivity and estimated the resolution of the multiplexed biosensor. Finally, the device allowed detecting a simulated primary hemostasis defect using a modified blood sample. This proposed bioassay technology offers strong potential for broad applications in biomedical studies as an improved alternative to quartz crystal microbalance-based devices for multiplexed biointeraction analysis.

BACKGROUND Autologous hematopoietic progenitor cell transplantation (ASCT) is the standard treatment for many hematologic malignancies, and is usually performed with cryopreservation. However, many centers in resource-limited settings perform ASCT without cryopreservation. This retrospective study evaluated the feasibility and outcomes of implementing a non-cryopreserved ASCT program for hematologic malignancy in a public health system hospital in Chile, located far from the capital city and without local cryopreservation facilities. MATERIAL AND METHODS A retrospective study of consecutive peripheral blood ASCT procedures was performed at Hospital Base Valdivia in patients older than 15 and younger than 62 years, between June 2018 and July 2024. Data were extracted from patients' medical records. Overall survival was estimated using the Kaplan-Meier method and hazard ratios, and 95% confidence intervals were calculated using univariable Cox proportional hazards models. RESULTS A total of 140 patients underwent ASCT: 81 with multiple myeloma, 31 with Hodgkin lymphoma, and 28 with non-Hodgkin lymphoma. Mobilization failure occurred in 4 patients. There was no transplant-related mortality or graft failure. Median time to neutrophil engraftment was 10.9 days, and median time to platelet engraftment was 12.3 days. Febrile neutropenia occurred in 45% of patients. Overall survival at 6 years was 83% for the entire cohort, and 96%, 88%, and 76% for non-Hodgkin lymphoma, Hodgkin lymphoma, and multiple myeloma, respectively (P=0.41). CONCLUSIONS In this retrospective single-center public-hospital experience, non-cryopreserved ASCT was feasible without local backup cryopreservation facilities, and was associated with acceptable engraftment, early transplant-related mortality, and encouraging survival outcomes.

Survival after radiofrequency ablation (RFA) for very early- or early-stage hepatocellular carcinoma (HCC) remains heterogeneous because prognosis depends on both tumor burden and hepatic reserve. We retrospectively evaluated treatment-naive patients with Barcelona Clinic Liver Cancer (BCLC) Stages 0 or A HCC treated with RFA as initial therapy from January 2002 to September 2016. Patients with Child-Pugh class A or B and complete ablation were included. Four prespecified total scores, Child-Pugh-tumor (CP-T), albumin-bilirubin-tumor (ALBI-T), modified ALBI-tumor (mALBI-T), and platelet-ALBI-tumor (pALBI-T) were compared using the Akaike information criterion (AIC), Harrell concordance index (C-index), time-dependent area under the receiver operating characteristic curve, calibration, and subgroup analyses. Of 1238 patients screened, 950 were included; 831 (87.5%) were Child-Pugh class A. During a median follow-up of 5.44 years, 417 deaths occurred; 5- and 10-year overall survival rates were 58.0% and 35.8%, respectively. The American Joint Committee on Cancer eighth-edition T stage illustrated the best tumor-stage performance and was used in the total scores, while mALBI-T had the lowest AIC (5052.2) and highest Harrell C-index (0.628; 95% confidence interval, 0.601-0.655). Paired bootstrap differences versus CP-T, ALBI-T, and pALBI-T were statistically significant, but modest, while mALBI-T performed best at 5 years and in Child-Pugh class A patients, whereas all models showed limited discrimination in Child-Pugh class B patients. Apparent calibration was generally close, and mALBI-T also had the best fit for recurrence-free survival. mALBI-T provides a simple prognostic model for long-term survival stratification after complete ablation in early-stage hepatocellular carcinoma, especially in Child-Pugh class A patients.

Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a lifesaving strategy for refractory cardiac arrest, restoring systemic perfusion when conventional cardiopulmonary resuscitation fails. However, ECPR profoundly disrupts haemostasis, driven by the combined effects of whole-body ischaemia-reperfusion injury, systemic inflammation, endothelial activation, platelet dysfunction, and blood contact with extracorporeal surfaces. Together, these processes create a highly dynamic and unstable thromboinflammatory milieu, marked by the simultaneous risk of thrombosis and life-threatening bleeding. Systemic anticoagulation is required to maintain circuit patency and prevent thromboembolic complications, yet optimal strategies remain uncertain. Haemostasis during ECPR is highly dynamic, shaped by the underlying aetiology of cardiac arrest, patient-specific characteristics, and circuit-related factors. This complexity underscores the limitations of fixed anticoagulation targets and the need for individualized, context-sensitive management guided by continuous clinical and laboratory assessment. Despite the increasing global adoption of ECPR, high-quality evidence to guide anticoagulation practices remains scarce. Current strategies are largely extrapolated from other extracorporeal life support populations, contributing to substantial inter-centre variability. This review synthesizes the available evidence on coagulopathy and anticoagulation in adult patients receiving ECPR and discusses emerging approaches to monitoring and anticoagulation management.

Platelet-rich plasma (PRP) is increasingly used in regenerative medicine, yet the lack of standardized procedures for its preparation, storage, and molecular characterization remains a critical bottleneck. This chapter provides a step-by-step laboratory protocol for the preparation of leukocyte-rich PRP (L-PRP) and pure PRP (P-PRP) from whole blood, followed by untargeted metabolomic analysis using liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF-MS). The workflow includes blood collection, single-spin PRP fractionation, and methanol-based protein precipitation for metabolite extraction. The resulting extracts are subjected to chromatographic separation, high-resolution mass spectrometric detection, feature processing, and statistical analysis. Data evaluation includes principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), variable importance in projection (VIP) scoring, fold-change analysis, heatmap visualization, and putative metabolite annotation. To assess short-term storage, freshly processed aliquots are compared with matched aliquots stored at -20 °C for 7 days. The workflow enables characterization of formulation-dependent metabolic profiles and identification of differences between fresh and stored PRP. Collectively, these procedures provide a framework for PRP metabolomic profiling and may serve as a basis for the independent optimization and validation of alternative PRP preparation systems and targeted metabolomic assays.