bluuebunny/crossref_metadata_2025_split huggingface dataset:
F54Different types of umbilical venous pulsations and clinical implications
Authors: Gudmundsson S. , Hofstaetter C. , Dubiel M. 
Published: December 2004

ObjectiveNormally, blood flows evenly in the umbilical vein, without fluctuation. A pulsating pattern has been reported during fetal heart failure and asphyxia. Recently we have noticed different types of pulsating pattern, its physiological implication and relationship to outcome of pregnancy was analysed.Study designIn a prospective multicenter study, recording of umbilical cord venous blood flow was conducted in high‐risk pregnancies admitted for umbilical artery Doppler. In cases of pulsating flow or signs of vascular resistance in the umbilical artery, the examination was extended to the intra‐abdominal part of the umbilical vein. Venous pulsation, single or double, were noted and correlated to perinatal outcome.ResultsVenous flow pulsatility was noted in 83 fetuses during two years, 26 had a double pulsating pattern, which was closely related to increased vascular resistance in the umbilical artery and perinatal mortality. A single end‐diastolic pulsation only in the cord was noted in some of the fetuses with absent or reversed flow in the umbilical artery, probably due to decreased forward flow over the placenta. A single pulsating venous pattern in one location had good prognosis.ConclusionA double pulsating venous pattern, especially if extending to the cord, is an ominous finding associated with poor perinatal outcome in high‐risk pregnancy. A single pulsating pattern predicted a much better outcome and might be an indication for delivery in the high‐risk case.
THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Is Chronic Kidney Disease a Cardiovascular Disease Risk Factor?
Authors: Culleton Bruce F. , Hemmelgarn Brenda R. 
Published: December 2004

ABSTRACTCardiovascular disease (CVD) is prevalent in patients with chronic kidney disease (CKD) and may account for 50% of all deaths. The recent Dialysis Outcomes Quality Initiative (DOQI) publication on the evaluation, classification, and stratification of CKD states that a reduced glomerular filtration rate (GFR) identifies individuals at greater risk for CVD and death. This risk is the result of traditional and nontraditional CVD risk factors. However, the relative contribution of these risk factors in the CKD population remains uncertain. Recently interest in kidney disease (reduced GFR) as an independent nontraditional risk factor for CVD has come to the forefront. Studies examining this potential link have included community‐based cohort studies, studies in patients with extensive comorbidity, and reports in kidney transplant recipients. Herein, results from these studies are reviewed. The difference between an independent CVD risk factor and a causal CVD risk factor is discussed, with particular emphasis on the temporal association between exposure (GFR) and outcome (CVD and CVD death).
THE CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN CHRONIC KIDNEY DISEASE: Clinical Epidemiology of Cardiovascular Disease in Chronic Kidney Disease Prior to Dialysis
Authors: Levin Adeera 
Published: December 2004

ABSTRACTCardiovascular disease (CVD) remains the leading cause of morbidity and mortality in patients with end‐stage renal disease (ESRD). Both in dialysis and in transplant patients, CVD remains the leading cause of death. There is accumulating evidence that the increase in CVD burden is present in patients prior to dialysis, due to both conventional risk factors as well as those specific to kidney disease. Of importance is that even in patients with mild kidney disease, the risk of cardiovascular events and death is increased relative to patients without evidence of kidney disease. The new classification system proposed by the National Kidney Foundation as part of the Dialysis Outcomes Quality Initiative (DOQI) process describes the five stages of kidney disease, as well as those complications associated with chronic kidney disease (CKD), in particular cardiovascular risk factors and disease. Patients with kidney disease are deemed to be at highest cardiovascular risk. CVD, defined as the presence of either congestive heart failure (CHF), ischemic heart disease (IHD), or left ventricular hypertrophy (LVH), is prevalent in cohorts with established CKD (8–40%). The prevalence of hypertension, a major risk factor for coronary artery disease (CAD) and LVH is high in patients with CKD (87–90%). At least 35% of patients with CKD have evidence of an ischemic event (myocardial infarction or angina) at the time of presentation to a nephrologist. The prevalence of LVH increases at each stage of CKD, reaching 75% at the time of dialysis initiation, and the modifiable risk factors for LVH include anemia and systolic blood pressure, which are also worse at each stage of kidney disease. Even under the care of nephrologists, a change in cardiac status (worsening of heart failure or anginal symptoms) occurs in 20% of patients. The presence of CVD predicts a faster decline of kidney function and the need for dialysis, after controlling for all other factors including glomerular filtration rate (GFR), age, and the presence of LVH. This article describes the new classification system for staging of CKD, defines and describes CVD in CKD, and reviews the evidence and its limitations with respect to the current understanding of CKD and CVD. Specifically, methodologic issues related to survival and referral bias limit our current understanding of the complex interaction of conventional and nonconventional kidney disease‐specific risk factors. We identify the importance of well‐conducted studies of patient groups with and without CVD, with and without CKD, in order to better understand the complex physiology so that treatment strategies can be appropriately applied.
Viable Lymphocytes in Frozen Washed Blood
Authors: Telischi M. , Krmpotic E. , Moss G. 
Published: December 2004

Samples of glycerolized, frozen, packed cells, were washed by each of three systems and then were cultured for viable lymphocytes using the short‐term culture method. Of the 39 samples, 17 (43.6%) showed definite evidence of growth of lymphocytes. Of the 17, 11 (64.7%) were washed by Elutramatic, two (11.8%) by Haemonetics, and four (23.5%) by IBM. The 4 C prefreeze (two to five days) as well as the –80 C (21 to 40 days) storage times were the same for both positive and negative specimens.In all samples, clumps of distorted granulocytes with pyknotic nuclei were seen in addition to a number of well‐preserved mononucleated white cells. In the 17 specimens which showed growth, incorporation of 3H‐thymidine was seen only in the PHA‐induced blast cells; typical mitotic figures were seen in some cultures.These observations demonstrate that lymphocytes remain viable in frozen blood stored at –80 C up to 40 days. The significant difference in removal of viable lymphocytes noted in specimens washed by different instruments requires further evaluation.
Preparation of Cryoprecipitated Factor VIII Concentrates
Authors: Slichter S. J. , Counts R. B. , Henderson R. , Harker L. A. 
Published: December 2004

Factors affecting the yield of factor VIII in cryoprecipitate have been investigated in the context of a blood component program. Both in vitro and in vivo measurements were used to assess the effects of critical variables on the yield of factor VIII activity. Variables such as anticoagulant, plastic bag, mixing during collection, and platelet contamination had no significant effect on yield of factor VIII activity in cryoprecipitate. Among the most critical factors affecting yield were storage time of whole blood and procedures for freezing, thawing, and reconstitution. The following procedures were found to assure a 60 per cent recovery of factor VIII in cryoprecipitate: 1) processing of whole blood within six hours of collection; 2) use of a technique to freeze plasma within 30 minutes either in a –70 C ethanol bath or –85 C freezer; 3) rapid thawing (1 ½ hour or less) in a 4 C circulating water bath; 4) centrifugation at 4,500 × g for 10 minutes at 4 C followed by draining of the supernatant in a 4 C cold room; 5) storage of the precipitate at –20 C until ready for use; 6) thawing in a 37 C water bath for at least 15 minutes followed by addition of 20 ml of 0.15 M saline for a 20 minute period at room temperature, and gentle mixing before pooling units for transfusion.The recovery of factor VIII in cryoprecipitate appears to be limited to about 65 per cent by its solubility in plasma at 4 C. Therefore, further effort to increase the amount available for treatment should involve improving the supply of plasma for its preparation and decreasing the cost of processing.
Viability and Function of Platelets Frozen at 2 to 3C per Minute with 4 or 5 Per Cent DMSO and Stored at −80C for 8 Months
Authors: Spector J. I. , Yarmala J. A. , Marchionni L. D. , Emerson C. P. , Valeri C. R. 
Published: December 2004

Each of 15 healthy male volunteers was treated with 650 mg of aspirin 24 hours before the autologous transfusion of one unit of freeze‐preserved platelets. Freeze‐thaw‐wash recovery values in vitro, viability and function in vivo, and the bleeding time and platelet aggregation response were measured. The platelets were frozen with 4 or 5 per cent dimethylsulfoxide (DMSO) at an overall rate of 2 to 3 C per minute and were stored at −80 C in a mechanical freezer for up to eight months. They were washed by dilution/centrifugation.The mean recovery in vitro of platelets frozen with 4 per cent DMSO was 76 ± 16 per cent; the value was 64 ± 16 per cent for platelets frozen with 5 per cent DMSO. The mean in vivo 51Cr recovery of autologous platelets frozen with 4 per cent DMSO was 34 ± 6 per cent, and for platelets frozen with S per cent DMSO it was 33 ± 7 per cent. In both groups the platelet lifespan was normal. There was a significant reduction in bleeding time after the transfusion of a single unit of autologous platelets preserved with either 4 or 5 per cent DMSO, but no improvement in the aspirin‐induced platelet aggregation pattern.
Total and Partial Blood Exchange in the Rat with Hemoglobin Prepared by Crystallization
Authors: Venuto F. De , Moores W. Y. , Zegna A. I. , Zuck T. F. 
Published: December 2004

Hemoglogin, prepared by crystallization, has been used as a blood substitute in total (91 to 93%) and partial (70 to 76%) blood replacement studies. Exchange transfusions have been carried out in laboratory animals to a total blood replacement of 91 to 93 per cent with hemoglobin or with albumin solutions. When albumin was used, all animals died at approximately ten minutes after transfusion was completed, whereas all animals transfused with hemoglobin survived for five hours and displayed normal activity during this time. In these studies the plasma half‐disappearance time of hemoglobin was 3.5 hours and body distribution of 51Cr‐labeled hemoglobin, as a percentage of initial levels, has shown six per cent in the kidney, six per cent in the liver, 10.5 per cent in the marrow and 13 to 14 per cent in the urine at three hours after transfusion.Survival was obtained with all animals transfused with hemoglobin or albumin solutions to a partial blood replacement of 70 to 76 per cent. However, the oxygen capacity of the circulating fluid in the hemoglobin transfused animals was about three times greater than that found in the corresponding albumin‐transfused controls. Values of hemoglobin, hematocrit, platelets, and P50 returned to normal pretransfusion levels within five to seven days.
Plasmapheresis in a child with the hemolytic‐uremic syndrome
Authors: Kalmin N. D. , Himot E. D. 
Published: December 2004

Plasmapheresis, using fresh‐frozen plasma for replacement, has been reported to be of benefit in the treatment of hemolytic‐uremic syndrome and in thrombotic thrombocytopenic purpura. Both diseases have the same pathological characteristics and, possibly, the same pathogenesis. The mechanism by which plasma exchange results in clinical improvement is not clearly established, although recent reports indicate that it may be based on prostacyclin replacement rather than the removal of humoral factors toxic for platelets or vascular walls.Exchange plasmapheresis using an intermittent‐flow cell processor with a disposable 100‐ml pediatric centrifuge bowl is described in a 5‐year‐old girl with hemolytic‐uremic syndrome.
Physical and thermal properties of blood storage bags: implications for shipping frozen components on dry ice
Authors: Hmel Peter J. , Kennedy Anthony , Quiles John G. , Gorogias Martha , Seelbaugh Joseph P. , Morrissette Craig R. , Van Ness Kenneth , Reid T.J. 
Published: December 2004

BACKGROUND: Frozen blood components are shipped on dry ice. The lower temperature (–70°C in contrast to usual storage at –30°C) and shipping conditions may cause a rent in the storage bag, breaking sterility and rendering the unit useless. The rate of loss can reach 50 to 80 percent. To identify those bags with lower probability of breaking during shipment, the thermal and physical properties of blood storage bags were examined. STUDY DESIGN AND METHODS: Blood storage bags were obtained from several manufacturers and were of the following compositions: PVC with citrate, di‐2‐ethylhexylphthalate (DEHP), or tri‐2‐ethylhexyl‐tri‐mellitate (TEHTM) plasticizer; polyolefin (PO); poly(ethylene‐co‐ vinyl acetate) (EVA); or fluorinated polyethylene propylene (FEP). The glass transition temperature (Tg) of each storage bag was determined. Bag thickness and measures of material strength (tensile modulus [MT] and time to achieve 0.5 percent strain [T0.5%]) were evaluated. MT and T0.5% measurements were made at 25 and –70°C. Response to applied force at –70°C was measured using an impact testing device and a drop test. RESULTS: The Tg of the bags fell into two groups: 70 to 105°C (PO, FEP) and –50 to –17°C (PVC with plasticizer, EVA). Bag thickness ranged from 0.14 to 0.41 mm. Compared to other materials, the ratios of MT and T0.5% for PVC bags were increased (p ≤ 0.001) indicating that structural changes for PVC were more pronounced upon cooling from 25 to −70°C. Bags containing EVA were more shock resistant, resulting in the lowest rate of breakage (10% breakage) when compared with PO (60% breakage, p = 0.0573) or PVC (100% breakage, p = 0.0001). CONCLUSIONS: Blood storage bags made of EVA appear better suited for shipping frozen blood components on dry ice and are cost‐effective replacements for PVC bags. For the identification of blood storage bags meeting specific storage requirements, physical and thermal analyses of blood storage bags may be useful and remove empiricism from the process.
Statistical analysis of inappropriate results from current Hb screening methods for blood donors
Authors: James Virge , Jones Keith F. , Turner Elizabeth M. , Sokol Robert J. 
Published: December 2004

BACKGROUND : The objective was to apply statistical analysis to the false passes and fails that occur with the primary and secondary Hb‐screening methods used at blood‐donor sessions. STUDY DESIGN AND METHODS
: Venous samples from 1513 potential donors who had undergone primary CuSO
4 screening using capillary blood (Hb cut‐offs: women, 125 g/L; men, 135 g/L) were tested at the session by a secondary method (HemoCue; cut‐offs: women, 120 g/L; men, 130 g/L) and again at the base laboratory using another system (Beckman Coulter General S system), which generated the “true” Hb value. RESULTS
: False‐pass and ‐fail rates for women and men, respectively, were 11.2 and 6.3 percent (women) and 5.2 and 1.8 percent (men) for CuSO
4
; 1.9 and 3.7 percent (women) and 1.5 and 0.4 percent (men) for HemoCue; and 2.7 and 2.4 percent (women) and 1.8 and 0.2 percent (men) for a combined procedure that mimicked current practice of only testing CuSO
4 fails by HemoCue. CONCLUSION
: CuSO
4 Hb screening gives large numbers of false passes, particularly in women. Using venous samples, the majority correctly pass at the lower HemoCue cut‐offs. The current dual‐testing policy appears convenient for donor sessions, but because small percentages of false passes and fails represent large numbers of donors, every effort should be made to improve the accuracy of Hb screening.
Transmission of hepatitis A via WBC‐reduced RBCs and FFP from a single donation
Authors: Diwan A. Hafeez , Stubbs James R. , Carnahan Gary E. 
Published: December 2004

BACKGROUND: Currently, individuals donating whole blood and cellular components are not screened for hepatitis A (HA). However, transfusion‐transmitted HA can occur, albeit very rarely. Although infection is typically mild and self‐limited, it may be catastrophic in a small percentage of cases. Two cases of HA transmission from a single donation to two patients with subsequent variable morbidity are reported. CASE REPORTS: A 50‐year‐old, asymptomatic, volunteer blood donor made a whole‐blood donation. He was found to have HA 18 days later. When notified, the donor center initiated a recall of the components produced from the donated unit. However, the RBCs and FFP had already been transfused. Subsequently, both recipients developed HA as documented by IgM anti‐HA serology. The RBC recipient was a 49‐year‐old woman, transfused after a hysterectomy, who was found to have HA at the time of unit recall (20 days after transfusion). Her condition required the use of medical disability leave. The FFP was infused to a 52‐year‐old female cardiac surgical patient. Her course was marked by multiple complications, including postoperative development of mild hepatic dysfunction. After testing negative for HA, hepatitis B, and hepatitis C (24 days after transfusion), she suffered a second bout of more severe hepatic dysfunction and was documented to have HA at Day 55 after transfusion. Evaluation of both recipients' close contacts revealed no evidence for exposure to HA by any route other than transfusion. CONCLUSION: HA can be transmitted by transfusion of units obtained from asymptomatic, infectious donors. Two patients contracted HA from components obtained from a single whole‐blood donation. The RBC recipient had a typical self‐limited course of HA. The FFP recipient developed HA of relatively delayed onset. Both recovered from HA.
Factor concentrate usage in persons with hemophilia in New York State
Authors: Linden Jeanne V. , Kolakoski Marcia H. , Lima Jennifer E. , Du Ping , Lipton Richard A. 
Published: December 2004

BACKGROUND: Persons with a congenital deficiency of FVIII or F IX (hemophilia A and hemophilia B, respectively) receive factor concentrate to treat or prevent bleeding. STUDY DESIGN AND METHODS: A population‐based study of all persons with hemophilia residing in New York State at any time during 1993 through 1998 was conducted. All available medical records for each patient were reviewed to determine type of therapy. RESULTS: Case finding yielded 1160 cases, for a prevalence of 63.9 per 1 million population in 1998. Recombinant factor concentrates were used by 56 percent of patients. Patients with severe disease used more (158,234 IU/patient) factor concentrate than did patients with moderate disease (46,315 IU) or mild disease (5794 IU). Over half (57%) of all factor concentrate was prescribed for patients with severe disease on prophylactic therapy. Patients undergoing immune tolerance therapy used the most per person—455,116 IU each. Hemophilia treatment centers provided factor concentrate for 62 percent of all patients who used factor and 73 percent of patients with severe disease. CONCLUSION: Hemophilia patients, especially patients with severe disease, use large amounts of expensive factor concentrates to prevent and to treat bleeding episodes. Specialized hemophilia treatment centers play a key role in the care of these patients.
HLA and RBC immunization after filtered and buffy coat‐depleted blood transfusion in cardiac surgery: a randomized controlled trial
Authors: Van de Watering Leo , Hermans Jo , Witvliet Marian , Versteegh Michel , Brand Anneke 
Published: December 2004

BACKGROUND: WBC reduction of all blood components is being introduced in many countries. Prevention of immunologic side effects of transfusions is part of the motivation. To compare the immunogenicity of before‐ or after‐storage WBC‐reduced RBCs with RBCs without buffy coat, a randomized clinical trial was performed. STUDY DESIGN AND METHODS: Cardiac surgery patients were randomly assigned to receive either RBCs without buffy coat (PCs), WBC‐reduced RBCs that were filtered before storage (FFs), or WBC‐reduced RBCs that were filtered after storage (SFs). Serum samples for antibody analyses were collected before and after surgery. RESULTS: Sera of 404 patients were tested. Of the 317 patients with negative preoperative screening, 12.6 percent developed anti‐WBC antibodies (PC, 14.5%; FF, 9.6%; SF, 13.3%). Of the 87 patients with preoperative anti‐WBC antibodies, 28.7 percent showed a marked increase in panel reactivity (PC, 31.3%; FF, 29.0%; SF, 25.0%). ELISA showed the newly formed antibodies to be of IgG class and directed against HLA class I in more than 90 percent of the samples tested. Newly formed anti‐RBC antibodies appeared in 5.3 percent (PC, 7.1%; FF, 3.4%; SF 5.4%). Alloimmunization against WBCs and RBCs was strongly correlated (p < 0.01). The differences in newly formed anti‐WBC antibodies and anti‐RBC antibodies between the trial arms did not show significance. CONCLUSION: Buffy coat removal, and additional WBC reduction by filtration, either before or after storage, result in similar posttransfusion alloimmunization frequencies after a single transfusion event with multiple RBCs.
Prevalence of transfusion‐transmissible viral infections in first‐time US blood donors by donation site
Authors: Wang B. , Schreiber G.B. , Glynn S.A. , Nass C.C. , Smith J.W. , Higgins M.J. , Hutching S.T. , Wright D.J. , McEntire R.L. , For The Retrovirus Epidemiology Donor Study E.L. Murphy 
Published: December 2004

BACKGROUND: Understanding the donor base, infectious disease prevalence, and donation loss at various blood donation sites will help maximize blood collection efforts and blood availability. STUDY DESIGN AND METHODS: Using donation data collected at five US blood centers, the prevalence of HIV, HTLV, HBsAg, and HCV in first‐time whole‐blood donations at 10 donation sites was evaluated: military, education, religious, professional, industry, services, community, health care, government, and fixed sites. Donation loss from screening test reactivity at each donation site was also evaluated. RESULTS: During the study, 1.2 million first‐time whole‐blood donations were collected. Military and education sites had a low prevalence of all viral markers, except for HBsAg, which was highest at education sites. Variations in viral marker prevalence among donation sites were partially explained by donor demographic differences. Donation loss varied by donation site, ranging from 3.3 percent at education sites to 6.4 percent at industry sites, indicating differential efficiency of blood collection efforts. CONCLUSION: Different rates of positive viral test results and donation loss in first‐time whole‐blood donors were observed at various types of donation sites. This information may be useful in estimating the yield of usable units from specific blood drives and in allocating resources to meet blood center collection goals.