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Background: A prospective blood donor's oral temperature is affected by external stimuli such as drinking a hot or cold beverage or chewing gum. These stimuli can cause a deferral or an inappropriate acceptance for a certain unknown time.Study Design and Methods: Ten volunteer subjects were exposed to each of the three stimuli in separate studies. Oral and tympanic membrane temperatures were taken before exposure, immediately after exposure, and at various times until the subject's temperature returned to baseline.Results: The drinking of a hot beverage caused an immediate mean temperature elevation of 2.6 degrees F which would lead to deferral for 7 of 10 subjects. All subjects were acceptable for blood donation (temperature <99.6 degrees F) by 5 minutes. A cold beverage lowered the temperature; the temperature in 6 subjects returned to baseline by 10 minutes and that in 4 did so by 30 minutes. Gum chewing caused minimal temperature elevations; only 1 donor's temperature reached 99.6 degrees F, and it was at acceptable levels for blood donation by 5 minutes.Conclusion: Drinking a hot beverage and, to a much lesser degree, gum chewing can lead to a deferral for elevated temperature, but subjects were acceptable by 5 minutes. Cold beverages are of more concern, because they suppress the temperature for a short time and could theoretically lead to acceptance of a febrile, possibly infectious donor. [ABSTRACT FROM AUTHOR]

Background: While vasovagal syncopal reactions have been studied in the past, there are several safety questions that could be further addressed. The purpose of this study was to address these safety questions., Study Design and Methods: One hundred seventy-eight vasovagal reactions were reported in 1999 from 194,000 blood donations. The reactions were retrospectively reviewed for 38 variables that included donor demographics, symptoms, injury, and final disposition., Results: Sixty-one percent of the syncopal reactions occurred at the refreshment table and 12 percent offsite. Fourteen percent of the donors sustained an injury, usually to the head (10%). Eleven donors (6%) had additional medical care in an emergency room: 4 for injuries, 3 for delayed recovery, and 4 for offsite syncope. None of the donors was admitted to the hospital. One of the injured donors developed postconcussion syndrome and had later sequelae., Conclusion: Syncopal reactions most commonly occur at the refreshment table, where preventive safety measures against trauma could be applied. A significant number of syncopal reactions occur offsite, where the environment is less safe. The injuries that occur, particularly to the head, may in rare cases lead to long-term sequelae.

Background: An arterial puncture during whole-blood phlebotomy is a rare event. A series of arterial punctures was evaluated to determine the clinical findings and the incidence of complications., Study Design and Methods: Arterial punctures reported by staff between January 1, 1999, and February 28, 2001, were evaluated. Follow-up interviews were done with the phlebotomy nurses to determine what the clinical findings were and what the incidence of complications was., Results: Twelve cases of arterial punctures were identified from 410,000 blood donations (0.0029%; 1/34,000). Eleven cases had a fast blood-flow rate of <4 minutes; 9 units (75%) were bright red; and in 4 cases (33%), the needle was pulsating. One case was diagnosed because the donor developed a brachial artery pseudoaneurysm 3 days after donation. Four hematomas occurred, for an occurence rate of 33 percent (0.35% in the general donor population). There was also an association with newly trained staff., Conclusion: Fast blood-flow rate is the most common clinical feature after an arterial puncture. Bright red blood is usually, but not always, present, and a pulsating needle is sometimes present. Hematoma is a relatively common complication, and brachial artery pseudoaneurysms are rare, although one case was seen in this study.

In this review of common and uncommon donor reactions and injuries, donation-associated deaths were found to be extremely rare and generally thought to be coincidental; the rate of coincidental deaths was less than what would be expected based on life insurance tables. Vasovagal reactions, hematomas/bruises, and history of irritation or allergic reaction to adhesive tape or skin preparations are observed daily in a busy blood collection center. Syncopal vasovagal reactions sometimes resemble shock, but unlike shock, they reverse themselves and do not cause death. Through good management, a blood donor organization can minimize the incidence of syncope. Accidental arterial venipuncture is very uncommon (1 in 100,000), and donors with arterial punctures do well if pressure is applied for an extended period of time. Rarely, a pseudoaneurysm results, and this requires surgery. AV fistulas and compartment syndromes can also occur, but these are extremely rare; most experienced blood center physicians have never observed a case. Neurologic needle injuries occur approximately once in every 6,300 donations. Although neurologic needle injury complaints are usually received within 10 days of blood donation, 10% of the injured donors may complain weeks to months later. Most donors with needle injuries recover within a month and many within a day or two, but approximately 30% will have a recovery period of greater than 1 month and an occasional case may exceed 6 months. Donors with neurologic needle injuries generally have a full recovery, even when the recovery period may be extended. Thrombophlebitis has a low incidence (1 in 50,000 to 1 in 100,000), and infection at the phlebotomy site is rare. Both are easily treated and have little impact on the donor's health.

Background: In southeastern Michigan, the group O, Rh-negative (O-) red cell supply was below emergency levels during one-sixth of 1994, despite 43-percent overcollection of O- red cell units relative to the size of the O- patient population. O- red cell units are overutilized because of their universal ABO and Rh compatibility. This study evaluated how hospitals in a large metropolitan area utilized O- red cell units, so that strategies could be devised to reduce O- usage., Study Design and Methods: Through an O- red cell utilization survey, 56 hospitals were encouraged to collect three months' worth of transfusion data, either prospectively or retrospectively. O- usage was compared to total red cell usage and categorized into transfusions to O- patients, those to non-O- patients, and the number of O- units that outdated., Results: Of 40,616 units transfused in 38 hospitals, 3,535 (8.7%) were O-; 71 percent of the O- units were transfused to O- patients, 28 percent were transfused to non-O- patients, and 1 percent outdated. Hospital transfusions to O- patients appeared to correlate with the racial makeup of the patient population, while hospital transfusions to non-O- patients appeared to correlate with hospital size and the hospital's transfusion practices., Conclusion: O- red cell usage in a hospital is dependent on the racial and ethnic mix of the hospital's patient population, the amount of transfusion activity, and the hospital's transfusion practices. An understanding of the dynamics of O- usage allowed the development of strategies to decrease O- utilization.

A role for endogenous angiotensin II and its AT1 and AT2 receptor subtypes for mediating drinking elicited by eating was examined in adult male Sprague-Dawley rats. The ability of pharmacological antagonism of AT1 and/or AT2 receptors to abolish drinking elicited by exogenous angiotensin II was established first. The s.c. injection of the AT1 antagonist losartan (DuP 753) was sufficient to abolish drinking elicited by s.c. angiotensin II. The ICV injection (through a surgically implanted chronic cannula) of losartan inhibited drinking elicited by ICV angiotensin II; the combined ICV injection of losartan plus the AT2 antagonist PD123319 was sufficient to abolish drinking elicited by ICV angiotensin II. For rats drinking and eating after 24-h food deprivation, s.c. losartan plus PD123319 inhibited water to food ratio, but ICV losartan and/or PD123319 failed to inhibit food-related drinking. For nondeprived rats eating a small cracker, s.c. losartan and/or PD123319 attenuated water intake, but only ICV losartan produced statistically significant inhibition of drinking elicited by ingestion of cracker. The IG infusion (through a surgically implanted gastric catheter) of 2 ml 600 or 900 mOsm/kg NaCl, a treatment that is subthreshold for increase in systemic plasma osmolality at the initiation of drinking, elicited drinking that was attenuated by s.c. losartan and/or PD123319 and attenuated by ICV losartan only. The IG infusion of 2 ml 1800 mOsm/kg NaCl, a treatment that is above threshold for increase in systemic plasma osmolality at the initiation of drinking, elicited drinking that was not inhibited by S or ICV losartan and/or PD123319. These results demonstrate that peripheral AT1 and AT2 and central AT1 receptors for angiotensin II contribute to drinking elicited by eating and the gastrointestinal osmotic consequences of eating. These findings extend the evidence demonstrating a renal renin-angiotensin contribution to food-related drinking in rats.

Clinically significant cysts in the region of the larynx are uncommon. In this study, 20 cases were recovered for the period 1969-1983. There were eight males and 12 females whose ages ranged from 28-76 years and whose most common symptom combinations were hoarseness (9), local foreign body sensation (5), and pain (4). Laryngoscopic examination revealed cystic lesions 0.5-3.0 cm. in diameter, all localized to the supraglottis with half in the vallecula . Histologically, 17 cysts were closely associated with tonsillar lymphoid tissue. Nine cysts, having squamous lined crypt-like structures and abundant follicular lymphoid tissue, were designated "tonsillar cysts." Eight cysts had a prominent epithelial component and focal follicular lymphoid aggregates. Three cysts were unassociated with lymphoid tissue. Two of these, located in the ventricles of elderly patients, were oncocytic cysts. Both showed oncocytic changes on the surface mucosa and in adjacent salivary gland tissue. In one case, a biopsy of the contralateral ventricle demonstrated oncocytic metaplasia. Treatment in all cases was by surgical excision. Follow-up on 13 patients ranging from three months to 9 years revealed one recurrence of an oncocytic cyst one year after initial removal. We conclude that follicular lymphoid tissue is present in most laryngeal cysts and may play some pathogenetic role in their formation. Furthermore, oncocytic cysts are different from other laryngeal cysts, having a characteristic location, age group, field effect, and recurrence rate.

Ten patient-related blood drives were evaluated and compared to five other blood drives. The patient-related blood drives were easier to organize, more fruitful, and more satisfying for the donors and workers. The authors suggest a role for patient-related blood drives in the present recruitment system and discuss how hospitals and blood centers can coordinate their efforts to have this type of blood drive. Finally, it is suggested that patient-related blood drives can increase recruitment, especially in large metropolitan areas that suffer from chronic blood shortages.