bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidural Calcitonin: Does it Provide Better Postoperative Analgesia? An Analysis of the Haemodynamic, Endocrine, and Nociceptive Responses of Salmon Calcitonin and Opioids in Epidural Anesthesia for Hip Arthroplasty Surgery
Authors: Gabopoulou Zoi , Vadalouca Athina , Velmachou Kyriaki , Karanastasi Chryssoula , Van Zundert André 
Published: March 2003

Abstract: Calcitonin is an endogenous regulator of calcium homeostasis, which acts principally on bone. At present, the principal indications for the therapeutic use of calcitonin are disorders involving hypercalcemia Paget's disease, acute pancreatitis, high‐bone‐turnover osteoporosis, pain associated with osteoporosis or bone metastases, and Sudeck's atrophy. The aim of this study was to compare the analgesic effects on postoperative pain of salmon calcitonin versus opioids administered epidurally. Our prospective study included 53 ASA I‐II patients who were scheduled for total hip arthoplasty under epidural anaesthesia and who did not fulfill 1 or more of the exclusion criteria: a history of pituitary gland dysfunction; diabetes mellitus; obesity; contraindications to performing an epidural block and/or an allergy to calcitonin. These patients were randomly allocated into 3 groups (A, B, and C), each of which received postoperatively a different analgesic epidural mixture of 10 mL to control postoperative pain. Group A was given bupivacaine 0.5% (5 mL) + fentanyl 100 (2 mL) + NaCl 0.9% (3 mL). Group B was given bupivacaine 0.5% (5 mL) + salmon calcitonin 100IU (1 mL) + NaCl 0.9% (4 mL). Group C was given salmon calcitonin 100IU (1 mL) + NaCl 0.9% (9 mL). Perioperatively, 4 blood samples were taken from each patient at the following specific times: 1. Before the induction of anesthesia; 2. At the end of the operation and before the epidural administration of the analgesic mixture; 3. At the end of the first postoperative hour (1 hour after the administration of the analgesic mixture); and 4. At the end of the second postoperative hour (2 hours after the administration of the mixture).In each blood sample, glucose, cortisol, growth hormone, and prolactin plasma levels were determined in order to investigate the changes of these parameters as a result of the endocrine reaction to stress, and to pain relief. The analgesic solution was administered immediately after the second blood sample was taken. At the same time as the 4 blood samples were taken, haemodynamic parameters and pain scores were recorded. Epidural salmon calcitonin in combination with local anaesthetic produces an analgesic effect similar to fentanyl and with stable hemodynamic results. It also eliminates postoperative hyperglycaemia. The cortisol plasma level does not increase during the first postoperative hour, but increases significantly during the second postoperative hour. Growth hormone and prolactin plasma levels were stable in all patients in all 3 groups. This study shows that calcitonin is a suitable alternative for the treatment of acute postoperative pain.
The incidence and significance of anti‐“Mia” in Taiwan
Authors: Broadberry R.E. , Lin M. 
Published: March 2003

Background: The incidence of the Mill phenotype among Chinese blood donors in Taiwan is 7.3 percent. Anti‐“Mia” is the most frequently occurring alloantibody of potential clinical significance encountered among Chinese patients in Taiwan, with a frequency of 0.28 percent.Case Reports: A case of hemolytic disease of the newborn and a transfusion reaction due to anti‐“Mia” are described.Conclusion: It may be important to include the Mill phenotype in the antibody screening of sera from Chinese patients.
Detection of human immunodeficiency virus type 1 p24 antigen and plasma RNA: relevance to indeterminate serologic tests
Authors: Henrard D.R. , Phillips J. , Windsor I. , Fortenberry D. , Korte L. , Fang C. , Williams A.E. 
Published: March 2003

BACKGROUND: Most enzyme immunoassay‐reactive specimens producing indeterminate Western blot results belong to individuals who are not infected with human immunodeficiency virus type 1 (HIV‐1). However, a small percentage may correspond to early seroconversion or advanced disease, at which stage partial reactivity on Western blot may be observed.STUDY DESIGN AND METHODS: To determine the utility of HIV‐1 p24 antigen and cell‐free RNA detection for the resolution of Western blot‐indeterminate serologic results, several types of enzyme immunoassay‐positive, sero‐indeterminate specimens were analyzed. Samples were obtained from infected individuals at the time of seroconversion (n = 20), from patients with AIDS (n = 2), as specimens from clinical samples obtained for diagnostic testing (n = 57), from blood donors producing persistent indeterminate results (n = 47), and from random blood donors (n = 72).RESULTS: HIV‐1 p24 antigen was detected in 10 of 20 specimens collected from 9 of 12 individuals who seroconverted and in 2 of 2 AIDS patients. HIV‐1 plasma RNA was positive in 22 of 22 samples from those 14 individuals. All of 57 diagnostic specimens and 47 samples obtained from persistently indeterminate donors were negative for HIV‐1 p24 antigen and plasma HIV‐ 1 RNA. One of 72 blood donor specimens was positive for HIV‐1 plasma RNA and had borderline reactivity for p24 antigen.CONCLUSION: The detection of plasma RNA appears to be sensitive and specific; negative test results may be used to identify false‐positive serologic reactions. The detection of p24 antigen and plasma RNA can also be used to confirm HIV‐1 infection in persons with indeterminate serologic results associated with early seroconversion or late‐stage disease.
Changing blood use in the AIDS era: the case of elective hip surgery
Authors: Atlas S.J. , Singer D.E. , Skates S.J. 
Published: March 2003

BACKGROUND: Concern about the transmission of human immunodeficiency virus via blood has substantially increased the public's anxiety about the safety of the blood supply and has encouraged practices to minimize risks deriving from transfusions.STUDY DESIGN AND METHODS: To assess changes in transfusion practices in elective surgery as awareness of transfusion‐transmitted human immunodeficiency virus emerged, 80 randomly selected patients per year undergoing elective total hip replacement in five calendar years between 1977 and 1989 at a large university teaching hospital were studied.RESULTS: Total blood use decreased significantly from an average of 3.3 units per patient in 1977 to 2.1 units per patient in 1989 (p = 0.0003). Autologous blood use increased from essentially zero in 1977 to 82 percent of total blood use in 1989 (p < 0.0001). The threshold hematocrit for postoperative transfusion of allogeneic blood (defined by use of logistic regression models) decreased from 30.1 percent (0.30) in 1977 to 26.7 percent (0.27) in 1989 (p = 0.01). As a result of these changes, the proportion of patients exposed to allogeneic blood decreased from 90 to 16 percent across the study period (p < 0.0001). The dramatic decrease in the use of allogeneic blood in elective total hip replacement surgery during the study period was due to decreased demand for blood during and after the operation and to a striking shift in the blood supply from allogeneic to autologous sources.CONCLUSION: These findings demonstrate that physicians can appropriately alter practices when there are perceived health risks.
JMH variants: serologic, clinical, and biochemical analyses in two cases
Authors: Mudad R. , Rao N. , Issitt P.D. , Roy R.B. , Combs M.R. , Telen M.J. 
Published: March 2003

BACKGROUND: JMH is a high‐frequency red cell blood group antigen that resides on a 76‐ to 80‐kDa glycosylphosphatidylinositol‐linked protein also known as CDw108. Antibodies with JMH specificity are often autoimmune and are usually, if not always, clinically benign. Some individuals with JMH‐variant antigen produce alloantibodies to JMH, but little evidence concerning their clinical significance is available. This article reports on two patients who express a JMH‐variant antigen and produced alloanti‐JMH.STUDY DESIGN AND METHODS: Murine monoclonal antibodies and human antibodies to JMH were used in hemagglutination, radioimmunoassay, and Western blot testing of red cells from two JMH‐ variant patients; antiserum from one of these patients was also used in biochemical studies. In addition, in vivo survival of JMH‐positive red cells was studied in the same patient.RESULTS: Biochemically, both examples of red cells with the JMH‐variant phenotype expressed a JMH protein with a molecular weight similar to that of the normal JMH protein. For both patients, family studies suggested an autosomal recessive pattern of inheritance. Survival study demonstrated reduced in vivo red cell survival in one patient.CONCLUSION: JMH‐variant phenotypes express a protein of normal molecular weight and are inherited in an autosomal recessive pattern. Furthermore, individuals with this phenotype can produce clinically significant antibodies.
Determination of neutrophil antigen gene frequencies in five ethnic groups by polymerase chain reaction with sequence‐specific primers
Authors: Hessner M.J. , Curtis B.R. , Endean D.J. , Aster R.H. 
Published: March 2003

Background: The granulocyte antigens NA1 and NA2 are the two recognized allelic forms of Fcγ receptor IIIB. These antigens are clinically relevant, because they are the most frequent targets of neutrophil antibodies in alloimmune neonatal neutropenia, transfusion‐related acute lung injury, and chronic benign autoimmune neutropenia of infancy.Study Design and Methods: A genotyping assay for NA1 and NA2 using polymerase chain reaction with sequence‐specific forward and reverse oligonucleotide primers has been developed and validated. Genomic DNA was isolated from the peripheral blood of 478 unrelated individuals of five ethnic groups and used as template for NA genotyping.Results: A validation study of 22 serologically typed samples (2 NA1/NA1, 10 NA1/NA2, and 10 NA2/NA2) was performed. A concordance rate of 100 percent (22/22 samples) was observed between the genotyping assay and serologic typing. In the genotyping study conducted, the NA1 and NA2 gene frequencies observed were 0.31 and 0.69 for African Americans, 0.30 and 0.70 for Asian Indians, 0.37 and 0.63 for whites, 0.53 and 0.47 for Hispanics, and 0.55 and 0.45 for Native Americans, respectively.Conclusion: Polymerase chain reaction with sequence‐specific primers provides a simple and rapid alternative to neutrophil antigen typing by serologic tests. The NA1 and NA2 gene frequencies observed in Asian Indians and African American populations are similar to those observed in white populations, while those observed in Native American and Hispanic populations are more similar to those previously reported for Asian populations.
Frequency of human immunodeficiency virus (HIV) infection among contemporary anti‐HIV‐1 and anti‐HIV‐½ supplemental test‐ indeterminate blood donors
Authors: Busch M. P. , Kleinman S. H. , Williams A. E. , Smith J. W. , Ownby H. E. , Laycock M. E. , Lee L. L. L. , Pau C.‐P. , Schreiber G. B. ,   The Retrovirus Epidemiology Donor Study
Published: March 2003

Background: Follow‐up studies from the mid‐1980s showed that 1 to 5 percent of blood donors testing reactive in anti‐human immunodeficiency virus type 1 (HIV‐1) enzyme immunoassay (EIA) and testing indeterminate in Western blot were infected with HIV‐1 and were in the process of seroconverting. The present study was conducted to establish the rate of HIV infection among contemporary anti‐HIV‐1/HIV type 2 (HIV‐2) EIA‐ reactive, Western blot‐indeterminate donors.Study Design and Methods: Donations (n = 607) with indeterminate HIV supplemental test results were identified by screening 3,021,342 donations given from November 1990 through August 1993 at five participating blood centers. Consenting donors were enrolled and samples taken 4 to 8 weeks after donation. Follow‐up sera were tested by EIA and Western blot for anti‐ HIV‐1 seroconversion and by type‐specific peptide assays for antibodies to HIV‐2 and HIV‐1 subtype O. Peripheral blood mononuclear cells and/or plasma from the follow‐up samples were tested for HIV‐1 DNA and/or RNA by polymerase chain reaction. The rate of HIV‐1 infection among Western blot‐indeterminate donors was also estimated by multiplying the incidence rate of HIV‐1 seroconversion in this donor population by the estimated duration of the EIA‐reactive and Western blot‐indeterminate window during seroconversion (8.5 days).Results: Supplemental test‐ indeterminate donors (n = 355) enrolled a median of 38 days after donation; 265 (75%) of these donors were identified as indeterminate after an anti‐HIV‐1/2 EIA‐reactive donation. Enrolled and non‐enrolled donors had similar distributions of demographic characteristics and band patterns. Follow‐up samples from all 355 donors tested negative for HIV‐1 in polymerase chain reaction. Follow‐up sera tested Western blot‐negative in 54 cases (15%) and Western blot‐indeterminate in 299 (84%). Two follow‐up sera (0.6%) were interpreted, according to manufacturer's package insert criteria, as Western blot positive with p24 and gp41 bands and/or gp120/160 bands; however, paired testing of index and follow‐up sera from these two cases showed identical Western blot and EIA reactivity, and polymerase chain reaction was negative for HIV RNA and DNA, which ruled out HIV infection. The absence of HIV infection in 355 Western blot‐indeterminate donors was consistent with our incidence‐based model analysis, which yielded an estimate of one HIV‐1 infection for every 215 Western blot‐indeterminate donations (95% CI, 1/39‐1/8333).Conclusion: Contemporary blood donors classified as indeterminate in supplemental HIV testing are infrequently infected with HIV. Donors whose follow‐up samples test negative in anti‐HIV‐1/2 EIAs and negative or persistently indeterminate in Western blots should be considered eligible for reinstatement.
Molecular background of VS and weak C expression in blacks
Authors: Faas B.H.W. , Beckers E.A.M. , Wildoer P. , Ligthart P.C. , Overbeeke M.A.M. , Zondervan H.A. , von dem Borne A.E.G.Kr. , van der Schoot C.E. 
Published: March 2003

BACKGROUND: The Rh system is complex and consists of as many as 45 different antigens. Red cells of about 25 percent of the black population carry VS an Rh‐system antigen (Rh20), but this antigen is very rare in whites. VS positivity is always associated with a weak expression of e, and usually also of C.STUDY DESIGN AND METHODS: The RH genes of 11 black VS‐positive donors were studied. Transcripts were sequenced for four VS‐positive donors, three of whom had red cells with a weak expression of C. In the other donors, only analysis of genomic DNA was carried out.RESULTS: The occurrence of VS was shown to be related to a single‐point mutation in exon 5 of the RHCE gene (cytosine 733 guanine, leading to the Leu245Val substitution). The presence of this polymorphism in exon 5 may explain the simultaneously occurring weak e, because the E/e polymorphism is located in the same exon. Study of VS‐positive donors with different Rh phenotypes showed that the polymorphism can occur in different alleles of the RHCE gene. In all three donors whose red cells showed a weak expression of C, a hybrid D‐CE‐D transcript was found, containing exon 4, 5, 6, 7, and (probably) 8 from the RHCE gene. No transcripts were encountered carrying DNA markers normally associated with C expression.CONCLUSION: It is therefore postulated that the hybrid gene is responsible for the weak expression of C in these individuals. The hybrid gene carried a Leu62Phe substitution, as well as the Leu245Val substitution responsible for VS. The gene most probably cosegregates with a C allele encoding Cys 16 (normally encoded only by the C allele) and Val245 (responsible for VS antigenicity when encoded by the RHCE gene). This explains the combination of weak expression of C and VS positivity that is frequently found in blacks.
Mini‐pool screening by nucleic acid testing for hepatitis B virus, hepatitis C virus, and HIV: preliminary results
Authors: Cardoso M. S. , Koerner K. , Kubanek B. 
Published: March 2003

BACKGROUND: The purpose of this study was to evaluate the feasibility of nucleic acid testing (NAT) of mini‐pools as a blood donation screening test.STUDY DESIGN AND METHODS: The stepwise implementation of NAT of mini‐pools began in January 1997. Since March 1997, all blood donations collected by the German Red Cross Blood Transfusion Service of Baden‐Wurttemberg were tested for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV nucleic acids. An extra barcoded serum sample is collected from each blood donor for NAT‐based screening, which is performed only on hepatitis B surface antigen‐, anti‐HCV‐, anti‐HIV‐, and anti‐Treponema pallidum‐seronegative donations. Samples are pooled to a maximum of 96. Positive results are resolved through intersecting subpools (a chessboard design). NAT‐based screening does not include a virus concentration step before nucleic acid extraction.RESULTS: By the end of October 1997, 331, 783 donations in 3,779 pools had been screened. As yet, no viremic but seronegative blood donor has been found for the three markers.CONCLUSION: It is feasible to incorporate NAT‐based screening of mini‐pools into the routine virus diagnostics of a large blood transfusion service. It remains to be determined whether screening blood donations by NAT will indeed increase the safety of blood supply.
Granulocyte collection efficiency and yield are enhanced by the use of a higher interface offset during apheresis of donors given granulocyte‐ colony‐stimulating factor
Authors: Adkins D. , Ali S. , Despotis G. , Dynis M. , Goodnough L. T. 
Published: March 2003

BACKGROUND: Trials evaluating granulocyte transfusions for therapy of febrile neutropenia demonstrated mixed clinical results, which may in part be due to the low neutrophil cell dose of the transfused components. To optimize the latter variable, the effect of various interface offset (IO) settings during apheresis on granulocyte collection efficiency (GCE) and yield was determined in normal donors given granulocyte‐colony‐stimulating factor (G‐CSF).STUDY DESIGN AND METHODS: Seventeen donors underwent 44 granulocyte collections performed with a continuous‐flow blood cell separator with hetastarch infusion after stimulation with G‐CSF (5 μ/kg/day). Apheresis was performed alternatively using one of three IO settings: IO = 15 (Group 1, n = 16), IO = 25 (Group 2, n = 12), and IO = 35 (Group 3, n = 13). The GCE and yield and changes in donor platelet count, hematocrit (Hct), and red cell (RBC) volume of the components were compared among the three groups.RESULTS: The mean GCE was greater (p = 0.006) during apheresis at an IO setting of 35 (60 ± 12%) than at an IO setting of 15 (40 ± 17%). The mean granulocyte yield (×1010 per procedure was 10.8 ± 2.95 at an IO setting of 35 and 7.73 ± 4.02 at an IO setting of 15 (p = 0.08). In a multivariate linear regression model, factors independently associated with granulocyte yield were the absolute granulocyte count (r = 0.73, p < 0.001) and blood volume of the donor (r = 0.54, p = 0.001) before the procedure and the use of an IO setting of 35 (r = 0.50, p = 0.002). There was no significant difference among the three groups in the decrement in donor platelet count or Hct with apheresis, although the mean RBC volume was greater in Group 3.CONCLUSION: Granulocyte apheresis at an IO setting of 35 rather than 15 resulted in a significant increase in the GCE. The use of an IO setting of 35 during apheresis was an independent factor associated with granulocyte yield in the multivariate model. Donor safety was not compromised by collecting granulocytes at the higher IO setting.
Hepatitis A virus infections associated with clotting factor concentrate in the United States
Authors: Soucie J. M. , Robertson B. H. , Bell B. P. , McCaustland K. A. , Evatt B. L. 
Published: March 2003

BACKGROUND: Two cases of hepatitis A among persons exposed to the same lot of solvent/detergent‐treated antihemophilic factor VIII concentrate were reported to a surveillance system. An investigation was conducted to find additional cases and determine the source of infection.STUDY DESIGN AND METHODS: A seroprevalence study was conducted among persons with exposure to the suspect lot for serologic evidence of recent infection with hepatitis A virus (HAV).RESULTS: Six cases of recent HAV infection were discovered: four of the patients had been infused with material from the suspect lot of factor VIII, and two had received infusions of factor IX concentrate made from plasma pools common to the suspect factor VIII lot. HAV was identified in one of the plasma pools, in the factor VIII product, and in serum or stool from two factor VIII recipients and one factor IX recipient. The genetics sequence of the virus in the plasma pool, the factor VIII lot, and the factor VIII recipients were identical, while that of the virus in the factor IX recipient differed by a single base.CONCLUSION: These data document the transmission of HAV by a factor VIII concentrate and implicate factor IX products manufactured from a common source‐plasma pool.
Evaluation and comparison of three mobilization methods for the collection of granulocytes
Authors: Jendiroba D.B. , Lichtiger B. , Anaissie E. , Reddy K. , O'Brien S. , Kantarjian H. , Freireich EJ. 
Published: March 2003

BACKGROUND: Cancer chemotherapeutic regimens have become more potent and myeloablative. As a consequence, morbidity and mortality due to opportunistic infections have become a major challenge. The provision of adequate doses of viable granulocytes has thus become an important approach for circumventing the problem. A schedule for collecting therapeutic numbers of cells with minimal donor toxicity has yet to be established.STUDY DESIGN AND METHODS:An investigation of three mobilization schedules for the collection of granulocytes for transfusion‐granulocyte‐colony‐stimulating factor (G‐CSF) 5 micrograms per kg daily; G‐CSF 5 micrograms per kg every other day, and prednisone 60 mg given orally (20 mg doses at 17 hours, 12 hours, and 2 hours before the collection).RESULTS:A total of 464 apheresis procedures involving 163 healthy donors were analyzed. Prednisone caused a small increase in the white cell (WBC) counts over the collection days, while G‐CSF every other day and daily schedules improved WBC counts to 145 and 160 percent, respectively (p = 0.004). Similarly, administration of G‐CSF daily and every other day mobilized higher yields of granulocytes over the collection days, compared to the prednisone schedule (170% and 180% vs. 105%; p = 0.02). CONCLUSION: Compared with prednisone, higher WBC yields were achieved by G‐CSF stimulation; G‐CSF given every other day is as effective as daily G‐CSF administration for the recruitment of granulocytes, which makes the mobilization procedure more cost‐ effective.