bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood Transfusion at Delivery and Risk of Subsequent Malignant Lymphoma in the Mother
Authors: Anderson Harald , Brandt Lars , Ericson Anders , Olsson Håkan , Möller Torgil
Published: December 2004

Background and Objectives: Blood transfusion has been shown to be a risk factor for non‐Hodgkin's lymphoma (NHL). Materials and Methods: In a cohort of 77,928 women with bleeding complications at delivery in the period of 1973–1986, subsequent NHL cases were identified and the number was compared with the number expected from national incidence rates. In a case‐control study the proportion of transfused NHL cases was compared with the proportion of transfused controls. Results: The observed number of NHL in the cohort was 18 versus 22.0 expected. Information on transfusion was obtained for 15 of the NHL cases and none (0%) was transfused versus 32 out of 136 controls (23%). Conclusions: Blood transfusion at delivery is not a risk factor for NHL. The immune tolerance induced by pregnancy may reduce the risk of NHL associated with the transfusion of allogeneic blood cells.
Comparison of Filtration Properties of Hepatitis B Virus, Hepatitis C Virus and Simian Virus 40 Using a Polyvinylidene Fluoride Membrane Filter
Authors: Oshima Kevin H. , Evans‐Strickfaden Tammy T. , Highsmith Anita K.
Published: December 2004

Background and Objectives: We examined the ability of a modified polyvinylidene fluoride membrane filter to remove blood‐borne and surrogate viruses. Materials and Methods: Phages PR772 and PP7, hepatitis B virus (HBV), hepatitis C virus and simian virus 40 (SV40) were spiked in minimum essential media with 10% fetal calf serum and the concentration of these viruses compared before and after filtration by either plaque assay or polymerase chain reaction. Results: Viruses > 50 nm were removed to below detection limits (> 106 logs) for all filters tested. A 5‐log reduction of HBV (42 nm) and 2‐ to 3‐log reduction of HCV (30–65 nm) was observed. Conclusion: A predictable size‐based removal of virol agents was observed. The results also suggest the possible utility of SV40 as a surrogate to HBV for membrane filter challenge studies.
GB Virus C/Hepatitis G Virus and Intravenous Immunoglobulins
Authors: Nübling C. M. , Gröner A. , Löwer J.
Published: December 2004

Background and Objectives: Different intravenous immunoglobulins (IVIGs) were found to be GB virus C/hepatitis G virus polymerase chain reaction (GBV‐C/HGV‐PCR)‐positive. The potential transmission of this virus to recipients by a PCR‐positive IVIG batch was investigated. Materials and Methods: Polyclonal IVIGs of different manufacturers and with different virus inactivation procedures were analyzed by GBV‐C/HGV‐PCR and anti‐E2‐ELISA. Follow‐up sera of 13 participants of a clinical trial performed with a GBV‐C/HGV‐PCR‐positive batch were retrospectively investigated for GBV‐C/HGV seroconversion (specific antibodies, viral RNA). Results: Four out of ten IVIGs analysed by GBV‐C/HGV‐PCR were – at least for some batches ‐ virus genome‐positive. Virus inactivation by solvent/detergent treatment resulted in GBV‐C/HGV‐PCR‐negative products. GBV‐C/HGV‐specific antibodies were detectable in all IVIGs analyzed. There was no transmission of GBV‐C/HGV‐observed when recipients of a large amount of GBV‐C/HGV‐PCR‐positive batch were analyzed by an antibody test and specific PCR. Conclusions: Despite PCR positivity of an IVIG preparation no transmission of GBV‐C/HGV to recipients was observed. Possible explanations are a sufficient virus inactivation procedure and/or presence of specific antibodies in the final products.
Comparison of Seroprevalences of Human Herpesvirus‐6 and ‐7 in Healthy Blood Donors from Nine Countries
Authors: Krueger G. R. F. , Koch B. , Leyssens N. , Berneman Z. , Rojo J. , Horwitz C. , Sloots T. , Margalith M. , Conradie J. D. , Imai S. , Urasinski I. , de Bruyère M. , Ferrer Argote V. , Krueger J.
Published: December 2004

Background and Objectives: The purpose of the study was to register antibody prevalences of HHV‐7 in various locations of the world in comparison to the closely related HHV‐6. Materials and Methods: Sera of healthy blood donors from nine countries in five continents were titered by indirect immunofluorescent assays using HHV‐6 infected HSB2 and HHV‐7 infected SupT1 cells. Results: Antibody prevalence for HHV‐7 is high (75–98%) in practically all countries except for Northern Japan (44%), with no simple correlation to elevated HHV‐6 antibody titers. There were regions of low, intermediate and high mean antibody titers against HHV‐7 such as 78.5–91.3 for Belgium, Israel, Japan, USA and Australia, 175.4–182.6 for Mexico and Cologne/Germany, and 389.2 for South Africa for which geographic characteristics may be responsible. Conclusion: HHV‐7, similar to HHV‐6, is a widespread human herpesvirus with elevated antibody titers in the healthy human population essentially everywhere. The data warratn further studies to evaluate its possible pathologic potential, preferentially in persons with defective immune responses.
Three Cases of Platelet Alloimmunisation Associated with the Presence of a Novel Platelet Specific Antibody
Authors: Masters Ruth , Taaning Ellen
Published: December 2004

Background and Objectives: In three cases of platelet alloimmunisation, a platelet‐specific alloantibody was detected which could not be classified within the known human platelet alloantigen or HLA systems. The first case was of a family in which two siblings suffered neonatal alloimmune thrombocytopenia at birth. In the second case, the newborn was suffering from phocomelia with hypoplastic thrombocytopenia. The third case was a male who became refractory to transfusions of HLA‐matched platelets after a related bone marrow transplantation. Materials and Methods: The serum samples were investigated by: enzyme‐linked immunosorbent assay, platelet suspension immunofluorescence test (PSIFT), monoclonal antibody immobilisation of platelet antigens assay (MAIPA), and by the lymphocytotoxicity test. Results: The antibody gave positive reactions with 26% of normal donor platelets. Surprisingly, no platelet‐specific antibody was detected by PSIFT or by MAIPA and there was no evidence found to support classifying the antibody within the HLA system. Conclusion: The reactivity pattern of the antibody detected and the clinical presentation of the three cases described, strongly suggest the presence of an additional platelet specific alloantigen system.
Erythropoiesis after Therapy with Recombinant Human Erythropoietin: A Dose‐Response Study in Anemic Cancer Surgery Patients
Authors: Braga M. , Gianotti L. , Gentilini O. , Vignali A. , Corizia L. , Di Carlo V.
Published: December 2004

Background and Objectives:
Preoperative treatment with 600 U/kg of recombinant human erythropoietin (r‐HuEPO) effectively increases erythropoiesis in cancer patients. The aim of this study was to evaluate the erythropoietic response after different doses of r‐HuEPO in order to find the minimum effective dose. Materials and Methods: Twenty anemic sideropenic patients (hemoglobin ≤ 110 g/l; serum iron <600 μg/l) with cancer of the gastrointestinal tract were randomly allocated to two groups: the first (n = 10) received 400 U/kg of r‐Hu EPO divided in 4 doses (100 U/kg each, every 4 days); the second (n = 10) received 200 U/kg of r‐HuEPO (50 U/kg each, every 4 days). Both groups were given intravenous iron gluconate (125 mg) every day for 15 days. Results: After treatment, the serum iron level significantly rose in both groups. The production of new red blood cells was 176.3±90.8 ml in the 200 U/kg group and 268.4±79.4 ml in the 400 U/kg group (p = 0.036). The increase of hemoglobin was significantly higher in the 400 U/kg group (22.3±2.0 g/l) than in the 200 U/kg group (14.1±2.7 g/l) (p = 0.017). Conclusion: The r‐HuEPO dose of 400 U/kg appears significantly more effective than the 200 U/kg to stimulate erythropoiesis in anemic sideropenic cancer patients.
Press Review
Authors: M Sagmeister , L Oec , J Gmür
Published: December 2004

A Restrictive Platelet Transfusion Policy Allowing Long‐Term Support of Outpatients with Severe Aplastic Anemia
Efficiency of Donor Screening for Human Parvovirus B19 by the Receptor‐Mediated Hemagglutination Assay Method
Authors: Sakata H. , Ihara H. , Sato S. , Kato T. , Ikeda H. , Sekiguchi S.
Published: December 2004

Background and Objectives:
Mass screening for parvovirus B19 (B19) by receptor‐mediated hemagglutination assay (RHA) may be inadequate to eliminate the virus from plasma pools. We characterized B19 carriers detected in blood donor screening by RHA to explain why some carriers were not detected by RHA. Materials and Methods: Donor plasma was screened for B19 by RHA, B19 DNA by nested polymerase chain reaction (PCR) assay, and anti‐B19 by enzyme immunoassay. Results: B19 DNA‐positive specimens (n = 73) screened from 456,665 donors were divided into group A (n = 41) with high DNA and high RHA titers, group B (n = 16) with low DNA and low RHA titers, and group C (n = 16) RHA‐negative. Most (37/41) of the group A samples were without anti‐B19, while most (15/16) of the group B samples were positive for anti‐B19. Group C specimens were screened by PCR from 3,042 random RHA‐negative specimens. Analysis of samples from early infections revealed that the viremic period, corresponding to group A, lasted only 8‐10 days after infection. The RHA reactivity fell rapidly with the appearance of anti‐B19 and disappeared 28‐30 days after infection, thus corresponding to group B. The RHA reactions of group B specimens were often unstable, probably because of the formation of immune complexes. The B19 DNA‐positive, RHA‐negative state lasted for several months, which corresponded to group C. Conclusion: Only group A specimens are reliably eliminated in donor screening by RHA. Therefore, although donors with high B19 DNA could be screened out by testing for B19 by the RHA, most B19 carriers, with low B19 DNA and RHA‐negative, will not be eliminated.
Clinical Experience with a New Solvent Detergent‐Treated Intravenous Immunoglobulin Free of Hypotensive Effects
Authors: Chidwick K. , Matejtschuk P. , Gascoigne E. , Briggs N. , More J.E. , Dash C.H.
Published: December 2004

Objective:
To see if modifications to the processing of intravenous immunoglobulin to include a virus inactivation stage alter immunoglobulin G (IgG) resulting in hypotension in patients. Methods: Clinical trials were done involving extensive patient monitoring during infusion: in vitro‐testing for markers of hypotension, and in vivo‐an animal model which closely simulates clinical use. Results: No hypotensive response was seen in the animal model or clinical trial. Conclusions: The production process used does not damage IgG or create vaso‐active kinins as the preparation was free of hypotensive effects.
DVa Category Phenotype and Genotype in Japanese Families
Authors: Legler T.J. , Wiemann V. , Ohto H. , Matuda I. , Obara T. , Uchikawa M. , Köhler M.
Published: December 2004

Background and Objectives:
The genetic background of the DVa category phenotype has been described in two Caucasian individuals. We were interested in the RHD sequence of 7 Japanese DVa individuals and their families. Materials and Methods: With SSP‐PCR we tested exons 4, 5 and 7 of the RHD gene and used restriction enzymes for testing nucelotide associated with the DVa phenotype. Results: A single RHD G667 C697 allele was present in 5 individuals with DVa category phenotype, and in 2 individuals we found a D‐CE‐D hybrid gene (exon 5 had been replaced). The DVaCe gene complex was found in all families. Conclusion: The changes of the RHD gene described in European DVa individuals were also observed in Japanese families.
Press Review
Authors: Ludewig B. , Ochsenbein A.F. , Odermatt B.
Published: December 2004

Immunotherapy with Dendritic Cells Directed against Tumor Antigens Shared with Normal Host Cells Results in Severe Autoimmune Disease
Transfusion‐Associated Sepsis Caused by Candida parapsilosis
Authors: Pinto Vicente , Telenti Mauricio , Palomo Carmen , de Quirós José F. Bernaldo
Published: December 2004

Background and Objectives
: The contamination of blood components by bacteria is an adverse event, which, although very uncommon, has an exceptionally high mortality rate. Case Report: A patient suffering from terminal adenocarcinoma of the ovary received a red blood cell unit. During the transfusion, the patient developed fever. Cultures of both the patient's blood and the blood unit were done, and she was treated with antibiotics. Forty‐eight and seventy‐two hours after the transfusion, Candida parapsilosis grew in the blood cultures of the red blood cell bag and of the patient. The infection was controlled with amphotericin. The patient died from cancer progression. Conclusion: We describe the first case of transfusion‐associated sepsis caused by C. parapsilosis.
A Competitive Enzyme‐Linked Immunoassay Using Erythrocytes Fixed to Microtitre Plates For Anti‐D Quantitation in Immunoglobulin Products
Authors: Thorpe Susan J. , Turner Christina E. , Heath Amanda C. , Sands Dawn
Published: December 2004

Background and Objectives:
The batch control of anti‐D immunoglobulin for prevention of haemolytic disease of the newborn necessitates assessment of its potency. Anti‐D quantitation is usually performed using automated haemagglutination methodology although this can only be carried out in specialist centres. The aim of this study was to develop a simple and robust assay for anti‐D quantitation. Methods: We developed a competitive enzyme‐linked immunoassay (EIA) in which unlabelled anti‐D immunoglobulin and a biotinylated monoclonal anti‐D compete for red cell binding. Binding of biotinylated anti‐D is detected using an alkaline‐phosphatase‐labelled avidin preparation. The assay is conveniently carried out using erythrocytes fixed to microtitre plates. Results: The competitive EIA was specific for anti‐D activity, highly reproducible and showed good correlation with manufacturers' potency estimates using automated haemagglutination. The assay was quick and simple to perform using freshly prepared or stored plates, and the biotinylated monoclonal anti‐D could be lyophilized in ampoules for distribution as a standardized reagent. Conclusions: The competitive EIA described can be used for the specific quantitation of anti‐D and provides a robust alternative method to automated haemagglutination.
HLA‐C Expression on Platelets: Studies with an HLA‐Cw1‐Specific Human Monoclonal Antibody
Authors: Datema Gert , Stein Sophia , Eijsink Chantal , Mulder Arend , Claas Frans H.J. , Doxiadis Ilias I.N.
Published: December 2004

Background and Objectives:
The expression of HLA‐C on the surface of platelets is rarely studied due to the lack of proper alloantisera. We addressed this question using an IgM human monoclonal antibody directed against HLA‐Cw1 (VP6G3). Material and Methods: Both flow cytometry and complement dependent cytotoxicity studies were used in the current analysis. Results: The expression of the HLA‐Cw1 antigen on platelets is lower than on peripheral blood lymphocytes as shown by flow cytometry. Variation in expression levels between individuals is also observed. Using this antibody in a complementdependent cytotoxicity assay, we did not observe lysis using platelets as targets, whereas peripheral blood lymphocytes of the same blood donors were adequately lysed. Conclusions: These results confirm that platelets indeed express HLA‐C. Furthermore, the results support the insignificant role of HLA‐C in immunological platelet refractoriness.
Prevalence of GBV‐C/Hepatitis G Virus Viremia and Anti‐E2 in Canadian Blood Donors
Authors: Giulivi A. , Slinger R. , Tepper M. , Sher G. , Scalia V. , Kessler G. , Gill P.
Published: December 2004

Background and Objectives:
GB virus C (GBV‐C)/hepatitis G virus (HGV) is a recently recognized parenterally and sexually transmitted agent. The prevalence of GBV‐C/HGV markers in Canadian blood donors has not been previously studied and was therefore determined. Materials and Methods: Blood donors [identity unlinked (IU), short‐term temporarily deferred (STTD) and autologous groups] and donor samples with antibodies to hepatitis C (anti‐HCV) or hepatitis B core were tested for GBV‐C/HGV RNA and for antibodies to E2 antigen (anti‐E2). Results: GBV‐C/HGV RNA was found in 1.1% and anti‐E2 in 7.3% of the combined IU/STTD donor group. Viremia was much more common in anti‐HCV‐positive samples (12.5%); anti‐E2 was present in >50% of this group. In the STTD group, female gender was significantly associated with viremia. Conclusion: GBV‐C/HGV infection is relatively common in Canadian donors, and a small proportion are viremic. The association of female gender and viremia was unexpected. Further study is needed to clarify the epidemiology and natural history of GBV‐C/HGV infection.
An international study of the performance of sample collection from patients
Authors: Dzik W. H. , Murphy M. F. , Andreu G. , Heddle N. , Hogman C. , Kekomaki R. , Murphy S. , Shimizu M. , Smit‐Sibinga C. T. ,   the Biomedical Excellence for Safer Transfusion (BEST) Working Party of the International Society for Blood Transfusion
Published: December 2004

Background and Objectives Collection of a blood sample from the correct patient is the first step in the process of safe transfusion. The aim of this international collaborative study was to assess the frequency of mislabelled and miscollected samples drawn for blood grouping.

Materials and Methods Hospitals in 10 countries provided data on sample error rates during a period of at least 3 months, including the last quarter of 2001. Mislabelled samples were defined as those not meeting local criteria for acceptance by the laboratory. Miscollected samples [wrong‐blood‐in‐tube (WBIT)] were defined as samples in which the blood group result differed from the result on file from prior testing. WBIT rates were corrected for the proportion of repeat samples and for undetectable errors occurring as a result of chance collection of blood from the wrong patient with the same ABO group. Participants also completed a questionnaire on current policies regarding sample collection.

Results A total of 71 hospitals completed surveys describing policies related to sample collection. Sixty‐two hospitals provided usable data on the frequency of mislabelled and miscollected samples. Mislabelled and miscollected samples were common. Based on results from over 690 000 samples, the median hospital performance resulted in a rate for mislabelling of 1 in every 165 samples (6·1 per 1000; interquartile range 1·2–17 per 1000). The presence of national patient identification systems in Sweden and Finland was associated with rates of miscollected samples that were too low to estimate. Outside these nations, miscollected samples demonstrating WBIT occurred at a median rate of 1 in every 1986 samples (0·5 per 1000; interquartile range < 0·3–0·9 per 1000). There was great variation worldwide in the reported frequency of mislabelled samples, probably resulting from variation in policies for sample acceptance. Miscollected samples occurred at a more constant rate.

Conclusions The rate of mislabelled samples and miscollected samples is 1000–10 000‐fold more frequent than the risk of viral infection. Rates of mislabelled samples and WBIT can be tracked as key indicators of performance of an important step in the clinical transfusion process. WBIT episodes represent important ‘near‐miss’ errors. By providing baseline performance data for the collection of patient blood samples, this study may be useful in formulating future national standards of performance for sample collection from patients.
Monitoring blood transfusion in patients undergoing coronary artery bypass grafting: an audit methodology
Authors: Grayson A. D. , Jackson M. , Desmond M. J.
Published: December 2004

Background and Objectives The purpose of this work was to describe the methodology used to build a transfusion database that allows continuous audit of transfusion practices in coronary artery bypass surgery.

Materials and Methods The transfusion database requires electronic data available from two sources: the hospital's patient administration system; and the local blood transfusion service.

Results We demonstrated a reduction in the percentage of patients receiving red blood cell transfusion: from 47·4% in 1997/1998 to 31·6% in 2001/2002 (P < 0·001). Reductions have also been shown in the percentage of patients receiving fresh‐frozen plasma and platelet units.

Conclusions The data sourcing the transfusion database should be available to all hospitals through their patient administration systems and local blood transfusion service. Its use can help to reduce transfusion rates significantly.
Primary ocular osteosarcoma in a dog
Authors: Heath Susan , Rankin Amy J. , Dubielzig Richard R.
Published: December 2004

An adult male Rottweiler presented to the veterinary medical teaching hospital at Purdue University with a 1‐month history of hyphema. On physical examination conjunctivitis, episcleral hyperemia, corneal edema, hyphema, mild glaucoma and loss of vision were observed in the left eye. No other abnormalities were found. The left globe was surgically removed because of the high likelihood of neoplasia and it was fixed in 10% buffered formalin and submitted for pathology. A histologic diagnosis of primary osteosarcoma of the eye was made. Radiographic evaluation did not reveal any evidence of other tumors or pulmonary metastasis. This is the fourth canine case of primary intraocular osteosarcoma to be documented.
Neuroepithelial tumor of the retina in a dog
Authors: Jensen Ove A. , Kaarsholm Susanne , Prause Jan U. , Heegaard Steffen
Published: December 2004

Animal studied At routine vaccination a tumor in the right eye of a Golden Retriever was diagnosed.

Procedure The eye was enucleated, fixed in formalin and processed according to routine paraffin technique. Standard histologic, histochemical and immunohistochemical stainings were applied. Formalin‐fixed tissue was used for electron microscopic examination.

Results The tumor originated from the retina and was composed of two different morphologic parts, a retinoblastoma‐like part of small neuroepithelial cells and a medulloepithelioma‐like part of columnar cells arranged in cords.

Discussion and conclusion It is discussed whether the tumor had its origin in different clones or in one clone, and it is suggested that the double differentiation might be the result of a transformation of retinal cells, demasking stem cell‐like potentials.
Oral health education for nursing personnel; experiences among specially trained oral care aides: One‐year follow‐up interviews with oral care aides at a nursing facility
Authors: Wårdh Inger , Hallberg Lillemor R‐M. , Berggren Ulf , Andersson Lars , Sörensen Stefan
Published: December 2004

The improved dental health in most industrialized countries is not apparent among elderly and long‐term care patients. Oral healthcare has been found to have low priority in nursing care. To create lasting positive effects in oral healthcare education, a new educational model was tested in an oral healthcare project. After approval from ethical committee, nursing assistant and nurses’ aides took part in a dental auscultation period at a dental clinic to serve as oral care aides additional to traditional oral healthcare education. Following this period, the aides were given responsibility for the oral healthcare at their ward. After serving as oral care aides for 1 year, interviews were made and analysed based on the Grounded Theory methodology. The aim was to investigate how the oral care aides had experienced their new duties regarding oral healthcare. The results indicated that, despite several environmental changes, reluctant residents and occasional lack of commitment from colleagues, the oral care aides felt responsible for the oral healthcare provision. The oral care aides expressed courage, the capacity to cope with reality, confirmation and empathy, characteristics that propelled them from novices to oral care aides with an expert competence.
The first year of rehabilitation after a stroke – from two perspectives
Authors: Bendz Mona
Published: December 2004

This phenomenographic study aimed to highlight divergent ways in which a group of people hit by a stroke and their health care professionals understand the implications of having a stroke. Data consisted of interviews with 15 patients (aged less than 65 years) who have had a stroke and transcripts from the health care professionals’ recording during the first year of rehabilitation. Three basic conceptions related to the stroke were shared, but the interpretation of these conceptions and the goals of the rehabilitative activities differed. While the patients’ experience of the loss of control, fatigue and a fear of a relapse influenced their rehabilitation process, the health care professionals ignored these aspects in their recording. Their focus was more on reduced functions and training. Successful rehabilitation must be based on the conceptions of those who have had a stroke of what it involves. Goals should be explicitly expressed and discussed and be experienced as relevant by the person who has had a stroke as well as by the health care professionals.

Measures to assess all the implications of strokes must be developed. The multi‐professional perspectives represented amongst the team of health care professionals must be adopted and implemented.
Elevated monocyte chemoattractant protein‐1 levels following thermal injury precede monocyte recruitment to the wound site and are controlled, in part, by tumor necrosis factor‐α
Authors: Heinrich Scott A. , Messingham Kelly A. N. , Gregory Meredith S. , Colantoni Alessandra , Ferreira Ahalia M. , Dipietro Luisa A. , Kovacs Elizabeth J.
Published: December 2004

In previous studies, mice given a full‐thickness scald injury had an influx of neutrophils into the skin that followed a local increase in a neutrophil chemoattractant. Because macrophages are known to infiltrate the wound area after neutrophils and are essential for normal wound repair, studies were designed to characterize the time course of macrophage accumulation in the wound and to identify the factor(s) responsible for this influx. A macrophage infiltrate into the wound was observed at 4 days post‐injury and persisted through at least 10 days. This influx was preceded by an initial fourfold increase in dermal monocyte chemoattractant protein‐1 levels at 24 hours post‐injury (p < 0.05). This elevation in monocyte chemoattractant protein‐1 was enhanced at 4 and 10 days postburn resulting in a sixfold increase over baseline (p < 0.01). Levels of tumor necrosis factor‐α, a proinflammatory cytokine known to induce chemokine production, were elevated at 90 minutes after injury in burn‐ versus sham‐injured groups (p < 0.05). Furthermore, administration of tumor necrosis factor‐α neutralizing antibody in vivo reduced the dermal levels of monocyte chemoattractant protein‐1 seen at 10 days postburn by 57% (p < 0.01); however, macrophage accumulation was not altered. Thus, elevated systemic TNF‐α levels may influence the local chemokine milieu following burn injury. (WOUND REP REG 2003;11:110–119)
THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Clinical Epidemiology of Cardiac Disease in Dialysis Patients: Left Ventricular Hypertrophy, Ischemic Heart Disease, and Cardiac Failure
Authors: Foley Robert N
Published: December 2004

Patients with end‐stage renal disease (ESRD) are at extreme cardiovascular risk. At least half of all patients starting dialysis therapy have overt cardiovascular disease (CVD). In addition, recent studies suggest annual incidence rates for new‐onset cardiac failure, peripheral vascular disease, ischemic heart disease (IHD), and stroke of approximately 7%, 7%, 5%, and 1%, respectively. High‐level exposure to traditional risk factors, such as smoking and dyslipidemia, hemodynamic overload factors, such as anemia and hypertension, and a myriad of metabolic factors related to uremia are all likely to play a role. There has been explosive growth in observational studies and a heartening, if less dramatic, increase in risk factor intervention trials, suggesting that risk factor modification can lead to meaningful benefit.
THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Traditional Cardiac Risk Factors in Individuals with Chronic Kidney Disease
Authors: Uhlig Katrin , Levey Andrew S. , Sarnak Mark J.
Published: December 2004

Individuals with chronic kidney disease (CKD) are at increased risk for the development and progression of cardiovascular disease (CVD). The increased risk is due to a higher prevalence of both traditional risk factors as well as nontraditional risk factors. In this review we focus on individuals at all stages of CKD and discuss modifiable traditional risk factors, namely hypertension, dyslipidemia, diabetes mellitus and poor glycemic control, smoking, and physical inactivity. The prevalence of each risk factor and its relationship with CVD is described. Treatment recommendations are provided using evidence available from populations with CKD or evidence extrapolated from the general population when there are insufficient data on individuals with CKD.
Micro‐ and Macrocirculatory Effects of Apheresis in Patients withFamilial Hyperlipidemia
Authors: Lu Qing , Eriksson Mats , Jogestrand Tomas , Henriksson Peter , Freyschuss Anna
Published: December 2004

High lipid levels have been shown to coexist with a disturbedvascular endothelial function. Thus, acute lipid lowering couldbe expected to improve vascular reactivity. Patients with familialhyperlipidemia (FH) have substantial and rapid decreases in lipidlevels after low‐density lipoprotein apheresis. Thus, an opportunityexists to study acute effects of lipid lowering on vascular reactivity.Flow mediated vasodilation (FMD) is commonly used to assess endothelialfunction in conduit vessels, whereas vital capillary microscopyduring the post‐reactive hyperemia (PRH) phase is used to assessresponse at the microvascular level. It is not known whether endothelialdysfunction is a general phenomenon in all kinds of vessels or ifthere are differences between micro‐ and macrovessels. In the presentstudy, we were not able to demonstrate an improved vascular responseafter acute lipid lowering in FH patients. This was true both inthe microcirculation (PRH) and in the conduit vessels (FMD). However,the two methods gave concordant results, demonstrating disturbedvascular reactivity in the patients as compared with healthy subjects.We have found no previous report with parallel assessments at themicrocirculatory and macrocirculatory levels.
Development of Reduced‐intensity Hematopoietic Stem Cell Transplantation in the National Cancer Center Hospital, Japan
Authors: Kami Masahiro , Takaue Yoichi
Published: December 2004

Abstract: Reduced‐intensity hematopoietic stem cell transplantation (RIST) is a new approach of stem cell transplantation, which has shown promising features as reported in multiple phase I and II studies. Elderly patients, who are not eligible for conventional myeloablative hematopoietic stem cell transplantation (HSCT), are now treatable with RIST. It has also reduced regimen‐related toxicity and provided better prognosis in short‐term follow‐up than that of conventional HSCT. Favorable results have been reported particularly in hematological malignancies, such as chronic myelocytic leukemia and malignant lymphoma. Among solid tumors, metastatic renal cell carcinoma was found to respond well to RIST. Clinical studies are currently being conducted to evaluate the efficacy of RIST in other types of solid tumors. However, the mechanism of graft‐versus‐host disease and graft‐versus‐tumor remains unclear. More knowledge on the mechanism is crucial to enhance antitumor effect and to further improve the prognosis.
Low‐density Lipoprotein Apheresis in the Treatment of Peripheral Arterial Disease
Authors: Kawashima Akira
Published: December 2004

Abstract:  Low‐density lipoprotein (LDL) apheresis is performed in patients with homozygous familial hyper‐cholesterolemia who lack LDL receptors and with heterozygous familial hypercholesterolemia who are LDL receptor deficient with documented, symptomatic coronary artery disease who are resistant to diet changes and maximum drug therapy. LDL apheresis can reduce or abolish anginal symptoms and improve coronary lesions. Several reports reveal the improvement of insufficient peripheral blood flow. By extensively removing blood LDL and changing coagulation factors and various vasoactive substances, LDL apheresis improves blood rheology and thereby peripheral circulation. It seems worth trying on all patients with arteriosclerotic lesions, even if they are normocholesterolemic.
Another Example of a B Variant
Authors: Simmons A. , Twaitt J.
Published: December 2004

A family in which five members had a weak B variant and one member had a normal A and weak B reaction is reported. It appears that these phenotypes arise by the inheritance of a variant allele of the ABO locus. Their cells react weakly when added to anti‐B sera, and they have normal anti‐A activity and an absence of anti‐B in their sera. Additionally, all of the members tested had increased levels of cellular H substance and all of the affected secretor members of the family secreted normal amounts of both B and H substance. Transferase activity of the sera of these individuals confirmed the presence of the B‐gene specific transferase.
The Groupamatic System for Routine Immunohematology
Authors: Garretta M. , Gener J. , Muller A. , Matte C. , Moullec J.
Published: December 2004

Approximately 600,000 routine immunohematological tests have been conducted with Groupamatic GC systems at the National Blood Transfusion Center in Paris. The system is used for determination of the ABO group including A1 and A2 subgrouping; the Rh factors including Du, C, c, E, e, Cw; K; Lea; P1; M and N. The detection and identification of irregular alloantibodies is carried out systematically together with detection of the anti‐A and anti‐B antibodies. Simultaneously, testing for syphilis is done with a cardiolipid antigen. Groupamatic equipment allows 340 samples to be tested per hour and 12 reactions can be carried out simultaneously on each sample. The system is fully automated.
Short‐Term and Long‐Term Effects of Plasmapheresis on Serum Proteins and Immunoglobulins
Authors: Friedman B. A. , Schork M. A. , Mocniak J. L. , Oberman H. A.
Published: December 2004

In order to evaluate the short‐term and long‐term effects of plasmapheresis on serum proteins and immunoglobulins, the levels of α1, α1, β, and γ globulins, and IgG, IgA, and IgM were measured and statistically evaluated in 41 active plasmapheresis donors donating 500 to 1,000 ml of plasma weekly for up to three years. During the initial four months of plasmapheresis, the percentage of α1 and α2 globulins manifested a statistically significant rise and the IgG, IgA, and IgM concentrations declined. By the end of ten months, only the IgM continued to be depressed. Although the concentration of IgM continued to show a statistically significant decline for three years, it remained well within the normal range of values for our laboratory. Although no statistically significant difference existed between the baseline value of albumin and the level reached at the end of the third year, a gradual rise was followed by a decline in this interval.

Most of the statistically significant alterations of serum protein and immunoglobulins occurring in plasmapheresis donors are seen in the initial six months of plasmapheresis. A falling serum protein in this time period is most likely an indication of declining immunoglobulins. It is feasible and appropriate to measure the donor's total serum protein at the time of each plasmapheresis. Any untoward reduction in this value necessitates quantification of the serum immunoglobulins. Routine measurement of the immunoglobulins in the face of normal total serum protein can be performed on a less frequent basis as is presently recommended by accrediting agencies, although this study should be performed more often during the first six months of a serial plasmapheresis program.
The Effect of Hydroxyethyl Starch on In Vitro Platelet and Granulocyte Function
Authors: Schiffer C. A. , Aisner J. , Schmukler M. , Whitaker C. L. , Wolff J. H.
Published: December 2004

The effect of hydroxyethyl starch (HES) on granulocyte and platelet functions was assessed. No alteration of granulocyte viability, morphology, phagocytic ability, or bactericidal capacity was detected after incubation with 6 per cent HES at 25 C for two hours. Platelet morphology, size distribution, aggregation, nucleotide and serotonin release, and platelet factor‐3 availability were also unchanged after exposure to HES. It is concluded that HES has no adverse effect on cell function and appears to be a suitable adjuvant agent for blood cell component collection.
Distribution of Progesterone and Its Effect on Human Blood During Storage
Authors: DeVenuto F. , Wilson S. M.
Published: December 2004

Human blood, drawn into ACD, was stored under blood bank conditions with and without addition of tritium‐labeled progesterone. At selected storage intervals, several biochemical and biophysical parameters were assayed and the distribution of the hormone between plasma and erythrocytes was determined. The retention of the radioactive material by erythrocytes was studied by repeated washes with isotonic saline. The results indicate that erythrocytes stored with addition of progesterone have higher ATP levels, less spontaneous lysis, higher osmotic resistance, and higher uptake of methylene blue throughout the time of storage than do cells stored without added progesterone. This hormone appears to be in steady‐state equilibrium between plasma and red blood cells during 42 days of storage and the amount in the plasma is almost twice that present in the cells. After repeated saline washes, about 10 per cent of the progesterone remains attached to the erythrocytes. Specific association of progesterone with red blood cell populations of different density shows that high specific activity is obtained in cell populations of low density (young cells) throughout the storage time investigated.
Detection of HBsAg in Coagulation Factor IX Concentrates
Authors: O'Connor M. L. , Meek E. S. , Simmons A.
Published: December 2004

HBsAg was detected in two commercial clotting factor concentrates: Proplex (Hyland) and Konyne (Cutter). HBsAg was positive by RIA in samples of Proplex but not Konyne. Immune‐electron microscopy, however, demonstrated clumped small spheres of HBsAg in both preparations, and lamellar‐type strands were seen in several preparations.
A review of blood donor motivation and recruitment
Authors: Oswalt RM
Published: December 2004

Sixty English‐language articles on the motivation and recruitment of blood donors and nondonors are reviewed and evaluated. Apparently researchers have been finding essentially the same results for approximately twenty years. Motivations to donate are: altruism/humanitarian, personal or family credit, social pressure, replacement and reward. Motivations not to donate are: fear (of needle, sight of blood, weakness, finger or ear pricking), medical excuses, reactions, apathy, and inconvenience. Deeper analysis of motivation suggests that donors may unconsciously desire a “pat‐on‐the‐back” for their efforts. Retention and management of prior donors may be more significant to meeting blood needs than motivation of new donors. Suggestions for donor recruitment effectiveness are presented.
Blood Group Alloantibodies: An Assessment of Some Laboratory Practices
Authors: Giblett E. R.
Published: December 2004

Over a 20‐year period, the number of blood donors and transfusion recipients previously immunized by blood group antigens was determined in a large blood center. During that period, the proportion of patients found to have anti‐D declined, while those with other antibodies in the Rh system, as well as in the Kell, Duffy, and Kidd systems, increased sharply. As expected, the rate of sensitization was much lower among blood donors than among recipients. In both groups, sensitized females greatly outnumbered sensitized males. Some of the findings summarized here raise questions about current practices in transfusion laboratories and emphasize the responsibilities of blood bank professionals to donors as well as to patients.
Formation of Oxyadenine Metabolites in the Rabbit after Intravenous Administration of Adenine
Authors: Bartlett G. R.
Published: December 2004

Adenine, 8‐oxyadenine, and 2,8‐dioxyadenine were analyzed, by Dowex‐50 column chromatography, in rabbit urine four hours after IV infusion of the following doses of adenine in mg/kg: 2, 4, 8.75, 17.5, 35, 70, 140 and 210. The average excretion in mole percentage of the dose was: adenine, 11.1; 8‐oxyadenine, 6.1; and 2,8‐dioxyadenine, 6.2. The percentage of excretion of 8‐oxyadenine and of 2,8‐dioxyadenine was unrelated to the dose of adenine. At doses of adenine of 35 mg/kg and above more than 80 per cent of the 2,8‐dioxyadenine in the urine was in the form of microscopic pale yellow spherical particles. The particulate 2,8‐dioxyadenine was found in the kidney in a very small amount at the dose of 70 mg/kg and in much greater quantities at 140 and 210 mg/kg.
A Simplified Procedure for Deglycerolizing Red Blood Cells Frozen in a High Glycerol Concentration
Authors: Meryman H. T. , Hornblower M.
Published: December 2004

Although the high (40 to 50 per cent) glycerol method of freezing red blood cells has many advantages, no feasible procedure for deglycerolizing with only a clinical centrifuge has been available. Thus this method has been restricted to blood centers that distribute a sufficient number of frozen cells to warrant the installation of automated cell washing equipment. However, by sedimenting the glycerolized cells prior to freezing and discarding the excess glycerol solution, postthaw deglycerolizing can be simplified to consist of an initial double dilution with hypertonic NaCl and isotonic saline‐glucose followed by two cycles of sedimentation and resuspension in isotonic saline‐glucose. The method is applicable to units frozen either at ‐80 C or in liquid nitrogen vapor. Units frozen in this way can also be deglycerolized in commercial automated cell washers using suitably modified protocols.
Studies on 4 C Stored Frozen‐Reconstituted Red Blood Cells: I. Bacterial Growth
Authors: Myhre B. A. , Nakasako Y. Y. , Schott R.
Published: December 2004

A knowledge of the growth rates of various organisms at the storage temperature of 4 C in the different suspending media used for red blood cells would aid the extension of the thawed storage time of frozen‐reconstituted blood beyond the 24 hours allowed by the Food and Drug Administration. Knowing these rates, a prediction could be made that the growth rate would be sufficiently slow and the unit (sterile or minimally contaminated) could be given safely after a longer storage period. The studies reported show that the pathogenic organisms S. aureus, Ps. aeruginosa, E. coli, Klebsiella sp. and Enterobacter sp. grow at such a slow rate at 4 C that they do not represent any great hazard to the recipient unless introduced in great numbers. The studies further show that in the process of washing frozen blood the number of organisms is reduced by between one and two orders of magnitude (base 10). Therefore, extension of frozen red blood cell storage life to at least 72 hours should be considered.
Liver Dysfunction in Patients with Hemophilia A, B, and von Willebrand's Disease
Authors: Hilgartner M. W. , Giardina P.
Published: December 2004

Ninety‐five patients with Hemophilia A, B and von Willebrand's disease followed over a three year period were evaluated for liver disease. Half of the patients were treated episodically and half received additional prophylactic treatment. Fifty‐five per cent have significant transaminitis (elevated SGOT‐SGPT), 42 per cent have biochemical evidence of chronic active liver disease and two per cent have subacute and active cirrhosis. There is an annual attack rate of Hepatitis B disease of 3.5 per cent and Hepatitis B antibody titres are present in 84 per cent. This asymptomatic liver disease requires close monitoring for clinical significance.
Blood Typing in Disputed Paternity Cases Capabilities of American Laboratories
Authors: Polesky H. F. , Krause H. D.
Published: December 2004

This paper summarizes a survey of the blood typing capabilities of representative American laboratories as they are: 1) currently applied to disputed paternity cases and 2) these laboratories potential for utilizing additional tests in disputed paternity cases.
Evaluation of Passive Hemagglutination Techniques in Detection of Australia Antigen (HBsAg)
Authors: Scalise G. , Mura M. S. , Delia S.
Published: December 2004

Some techniques for HBsAg detection in the serum were evaluated. The direct hemagglutination test with turkey erythrocytes appears to be a suitable test for speed, simplicity, and cost.
In Vitro and in Vivo Comparison of Single‐Donor Platelets and Multiple‐Donor Pooled Platelets Transfusions in Leukemic Patients
Authors: Patel I. P. , Ambinder E. , Holland J. F. , Aledort L. M.
Published: December 2004

In vitro and in vivo studies were done to evaluate efficacy of fresh, single donor platelets (SDP) obtained by Latham‐bowl plateletpheresis and multiple donor, pooled platelets (MDPP) obtained by conventional centrifugation for transfusion of leukemic patients. Results indicate increased effectiveness, both in vitro and in vivo, of single donor platelets as compared to multiple donor pooled platelets.
Platelet Preservation
Authors: Odink J. , de Wit J. J. F. M. , Janssen C. L. , Prins H. K.
Published: December 2004

Two methods were used for the preparation of platelet concentrates from fresh and overnight‐stored human ACD blood. In a two‐step method prostoglandin E1 was added to platelet rich plasma and the mixture was centrifuged to obtain platelet concentrate. The IBM 2991 Blood Cell Processor was used in a one‐step‐method. The concentrates were stored in the frozen state. Concentrates prepared with the two‐step method had a higher platelet recovery and a lower leukocyte contamination than did concentrates prepared with the one‐step method. Based on serotonin uptake velocity, response to hypotonic stress and available platelet factor 3, no essential differences were observed between platelet concentrates prepared from fresh and overnight‐stored blood. Concentrates prepared with the one‐step method had a higher serotonin uptake velocity than those prepared with the two‐step method. This did not result in a better recovery after cryopreservation.
Patterns of Blood Utilization by Physicians: Transfusion of Nonoperated Anemic Patients
Authors: Friedman B. A.
Published: December 2004

Prior studies have suggested that a high percentage of blood transfusions to hospital patients are unnecessary. If such transfusions can be reduced, more blood would be made available for those patients with legitimate blood requirements. In this study, blood transfusion of 401 nonoperated hospital patients with anemia as the final diagnosis explaining admission and with admission hemoglobin values ≥10 gm/dl was analyzed. These patients were drawn from a 300 hospital sample distributed across the United States. Descriptive data showing the extent to which this selected population of patients is transfused with blood must be considered as one measure of unnecessary blood transfusion in this country. Hospital‐based programs designed to identify and eliminate unnecessary blood transfusions should be established. The first step in the creation of such programs at the hospital level must be the development of guidelines for blood transfusion derived through the cooperative efforts of hospital physicians who fully understand and accept the rationale for them. Once guidelines for blood transfusion are established in a hospital, transfusion practice need only be measured against them.