bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiofrequency Treatment in the Netherlands
Authors: Van Dasselaar N.T. 
Published: March 2003

Abstract: A national enquiry was developed by the Pain Control Department of the Dutch Society of Anesthesiology (NVA) in co‐operation with the National Organisation for Quality Assurance in Hospitals (CBO). A questionnaire for retrospective collection of invasive pain control data was sent to all (147) Dutch hospitals as part of the “Quality Assurance of Anesthesiological Pain Control Study” which took place from 1991 to 1997.The questionnaire related to the organisation of pain departments, availability of personnel, material and space facilities, use of treatment protocols, type and number of procedures carried out in cancer and non‐cancer pain management during a 1 year period (1990‐1991). The response rate to the enquiry was 98 per cent; this high response rate was important to evaluate the status of anesthesiological pain control in the Netherlands. During the study period 92 per cent of the respondents carried out 9,700 invasive cancer pain procedures; 85 per cent of the respondents were active in the field of chronic non‐cancer pain control and were responsible for approximately 63,000 procedures.
Quantitation of residual white cells in filtered blood components by polymerase chain reaction amplification of HLA DQ‐A DNA
Authors: Lee T.‐H. , Stromberg R. , Heitman J. , Tran K. , Busch M. P. 
Published: March 2003

BACKGROUND: Over the past several years, blood filtration technology has improved dramatically, such that currently available experimental filters are capable of reducing white cells (WBCs) in blood components to less than 0.1 WBC per microL. These residual WBC concentrations are below the sensitivity of automated cell counters, as well as of large‐ volume (Nageotte) hemocytometers.STUDY DESIGN AND METHODS: A quantitative polymerase chain reaction (PCR) amplification assay directed at HLA DQ‐A DNA sequences has been developed for the enumeration of WBCs in filtered blood. To ensure quantitative recovery of WBCs at very low residual cell concentrations, a direct red cell lysis and WBC concentration protocol using 0.5 mL of filtered blood was perfected. Amplified product is detected by oligomer hybridization using 32P‐labeled probes, with quantitation by image analysis of autoradiographic signals relative to a standardized dilution series processed in parallel.RESULTS: Recovery of residual WBCs in filtrates was shown to be enhanced by the addition of xenogeneic WBCs or polystyrene beads, which served as “carrier” particles during red cell lysis and wash steps. A contribution of nuclear fragments in filtered blood to PCR signal in the range of 0.01 to 0.5 WBCs per microL was observed; a modified protocol was developed to minimize this effect. Parallel analysis of spiked dilution series and evaluations of 39 red cell components filtered through commercial filters indicated good correlation between PCR and standard Nageotte counts in the range of 0.1 to 10 WBCs per microL (r2 = 0.94); only PCR was able to detect residual WBCs in filtrates from prototype 6 log10 WBC‐reduction filters.CONCLUSION: This assay should prove useful for the development and quality assurance of increasingly efficient WBC‐reduction filters.
Altered expression of adhesion molecules (L‐selectin and Mac‐1) on granulocytes during storage
Authors: Wikman A. , Lundahl J. , Fernvik E. , Shanwell A. 
Published: March 2003

Background: The success of granulocyte transfusion therapy for neutropenic patients with sepsis is dependent on the number and quality of the granulocytes transfused. There is a progressive impairment in granulocyte function during storage.Study Design and Methods: The effect of 1 to 2, 4, 24, and 48 hours' storage on receptor expression associated with granulocyte function has been analyzed.Results: After 24 hours' storage, significant changes were found in the expression of receptors associated with adhesion to the endothelium: a decrease in L‐ selectin expression (p < 0.01) and an increase in Mac‐1 expression (p < 0.01). Receptors (CR1 and FcRIII), associated with adhesion to target, were either increased (CR1) or unaltered (FcRIII). The capacity to produce a reactive oxygen metabolite (hydrogen peroxide) remained essentially unchanged after 48 hours' storage. The ability of N‐formyl‐ methionyl‐leucyl‐phenyl alanine to mobilize Mac‐1 and CR1 was reduced after 48 hours' storage.Conclusion: Since the regulation of adhesion molecules is important for the recruitment of granulocytes into an inflammatory site, the observed in vitro changes in L‐selectin and Mac‐ 1 expression during storage may be of importance for the quality of granulocyte concentrates.
Iron and erythropoietin measurement in autologous blood donors with anemia: implications for management
Authors: Tasaki T. , Ohto H. , Noguchi M. , Motoki R. , Kikuchi S. , Sato A. , Hoshino S. 
Published: March 2003

Background: The importance of autologous blood donation for elective surgery is recognized, and the method is being used at many hospitals. Not all patients are able to deposit a sufficient amount of blood before surgery because they cannot recover rapidly enough from phlebotomy‐induced anemia. The ability to donate sufficient blood for autologous use was studied in patients who are particularly susceptible to phlebotomy‐induced anemia.Study Design and Methods: Of 840 patients who donated blood for autologous use in elective surgery from November 1987 through May 1993, 20 with rheumatoid arthritis, 24 with iron deficiency anemia, and 37 aged 65 years and above with normocytic anemia were compared with 24 nonanemic elderly patients who donated a total of 1000 mL of blood for autologous use. Patients received iron sulfate orally and donated blood once a week until operation.Results: The amount of blood collected before surgery per control patient was more than that in others. Consequently, there was a tendency to allogeneic blood transfusion in patients with rheumatoid arthritis or elderly patients. The ferritin levels in controls and in patients with iron deficiency anemia during the donation period were almost within the normal range in spite of iron supplementation, which implied a good utilization of iron sulfate for erythropoiesis. On the other hand, the rise in ferritin levels in the elderly and in patients with rheumatoid arthritis suggested inappropriate iron availability for erythropoiesis and resulted in an increase in iron storage. Since an adequate endogenous erythropoietin response to phlebotomy‐induced anemia was not observed in these patients, impaired erythropoietin production was considered one of the reasons for anemia.Conclusion: Patients with iron deficiency anemia are able to continue donating blood for autologous use so long as they have sufficient iron supplementation. However, the elderly or those with rheumatoid arthritis occasionally fail to donate a sufficient volume of blood before surgery as a result of phlebotomy‐induced anemia, which is caused in turn by impaired erythropoietin production.
Confirmation of hepatitis C infection: a comparison of five immunoblot assays
Authors: Zaaijer H.L. , Vrielink H. , van Exel‐Oehlers PJ , Cuypers H.T. , Lelie P.N. 
Published: March 2003

BACKGROUND: Recently, new immunoblot assays for the detection of antibodies to hepatitis C virus (HCV) became available.STUDY DESIGN AND METHODS: The performance of five confirmatory anti‐HCV immunoblot assays was studied with samples with known HCV antibody and HCV RNA status. The assays were a third‐generation strip recombinant immunoblot assay (RIBA‐3, Chiron Corp., Emeryville, CA), a second‐generation HCV blot (DB‐2 blot, Diagnostic Biotechnology, Singapore), the Wellcozyme HCV Western blot (Murex blot, Murex Diagnostics, Dartford, UK), an immunodot HCV assay (Matrix, Abbott Laboratories, Chicago, IL), and the third‐generation HCV line immunoassay (Liatek‐III, Organon Teknika, Boxtel, The Netherlands).RESULTS: Sensitivity on samples from 48 HCV RNA‐positive, second‐generation RIBA (RIBA‐2)‐positive persons and specificity on samples from 31 low‐risk donors was 96 percent or better for all assays. The sensitivity on 31 HCV RNA‐positive, RIBA‐2‐ indeterminate samples was as follows: Liatek‐III, 94 percent; RIBA‐3, 90 percent; Murex blot, 61 percent; Matrix, 55 percent; and DB‐2 blot, 39 percent. In testing 39 HCV RNA‐negative, RIBA‐2‐indeterminate donor samples, the percentage found to be negative was Liatek‐III, 77 percent; RIBA‐3, 67 percent; Murex blot, 49 percent; DB‐2 blot, 33 percent; and Matrix, 15 percent. The order of sensitivity on four HCV seroconversion series was (from high to low): RIBA‐3, Liatek‐III, DB‐2 blot, Murex blot, and Matrix; the differences were small.CONCLUSION: Detection of HCV antibodies was not refined by the addition of new HCV antigens (NS5, E2/NS1), but by improved classical antigens (core, NS3, NS4). Replacement of the commonly used RIBA‐2 will resolve the status of a high proportion of RIBA‐2‐indeterminate samples.
Lack of transmission of neutrophil and platelet antibodies by intravenous immunoglobulin in bone marrow transplant patients
Authors: KLUMPP T.R. , HERMAN J.H. , MANGAN K.F. , SCHNELL M.K. , GOLDBERG S.L. , MACWNALD J.S. 
Published: March 2003

BACKGROUND: Several studies have demonstrated that the administration of intravenous immunoglobulin (IVIG) may be followed by the transient appearance of positive red cell antibody screens, positive direct antiglobulin tests, and, occasionally, frank hemolysis. However, little information is available regarding the possibility that IVIG could transmit neutrophil and/or platelet antibodies.STUDY DESIGN AND METHODS: Serum samples were obtained both immediately before and immediately after the administration of 12 separate lots of commercially available IVIG to bone marrow transplant patients. RESULTS: None of the patients were shown by standard granulocyte immunofluorescence testing to have acquired neutrophil antibodies. Four of the 12 postinfusion sera were positive for platelet antibodies in standard platelet suspension immunofluorescence testing, but in all four instances the corresponding preinfusion serum was positive as well. CONCLUSION: The risk of acquiring neutrophil and/or platelet antibodies after the administration of commercially available IVIG appears to be low.
Quencher‐enhanced specificity of psoralen‐photosensitized virus inactivation in platelet concentrates
Authors: MARGOLIS‐NUNNO H. , ROBINSON R. , BEN‐HUR E. , HOROWITZ B. 
Published: March 2003

BACKGROUND: Treatment with psoralens and UVA (PUVA) has been shown to be efficacious in eliminating the risk of virus transmission by platelet concentrates (PCs). It has previously been demonstrated that, during the inactivation of cell‐free vesicular stomatitis virus (VSV) by aminomethyltrimethylpsoralen (AMT) and UVA in PCs, platelet function could be protected either by oxygen removal before irradiation or by inclusion of a type I free radical quencher, such as mannitol.STUDY DESIGN AND METHODS: Under previous PUVA treatment conditions for PCs (25 micrograms/mL AMT; 30 min UVA at 7 mW/cm2; 2 mM [2 mmol/L] mannitol), more than 6 log10 of added cell‐free VSV was completely inactivated. In the current study, various PUVA conditions are evaluated for efficacy in inactivating other viral forms that could be present in PCs. Maintenance of platelet integrity (i.e., platelet number, solution pH, and aggregation response during initial storage after treatment) and kill of cell‐associated VSV are examined.RESULTS: While cell‐free viruses were inactivated efficiently under previous PUVA conditions, cell‐associated VSV and the non‐lipid‐enveloped bacteriophage M13 were not. Effective inactivation of these viruses was achieved by raising the concentration of AMT to 50 micrograms per mL and extending the period of irradiation to 90 minutes (39 J/cm2). However, for maintenance of platelet integrity under these conditions, the prior removal of oxygen or the inclusion of compounds known to quench both type I and type II photoreactants (e.g., flavonoids such as rutin) was required.CONCLUSION: These findings suggest that the viral safety of PCs may be enhanced through treatment with AMT and UVA in the presence of flavonoids, and that flavonoid use may prove beneficial in other systems where oxygen‐mediated damage occurs
The collection and evaluation of peripheral blood progenitor cells sufficient for repetitive cycles of high‐dose chemotherapy support
Authors: Benjamin R.J. , Linsley L. , Axelrod J.D. , Churchill W.H. , Sieff C. , Shulman L.N. , Elias A. , Ayash L. , Malachowski M.E. , Uhl L. , Gaynes Lisa , McCauley Mary , Thompson Lynn , Mazanet Rosemary , Antman Karen , Schnipper Lionel E. , Tepler Isadore , Antin J.H. , Wheeler Catherine 
Published: March 2003

BACKGROUND: The development of an optimized peripheral blood progenitor cell (PBPC) harvest protocol to provide support for repetitive chemotherapy cycles is described.STUDY DESIGN AND METHODS: PBPCs mobilized by cyclophosphamide plus granulocyte‐colony‐stimulating factor (G‐CSF) were studied in 163 leukapheresis harvests from 26 lymphoma patients. Harvested cells were transfused with two chemotherapy cycles and with an autologous bone marrow transplant. Progenitor cell content was examined in the context of hematopoietic engraftment.RESULTS: Mobilization allowed the harvest of large numbers of PBPCs. Peak harvests tended to occur after the recovering white cell count exceeded 10 × 10(9) per L. CD34+ lymphomononuclear cell (MNC) and colony‐forming units‐granulocyte‐macrophage (CFU‐GM) counts correlated poorly, but both measures peaked within 24 hours of each other in 21 of 26 patients, which demonstrated PBPC mobilization. Engraftment of platelets (> 50×10(9)/L) and granulocytes (> 500×10(6)/L) was achieved in a median of 20.5 and 16 days, respectively. A minimum number of progenitors necessary to ensure engraftment could be derived.CONCLUSION: Cyclophosphamide and G‐CSF allowed the harvest of sufficient PBPCs to support multiple rounds of chemotherapy. Harvest should commence when the recovery white cell count exceeds 10×10(9) per L. PBPC harvest CD34+MNC counts are as useful as CFU‐GM results in the assessment of PBPC content, and they may allow harvest protocols to be tailored to individual patients.
Elimination of potential mutagenicity in platelet concentrates that are virally inactivated with psoralens and ultraviolet A light
Authors: Margolis‐Nunno H. , Robinson R. , Ben‐Hur E. , Chin S. , Orme T. , Horowitz B. 
Published: March 2003

BACKGROUND: For virus sterilization of platelet concentrates (PCs), treatment with aminomethyltrimethyl psoralen (AMT) and long‐wavelength ultraviolet A light (UVA) has shown efficacy. It has been found that treatment with 50 micrograms per mL of AMT and 38 J per cm2 of UVA in the presence of 0.35‐mM rutin efficiently kills viruses while maintaining platelet integrity. There is, however, concern about the mutagenic potential of psoralens and UVA (PUVA)‐treated PCs.STUDY DESIGN AND METHODS: Adsorption of PUVA‐treated PCs with a hydrophobic resin containing C18 as the ligand was used for AMT removal, which was quantitated by the use of radioactive AMT. PUVA‐treated PCs, with and without C18 treatment, were examined for solution pH and platelet aggregation response to agonists. In addition, residual AMT activity was determined by AMT's virucidal activity or incorporation into cellular DNA upon a second UVA irradiation and by its mutagenic potential in the Ames test.RESULTS: After PUVA treatment of PCs, residual AMT retained virucidal and adduct‐forming ability upon re‐ exposure to UVA, but activities were less than those observed originally. As has been found previously, AMT had mutagenic potential following incubation in the dark with rat liver S9 microsomal enzymes. The PUVA treatment reduced this potential by 90 percent. C18 adsorption following PUVA treatment had no negative effect on platelet integrity and eliminated 50 percent of the added radioactive AMT. In addition, all detectable virucidal, nucleic acid‐modifying, and mutagenic activities of AMT‐treated PCs were removed by C18.CONCLUSION: These results suggest that hydrophobic resin adsorption of PUVA‐treated PCs will conveniently remove functional psoralens and eliminates their mutagenic potential.
Immune responsiveness in orthopedic surgery patients after transfusion of autologous or allogeneic blood
Authors: Tietze M. , Klüter H. , Troch M. , Kirchner H. 
Published: March 2003

BACKGROUND: The proposed immunosuppressive effect of blood transfusion is not yet understood, and the clinical relevance is a controversial topic of discussion.STUDY DESIGN AND METHODS: The effect of blood transfusions on the capacity of the host's immunocompetent cells to react to mitogenic stimulation was evaluated. Patients undergoing hip replacement surgery received either allogeneic (n = 13) or autologous (n = 14) buffy coat‐depleted red cells or plasma. Patients' blood samples taken before and on Days 1 and 5 after surgery were stimulated in a whole‐blood assay. The release of interleukin 2, soluble interleukin 2 receptor, interleukin 6, tumor necrosis factor alpha, interferon alpha 2, and interferon gamma was assessed by enzyme‐linked immunosorbent assay. In addition, the white cell counts and frequencies of the lymphocyte subsets CD4+, CD8+, and natural killer cells were analyzed.RESULTS: For both groups, decreased levels of interleukin 2 and interferon‐gamma were detected postoperatively, whereas the values for soluble interleukin 2 receptor and tumor necrosis factor alpha showed no significant change. Interferon alpha 2 was decreased on Day 1, but returned to normal by Day 5. Interleukin 6 increased during the time of observation. There were no significant differences between the two groups in cytokine production and lymphocyte‐subset analysis that could be attributed to the transfusion of allogeneic blood.CONCLUSION: The transfusion of buffy coat‐depleted red cells showed no immediate suppressive effect on the immune function of the host's peripheral blood cells.
The effect of donor red cell sedimentation rate on efficiency of granulocyte collection by centrifugal leukapheresis
Authors: Lee J.‐H. , Klein H. G. 
Published: March 2003

BACKGROUND: Granulocyte collection relies on the use of a red cell‐ sedimenting agent and is influenced by poorly defined intrinsic donor characteristics. The donor's baseline red cell (erythrocyte) sedimentation rate (ESR), a readily measurable intrinsic donor variable, may influence the effectiveness of red cell‐sedimenting agents and affect the granulocyte yield.STUDY DESIGN AND METHODS: The in vitro and in vivo effects of 6‐percent hydroxyethyl starch on the donor ESR were prospectively studied in 67 granulocytapheresis procedures with a blood cell separator, and the findings were correlated with granulocyte collection efficiency (GCE). A relationship that predicts the GCE on the basis of the donor ESR was then derived and tested.RESULTS: The 3.7‐fold mean increase in the donor ESR measured after in vitro addition of hydroxyethyl starch approximated the 3.3‐fold increase measured when it was administered to the donors. Higher baseline ESR correlated with larger in vitro and in vivo hydroxyethyl starch‐induced increases in ESR and predicted more efficient cell collections and greater cell yields. Furthermore, both ESR and GCE, which varied significantly among donors, remained constant for a given donor undergoing repeat procedures. The results could be summarized by a simple predictive formula that relates the GCE (%) to the ESR (mm/hour): GCE = 1.3ESR + 45. The GCE and yield as predicted by the formula were accurate within 10 percent of the observed values in six subsequent procedures.CONCLUSION: In granulocyte harvests using a blood cell separator with hydroxyethyl starch as the sedimenting agent, 1) both ESR and GCE vary widely among donors yet may remain relatively constant for a given donor; 2) the baseline ESR correlates with hydroxyethyl starch‐modified ESR and with GCE; and 3) it may be possible to predict GCE and yield from the donor's baseline ESR.
Comparison of two anti‐hepatitis C virus enzyme‐linked immunosorbent assays
Authors: Vrielink H. , Zaaijer H. L. , Lelie P. N. , van der Poel C. L. 
Published: March 2003

BACKGROUND: Third‐generation anti‐hepatitis C virus (HCV) enzyme‐linked immunosorbent assays (ELISA) are now implemented in most laboratories in Europe, but have not yet been fully implemented in the United States.STUDY DESIGN AND METHODS: Two ELISAs (Ortho 3.0 and Ortho 2.0, Ortho Diagnostics, Raritan, NJ) were compared by tests on various serum panels: A) blood donor samples (n = 530) that tested positive in first‐ or second‐generation anti‐HCV ELISA; B) samples from persons with chronic non‐A, non‐B hepatitis (n = 185); C) samples from multiply transfused patients (n = 79); D) samples from patients on hemodialysis (n = 473); and E) samples from Dutch random blood donors (n = 2153).RESULTS: In panels A, B, and C, 247 (100%) of 247 polymerase chain reaction (PCR)‐positive and 278 (100%) of 278 second‐generation recombinant immunoblot assay (RIBA‐2)‐positive specimens were detected by Ortho 2.0 and 3.0 (sensitivity, 100%). In the sera of panel D, used to represent a group of patients with a high risk for HCV, no additional positives were found by Ortho 3.0. In panel E, of 2153 blood donor samples, 2 (0.1%) were positive in Ortho 2.0 and 8 (0.4%) in Ortho 3.0. Two samples that were positive in both Ortho 2.0 and 3.0 were also positive in RIBA‐2; one was positive on PCR. From the 6 remaining Ortho 3.0‐positive (Ortho 2.0‐negative) samples, 1 was positive in RIBA‐2 (isolated anti‐c100) and 3 were positive in third‐ generation RIBA (1/3 isolated anti‐c100, 2/3 isolated NS5). All 6 samples were PCR negative. In first‐time donors, no difference in specificity was found.CONCLUSION: The sensitivity and specificity of the Ortho 3.0 ELISA are comparable to those of the Ortho 2.0 ELISA.
A novel strategy to limit blood donor exposure and blood waste in multiply transfused premature infants
Authors: Wang‐Rodriguez J. , Mannino F. L. , Liu E. , Lane T. A. 
Published: March 2003

Background: Small, premature infants require frequent small‐volume transfusions. Traditional methods of transfusion expose these infants to multiple blood donors. It has recently been demonstrated that multiple donor exposures can be safely prevented in these infants by the assignment of fresh units to them and by the use of a sterile connecting device to remove blood for transfusion, as needed until the expiration of the unit. However, the program resulted in the wasting of approximately 60 percent of the blood in each unit.Study Design and Methods: To minimize blood waste without compromising the goal of limiting donor exposure, a model designed to predict each infant's transfusion requirements was investigated. The model assigned infants predicted to have high transfusion requirements to receive blood from a unit dedicated to their individual use. All other infants were assigned to receive blood from a unit that could be shared among as many as four similar infants. Infant donor exposure and blood unit wastage after institution of the infant assignment model were compared with the same measurements obtained before the use of the model, during which time infants were assigned to dedicated units at the discretion of the physician.Results: The numbers of transfusions per infant (3.5 +/− 2.3) and of donor exposures per infant (1.5 +/− 0.7) under the assignment model were unaltered from those in controls (4.1 +/− 2.9 transfusions and 1.6 +/− 0.8 donor exposures); however, there was significantly less blood wastage in the group assigned to shared units (32 +/− 28%) than in the group assigned to dedicated units (62 +/− 17%; p < 0.05) or than was seen in an earlier study (60 +/− 23% wasted; p < 0.05).Conclusion: Improved management of blood resources can be achieved within the context of a transfusion program designed to safely limit donor exposure in infants who require frequent transfusion.