bluuebunny/crossref_metadata_2025 huggingface dataset:
Partial amino acid sequence and physiological effects of a 27 kDa parasitism‐specific protein present in the plasma of parasitized Lacanobia oleracea (Noctuidae)
Authors: Richards E. H. , Manderyck B. , Edwards J. P.
Published: September 2010

Abstract.  Parasitization of larvae of the tomato moth, Lacanonbia oleracea, by the ectoparasitic wasp, Eulophus pennicornis, results in the appearance of a 27 kDa parasitism‐specific protein (PSP) in the plasma of the host. After isolation of this protein by native discontinuous polyacrylamide gel electrophoresis, whole gel elution and electroblotting, the N‐terminal sequence of the 27 kDa PSP is determined by Edman degradation. The 20 amino acid residues obtained reveal 70% identity with a female‐specific fat body protein from the moths Antheraea pernyi and Antheraea yamamai, 60% identity with a glutathione S‐transferase (GST) isolated from Orthosia gothica, and a low level of identity with the N‐termini of proteins belonging to the GST superfamily. Injection of the 27 kDa PSP into L. oleracea larvae has no significant effect on their ability to gain weight or the time at which they pupate. Furthermore, assays performed in vitro demonstrate that the 27 kDa PSP does not affect the ability of L. oleracea haemocytes to form aggregates. The precise source of the 27 kDa PSP remains unclear, although the current results suggest that it is most likely synthesized by host larvae in response to parasitism. The possible role(s) of the 27 kDa PSP are discussed with regard to the physiological effects of parasitism on the host.
Shallow erosion beneath turbidity currents and its impact on the architectural development of turbidite sheet systems
Authors: EGGENHUISEN JORIS T. , McCAFFREY WILLIAM D. , HAUGHTON PETER D.W. , BUTLER ROBERT W.H.
Published: September 2010

Erosion by turbidity currents changes the morphology of the sea floor. The relief of the scoured surface may affect the dynamics of the flow and thereby the pattern of deposition; this could, in turn, affect flow and deposition patterns in subsequent events. This study investigates shallow, centimetre to decimetre scale erosion beneath turbidite sheet sandstones of the Oligocene Macigno Formation of North‐west Italy, where erosion and deposition are variably coupled at the bed scale in a net‐aggradational setting. The research focus was on: (i) the recognition of scour edges and erosive surfaces; (ii) quantification of spatial differences in the amount of erosion; and (iii) an investigation of how this differential erosion can be compensated by the deposits directly overlying the erosional surfaces. Where they can be observed, scour edges commonly have sills of the overlying sandstone intruding beneath blocks and wings of the substrate that is being eroded. A consequence of this de‐laminating scouring style is that erosional surfaces are bedding parallel when followed away from the scour edges, giving the appearance of normal conformable bed bases. Despite their cryptic nature, such bedding‐parallel scour surfaces can be recognized by comparing serial detailed sedimentary logs (here, 16 bed‐parallel scour surfaces were identified in a succession comprising 95 beds). Different styles of compensation by the overlying turbidite beds are defined based on differential sedimentation inside and outside of the scour relief. It is found that differential erosion is on average under‐compensated by differential sedimentation. In some cases, the overlying deposits anti‐compensate, being thinner at the location where more erosion has occurred. Unequal spatial distribution of differential erosion in the study area combines with sedimentary under‐compensation to result in a trend of accumulating section thickness differences over multiple beds. In one ca 25 m thick package, the maximum cumulative change in lateral gradient during some 20 events reached 0·17°, before being reset by a single event. This process can be interpreted either as a lobe compensation effect, or as a scour enhancement effect, depending on the orientation of the palaeohorizontal datum. If allowed to proceed, the latter process could force the system past a channellization threshold, prompting a change from sheet to channelled architecture. This type of shallow substrate scouring and differential deposition is likely to be an important process in the build‐up of sheet turbidite sandstone units and could play a major role in autocyclic adjustment of local sea‐floor gradients.
Two new genera and species of Oriental Cicadellidae and remarks on the significance of the male genitalia in leafhopper classification (Honioptera: Cicadelloidea)
Authors: EVANS J. W.
Published: September 2010

SYNOPSIS

Two new genera and species of Oriental Cicadellidae are described and tentatively assigned to the subfamily Coelidiinae. The significance of the male genitalia in the determination of subfamily relationships in leaf‐hoppers is discussed.
Some immature stages of the subgenus Chironomus (Meigen) (Diptera:Chironomidae) from Malawi, Central Africa
Authors: McLACHLAN A. J.
Published: September 2010

SYNOPSIS

An account is given of the diagnostic characters of the larvae and pupae of 10 of the 18 African species of the subgenus Chironomus Meigen from a wide range of habitats in southern Malawi.
Isotopic evidence for the origin of an acid sulphate alteration, Styrian basin, Austria
Authors: Bojar Ana‐Voica , Halas Stanislaw , Bojar Hans‐Peter , Szaran Janina
Published: September 2010

The Gossendorf volcanic body is the only one in the Styrian basin that shows extensive hydrothermal alteration. K‐Ar dating of primary volcanic biotite and alteration products (alunite) suggests that the emplacement of the volcanic body and hydrothermal alteration took place synchronously, 15 Ma ago. The stable isotope compositions of the alteration products such as opal, barite, pyrite and alunite combined with crystallographia investigations indicate temperatures between 150 and 200 °C for the formation of the alteration zones. The calculated stable isotopic compositions of the parent fluid, responsible for the alteration, show an exogene marine component, which interacted with the host rock. Sulphur isotopic compositions of sulphur, sulphides and sulphates indicate disequilibrium, and progressive oxidation. This fact, combined with the mineral zonation of the alteration zone, reflects not only change in the pH but also change in the fO2 of the ascending fluids.
Anomalous rare earth element, yttrium and zirconium mobility associated with uranium mineralization
Authors: René Miloš
Published: September 2010

The mobility of REE, Y and Zr during the Variscan uranium mineralization event in high‐grade metasediments of the Bohemian Massif, Czech Republic has been investigated to understand their behaviour in alkaline hydrothermal alterations. The REE patterns together with high mobility of Y and Zr point to movement of REE, Y, Zr and U by highly mineralising, oxidising basinal fluids in the Permian. Their high mobility during the origin of an economically important uranium mineralization is supported by the occurrence of Y‐ and Zr‐rich coffinite.
Implementation of Antenatal Prophylaxis: A Midwife’s Perspective
Authors: Kyriakopoulos Vickie
Published: September 2010

In July 2003, The Royal Women’s Hospital, Melbourne implemented the use of Prophylactic Rh D Immunoglobulin in obstetrics to help reduce the incidence of Haemolytic Disease of the Newborn (HDN), as recommended by the Chief Medical Officer in December 2002. Successful implementation required the coordinated efforts of a large working party including haematologists, laboratory staff, blood bank, product technicians, CSL, clinical managers, midwives, obstetricians, clerical staff and educators. New practice guidelines, system processes, procedures and staff education needed to be developed and coordinated to support the successful implementation across the Royal Women’s Hospital complex maternity care programme sites. This talk firstly outlines how this implementation was achieved across a complex organisation as is The Royal Women’s Hospital, and the tools that were invaluable in contributing to its consistent success. Examples of materials developed to support staff, from discussion guidelines to materials developed to aid pregnant women to make an informed choice will be shown. The second part of this talk offers an insight into the concerns that pregnant women raise regarding the offering of prophylactic Anti – D, from a midwifery perspective. What does the consumer think and how can we best serve their needs? What are the practical considerations that help Rh D negative women choose what is best for themselves and their babies? It is hoped that this talk contributes practical information to anyone involved in the delivery of prophylactic Anti‐D to pregnant women for the prevention of HDN.
RhD Antenatal Prophylaxis – The Pathology Laboratory Perspective
Authors: Davis Ken
Published: September 2010

Stage 1 of routine antenatal RhD immunoglobulin prophylaxis was recommended in late 2002, for RhD negative women having their first child. This was as a result of a 1999 National Health Medical Research Council [NHMRC] recommendation as best practice to further reduce the incidence of HDN due to anti‐D. Revised guidelines were released in 2003 by the National Blood Authority with NHMRC endorsement. It is likely that stage 2 [for all pregnancies in RhD negative women] will be in place by early 2005. The introduction of antenatal prophylaxis has raised a number of issues for pathology laboratories:

a) frequency of antenatal testing within this new program

b) laboratory protocols where the presence of RhD immunoglobulin is confirmed or suspected

c) reporting formats in such circumstances

d) inventory and supply issues including product traceability

e) testing of maternal and cord samples at delivery in women who have received antenatal prophylaxis The Australian & New Zealand Society of Blood Transfusion released revised antenatal testing guidelines in early 2004 to assist laboratories in dealing with some of these issues. Collaboration with ARCBS, CSL and RANZCOG has also resulted in useful information being made available covering other aspects of this new initiative. The presentation will explore some of the above issues leading to more general discussion during the symposium.
Transfusion for Doctors: Why, What & Who
Authors: Whyte Gordon
Published: September 2010

Training doctors in transfusion medicine needs a new perspective because the existing knowledge based structure has neither attracted enough doctors nor made the system safer. Safety: Intra‐hospital transfusion systems, where most transfusions are delivered by overworked, under skilled PGY1s or PGY2s or nurses, are usually inherently unstable and unsafe. The system itself has to be designed to protect the patient in real hospital life situations. That means competency based training of all staff connected with transfusion and fail safe system design with continuous quality review. Knowledge: The range of knowledge required in a blood centre underscores the difficulty of pigeon holing transfusion medicine in a particular College. More fundamentally, the issue is about what practical benefit the knowledge brings to its owner in terms of jobs or recognition. It includes ‘Health assessment of well donors ‘Relevant viruses, bacteria and prions, ‘Immunology at molecular, cellular, process and tissue levels and the associated clinical syndromes and their management ‘Haematology at molecular, cellular, process and tissue levels of inflammation and coagulation and the congenital anaemias ‘Cytotoxic, immunological or inflammatory effects of chemotherapy and transplantation in malignant haematology ‘Resuscitation and immunological or inflammatory conditions in medicine & surgery, with implications for blood products ‘Public health particularly for management of public safety, regulatory systems and health economics Transfusion knowledge is broad and often task specific. Developing appropriate task specific experts requires training and research publications to develop credibility and professional networks.
Purification of RBC Agglutinating Antibodies by Affinity Chromatography on Peptides Representing Specific Variant MNS Antigens
Authors: Flower Robert , Lin Marie
Published: September 2010

Aim  Variant MNS (vMNS) phenotypes are characterised by the presence of multiple antigens that provoke complex antibody responses. The hypothesis tested was that red cell‐agglutinating antibodies of a single specificity could be purified by affinity chromatography on peptides representing vMNS antigens. The Vw and Hut/Mut antigens vary only at glycophorin residue 28, Vw methionine‐28, Hut and Mut lysine‐28. The Mur peptide TYPAHTANEV was aa 33 to 42 of GpMur. For each experiment a 5 ml pool of 4 and 10 sera that agglutinated Mi‐positive cells of known MNS‐peptide‐ELISA activity, was subjected to affinity chromatography on a single peptide.

Result  For a serum pool that was strong peptide‐ELISA positive with the lysine‐28 peptide but was methionine‐28 peptide negative, the antibody eluate was lysine‐28 pos by ELISA and agglutinated all MUT and HUT pos cells tested but not Vw cells or Mi(a) negative cells. For the MUT antigen the hypothesis that a rbc‐agglutinating antibody of a defined specificity could be purified by affinity chromatography on a linear peptide representing the antigen was confirmed. In a similar fashion a specific anti‐Mur was prepared. However, for one serum pool the antibody eluted from the Mur‐column reacted with Hut (MiII) as well as Mur‐positive cells, suggesting that Mut.Mur was recognised as a single antigen.

Conclusion  Purified monospecific polyclonal antibodies that define vMNS phenotypes may be useful in resolving difficult serological investigations. The complexity of responses to vMNS glycophorins is confirmed by the recovery of an antibody reacting with sequentially adjacent antigens as a single entity.
Fetal Loss Due to Anti‐Hro in a Lady Having Rare Genotype of Rh (D‐‐/D‐‐)
Authors: Vasantha K , Jadhav Seema , Kulkarni Swati , Mohanty Dipika
Published: September 2010

Aim  A lady of 30 years was referred to our Institute for investigations who had an obstetric history of one living child, followed by one still birth and then a termination of pregnancy due to suspected fetal ascitis.

Method  Blood grouping and Rh genotyping was done by us by standard serological procedures and patient’s serum was investigated for atypical antibodies by panel of cells. Fourteen family members were investigated for ABO grouping and Rh genotyping.

Result  Patient’s blood group was identified as O Rh Positive showing a rare Rh genotype D‐‐ with presence of only D antigen and absence of C, c, E and e antigens. Confirmation of this was done by absorption of patient’s red cells with anti‐C, anti‐c, anti‐E and anti ‐e antisera and testing the eluate reactivity for presence of the respective antigens. Patient’s serum reacted with all panel red cells of the common Rh genotypes and the antibody is anti – Hro which is the most potent antibody a D‐‐ individual produces. Amongst the family members of the propositus, seven probable heterozygote D‐‐ individuals were identified by testing with incomplete anti ‐D by saline technique.

Conclusion  The patient had a rare Rh genotype D‐‐/D‐‐ and had produced anti – Hro antibody due to fetomaternal leak during pregnancies and this must have been responsible for the fetal loss. No other family member exhibited this rare Rh genotype in homozygous form.
Audit of Nurses‐ Adherence to Pre‐transfusion Checking
Authors: Furmedge Janine , Surya Hans , Darlington Jane , Savoia Helen , Monagle Paul
Published: September 2010

Background  Errors in blood product administration occur not infrequently and cause morbidity and mortality. Pre‐transfusion checking at the bedside is the final opportunity to detect errors and is thus a vital step in preventing wrong transfusions. Unfortunately, pre‐transfusion checking is the area where most common errors are documented. We developed a number of strategies to improve nurses’ adherence to pre‐transfusion checking guidelines.

Method  Pre‐transfusion checking practices were audited by direct observation. Nurses in Haematology/Oncology unit and PICU were targeted because both units are major blood users in our hospital. Pre defined key measures of adherence to best practice recommendations were noted, including checking of the blood product, the recipient’s wristband and the compatibility report. An audit of practice was carried out before and after the introduction of a multifaceted educational intervention, comprised of information transfer (posters, in‐services, and hospital web‐based clinical practice guidelines), audit feedback, and the provision of pre‐transfusion checking reminders on the reverse side of the issued compatibility report.

Result  There was significant improvement in the results for two aspects of pre‐transfusion checking following intervention. Checking of the blood unit for normal appearance (Haem/Onc Pre intervention 43%, Post 81% and PICU Pre 11%, Post 58%) and checking the patient’s identification wristband prior to administering a blood product. (Haem/Onc Pre 19%, Post 81% and PICU Pre 68%, Post 79%).

Conclusion  Baseline compliance with pre transfusion checking was poor in a tertiary hospital. The introduction of a multifaceted educational intervention appears to be effective in improving nurses’ adherence to pre‐transfusion checking.
BloodSafe – From Project to Practice in South Australia
Authors: Robinson K , Hetzel P , Jones D , Davis K , Irel S
Published: September 2010

BloodSafe is a joint initiative between the South Australian (SA) Department of Health, Australian Red Cross Blood Service, hospitals and transfusion service providers. It has successfully established quality assurance programs to improve the safety and quality of blood management practice within the SA health system. BloodSafe began as a project in September of 2002 initially with 12 months funding from the Safety and Quality Council. Four Transfusion Nurse Consultants were appointed across five major metropolitan teaching hospitals. Audit of practice within these hospitals demonstrated three major problem areas‐ transfusion specimen collection, the decision to transfuse and administration of blood. A further 12 months funding was granted including extension of the project to include a Nurse Educator for the state to introduce initiatives into country and private hospitals. Reaudit of practice after interventions and education demonstrated that the Transfusion Nurse Consultants were effective change agents. In particular red cell use outside the NHMRC/ASBT guidelines fell from 18% to 4%(p < 0.01) in stable adult orthopaedic patients audited. A number of other important aspects of transfusion practice also showed significant improvement including documentation, consent and administration. Recurrent funding for BloodSafe Transfusion Nurse Consultants was granted by the SA Department of Health from July 2004. Factors contributing to the success of BloodSafe include a multidisciplinary team, Transfusion Nurses of clinical nurse consultant level, demonstration of a clear need for the initiatives, evidence of successful practice improvement, statewide collaboration and interventions, benchmarking across hospitals, and impartiality of the BloodSafe name with acceptance by stakeholders.
Implementation of a Quality System; Australian Code of Good Manufacturing Practice‐Human Blood and Tissues
Authors: Casey Peter , Wake Beverley , Canty Anne , Hayward Allan , Atkins Andrew
Published: September 2010

The Haematology Day Centre (HDC), Royal Adelaide Hospital (RAH) is the contracted facility for supply of Peripheral Blood Stem Cells (PBSC), for Autologous and Allogeneic Transplantation by Apheresis to the Therapeutic Product Facility (TPF), Institute of Medical and Veterinary Science (IMVS). The IMVS was working towards compliance for Code of Good Manufacturing Practice (cGMP), Human Blood and Tissues for their Processing and Cryopreservation Facility and had submitted an application for licence in 2000 to the regulatory agency, Therapeutic Goods Administration. The HDC began formalising processes towards compliance to the cGMP in November 2001. The collection process of PBSC is integral to successful licensure for cGMP which was obtained by the IMVS in July 2003. This process was as much about change management, as fi nding solutions to practical issues relating to cGMP within an area of diverse clinical practice. The HDC experience is discussed in relation to fundamental change management and practical issues implementing quality systems within and across two organisations.
Platelet Transfusion – Back to Basics
Authors: Williamson Lorna M
Published: September 2010

As in many aspects of transfusion medicine, practices have developed based on low levels of evidence. Let’s review some assumptions and think how these might change in future:‐

(1) Indications. 80% of platelet transfusions are given prophylactically to patients with bone marrow failure, yet no trials have demonstrated the value of prophylaxis over treatment of bleeding alone.

(2) Trigger. A trigger of 10 × 10 g/l is now accepted. Reducing this further will depend on accurate counting, challenging at this level.

(3) Dose & frequency. The optimum dosing schedule has not been derived by pharmacokinetic studies, but by what can be conveniently manufactured. An adult dose of 3 × 1011 platelets is accepted, but there is wide variation in practice.

(4) Manufacture. Globally, 3 methods (pooled buffy coats, platelet rich plasma and apheresis) all produce an efficacious product. Although apheresis platelets reduce donor exposure, no functional advantage has been demonstrated.

(5) In vitro assessment of function. A battery of tests is recommended, but only pH has been shown to correlate with posttransfusion survival.

(6) ABO matching. ABO compatible platelets give better increments, and transfusing ABO incompatible plasma can be associated with haemolysis, but ABO matching to patient is often compromised by stock management.

(7) Use of platelet additive solution. A 70:30 mix of PAS:plasma would reduce reactions and perhaps TRALI but this is not standard practice. Is the plasma useful?

(8) CMV safety. Overall, leucocyte depletion alone appears to provide a high degree of protection, but this is not universally accepted.

(9) Assessment of response. 1 and 24 hr increments are standard, but is regression analysis the way forward?

(10) Management of refractoriness. Better HLA and HPA matching is now technically possible. Should these lead to better HLA matching for all?

(11) Is one product for all appropriate? 20% of platelets go to surgical patients who are bleeding. Do they need a product with a different specification?
Regulation of Blood Components – a Help or Hindrance to Good Clinical Practice?
Authors: Flanagan Peter
Published: September 2010

The application of formal regulatory structures to the field of blood component and blood product manufacture is an understandable response to public and governmental concern over the safety of such products. Internationally the trend is to greater central control of blood service provision and regulation is one of several tools used to achieve this. In both Australia and New Zealand, blood components are treated as medicinal products for the purposes of regulation. The imminent creation of a TransTasman Regulatory Authority provides an opportunity to review systems used for the regulation of these products within Australasia and to ensure that an appropriate balance between clinical need and quality conformance is achieved. The control of human derived medicinal products presents a number of specific challenges. This is particularly the case in relation to blood components where biological variation will impact on the ‘formulation’ of any given product. Essentially each component becomes a unique batch. Efforts at control and regulation should recognise this. Two broad approaches can be used for regulation. In the first control is achieved through the application of standard processes. In the second the necessary outcome is defined but the process not formally defined. Increasingly regulatory control of blood component manufacture favours control of the process. Control through process can however ultimately restrict clinical flexibility and responsiveness. Care must be taken to ensure that this is recognised and addressed in the development of systems utilised to assure the quality and safety of blood components.
Prothrombinex Use in Cardiac Surgery: Results of a 6 Month Audit
Authors: Campbell Philip , Stevenson Lisa , Corke Charlie , Plowman Anthony , Mohajeri Morteza
Published: September 2010

Cardiac surgery continues to be associated with excessive perioperative bleeding due to poorly characterised haemostatic changes associated with cardiopulmonary bypass (CPB) and the trauma of major surgery. Blood component support varies between institutions and the recent introduction of recombinant VIIa promises to improve perioperative haemostasis, albeit at significant expense. Prothrombin complex concentrates (ProthrombinexTM‐HT(PTX), CSL Australia) are utilised increasingly to correct excessive oral anticoagulation and have a number of advantages over FFP including greater coagulation factor concentration (particularly IX), reduced product volume and viral inactivation. There is no data on the use of PCCs in cardiac surgery. During a 6 month period (February – August 2003), 203 patients underwent cardiac surgery at Barwon Health of whom 60 received PTX during the intra‐operative or post‐operative period (45 M, 15 F; Mean age 68.7 years). 28 (47%) patients underwent simple procedures (either valvular or graft surgery alone) while the remaining 32 (53%) patients had complex surgery (emergency cases, graft/valves, double valves, Bentall’s or redos). PTX was employed following the use of standard blood component support when there was evidence of persistent bleeding and abnormal laboratory coagulation studies. 20 patients intra‐operatively and 34 patients post‐op required no PTX. The mean dose of PTX administered intra‐operatively was 595 U (range 500–2000 U) and 240 U post‐operatively (range 500–1000). PTX use was associated with documented improvements in bleeding and coagulation studies; mean INRs and APTTs pre‐ & post‐ PTX 1.7 > 1.3 and 65 s > 52s respectively. 33 (55%) patients were evaluated at 3 months through their physicians for evidence of prothrombotic sequelae. 8 patients were noted to have had potential prothrombotic complications (4 myocardial ischaemia, 1 pulmonary embolus, 1 CVA and 2 thrombophlebitis).

Conclusion  On the basis of this small study, PTX is a useful adjunct to standard blood component support in cardiac surgery and may defer the use of rVIIa in this setting.
Trial of Baxter ‘Blood in Motion’ Transport System
Authors: Power Ruth
Published: September 2010

Aim  To evaluate the Baxter ‘Blood in Motion’ temperature controlled system for transportation of Red Blood Cells (RBCs) by the blood bank at St Vincent’s Hospital Melbourne. The trial incorporates transport of RBCs between the blood bank and theatre within St Vincent’s, and between St Vincent’s blood bank and blood banks within peripheral laboratories. Interest in this system arose in response to the Australian Red Cross Blood Service (ARCBS) proposed Memorandum of Understanding (MOU) and ARCBS amendments to packing of RBCs for transport effective 1st January 2004. According to the MOU, RBCs must be transported in a system which maintains a temperature range of 2–10 degrees Celcius.

Method  RBCs were transported between the blood bank and theatre in the ‘Blood in Motion’ transport elements on 11 occasions [N(t) = 11]. RBCs were transported between St Vincent’s blood bank and Werribee Mercy Hospital blood bank in the ‘Blood in Motion’ transport elements contained within a ‘Blood in Motion’ silver bag on 6 occasions [N(w) = 6]. An acceptable outcome resulted if the temperature displayed on the LCD thermometer inside the system was within range of 2–10 degrees Celcius on arrival at destination.

Result  An acceptable outcome was achieved in 100% of transport episodes to date. Further data will be collected and evaluated.

Conclusion  The Baxter ‘Blood in Motion’ transport system is a viable alternative to the ARCBS packing system for transport of RBCs (and facilitates compliance with the proposed ARCBS MOU). This system would ensure maintenance of RBC quality and safety during transport by St Vincent’s blood bank and minimise wastage of RBCs.
A Model for Isolated Area Emergency Donor Panels
Authors: Flecknoe‐Brown Steve , Dean Mark , Pearce Jan
Published: September 2010

Aim  To review the operation of an Emergency Donor Panel in an isolated Australian community.

Result  The Panel has been in operation for 4 years. Two donors have been rejected, one due to development of cancer and one due to biological false positive hepatitis C serology. Thirty five donors remain active on the panel. No donors have sero‐converted for transmissable disease during the operation of the panel. The panel has been activated on 3 occasions, all for surgical bleeding, resulting in blood transfused within 40 minutes of activation in all cases. Two cases were for bleeding associated with ruptured AAA and one for bleeding associated with gangrenous bowel.

Conclusion  A properly designed and monitored Emergency Donor Panel can safely supply blood for transfusion in the event of depletion of local stores. The EDP should be activated after 10 units of stored blood have been transfused into a patient undergoing massive bleeding from a correctible source, or in association with the hospital’s Disaster Plan.
Significant Differences in the Borna Virus p24 Region Between Nucleotide Sequences from Humans in Australia and Reference European Strains
Authors: Kamhieh Sandra , Bode Liv , Bolton Wayne , Hodgson Jennifer , Flower Robert
Published: September 2010

Aim  Borna Virus (BV) is a negative strand RNA virus associated with neurological diseases in animals. An association with human neuro‐psychiatric disease has been suggested. The hypothesis investigated was that potentially infectious levels of blood borne BV may be present in humans. Levels of antibody to BV in human and cat sera were studied by ELISA with antigen from infected horse brain, immunofluorescence with infected cells, Western blot and BV epitope peptide‐ELISA. Monoclonal antibodies were used in capture ELISAs to measure BV antigen levels (BVAg) in plasma and RT‐PCR and sequencing used to investigate relatedness of BV sequences from humans in Australia with European sequences.

Result  In 1% of blood donors, free BV antigen was detected in plasma and reactions with BV p24 or p40 antigens confirmed by Western Blot. Circulating immune complexes, antibody to brain‐derived antigen and reactions with two of the eight peptides tested were also detected. Strong positive reactions in tests for circulating immune complexes, free plasma antigen and free antibody, were observed in a small number of blood donors. Individuals with high levels of plasma antigen were investigated by RT‐PCR and sequencing. Sequence from the p24 region of the Australian human BV genome was 5% different from European reference strains.

Conclusion  These data support the hypothesis that a form of BV is endemic in humans in Australia, including potentially infectious levels in blood donors. The extent of difference, in regions other than p24, between BV in Australia and strains infecting animals overseas remains to be clarified.
Use of a solid‐phase fluorescent cytometric technique for the detection of bacteria in platelet concentrates
Authors: McDonald C. P. , Colvin J. , Robbins S. , Barbara J. A. J.
Published: September 2010

summary.  Blood services worldwide are now striving to reduce the risk of transmission of bacteria by transfusion. The BacT/ALERT® microbial detection system (bioMérieux, Basingstoke, Hants, UK) is currently regarded as the ‘gold standard’ for bacterial screening of platelet concentrates. The BacT/ALERT® is a culture system and will not generate an ‘instant’ (within 2 h) determination. We report on the Scansystem™ (Hemosystem, Marseille, France), a solid‐phase fluorescent cytometric technique, which enables the rapid detection of bacteria (within 90 min) in platelet concentrates. The study was performed in two parts – one involving the routine screening of platelet concentrates and the other determining the sensitivity of the system. In both arms of the study, the BacT/ALERT® was used for comparative purposes. In total, 900 platelet concentrates were screened (63 apheresis and 837 buffy coat pooled). No bacteria were detected in any of the platelet concentrates tested by means of either the Scansystem™ or the BacT/ALERT®. The sensitivity of the Scansystem™ was in the order of 103 cfu mL−1. Escherichia coli and Staphylococcus aureus were detected by using the Scansystem™ at 1 cfu mL−1. The BacT/ALERT® detected all organisms tested (n = 6) at 1 cfu mL−1. The Scansystem™ offers a sensitive alternative technology to bacterial culture, with the benefit of a rapid test time.
Pseudocontamination of blood components with Burkholderia cepacia during quality controls
Authors: Ebner W. , Meyer E. , Schulz‐Huotari C. , Scholz R. , Zilow G. , Daschner F. D.
Published: September 2010

summary.  We report on a pseudooutbreak of Burkholderia cepacia because of the use of a contaminated disinfectant during quality controls in a university blood bank. No septic reactions associated with transfusions had been reported in patients over the last 6 months. Analysis of the individual quality control procedures showed that a disinfectant based on a quaternary ammonium compound (QAC) had been used in order to disinfect the rubber stopper of the blood culture bottle. B. cepacia was found in a sample taken from this disinfectant, which was prepared with concentrate and tap water according to the manufacturer's instructions. The four isolates (one in disinfectant and three in blood components) were found to be identical in their biochemical reactions and resistance patterns. QAC‐based disinfectants are not efficacious against a part of the spectrum of gram‐negatives and are therefore inadequate. After introduction of an alcohol‐based preparation, no more cases of B. cepacia contamination have been identified.
Clinical effectiveness of processed and unprocessed bone
Authors: Galea G. , Kearney J. N.
Published: September 2010

summary.  Bone allografts have been used clinically for a number of years. Understanding the biology of bone healing and the impact that bone banking has on this helps to improve the methodologies used in increasing the quality and safety of banked bone.

Banked bone in its various forms has been used in a variety of surgical procedures, and although there is no doubt that it is clinically effective, most of the studies have been retrospective and non‐randomized. The review attempts to summarize some of the data in this area and highlights some of the difficulties encountered in such work.

Although there is no doubt that bone banking is nowadays better controlled, there are ever‐increasing pressures to produce bone that is as safe as possible with the least impact on its effectiveness. This can only be achieved if the requirements of the providers and users of bone are better understood.
Reducing replacement donors in Sub‐Saharan Africa: challenges and affordability
Authors: Bates I. , Manyasi G. , Lara A. Medina
Published: September 2010

summary In 1975, the World Health Assembly recommended that blood for transfusion should come from voluntary, non‐remunerated donors; yet, in Africa, 75–80% of blood for transfusion still comes from hospital‐based replacement donors. Although comprehensive economic data are scarce, evidence indicates that blood from voluntary donors recruited and screened at centralized transfusion centres, costs four to eight times as much as blood from a hospital‐based, replacement donor system. Donor recruitment, quality assurance systems and distribution mechanisms in the centralized system are major reasons for the cost difference. There are concerns about the sustainability of centralized voluntary donor systems and their compatibility with the levels of health care that exist in many poor countries yet burdening patients’ families with the responsibility of finding replacement blood donors will exacerbate poverty and reduce the safety of the blood supply. There are measures that can be introduced into hospital‐based systems to improve safe blood supply in Africa but their effectiveness in different contexts needs to be evaluated.
Assessment of corrected QT interval in sickle cell disease patients who undergo erythroapheresis
Authors: Boga C. , Kozanoglu I. , Yeral M. , Bakar C.
Published: September 2010

summary Extension of the QT interval is characterized by syncope and cardiac arrest and often occurs in association with medical therapies and procedures. Whether erythroapheresis (EPH) could influence the QT interval duration in patients with sickle cell disease (SCD) is not known.

We aimed to investigate the effects of EPH on the heart rate‐corrected QT (QTc) interval.

The study included 25 patients with SCD who underwent 34 EPH procedures. Two independent observers measured QTc interval duration from electrocardiograms performed continuously for 3 min at three different points during the EPH procedures (prior to EPH, after completion of 50% EPH and 15 min after EPH). Multiple regression analysis was used to determine if the ionized plasma calcium, the level of plasma magnesium, citrate infusion rate and painful crisis significantly contributed to the QTc interval.

There was a non‐significant trend (P = 0·184) towards increased QTc in sickle cell patients during EPH compared with pre‐EPH values. QTc prolongation (>440 ms) occurred in 72% of the procedures. Fifty percent QTc values returned to baseline after the procedure. The independent variables were not significantly associated with QTc interval.

Exchange procedures can induce QTc prolongation in patients with SCD.
Modest increase in seasonal allergic rhinitis and eczema over 8 years among Estonian schoolchildren
Authors: Annus Triine , Riikjärv Mall‐Anne , Rahu Kaja , Björkstén Bengt
Published: September 2010

We studied time trends in the prevalence of asthma and allergic diseases in Estonian children born before and after the collapse of the Soviet Union, as this event markedly altered the lifestyle in Estonia. Two identical cross‐sectional studies were performed as part of phase I and phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Children, aged 6–7 yr (n = 3070 in 1993–94 and 2383 in 2001–02) and 13–14 yr (n = 3476 and 3576, respectively), completed ISAAC core‐written questionnaires, and 13–14‐yr olds (n = 3427 and 3259, respectively) also video questionnaires. The prevalence of respiratory symptoms was mostly similar in the two studies. Despite this, the prevalence of diagnosed asthma increased. This was probably due to modified diagnostic criteria and increased awareness. Furthermore, the prevalence of rhinitis during the pollen season increased, e.g., rhinitis in May from 1.7% to 3.5%; sex‐adjusted prevalence odds ratio (POR) 2.09 (95% confidence interval 1.47–2.96) in 6–7‐yr olds, and from 2.6% to 5.5%; POR 2.22 (1.72–2.87) in 13–14‐yr olds. The prevalence of flexural dermatitis also increased from 12.0% to 13.5%; POR 1.20 (1.02–1.41) in 6–7‐yr olds, and from 7.7% to 9.4%; POR 1.26 (1.07–1.50) in 13–14‐yr olds. The increase was similar in children born before and after the regaining of Estonian independence, indicating that the influence of factors related to a Western lifestyle and affecting the prevalence of allergic symptoms is not restricted to infancy, but may be operative throughout childhood.
A common variable immunodeficient patient who developed acute disseminated encephalomyelitis followed by the Lennox‐Gastaut syndrome
Authors: Kondo Masashi , Fukao Toshiyuki , Teramoto Takahide , Kaneko Hideo , Takahashi Yukitoshi , Okamoto Hiroyuki , Kondo Naomi
Published: September 2010

Common variable immunodeficiency (CVID) is a primary disorder characterized by impaired antibody production. CVID patients may develop recurrent infections, autoimmune disorders, and malignant lymphomas, but to our knowledge, there is no report on CVID patients who develop acute disseminated encephalomyelitis (ADEM) or the Lennox‐Gastaut syndrome. We describe a 1‐yr‐old female CVID patient with ADEM who evolutionally manifested the Lennox‐Gastaut syndrome. She was admitted with convulsions and T2‐weighted magnetic resonance imaging (MRI) revealed high‐intensity areas in the right temporal lobe and the left fronto‐parietal region but she became conscious soon. Her serum findings showed severe hypogammaglobulinemia and a follow up MRI revealed that these areas had diminished. Consequently, she was diagnosed as having CVID with ADEM. After 5 months, she fell to having tonic and absence seizures and we diagnosed her as having the Lennox‐Gastaut syndrome from electroencephalograms (EEG) and the seizure pattern. She is now 7 yr old and her tonic seizures are controlled with valproic acid, clobazam, and immunoglobulin replacement therapy which is administrated every 2 wk. It is well known that the immune and neurologic systems have a close relationship. We suspect that a genetic defect in the immune system of our patient might also be associated with the neurologic disorders of ADEM and the Lennox‐Gastaut syndrome.
Fetal growth promotion in allergic children
Authors: Kawano Yutaka , Morikawa Miki , Watanabe Misa , Ohshiba Akihiro , Noma Takeshi , Odajima Hiroshi
Published: September 2010

Several in vitro studies have suggested the presence of Th2‐skewed immunity during pregnancy in infants with atopic diseases. Our study indicated that allergic infants showed a higher birth weight and shorter gestational period at birth than those of non‐allergic peers. Moreover, allergic mothers gave birth to neonates whose birth weights and gestational ages were higher and shorter than those of the non‐allergic mothers, respectively. Thus, our data clearly demonstrated the promotion of intrauterine growth, either in the allergic children, or allergic mothers. Such an intrauterine environment favorable for the fetal growth may also accelerate the development of allergic diseases in their offspring that are most probably caused by the Th2‐oriented immunity.
Aerosol delivery to young children by pMDI‐spacer: Is facemask design important?
Authors: Esposito‐Festen José , Ates Bahar , Van Vliet Frans , Hop Wim , Tiddens Harm
Published: September 2010

This study aimed at identifying in a daily‐life setting the influence of facemask design on drug delivery via a spacer to young children. In a 4‐week randomized crossover study, 24 children (7–23‐months old) with recurrent wheeze tested the AstraZeneca®, Galemed®, and Hans Rudolph® facemask combined with the NebuChamber® at home. Each mask was tested twice daily for seven consecutive days. Filters positioned between the NebuChamber and facemask trapped the budesonide aerosol (200 μg, Pulmicort®). Parents were asked to score the child's degree of cooperation during administration on diary cards. The administration procedure was evaluated through video recordings. Mean filter dose (standard deviation (s.d.)), expressed as % of nominal dose, was 39% (14), 47% (12), and 42% (11) for the AstraZeneca, the Galemed and the Hans Rudolph mask, respectively. Irrespective of the degree of cooperation, the Galemed mask gave significantly higher mean filter doses than the other masks (level of significance) (p < 0.045). Median (range) within‐subject dose variability, expressed, as coefficient of variation (CV), was 37% (19–255), 32% (9–114), and 30% (9–115) for the AstraZeneca mask, the Galemed mask and the Hans Rudolph mask, respectively, not significant. Dose variability increased with decreasing cooperation for all three masks (p = 0.007). Drug delivery to young children with recurrent wheeze by means of the NebuChamber can be enhanced using the Galemed facemask. Dose variability seems to be independent of facemask design but mainly depends on cooperation.
Comparison of quality of life between asthmatic and healthy school children
Authors: Merikallio Virpi Johanna , Mustalahti Kirsi , Remes Sami Tapani , Valovirta Erkka Juhani , Kaila Minna
Published: September 2010

There are only a few studies which have assessed the impact of asthma on the quality of life (QoL) compared to healthy children. In this study we wanted to compare QoL between asthmatic and healthy children in a population based setting. We surveyed 2159 children aged 11–15 yr with a Child Health Questionnaire; a generic QoL measure for children. This method gives a profile of the QoL consisting of 11 scales giving a range from 0 to 100. Asthma was defined based on the ISAAC questionnaire on asthma and asthma symptoms. In all, 192 children (8.9%) reported to have asthma diagnosed by a doctor and 61 of them (2.8% of all children) had been symptomatic during the previous month. Among these symptomatic children significantly impaired QoL was observed in 8 of the11 scales compared to non‐asthmatics. The most affected scales were those defining the physical part of child's QoL: Mean General Health scores were 60 for asthmatic and 74 for non‐asthmatic children and mean Bodily Pain scores 71 and 86, respectively. Symptoms during longer periods were associated with an overall decreased QoL. In conclusion, a child's asthma impairs the QoL and especially the physical dimensions.
Polymorphisms of the TGF‐β1 gene are not associated with bronchial asthma in Caucasian children
Authors: Heinzmann Andrea , Bauer Esther , Ganter Kerstin , Kurz Thorsten , Deichmann Klaus A.
Published: September 2010

The chromosomal region 19q13 has been found in linkage to allergic diseases in several genome‐wide linkage screens. One candidate gene within this region is the gene coding for TGF‐β1. Transforming growth factor (TGF)‐β acts as an anti‐inflammatory cytokine suppressing allergic inflammation and hyper‐reactivity. However, in ongoing inflammation of the lungs it can induce fibrosis and airway remodelling as seen in chronic asthma. Several polymorphisms within TGF‐β1 have been identified and one, −C509T, has been shown to be in association with elevated immunoglobulin E levels and severe bronchial asthma in different populations. However, other studies failed to confirm the association. The present study investigated two polymorphisms within the gene coding for TGF‐β1, −C509T and G915C, and for their potential association with bronchial asthma in Caucasian children. Genotyping of these polymorphisms was performed by means of restriction fragment length polymorphisms in a population of 231 asthmatic children and a control population of 269 individuals. Statistical analyses made use of the Armitage's trend test. In addition haplotypes were calculated by arlequin. None of the two polymorphisms showed association with bronchial asthma. They were found to be in linkage disequilibrium. We conclude from our data that TGF‐β1 is unlikely to represent a major gene in the development of bronchial asthma in the Caucasian population.