75 results on '"BLOOD-TRANSFUSION"'
Search Results
2. Clinico-haematological Profile and Therapeutic Management of Acute Babesiosis in Sheep and Goats
- Author
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Tufani, N.A., Malik, H.U., and Fazili, M.R.
- Published
- 2017
- Full Text
- View/download PDF
3. Tranexamic Acid in Patients Undergoing Noncardiac Surgery
- Abstract
BACKGROUND & nbsp;Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding.& nbsp;METHODS & nbsp;We conducted a trial involving patients undergoing noncardiac surgery. Patients were randomly assigned to receive tranexamic acid (1-g intravenous bolus) or placebo at the start and end of surgery (reported here) and, with the use of a partial factorial design, a hypotension-avoidance or hypertension-avoidance strategy (not reported here). The primary efficacy outcome was life-threatening bleeding, major bleeding, or bleeding into a critical organ (composite bleeding outcome) at 30 days. The primary safety outcome was myocardial injury after noncardiac surgery, nonhemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism (composite cardiovascular outcome) at 30 days. To establish the noninferiority of tranexamic acid to placebo for the composite cardiovascular outcome, the upper boundary of the one-sided 97.5% confidence interval for the hazard ratio had to be below 1.125, and the one-sided P value had to be less than 0.025.& nbsp;RESULTS & nbsp;A total of 9535 patients underwent randomization. A composite bleeding outcome event occurred in 433 of 4757 patients (9.1%) in the tranexamic acid group and in 561 of 4778 patients (11.7%) in the placebo group (hazard ratio, 0.76; 95% confidence interval [CI], 0.67 to 0.87; absolute difference, -2.6 percentage points; 95% CI, -3.8 to -1.4; two-sided P < 0.001 for superiority). A composite cardiovascular outcome event occurred in 649 of 4581 patients (14.2%) in the tranexamic acid group and in 639 of 4601 patients (13.9%) in the placebo group (hazard ratio, 1.02; 95% CI, 0.92 to 1.14; upper boundary of the one-sided 97.5% CI, 1.14; absolute difference, 0.3 percentage points; 95% CI, -1.1 to 1.7; one-sided P=0.04 for noninferiority).& nbsp;CONCLUSIONSAmong pati
- Published
- 2022
4. Tranexamic Acid in Patients Undergoing Noncardiac Surgery
- Abstract
BACKGROUND & nbsp;Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding.& nbsp;METHODS & nbsp;We conducted a trial involving patients undergoing noncardiac surgery. Patients were randomly assigned to receive tranexamic acid (1-g intravenous bolus) or placebo at the start and end of surgery (reported here) and, with the use of a partial factorial design, a hypotension-avoidance or hypertension-avoidance strategy (not reported here). The primary efficacy outcome was life-threatening bleeding, major bleeding, or bleeding into a critical organ (composite bleeding outcome) at 30 days. The primary safety outcome was myocardial injury after noncardiac surgery, nonhemorrhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism (composite cardiovascular outcome) at 30 days. To establish the noninferiority of tranexamic acid to placebo for the composite cardiovascular outcome, the upper boundary of the one-sided 97.5% confidence interval for the hazard ratio had to be below 1.125, and the one-sided P value had to be less than 0.025.& nbsp;RESULTS & nbsp;A total of 9535 patients underwent randomization. A composite bleeding outcome event occurred in 433 of 4757 patients (9.1%) in the tranexamic acid group and in 561 of 4778 patients (11.7%) in the placebo group (hazard ratio, 0.76; 95% confidence interval [CI], 0.67 to 0.87; absolute difference, -2.6 percentage points; 95% CI, -3.8 to -1.4; two-sided P < 0.001 for superiority). A composite cardiovascular outcome event occurred in 649 of 4581 patients (14.2%) in the tranexamic acid group and in 639 of 4601 patients (13.9%) in the placebo group (hazard ratio, 1.02; 95% CI, 0.92 to 1.14; upper boundary of the one-sided 97.5% CI, 1.14; absolute difference, 0.3 percentage points; 95% CI, -1.1 to 1.7; one-sided P=0.04 for noninferiority).& nbsp;CONCLUSIONSAmong pati
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- 2022
5. Effect of haemoglobin levels on outcome in intravenous thrombolysis-treated stroke patients
- Author
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Stefan T. Engelter, Sophie A. van den Berg, Gerli Sibolt, Alessandro Pezzini, Simon Jung, Marjaana Tiainen, Stefania Nannoni, Nicolas Martinez-Majander, Georg Kägi, Abdulaziz S Al Sultan, Lars Kellert, Sami Curtze, Thomas P. Zonneveld, Visnja Padjen, Paul J. Nederkoorn, Andrea Zini, Henrik Gensicke, Christian Hametner, Ashraf Eskandari, Gian M DeMarchis, Philippe Lyrer, Leo H. Bonati, Peter A. Ringleb, Silja Räty, Stefania Maffei, Valerian L Altersberger, Patrik Michel, Mirjam Rachel Heldner, Alexandros A Polymeris, Marcel Arnold, HUS Neurocenter, Neurologian yksikkö, University of Helsinki, Helsinki University Hospital Area, Department of Neurosciences, Graduate School, ACS - Atherosclerosis & ischemic syndromes, Amsterdam Neuroscience - Neurovascular Disorders, and Neurology
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EXPRESSION ,BLOOD-TRANSFUSION ,Blood transfusion ,Stroke patient ,Anemia ,Iv thrombolysis ,CELL TRANSFUSION ,IMPACT ,medicine.medical_treatment ,Haemoglobin levels ,Anaemia ,030204 cardiovascular system & hematology ,GUIDELINES ,3124 Neurology and psychiatry ,03 medical and health sciences ,0302 clinical medicine ,Original Research Articles ,medicine ,In patient ,intravenous thrombolysis ,ANEMIA ,Stroke ,RISK ,business.industry ,3112 Neurosciences ,Thrombolysis ,medicine.disease ,haemoglobin ,stroke ,3. Good health ,IV THROMBOLYSIS ,polyglobulia ,Anesthesia ,TRANSFUSION THRESHOLDS ,outcome ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Introduction Alterations in haemoglobin levels are frequent in stroke patients. The prognostic meaning of anaemia and polyglobulia on outcomes in patients treated with intravenous thrombolysis is ambiguous. Patients and methods In this prospective multicentre, intravenous thrombolysis register-based study, we compared haemoglobin levels on hospital admission with three-month poor outcome (modified Rankin Scale 3–6), mortality and symptomatic intracranial haemorrhage (European Cooperative Acute Stroke Study II-criteria (ECASS-II-criteria)). Haemoglobin level was used as continuous and categorical variable distinguishing anaemia (female: 15.5 g/dl; male: >17 g/dl). Anaemia was subdivided into mild and moderate/severe (female/male: Results Among 6866 intravenous thrombolysis-treated stroke patients, 5448 (79.3%) had normal haemoglobin level, 1232 (17.9%) anaemia – of those 903 (13.2%) had mild and 329 (4.8%) moderate/severe anaemia – and 186 (2.7%) polyglobulia. Anaemia was associated with poor outcome (ORadjusted 1.25 (1.05–1.48)) and mortality (ORadjusted 1.58 (1.27–1.95)). In anaemia subgroups, both mild and moderate/severe anaemia independently predicted poor outcome (ORadjusted 1.29 (1.07–1.55) and 1.48 (1.09–2.02)) and mortality (ORadjusted 1.45 (1.15–1.84) and ORadjusted 2.00 (1.46–2.75)). Each haemoglobin level decrease by 1 g/dl independently increased the risk of poor outcome (ORadjusted 1.07 (1.02–1.11)) and mortality (ORadjusted 1.08 (1.02–1.15)). Anaemia was not associated with occurrence of symptomatic intracranial haemorrhage. Polyglobulia did not change any outcome. Discussion The more severe the anaemia, the higher the probability of poor outcome and death. Severe anaemia might be a target for interventions in hyperacute stroke. Conclusion Anaemia on admission, but not polyglobulia, is a strong and independent predictor of poor outcome and mortality in intravenous thrombolysis-treated stroke patients.
- Published
- 2020
6. Tranexamic Acid in Patients Undergoing Noncardiac Surgery
- Author
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P J, Devereaux, Maura, Marcucci, Thomas W, Painter, David, Conen, Vladimir, Lomivorotov, Daniel I, Sessler, Matthew T V, Chan, Flavia K, Borges, María J, Martínez-Zapata, Chew Yin, Wang, Denis, Xavier, Sandra N, Ofori, Michael K, Wang, Sergey, Efremov, Giovanni, Landoni, Ydo V, Kleinlugtenbelt, Wojciech, Szczeklik, Denis, Schmartz, Amit X, Garg, Timothy G, Short, Maria, Wittmann, Christian S, Meyhoff, Mohammed, Amir, David, Torres, Ameen, Patel, Emmanuelle, Duceppe, Kurt, Ruetzler, Joel L, Parlow, Vikas, Tandon, Edith, Fleischmann, Carisi A, Polanczyk, Andre, Lamy, Sergey V, Astrakov, Mangala, Rao, William K K, Wu, Keyur, Bhatt, Miriam, de Nadal, Valery V, Likhvantsev, Pilar, Paniagua, Hector J, Aguado, Richard P, Whitlock, Michael H, McGillion, Michael, Prystajecky, Jessica, Vincent, John, Eikelboom, Ingrid, Copland, Kumar, Balasubramanian, Alparslan, Turan, Shrikant I, Bangdiwala, David, Stillo, Peter L, Gross, Teresa, Cafaro, Pascal, Alfonsi, Pavel S, Roshanov, Emilie P, Belley-Côté, Jessica, Spence, Toby, Richards, Tomas, VanHelder, William, McIntyre, Gordon, Guyatt, Salim, Yusuf, Kate, Leslie, Erin, Hittesdorf, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, Devereaux, P J, Marcucci, Maura, Painter, Thomas W, Conen, David, Lomivorotov, Vladimir, Sessler, Daniel I, Chan, Matthew T V, Borges, Flavia K, Martínez-Zapata, María J, Wang, Chew-Yin, Xavier, Deni, Ofori, Sandra N, Wang, Michael K, Efremov, Sergey, Landoni, Giovanni, Kleinlugtenbelt, Ydo V, Szczeklik, Wojciech, Schmartz, Deni, Garg, Amit X, Short, Timothy G, Wittmann, Maria, Meyhoff, Christian S, Amir, Mohammed, Torres, David, Patel, Ameen, Duceppe, Emmanuelle, Ruetzler, Kurt, Parlow, Joel L, Tandon, Vika, Fleischmann, Edith, Polanczyk, Carisi A, Lamy, Andre, Astrakov, Sergey V, Rao, Mangala, Wu, William K K, Bhatt, Keyur, de Nadal, Miriam, Likhvantsev, Valery V, Paniagua, Pilar, Aguado, Hector J, Whitlock, Richard P, Mcgillion, Michael H, Prystajecky, Michael, Vincent, Jessica, Eikelboom, John, Copland, Ingrid, Balasubramanian, Kumar, Turan, Alparslan, Bangdiwala, Shrikant I, Stillo, David, Gross, Peter L, Cafaro, Teresa, Alfonsi, Pascal, Roshanov, Pavel S, Belley-Côté, Emilie P, Spence, Jessica, Richards, Toby, Vanhelder, Toma, Mcintyre, William, Guyatt, Gordon, Yusuf, Salim, Leslie, Kate, and Anesthesiology
- Subjects
BLOOD-TRANSFUSION ,HEMORRHAGE ,Canada ,Tranexamic Acid ,MORTALITY ,Surgical Procedures, Operative ,BIMS ,Humans ,Hemorrhage ,Thrombosis ,General Medicine ,Antifibrinolytic Agents - Abstract
BACKGROUND Perioperative bleeding is common in patients undergoing noncardiac surgery. Tranexamic acid is an antifibrinolytic drug that may safely decrease such bleeding. METHODS We conducted a trial involving patients undergoing noncardiac surgery. Patients were randomly assigned to receive tranexamic acid (1-g intravenous bolus) or placebo at the start and end of surgery (reported here) and, with the use of a partial factorial design, a hypotension-avoidance or hypertension-avoidance strategy (not reported here). The primary efficacy outcome was life-threatening bleeding, major bleeding, or bleeding into a critical organ (composite bleeding outcome) at 30 days. The pri- mary safety outcome was myocardial injury after noncardiac surgery, nonhemor- rhagic stroke, peripheral arterial thrombosis, or symptomatic proximal venous thromboembolism (composite cardiovascular outcome) at 30 days. To establish the noninferiority of tranexamic acid to placebo for the composite cardiovascular out- come, the upper boundary of the one-sided 97.5% confidence interval for the hazard ratio had to be below 1.125, and the one-sided P value had to be less than 0.025. RESULTS A total of 9535 patients underwent randomization. A composite bleeding outcome event occurred in 433 of 4757 patients (9.1%) in the tranexamic acid group and in 561 of 4778 patients (11.7%) in the placebo group (hazard ratio, 0.76; 95% confi- dence interval [CI], 0.67 to 0.87; absolute difference, −2.6 percentage points; 95% CI, −3.8 to −1.4; two-sided P
- Published
- 2022
7. Low-dose CT from myocardial perfusion SPECT/CT allows the detection of anemia in preoperative patients
- Author
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Gennari, Antonio G, Grünig, Hannes, Benz, Dominik C, Skawran, Stephan, Maurer, Alexander, Abukwaik, Ahmad M A, Rossi, Alexia, Gebhard, Catherine, Buechel, Ronny R, Messerli, Michael, University of Zurich, Messerli, Michael, RS: Carim - H02 Cardiomyopathy, and Cardiologie
- Subjects
BLOOD-TRANSFUSION ,MORTALITY ,610 Medicine & health ,Anemia ,X-ray computed ,10181 Clinic for Nuclear Medicine ,ASSOCIATION ,2705 Cardiology and Cardiovascular Medicine ,MORBIDITY ,Hematocrit ,10036 Medical Clinic ,10209 Clinic for Cardiology ,2741 Radiology, Nuclear Medicine and Imaging ,Radiology, Nuclear Medicine and imaging ,Hemoglobin ,Single-photon ,Cardiology and Cardiovascular Medicine ,Tomography ,Emission-computed - Abstract
Background To assess whether low-dose CT for attenuation correction of myocardial perfusion single-photon emission computed tomography (SPECT) allows for identification of anemic patients and grading anemia severity. Methods and Results Patients who underwent a preoperative blood-test and low-dose CT scan, as a part of a cardiac SPECT exam, between 01 January 2015 and 31 December 2017 were enrolled in this retrospective study. Hemoglobin (Hb) levels and hematocrit were derived from clinical records. CT images were visually assessed (qualitative analysis) for the detection of inter-ventricular septum sign (IVSS) and aortic rim sign (ARS) and quantitative analysis were performed. The diagnostic accuracy for detecting anemia was compared using Hb values as the standard of reference. A total of 229 patients were included (110 with anemia; 57 mild; 46 moderate; 7 severe). The AUC of IVSS and ARS were 0.830 and 0.669, respectively (p Conclusion Quantitative analysis derived from low-dose CT images, as a part of cardiac SPECT exams, have a diagnostic accuracy similar to that of hematocrit for the detection of anemia and may allow discriminating different anemia severities. Graphical abstract
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- 2022
- Full Text
- View/download PDF
8. Hypocalcemia in trauma patients: A systematic review
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Vasudeva, M, Mathew, Joseph, Groombridge, C, Tee, JW, Johnny, CS, Maini, A, Fitzgerald, MC, Vasudeva, M, Mathew, Joseph, Groombridge, C, Tee, JW, Johnny, CS, Maini, A, and Fitzgerald, MC
- Published
- 2021
9. Immediate Transfusion in African Children with Uncomplicated Severe Anemia
- Author
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Kathryn, Maitland, Sarah, Kiguli, Peter, Olupot-Olupot, Charles, Engoru, Macpherson, Mallewa, Pedro, Saramago Goncalves, Robert O, Opoka, Ayub, Mpoya, Florence, Alaroker, Julius, Nteziyaremye, George, Chagaluka, Neil, Kennedy, Eva, Nabawanuka, Margaret, Nakuya, Cate, Namayanja, Sophie, Uyoga, Dorothy, Kyeyune Byabazaire, Bridon, M'baya, Benjamin, Wabwire, Gary, Frost, Imelda, Bates, Jennifer A, Evans, Thomas N, Williams, Elizabeth C, George, Diana M, Gibb, A Sarah, Walker, F, Tenu, Group, for the TRACT, Wellcome Trust, Medical Research Council, Medical Research Council (MRC), and Medical Research Council, UK
- Subjects
Male ,BLOOD-TRANSFUSION ,Malawi ,Pediatrics ,Blood transfusion ,Cost-Benefit Analysis ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,law.invention ,TRACT Group ,Hemoglobins ,0302 clinical medicine ,Randomized controlled trial ,law ,Uganda ,030212 general & internal medicine ,Child ,11 Medical and Health Sciences ,wh_155 ,Evidence-Based Medicine ,Anemia ,Health Care Costs ,General Medicine ,ws_300 ,Child, Preschool ,Female ,Life Sciences & Biomedicine ,medicine.medical_specialty ,wh_460 ,MEDLINE ,Patient Readmission ,Article ,World health ,Time-to-Treatment ,Severe anemia ,wb_356 ,03 medical and health sciences ,Medicine, General & Internal ,SDG 3 - Good Health and Well-being ,General & Internal Medicine ,medicine ,Humans ,Blood Transfusion ,Science & Technology ,business.industry ,Infant ,Transfusion Reaction ,CARE ,Length of Stay ,medicine.disease ,Malaria ,Hemoglobin ,business ,Follow-Up Studies - Abstract
BACKGROUND: The World Health Organization recommends not performing transfusions in African children hospitalized for uncomplicated severe anemia (hemoglobin level of 4 to 6 g per deciliter and no signs of clinical severity). However, high mortality and readmission rates suggest that less restrictive transfusion strategies might improve outcomes.METHODS: In this factorial, open-label, randomized, controlled trial, we assigned Ugandan and Malawian children 2 months to 12 years of age with uncomplicated severe anemia to immediate transfusion with 20 ml or 30 ml of whole-blood equivalent per kilogram of body weight, as determined in a second simultaneous randomization, or no immediate transfusion (control group), in which transfusion with 20 ml of whole-blood equivalent per kilogram was triggered by new signs of clinical severity or a drop in hemoglobin to below 4 g per deciliter. The primary outcome was 28-day mortality. Three other randomizations investigated transfusion volume, postdischarge supplementation with micronutrients, and postdischarge prophylaxis with trimethoprim-sulfamethoxazole.RESULTS: A total of 1565 children (median age, 26 months) underwent randomization, with 778 assigned to the immediate-transfusion group and 787 to the control group; 984 children (62.9%) had malaria. The children were followed for 180 days, and 71 (4.5%) were lost to follow-up. During the primary hospitalization, transfusion was performed in all the children in the immediate-transfusion group and in 386 (49.0%) in the control group (median time to transfusion, 1.3 hours vs. 24.9 hours after randomization). The mean (±SD) total blood volume transfused per child was 314±228 ml in the immediate-transfusion group and 142±224 ml in the control group. Death had occurred by 28 days in 7 children (0.9%) in the immediate-transfusion group and in 13 (1.7%) in the control group (hazard ratio, 0.54; 95% confidence interval [CI], 0.22 to 1.36; P = 0.19) and by 180 days in 35 (4.5%) and 47 (6.0%), respectively (hazard ratio, 0.75; 95% CI, 0.48 to 1.15), without evidence of interaction with other randomizations (P>0.20) or evidence of between-group differences in readmissions, serious adverse events, or hemoglobin recovery at 180 days. The mean length of hospital stay was 0.9 days longer in the control group.CONCLUSIONS: There was no evidence of differences in clinical outcomes over 6 months between the children who received immediate transfusion and those who did not. The triggered-transfusion strategy in the control group resulted in lower blood use; however, the length of hospital stay was longer, and this strategy required clinical and hemoglobin monitoring. (Funded by the Medical Research Council and Department for International Development; TRACT Current Controlled Trials number, ISRCTN84086586.).
- Published
- 2019
10. International point prevalence study of Intensive Care Unit transfusion practices-Pilot study in the Netherlands
- Author
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H. Schoechl, Simon Oczkowski, Jens Meier, M. Y. Alders, Matthias Müller, Anders Perner, Cécile Aubron, Gavin J. Murphy, M. Lance, Timothy S. Walsh, Maurizio Cecconi, Joanna C. Dionne, N. Nielsen, R. van Bruggen, Thomas Scheeren, Aarne Feldheiser, B. Hunt, S. de Bruin, Jacques Duranteau, Alexander P.J. Vlaar, M. Antonelli, Jan Bakker, Dirk de Korte, Graduate School, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, Human Genetics, Amsterdam Reproduction & Development (AR&D), Landsteiner Laboratory, ACS - Microcirculation, Intensive Care Medicine, Intensive Care, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Vascular Ageing Programme (VAP), Clinical Genetics, and Amsterdam Reproduction & Development
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Male ,BLOOD-TRANSFUSION ,Blood transfusion ,Internationality ,medicine.medical_treatment ,Clinical Biochemistry ,MULTICENTER ,University/statistics & numerical data ,Pilot Projects ,030204 cardiovascular system & hematology ,Hospitals, University/statistics & numerical data ,Red blood cells ,law.invention ,Hospitals, University ,Plasma ,0302 clinical medicine ,law ,Medicine ,Multicenter Studies as Topic ,Prospective Studies ,Netherlands ,education.field_of_study ,OUTCOMES ,Critical Care/methods ,Hematology ,Middle Aged ,Intensive care unit ,Hospitals ,Intensive Care Units ,Treatment Outcome ,Research Design ,Blood Component Transfusion/statistics & numerical data ,Female ,Fresh frozen plasma ,Cohort study ,Multicenter Studies as Topic/methods ,Platelets ,medicine.medical_specialty ,Critical Care ,Anemia ,Population ,PLATELET TRANSFUSION ,Blood Component Transfusion ,03 medical and health sciences ,Humans ,ANEMIA ,education ,Critically ill ,Diagnosis-Related Groups ,Aged ,business.industry ,CRITICALLY-ILL ,Biochemistry (medical) ,FRESH-FROZEN PLASMA ,RESTRICTIVE TRANSFUSION ,Guideline ,medicine.disease ,Platelet transfusion ,Emergency medicine ,Feasibility Studies ,Transfusion practice ,AUDIT ,business ,Procedures and Techniques Utilization ,030215 immunology - Abstract
Background. - Anaemia and coagulopathy are common issues in critically ill patients. Transfusion can be lifesaving, however, is associated with potential life threatening adverse events. As an international transfusion guideline for this specific patient population is lacking, we hypothesize that a high heterogeneity in transfusion practices exists. In this pilot-study we assessed transfusion practice in a university hospital in the Netherlands and tested the feasibility of this protocol for an international multi-centre study.Methods. - A prospective single centre cohort study was conducted. For seven days all consecutive non-readmitted patients to the adult Intensive Care Unit (ICU) were included and followed for 28 days. Patients were prospectively followed until ICU discharge or up to day 28. Patient outcome data was collected at day 28. Workload for this study protocol was scored in hours and missing data.Results. - In total, 48 patients were included, needed in total three hours patient to include and collect all data, with 1.6% missing data showing the feasibility of the data acquisition. Six (12.5%) patients received red blood cells (RBCs), three patients (6.3%) received platelet concentrates, and two (4.2%) patients received plasma units. In total eight (16.7%) patients were transfused with one or more blood products. Median pre- and post-transfusion haemoglobin (Hb) levels were 7.6 (6.7-7.7) g/dL and 8.1 (7.6-8.7) g/dL, respectively.Conclusion. - In this pilot-study we proved the feasibility of our protocol and observed in this small population a restrictive transfusion practice for all blood products. (C) 2019 Societe francaise de transfusion sanguine (SFTS). Published by Elsevier Masson SAS. All rights reserved.
- Published
- 2019
11. A Cross-Sectional Study on Burden of Hepatitis C, Hepatitis B, HIV and Syphilis in Multi-Transfused Thalassemia Major Patients Reporting to a Government Hospital of Central India.
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Manisha, Shrivastava, Sanjeev, Kumar, Seema, Navaid, Dilip, Chotrani, and Rashmi, Dwivedi
- Abstract
Need for frequent blood transfusions exposes thalassemia major patients to risk of transfusion-transmitted infections (TTIs). Screening of donor blood through national protocols for possible infections like hepatitis B and C, HIV, syphilis and malaria is considered the optimal preventive method. There is constant need to explore the effect of currently used protocols of blood-donor screening by determining the burden of TTIs in multi-transfused patients. The current study was conducted to determine the burden of TTIs among multi-transfused Thalassemia patients registered at a Government hospital of central India. Sixty-six multi-transfused Thalassemia patients reporting during a period of eight months were screened for hepatitis B and C, HIV as well as syphilis by using standard diagnostic tests. Selected clinical, socio-demographic and other characteristics were also recorded to understand the determinants of risks of these infections. The sero-prevalence of hepatitis B, hepatitis C, HIV and syphilis was 3.0, 18.2, 1.5 and 0 % respectively amongst the patients. Vaccination against hepatitis B was found to be protective. Majority of the infected patients had history of transfusion from non government blood banks. There is a considerable burden of Hepatitis C among multi-transfused Thalassemia patients. The currently used screening tests need to be revalidated or replaced to prevent false-negative diagnoses. All sectors need to optimally implement and control both, the quality of blood donors and the mandatory screening of blood and blood products against the TTIs along with prospective longitudinal data and follow up of patients. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
12. Preoperative identification of cardiac surgery patients at risk of receiving a platelet transfusion: The Australian Cardiac Surgery Platelet Transfusion (ACSePT) risk prediction tool
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Flint, A.W.J., Bailey, M., Reid, Christopher, Smith, J.A., Tran, L., Wood, E.M., McQuilten, Z.K., Reade, M.C., Flint, A.W.J., Bailey, M., Reid, Christopher, Smith, J.A., Tran, L., Wood, E.M., McQuilten, Z.K., and Reade, M.C.
- Abstract
© 2020 AABB Platelet (PLT) transfusions are limited and costly resources. Accurately predicting clinical demand while limiting product wastage remains difficult. A PLT transfusion prediction score was developed for use in cardiac surgery patients who commonly require PLT transfusions. Study Design and Methods: Using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database, significant predictors for PLT transfusion were identified by multivariate logistic regression. Using a development data set containing 2005 to 2016 data, the Australian Cardiac Surgery Platelet Transfusion (ACSePT) risk prediction tool was developed by assigning weights to each significant predictor that corresponded to a probability of PLT transfusion. The predicted probability for each score was compared to actual PLT transfusion occurrence in a validation (2017) data set. Results: The development data set contained 38 independent variables and 91 521 observations. The validation data set contained 12 529 observations. The optimal model contained 23 variables significant at P <.001 and an area under the receiver operating characteristic (ROC) curve of 0.69 (95% confidence interval [CI], 0.68-0.69). ACSePT contained nine variables and had an area under the ROC curve of 0.66 (95% CI, 0.65-0.66) and overall predicted probability of PLT transfusion of 19.8% for the validation data set compared to an observed risk of 20.3%. Conclusion: The ACSePT risk prediction tool is the first scoring system to predict a cardiac surgery patientʼs risk of receiving a PLT transfusion. It can be used to identify patients at higher risk of receiving PLT transfusions for inclusion in clinical trials and by PLT inventory managers to predict PLT demand.
- Published
- 2020
13. Bleeding Severity in Percutaneous Coronary Intervention (PCI) and Its Impact on Short-Term Clinical Outcomes
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Murali, Shashank, Vogrin, Sara, Noaman, Samer, Dinh, Diem T, Brennan, Angela L, Lefkovits, Jeffrey, Reid, Christopher, Cox, Nicholas, Chan, William, Murali, Shashank, Vogrin, Sara, Noaman, Samer, Dinh, Diem T, Brennan, Angela L, Lefkovits, Jeffrey, Reid, Christopher, Cox, Nicholas, and Chan, William
- Abstract
Bleeding severity in patients undergoing percutaneous coronary intervention (PCI), defined by the Bleeding Academic Research Consortium (BARC), portends adverse prognosis. We analysed data from 37,866 Australian patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR), and investigated the association between increasing BARC severity and in-hospital and 30-day major adverse cardiac and cerebrovascular events (MACCE) (a composite of mortality, myocardial infarction, stent thrombosis, target vessel revascularisation, or stroke). Independent predictors associated with major bleeding (BARC groups 3&5), and MACCE were also assessed. There was a stepwise increase in in-hospital and 30-day MACCE with greater severity of bleeding. Independent predictors of bleeding included female sex (Odds Ratio (OR) 1.34), age (OR 1.02), fibrinolytic therapy (OR 1.77), femoral access (OR 1.51), and ticagrelor (OR 1.42), all significant at the p < 0.001 level. Following adjustment of clinically important variables, BARC 3&5 bleeds (OR 4.37) were still predictive of cumulative in-hospital and 30-day MACCE. In conclusion, major bleeding is an uncommon but potentially fatal PCI complication and was independently associated with greater MACCE rates. Efforts to mitigate the occurrence of bleeding, including radial access and judicious use of potent antiplatelet therapies, may ameliorate the risk of short-term adverse clinical outcomes.
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- 2020
14. Transfusion management of severe anaemia in African children: a consensus algorithm
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Elizabeth Molyneux, Yami Chimalizeni, Diana M. Gibb, Thomas N. Williams, Kathryn Maitland, Dora Mbanya, Peter Olupot-Olupot, Dorothy Kyeyune-Byabazaire, Florence Alaroker, Deogratias Munube, Sophie Uyoga, Robert O. Opoka, A. Sarah Walker, Elizabeth C. George, Bridon M'baya, Sarah Kiguli, Imelda Bates, Annabelle South, Bongomin, Bodo, Nabawanuka, Eva, Musoke, Philippa, Nasiima, Ritah, Mnjalla, Hellen, Mogaka, Christabel, Bah, Abubakarr, Umuhoza, Christian, Obeng, William K. A., Kilba, Charlyne, Appiah, John, Ticklay, Ismail, Ware, Russel, Petrucci, Roberta, Mberi, ET, Tagny, Claude T., Diop, Saliou, Moftah, Faten, Acquah, Michael E., Olatunji, Philip, Lyimo, Magdalena, Anani, Ludovic, Ofori, Shirley O., Engoru, Charles, Medical Research Council (MRC), Medical Research Council, and Wellcome Trust
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Consensus algorithm ,Male ,Pediatrics ,medicine.medical_specialty ,Disease status ,BLOOD-TRANSFUSION ,Blood transfusion ,Consensus ,medicine.medical_treatment ,Immunology ,malaria ,wa_395 ,Anemia, Sickle Cell ,Severity of Illness Index ,Article ,03 medical and health sciences ,wb_356 ,0302 clinical medicine ,TRACT Stakeholders meeting group ,medicine ,Humans ,Blood Transfusion ,Transfusion management ,guidelines ,Child ,1102 Cardiorespiratory Medicine and Haematology ,Whole blood ,transfusion ,wh_155 ,anaemia ,Science & Technology ,business.industry ,wh_20 ,Hematology ,medicine.disease ,ws_300 ,030220 oncology & carcinogenesis ,Shock (circulatory) ,Child, Preschool ,VOLUME ,Africa ,African children ,medicine.symptom ,business ,Life Sciences & Biomedicine ,Malaria ,Algorithms ,030215 immunology ,Severe anaemia - Abstract
Summary: The phase III Transfusion and Treatment of severe anaemia in African Children Trial (TRACT) found that conservative management of uncomplicated severe anaemia [haemoglobin (Hb) 40–60 g/l] was safe, and that transfusion volume (20 vs. 30 ml/kg whole blood equivalent) for children with severe anaemia (Hb 37·5°C). In 2020 a stakeholder meeting of paediatric and blood transfusion groups from Africa reviewed the results and additional analyses. Among all 3196 children receiving an initial transfusion there was no evidence that nutritional status, presence of shock, malaria parasite burden or sickle cell disease status influenced outcomes or modified the interaction with fever status on volume required. Fever status at the time of ordering blood was a reliable determinant of volume required for optimal outcome. Elevated heart and respiratory rates normalised irrespective of transfusion volume and without diuretics. By consensus, a transfusion management algorithm was developed, incorporating three additional measurements of Hb post‐admission, alongside clinical monitoring. The proposed algorithm should help clinicians safely implement findings from TRACT. Further research should assess its implementation in routine clinical practice.
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- 2021
15. Perioperative management and anaesthetic considerations in pelvic exenterations using Delphi methodology: results from the PelvEx Collaborative
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PelvEx Collaborative, [missing], Chok, A Y, Oliver, A, Rasheed, S, Tan, E J, Kelly, M E, Aalbers, A G J, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, K K, Aziz, O, Baker, R P, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, B K, Beets, G L, Berg, P L, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, A B, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, J W A, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, K K L, Chang, G J, Chew, M H, Chong, P, Christensen, H K, Clouston, H, Codd, M, Collins, D, Colquhoun, A J, Corr, A, Coscia, M, Coyne, P E, Creavin, B, Croner, R S, Damjanovic, L, Daniels, I R, Davies, M, Davies, R J, Delaney, C P, de Wilt, J H W, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, E J, Duff, M, Eglinton, T, Enrique-Navascues, J M, Espin-Basany, E, Evans, M D, Fearnhead, N S, Flatmark, K, Fleming, F, Frizelle, F A, Gallego, M A, Garcia-Granero, E, Garcia-Sabrido, J L, Gentilini, L, George, M L, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, D A, Hagemans, J A W, Hanchanale, V, Harji, D P, Helewa, R M, Hellawell, G, Heriot, A G, Hochman, D, Hohenberger, W, Holm, T, Holmström, A, Hompes, R, Jenkins, J T, Kaffenberger, S, Kandaswamy, G V, Kapur, S, Kanemitsu, Y, Kelley, S R, Keller, D S, Khan, M S, Kim, H, Kim, H J, Koh, C E, Kok, N F M, Kokelaar, R, Kontovounisios, C, Kristensen, H Ø, Kroon, H M, Kusters, M, Lago, V, Larsen, S G, Larson, D W, Law, W L, Laurberg, S, Lee, P J, Limbert, M, Lydrup, M L, Lyons, A, Lynch, A C, Mantyh, C, Mathis, K L, Margues, C F S, Martling, A, Meijerink, W J H J, Merkel, S, Mehta, A M, McArthur, D R, McDermott, F D, McGrath, J S, Malde, S, Mirnezami, A, Monson, J R T, Morton, J R, Mullaney, T G, Negoi, I, Neto, J W M, Nguyen, B, Nielsen, M B, Nieuwenhuijzen, G A P, Nilsson, P J, O’Dwyer, S T, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, A C, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, R W, Rasmussen, P C, Rausa, E, Regenbogen, S E, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, H J T, Ryan, É J, Safar, B, Sagar, P M, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, A M P, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, N J, Smart, P, Smith, J J, Solbakken, A M, Solomon, M J, Sørensen, M M, Steele, S R, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, N A, Swartling, T, Sumrien, H, Sutton, P A, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, E L, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, J J, Turner, W H, Tuynman, J B, van Ramshorst, Gabriëlle, Zoggel, D van, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, E L K, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, H H, Weber, K, Weiser, M R, Wheeler, J M D, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, R N, Winter, D C, Tekkis, P P, Surgery, Chok, A Y, Oliver, A, Rasheed, S, Tan, E J, Kelly, M E, Aalbers, A G J, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, K K, Aziz, O, Baker, R P, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, B K, Beets, G L, Berg, P L, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, A B, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, J W A, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, K K L, Chang, G J, Chew, M H, Chong, P, Christensen, H K, Clouston, H, Codd, M, Collins, D, Colquhoun, A J, Corr, A, Coscia, M, Coyne, P E, Creavin, B, Croner, R S, Damjanovic, L, Daniels, I R, Davies, M, Davies, R J, Delaney, C P, de Wilt, J H W, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, E J, Duff, M, Eglinton, T, Enrique-Navascues, J M, Espin-Basany, E, Evans, M D, Fearnhead, N S, Flatmark, K, Fleming, F, Frizelle, F A, Gallego, M A, Garcia-Granero, E, Garcia-Sabrido, J L, Gentilini, L, George, M L, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, D A, Hagemans, J A W, Hanchanale, V, Harji, D P, Helewa, R M, Hellawell, G, Heriot, A G, Hochman, D, Hohenberger, W, Holm, T, Holmström, A, Hompes, R, Jenkins, J T, Kaffenberger, S, Kandaswamy, G V, Kapur, S, Kanemitsu, Y, Kelley, S R, Keller, D S, Khan, M S, Kim, H, Kim, H J, Koh, C E, Kok, N F M, Kokelaar, R, Kontovounisios, C, Kristensen, H Ø, Kroon, H M, Kusters, M, Lago, V, Larsen, S G, Larson, D W, Law, W L, Laurberg, S, Lee, P J, Limbert, M, Lydrup, M L, Lyons, A, Lynch, A C, Mantyh, C, Mathis, K L, Margues, C F S, Martling, A, Meijerink, W J H J, Merkel, S, Mehta, A M, McArthur, D R, McDermott, F D, McGrath, J S, Malde, S, Mirnezami, A, Monson, J R T, Morton, J R, Mullaney, T G, Negoi, I, Neto, J W M, Nguyen, B, Nielsen, M B, Nieuwenhuijzen, G A P, Nilsson, P J, O’Dwyer, S T, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, A C, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, R W, Rasmussen, P C, Rausa, E, Regenbogen, S E, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, H J T, Ryan, É J, Safar, B, Sagar, P M, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, A M P, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, N J, Smart, P, Smith, J J, Solbakken, A M, Solomon, M J, Sørensen, M M, Steele, S R, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, N A, Swartling, T, Sumrien, H, Sutton, P A, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, E L, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, J J, Turner, W H, Tuynman, J B, Ramshorst, G H van, Zoggel, D van, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, E L K, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, H H, Weber, K, Weiser, M R, Wheeler, J M D, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, R N, Winter, D C, Tekkis, P P, Mcarthur, D R, Mcdermott, F D, Mcgrath, J S, Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Faculteit FHML Centraal, Health Services Research, RS: CAPHRI - R1 - Ageing and Long-Term Care, RS: FdR IC Goederenrecht, School Office GROW, and Amsterdam Gastroenterology Endocrinology Metabolism
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BLOOD-TRANSFUSION ,CARDIAC RISK ,AcademicSubjects/MED00910 ,medicine.medical_treatment ,Delphi method ,Computer-assisted web interviewing ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,0302 clinical medicine ,030202 anesthesiology ,Multidisciplinary approach ,Medicine and Health Sciences ,Medicine ,humans ,RISK ,COMPLICATIONS ,Perioperative management - anaesthetic - pelvic exenterations - rectal cancer - Delphi - PelvEx Collaborative ,Manchester Cancer Research Centre ,General Medicine ,SYSTEMIC INFLAMMATORY RESPONSE ,030220 oncology & carcinogenesis ,Original Article ,Medical emergency ,EPIDURAL-ANESTHESIA ,AcademicSubjects/MED00010 ,Life Sciences & Biomedicine ,Consensus ,ENHANCED RECOVERY ,Best practice ,education ,MEDLINE ,patient care team/organization & administration ,03 medical and health sciences ,anesthetics ,Humans ,MAJOR ABDOMINAL-SURGERY ,METAANALYSIS ,RECTAL-CANCER ,Anesthetics ,Patient Care Team ,Science & Technology ,Pelvic exenteration ,business.industry ,ResearchInstitutes_Networks_Beacons/mcrc ,MORTALITY ,LONG-TERM SURVIVAL ,Perioperative ,COMPARTMENT SYNDROME ,medicine.disease ,pelvic exenteration ,Pelvic Exenteration ,Subject-matter expert ,consensus ,Surgery ,business - Abstract
Background The multidisciplinary perioperative and anaesthetic management of patients undergoing pelvic exenteration is essential for good surgical outcomes. No clear guidelines have been established, and there is wide variation in clinical practice internationally. This consensus statement consolidates clinical experience and best practice collectively, and systematically addresses key domains in the perioperative and anaesthetic management. Methods The modified Delphi methodology was used to achieve consensus from the PelvEx Collaborative. The process included one round of online questionnaire involving controlled feedback and structured participant response, two rounds of editing, and one round of web-based voting. It was held from December 2019 to February 2020. Consensus was defined as more than 80 per cent agreement, whereas less than 80 per cent agreement indicated low consensus. Results The final consensus document contained 47 voted statements, across six key domains of perioperative and anaesthetic management in pelvic exenteration, comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management. Consensus recommendations were developed, based on consensus agreement achieved on 34 statements. Conclusion The perioperative and anaesthetic management of patients undergoing pelvic exenteration is best accomplished by a dedicated multidisciplinary team with relevant domain expertise in the setting of a specialized tertiary unit. This consensus statement has addressed key domains within the framework of current perioperative and anaesthetic management among patients undergoing pelvic exenteration, with an international perspective, to guide clinical practice, and has outlined areas for future clinical research., The PelvEx Collaborative consensus statement systematically addresses the perioperative and anaesthetic management of patients undergoing pelvic exenteration (PE). Using the modified Delphi methodology, recommendations across six key clinical domains comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management were developed. pelvic exenteratio and recommendation
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- 2021
16. Nursing Care Guide for the administration of blood and its components (integrative review)
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Vargas Bermúdez, Zeidy María
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Blood-transfusion ,Componentes-sanguíneos ,Transfusão-do-sangue ,Nursing-care ,Cuidados-de-Enfermagem ,Transfusión-Sanguínea ,Blood-components ,Cuidados-de-Enfermería ,Componentes-do-sangue - Abstract
Resumen 13. El objetivo de esta investigación fue identificar la mejor evidencia científica que respalda el cuidado de enfermería a las personas que reciben una transfusión de sangre y sus componentes. La metodología siguió las pautas de la revisión integrativa partiendo de una pesquisa general a partir de la que se redactó una pregunta utilizando el formato PCC (Población, concepto y contexto); se estableció una estrategia de búsqueda de información en bases de datos en idioma español, inglés y portugués. Se llevó a cabo la selección y análisis crítico e interpretación de la evidencia encontrada. Se identificó inicialmente un total de 3543 artículos, de los que se removió 3513 (por duplicación) y se excluyó 30 (por título); por tanto, se seleccionó 16. Como resultado, se destaca los cuidados de enfermería antes, durante y posterior a la administración de los hemocomponentes, relacionados con el receptor, calidad del producto, materiales, prevención y valoración e intervención oportuna ante eventuales reacciones adversas. Se concluye que los cuidados de enfermería establecidos son semejantes entre los diferentes documentos, esta revisión integrativa se considera una guía óptima, para que los profesionales apliquen las diferentes actividades descritas para mejorar la calidad del procedimiento de transfusión de hemocomponentes en las instituciones de salud. Abstract 17. The objective of this research was to identify the best scientific evidence that supports nursing care for people who receive a transfusion of blood and its components. The methodology followed the guidelines of the integrative review based on a general survey from which a question was written using the PCC format (Population, concept and context); an information search strategy was established in Spanish, English and Portuguese databases. The selection and critical analysis and interpretation of the evidence found was carried out. A total of 3543 articles were initially identified, of which 3513 were removed (by duplication) and 30 were excluded (by title); therefore, 16 were selected. As a result, the nursing care before, during and after the administration of blood components, related to the recipient, product quality, materials, prevention and assessment and timely intervention in the event of adverse reactions is highlighted. It is concluded that the established nursing care is similar among the different documents, this integrative review is considered an optimal guide for professionals to apply the different activities described to improve the quality of blood transfusion procedure in health institutions. Resumo 21. O objetivo desta pesquisa foi identificar as melhores evidências científicas que sustentam o cuidado de enfermagem às pessoas que recebem transfusão de sangue e seus componentes. A metodologia seguiu as diretrizes da revisão integrativa com base em uma pesquisa geral da qual uma questão foi escrita usando o formato PCC (População, conceito e contexto); uma estratégia de busca de informações foi estabelecida em bancos de dados espanhóis, ingleses e portugueses. A seleção e análise crítica e interpretação das evidências encontradas foram realizadas. Um total de 3543 artigos foram inicialmente identificados, dos quais 3513 foram removidos (por duplicação) e 30 foram excluídos (por título); portanto, foram selecionados 16. Como resultado, destaca-se o cuidado de enfermagem antes, durante e após a administração dos componentes sanguíneos, relacionado ao receptor, qualidade do produto, materiais, prevenção e avaliação e intervenção oportuna em caso de reações adversas. Conclui-se que a assistência de enfermagem estabelecida é semelhante entre os diferentes documentos, sendo essa revisão integrativa considerada um guia ótimo para que os profissionais apliquem as diferentes atividades descritas para melhorar a qualidade do procedimento de transfusão sanguínea nas instituições de saúde.
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- 2019
17. Does a digital regional nerve block improve the accuracy of noninvasive hemoglobin monitoring?
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Miller, Ronald, Ward, Theresa, McCulloch, Charles, and Cohen, Neal
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HEMOGLOBINS , *BLOOD flow , *ANESTHESIA , *BLOOD transfusion , *NERVE block - Abstract
Background: Blood hemoglobin (Hb) can be continuously monitored utilizing noninvasive spectrophotometric finger sensors (Masimo SpHb). SpHb is not a consistently accurate guide to transfusion decisions when compared with laboratory Co-Oximetry (tHb). We evaluated whether a finger digital nerve block (DNB) would increase perfusion and, thereby, improve the accuracy of SpHb. Methods: Twenty adult patients undergoing spinal surgery received a DNB with lidocaine to the finger used for the monitoring of SpHb. SpHb-tHb differences were determined immediately following the DNB and approximately every hour thereafter. These differences were compared with those in our previously reported patients ( N = 20) with no DNB. The SpHb-tHb difference was defined as 'very accurate' if <0.5 g/dL and 'inaccurate' if >2.0 g/dL. Perfusion index (PI) values at the time of each SpHb-tHb measurement were compared. Results: There were 57 and 78 data points in this and our previous study, respectively. The presence of a DNB resulted in 37 % of measurements having SpHb values in the 'very accurate group' versus 12 % in patients without a DNB. When the PI value was >2.0, only 1 of 57 DNB values was in the 'inaccurate' group. The PI values were both higher and less variable in the patients who received a DNB. Conclusions: A DNB significantly increased the number of 'very accurate' SpHb values and decreased the number of 'inaccurate' values. We conclude that a DNB may facilitate the use of SpHb as a guide to transfusion decisions, particularly when the PI is >2.0. [ABSTRACT FROM AUTHOR]
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- 2012
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18. Guía de Cuidados de enfermería para la administración de la sangre y sus componentes. (Revisión Integrativa)
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Vargas Bermudez, Zeidy and Vargas Bermudez, Zeidy
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Resumen. El objetivo de esta revisión integrativa fue identificar la mejor evidencia científica que respalda el cuidado de enfermería a las personas que recibe una transfusión de hemocomponentes. La metodología siguió las recomendaciones de Joanna Briggs Institute, partiendo de una pesquisa general para luego redactar una pregunta utilizando el formato PCC (Población, concepto y contexto); se estableció una estrategia de búsqueda de información en bases de datos, en idioma español, inglés y portugués. Se llevó a cabo la selección y análisis crítico e interpretación de la evidencia encontrada. Se identificaron un total de (3543) artículos, siendo removidos (3513) por duplicación y excluidos (30) por título y resumen, quedando seleccionados (16). Como resultado se destacan los cuidados de enfermería antes durante y posterior a la administración de los hemocomponentes, relacionados con el receptor, calidad del producto, materiales, prevención y valoración e intervención oportuna ante eventuales reacciones adversas. Conclusión: Los cuidados de enfermería establecidos son bastante uniformes en las diferentes guías y protocolos de atención creados en diversas instituciones, por lo tanto se considera esta revisión integrativa como una guía óptima, para que los profesionales apliquen las diferentes actividades descritas para mejorar la calidad del procedimiento de transfusión de hemocomponentes en las instituciones de Salud.
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- 2019
19. Changes of Cholinesterase Activity in the Erythrocytes, Plasma, Diaphragm, Liver and Various Parts of the Brain in the Rabbit Following Transfusion of Erythrocytes with Soman Inhibited Acetylcholinesterase
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Jiří Kassa, Jiří Bajgar, and Josef Fusek
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Soman ,Acetycholinesterase ,Butyrylcholinesterase ,Blood-transfusion ,Rabbit ,Medicine - Abstract
1. The changes of cholinesterase activity in rabbit blood, peripheral tissues and the central nervous system following transfusion of erythrocytes with soman inhibited acetylcholinesterase were demonstrated. 2. After incubation with soman for 0.5 or 24 h, erythrocytes without acetylcholinesterase activity were injected to intact rabbits and cholinesterase activity in the erythrocytes, plasma, diaphragm, liver and various parts of the brain were evaluated 24 h following blood-transfusion. 3. When erythrocytes were incubated with soman for 24 h, no changes of cholinesterase activity in the rabbit following blood-transfusion were observed with an exception of erythrocyte acetylcholinesterase. 4. When erythrocytes were incubated with soman for 0.5 h, a significant decrease in cholinesterase activity in the erythrocytes, plasma, diaphragm and liver following blood-transfusion was found. These data show that soman is able to release from erythrocytes and inhibit cholinesterase activities not only in vitro but also in vivo although the significant inhibition of cholinesterase activities by soman was only observed in the peripheral compartment.
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- 1997
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20. Incidence of Massive Transfusion and Overall Transfusion Requirements During Lung Transplantation Over a 25-Year Period
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Michiel E. Erasmus, Edwin R. van den Heuvel, Gerwin E. Engels, Arian Fred de Geus, Erik A M Verschuuren, Thomas Scheeren, Wim van der Bij, Adrianus J. de Vries, Vladimir Cernak, Annemieke Oude Lansink-Hartgring, Stochastic Studies and Statistics, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), Eindhoven MedTech Innovation Center, Statistics, and Stochastic Operations Research
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Adult ,Male ,BLOOD-TRANSFUSION ,Blood transfusion ,Time Factors ,medicine.medical_treatment ,massive transfusion ,030204 cardiovascular system & hematology ,law.invention ,Cohort Studies ,EXTRACORPOREAL MEMBRANE-OXYGENATION ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Interquartile range ,law ,medicine ,lung transplantation ,Lung transplantation ,Humans ,Blood Transfusion ,Retrospective Studies ,CARDIOPULMONARY BYPASS ,business.industry ,Incidence ,MORTALITY ,Hazard ratio ,Retrospective cohort study ,Middle Aged ,Intensive care unit ,Transplantation ,Anesthesiology and Pain Medicine ,SINGLE ,Anesthesia ,Cohort ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objective: To establish the incidence of massive transfusion and overall transfusion requirements during lung transplantation, changes over time, and association with outcome in relation to patient complexity.Design: Retrospective cohort study.Setting: University hospital.Participants: All 514 adult patients who underwent transplantation from 1990 until 2015.Interventions: None.Measurements and Main Results: Patient records and transfusion data, divided into 5-year intervals, were analyzed. The incidence of massive transfusion (>10 units of red blood cells [RBCs] in 24 h) was 27% and did not change over time, whereas the median (interquartile range) transfusion requirement in the whole cohort decreased from 8 (5-12) to 3 (0-10) RBCs (p Conclusion: The incidence of massive transfusion did not change over time, whereas transfusion requirements in the whole cohort decreased. In patients transplanted from the intensive care unit, massive transfusion and transfusion requirements increased. Massive transfusion was associated with poor outcome. (C) 2019 Elsevier Inc. All rights reserved.
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- 2019
21. Applicability of the WHO maternal near miss tool in sub-Saharan Africa
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Jos van Roosmalen, Thomas van den Akker, Abera Kenay Tura, Jelle Stekelenburg, To Lam Trang, Sicco A. Scherjon, and Joost J. Zwart
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medicine.medical_specialty ,BLOOD-TRANSFUSION ,Sub saharan ,Quality Assurance, Health Care ,Population ,Near Miss, Healthcare ,Reproductive medicine ,CINAHL ,Near miss ,World Health Organization ,Maternal near miss ,lcsh:Gynecology and obstetrics ,PRACTICAL CRITERIA ,World health ,SDG 3 - Good Health and Well-being ,Pregnancy ,Environmental health ,OBSTETRIC COMPLICATIONS ,Severe acute maternal morbidity ,Humans ,Medicine ,Maternal Health Services ,education ,Methodological quality ,Africa South of the Sahara ,lcsh:RG1-991 ,BURKINA-FASO ,education.field_of_study ,Severe maternal outcomes ,Sub-Saharan Africa ,business.industry ,NEAR-MISS ,DEATH ,Obstetrics and Gynecology ,WOMEN ,EXPERIENCES ,Pregnancy Complications ,Maternal Mortality ,Systematic review ,Female ,HEALTH ,QUALITY-OF-CARE ,business ,Research Article - Abstract
Background Applicability of the World Health Organization (WHO) maternal near miss criteria in low-income settings is not systematically addressed in the literature. The objective of this review was to determine the applicability of the WHO maternal near miss tool in sub-Saharan Africa. Methods We searched PubMed, Embase, Popline, CINAHL, AJOL, and Google scholar using key words for maternal near miss and sub-Saharan Africa. Studies which applied the WHO maternal near miss criteria, containing clear definitions, and published between January 1st, 2009 and December 31st, 2017 were included. Two authors independently extracted data. Quantitative analysis and narrative synthesis were conducted, and medians with interquartile range (IQR) were calculated for summarizing the findings. Methodological quality of the studies was assessed using the Estabrook’s quality assessment and validity tool. Results Fifteen studies from nine countries comprising 227,077 participants were included. Median maternal near miss ratio was 24.2 (IQR: 12.4–35.8) per 1000 live births ranging from 4.4 in a population-based study in South Africa to 198 in a rural private hospital in Nigeria. Eight studies reported challenges in implementing the WHO maternal near miss tool, especially related to the threshold for blood transfusion, and availability of several laboratory-based criteria. In three studies, local adaptations were made. Conclusion This review showed that the WHO maternal near miss tool is not uniformly applied in sub-Saharan Africa. Therefore, a common adaptation for the region is required to increase its applicability. Electronic supplementary material The online version of this article (10.1186/s12884-019-2225-7) contains supplementary material, which is available to authorized users.
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- 2019
22. Applicability of the WHO maternal near miss tool in sub-Saharan Africa
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Severe maternal outcomes ,BLOOD-TRANSFUSION ,Sub-Saharan Africa ,NEAR-MISS ,DEATH ,WOMEN ,Maternal near miss ,PRACTICAL CRITERIA ,EXPERIENCES ,OBSTETRIC COMPLICATIONS ,Severe acute maternal morbidity ,Systematic review ,HEALTH ,QUALITY-OF-CARE ,BURKINA-FASO - Abstract
BACKGROUND: Applicability of the World Health Organization (WHO) maternal near miss criteria in low-income settings is not systematically addressed in the literature. The objective of this review was to determine the applicability of the WHO maternal near miss tool in sub-Saharan Africa.METHODS: We searched PubMed, Embase, Popline, CINAHL, AJOL, and Google scholar using key words for maternal near miss and sub-Saharan Africa. Studies which applied the WHO maternal near miss criteria, containing clear definitions, and published between January 1st, 2009 and December 31st, 2017 were included. Two authors independently extracted data. Quantitative analysis and narrative synthesis were conducted, and medians with interquartile range (IQR) were calculated for summarizing the findings. Methodological quality of the studies was assessed using the Estabrook's quality assessment and validity tool.RESULTS: Fifteen studies from nine countries comprising 227,077 participants were included. Median maternal near miss ratio was 24.2 (IQR: 12.4-35.8) per 1000 live births ranging from 4.4 in a population-based study in South Africa to 198 in a rural private hospital in Nigeria. Eight studies reported challenges in implementing the WHO maternal near miss tool, especially related to the threshold for blood transfusion, and availability of several laboratory-based criteria. In three studies, local adaptations were made.CONCLUSION: This review showed that the WHO maternal near miss tool is not uniformly applied in sub-Saharan Africa. Therefore, a common adaptation for the region is required to increase its applicability.
- Published
- 2019
23. Conhecimento dos profissionais de enfermagem sobre os regulamentos de transfusão hemocomponente
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Vargas Bermúdez, Zeidy and Calderón Ríos, Angie
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knowledge ,profissionais-de-enfermagem ,conhecimento ,nurse ,enfermeras ,transfusión-sanguínea ,blood-transfusion ,transfusão-hemocomponente ,conocimiento - Abstract
Resumen Este artículo es la primera parte de una investigación, el objetivo fue evaluar el conocimiento y cumplimiento de la normativa establecida para la transfusión de hemocomponentes en un hospital Clase A de la Seguridad Social en Costa Rica por parte de enfermeras (os). Se contó con una población de 206 enfermeras (os) que laboran en los servicios de medicina, cirugía, ginecología, maternidad, neurocirugía, unidad de cuidado intensivo médico y quirúrgico. La muestra fue estratificada de 124 participantes. La investigación es cuantitativa, transversal/retrospectivo. Se utilizó un instrumento autoadministrado para la recolección de datos con los aspectos de la normativa transfusional; para el análisis de datos se utilizó el sistema Surveymonkey. Los resultados evidenciaron que existe un porcentaje importante de enfermeras (os) que desconocen aspectos básicos de la normativa institucional para la transfusión sanguínea. Se concluye que es necesario socializar la normativa, de manera que se ofrezca seguridad al usuario y enfermeras (os) en el proceso transfusional. Abstract This article is the first part of an investigation; the objective was to evaluate the knowledge and compliance of established regulations for the transfusion of blood components in a Class A Social Security hospital in Costa Rica by nurses. There was a population of 206 nurses working in the medical, surgical, gynecology, maternity, neurosurgery, medical, and surgical intensive care units. 124 participants stratified the sample. The research is quantitative, cross-sectional / retrospective. A self-administered instrument was used for data collection with the aspects of transfusion regulations; for data analysis the Surveymonkey system was used. The results showed that there is an important percentage of nurses who do not know basic aspects of the institutional regulations for blood transfusion. It is concluded that it is necessary to socialize the legislation, so as to offer safety to the user and nurses in the transfusion process. Resumo Este artigo é a primeira parte de uma investigação; o objetivo é avaliar o conhecimento e o cumprimento das normas estabelecidas para a transfusão de hemocomponentes em um hospital de Classe A da Previdência Social em Costa Rica por enfermeiras. Se cont com população de 206 profissionais de enfermagem que trabalhavam nos serviços de medicina, cirurgia, ginecologia, maternidade, neurocirurgia, unidade de terapia intensiva médica e cirúrgica. Uma amostra estratificada de 124 participantes foi obtida. A pesquisa é de abordagem quantitativa, transversal / retrospectiva. Utilizou-se um instrumento de coleta de dados autoadministrado com aspectos das normas de transfusão e a análise dos dados foi realizada com o sistema Surveymonkey. Os resultados mostraram que existe um percentual significativo de enfermeiras que desconhecem aspectos básicos dos regulamentos institucionais para a transfusão de hemocomponentes. Conclui-se que é necessário socializar os regulamentos, de forma a oferecer segurança ao usuário e aos enfermeiras no processo de transfusão.
- Published
- 2018
24. Conocimiento de los profesionales de enfermería sobre la normativa de transfusión de hemocomponentes
- Author
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Vargas Bermudez, Zeidy, Calderon Rios, Angie, Vargas Bermudez, Zeidy, and Calderon Rios, Angie
- Abstract
This article is the first part of an investigation; the objective was to evaluate the knowledge and compliance of established regulations for the transfusion of blood components in a Class A Social Security hospital in Costa Rica by nurses. There was a population of 206 nurses working in the medical, surgical, gynecology, maternity, neurosurgery, medical, and surgical intensive care units. 124 participants stratified the sample. The research is quantitative, cross-sectional / retrospective. A self-administered instrument was used for data collection with the aspects of transfusion regulations; for data analysis the Surveymonkey system was used. The results showed that there is an important percentage of nurses who do not know basic aspects of the institutional regulations for blood transfusion. It is concluded that it is necessary to socialize the legislation, so as to offer safety to the user and nurses in the transfusion process., Este artigo é a primeira parte de uma investigação; o objetivo é avaliar o conhecimento e o cumprimento das normas estabelecidas para a transfusão de hemocomponentes em um hospital de Classe A da Previdência Social em Costa Rica por enfermeiras. Se cont com população de 206 profissionais de enfermagem que trabalhavam nos serviços de medicina, cirurgia, ginecologia, maternidade, neurocirurgia, unidade de terapia intensiva médica e cirúrgica. Uma amostra estratificada de 124 participantes foi obtida. A pesquisa é de abordagem quantitativa, transversal / retrospectiva. Utilizou-se um instrumento de coleta de dados autoadministrado com aspectos das normas de transfusão e a análise dos dados foi realizada com o sistema Surveymonkey. Os resultados mostraram que existe um percentual significativo de enfermeiras que desconhecem aspectos básicos dos regulamentos institucionais para a transfusão de hemocomponentes. Conclui-se que é necessário socializar os regulamentos, de forma a oferecer segurança ao usuário e aos enfermeiras no processo de transfusão., Este artículo es la primera parte de una investigación, el objetivo fue evaluar el conocimiento y cumplimiento de la normativa establecida para la transfusión de hemocomponentes en un hospital Clase A de la Seguridad Social en Costa Rica por parte de enfermeras (os). Se contó con una población de 206 enfermeras (os) que laboran en los servicios de medicina, cirugía, ginecología, maternidad, neurocirugía, unidad de cuidado intensivo médico y quirúrgico. La muestra fue estratificada de 124 participantes. La investigación es cuantitativa, transversal/retrospectivo. Se utilizó un instrumento autoadministrado para la recolección de datos con los aspectos de la normativa transfusional; para el análisis de datos se utilizó el sistema Surveymonkey. Los resultados evidenciaron que existe un porcentaje importante de enfermeras (os) que desconocen aspectos básicos de la normativa institucional para la transfusión sanguínea. Se concluye que es necesario socializar la normativa, de manera que se ofrezca seguridad al usuario y enfermeras (os) en el proceso transfusional.
- Published
- 2018
25. Reconciling decision models with the real world. An application to anaemia of renal failure.
- Author
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Shih, Y-C.T., Kauf, T.L., and Shih, Y C
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- *
MEDICAL care , *HEALTH policy , *NATIONAL health insurance , *KIDNEY diseases , *BLOOD transfusion , *DECISION making , *CHRONIC kidney failure , *ALGORITHMS , *ANEMIA , *ERYTHROPOIETIN , *RECOMBINANT proteins , *COST analysis , *ECONOMICS , *THERAPEUTICS ,CHRONIC kidney failure complications - Abstract
Objective: The choice of evidence used in decision modelling of healthcare interventions divides analysts into 2 groups: (i) those who favour randomised clinical trial (RCT) data; and (ii) those who prefer 'real world' data. This preference may have serious consequences if the end result is to inform healthcare policy. This paper uses Medicare coverage of epoetin-alpha [erythropoietin (EPO)] as a case study to illustrate a technique which can be used to overcome some of the bias inherent in RCT data while avoiding some of the common pitfalls associated with the use of observational data.Design and Setting: Cost analysis of 2 treatments for anaemia of renal failure primarily in an outpatient setting is modelled in a decision tree. This method can be used to analyse healthcare interventions or policies in any setting.Patients and Participants: Patients with nontransplanted end-stage renal disease (ESRD) who received either EPO or blood transfusion for treatment of anaemia at any time during the 1-year study period (July 1989 to June 1990) were included in the sample.Methods: Outcome effects in the natural setting are decomposed into 2 parts: a treatment effect and a population effect. This is then extended to the special case of policy analysis. Logistic and multiple regression are used to estimate branch probabilities and payoffs, respectively, for 2 treatment options.Main Outcome Measures and Results: Under standard methods of decision analysis, an increase of $US7032 per patient following EPO coverage is observed. With the decomposition technique, the policy effect is estimated to be less, $US6172, the difference coming from the population effect.Conclusions: Failure to remove population effects from observed outcome effects may lead to biased decision-making. Although not directly observable, the population effect can be imputed from secondary data. The decomposition and imputting technique allows for a more meaningful interpretation of the results for the purpose of policy analysis. [ABSTRACT FROM AUTHOR]- Published
- 1999
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26. Intraoperative High-Dose Dexamethasone in Cardiac Surgery and the Risk of Rethoracotomy
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Dirk, van Osch, Jan M, Dieleman, Hendrik M, Nathoe, Marc P, Boasson, Jolanda, Kluin, Jeroen J H, Bunge, Arno P, Nierich, Peter M, Rosseel, Joost M, van der Maaten, Jan, Hofland, Jan C, Diephuis, Fellery, de Lange, Christa, Boer, Diederik, van Dijk, Jan G, Tijssen, Anesthesiology, ICaR - Circulation and metabolism, Cardiothoracic Surgery, Intensive Care, Internal Medicine, Neurosciences, Radiology & Nuclear Medicine, Amsterdam Cardiovascular Sciences, and Cardiology
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Male ,BLOOD-TRANSFUSION ,Blood transfusion ,medicine.medical_treatment ,Dexamethasone ,law.invention ,Postoperative Complications ,law ,Netherlands ,CARDIOPULMONARY BYPASS ,Incidence ,Middle Aged ,Cardiac surgery ,Treatment Outcome ,Thoracotomy ,Anesthesia ,Injections, Intravenous ,Female ,TRIAL ,Tamponade ,Cardiology and Cardiovascular Medicine ,medicine.drug ,Pulmonary and Respiratory Medicine ,Adult ,Reoperation ,medicine.medical_specialty ,Adolescent ,Heart Diseases ,STEROID USE ,Placebo ,Young Adult ,medicine ,Cardiopulmonary bypass ,Humans ,Cardiac Surgical Procedures ,Adverse effect ,Glucocorticoids ,METAANALYSIS ,Aged ,Retrospective Studies ,Inflammation ,Intraoperative Care ,Dose-Response Relationship, Drug ,business.industry ,INFLAMMATORY RESPONSE ,Perioperative ,Surgery ,UPDATE ,business ,Follow-Up Studies - Abstract
Background. Cardiac surgery with the use of cardiopulmonary bypass is associated with a systemic inflammatory response. Intraoperative corticosteroids are administered to attenuate this inflammatory response. The recent Dexamethasone for Cardiac Surgery (DECS) trial could not demonstrate a beneficial effect of dexamethasone on major adverse events in cardiac surgical patients. Previous studies suggest that corticosteroids may affect postoperative coagulation and blood loss, and therefore could influence the risk of surgical reinterventions. We investigated the effects of prophylactic intraoperative dexamethasone treatment on the rate of rethoracotomy after cardiac surgery.Methods. We performed a post-hoc additional data collection and analysis in the DECS trial. A total of 4,494 adult patients undergoing cardiac surgery with cardiopulmonary bypass were randomly assigned to intravenous dexamethasone (1.0 mg/kg) or placebo. The primary endpoint for the present study was the incidence of any rethoracotomy within the first 30 postoperative days. Secondary endpoints included the reason for rethoracotomy and the incidence of perioperative transfusion of blood products.Results. In the dexamethasone group, 217 patients (9.7%) underwent a rethoracotomy, and in the placebo group, 165 patients did (7.3%; relative risk 1.32, 95% confidence interval: 1.09 to 1.61, p = 0.005). The most common reason for rethoracotomy was tamponade in both groups: 3.9% versus 2.1%, respectively (relative risk 1.84, 95% confidence interval: 1.30 to 2.61, p Conclusions. Intraoperative high-dose dexamethasone administration in cardiac surgery was associated with an increased rethoracotomy risk. (C) 2015 by The Society of Thoracic Surgeons
- Published
- 2015
27. Guidelines for the Treatment of Preoperative Anaemia with Epoetin.
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Goodnough, L.T.
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ANEMIA treatment , *RECOMBINANT erythropoietin - Abstract
Recombinant human erythropoietin (epoetin) has been approved for use in patients undergoing autologous blood donation (ABD) in Japan, the European Union and Canada since 1993, 1994 and 1996 respectively, and for perisurgical adjuvant therapy without ABD in Canada and the US since 1996. Early clinical trials of epoetin therapy in the setting of ABD have provided important information with respect to clinical safety, dose and erythropoietic response. Later trials of perisurgical epoetin therapy without ABD provided data on efficacy (i.e. reduced allogeneic blood exposure) that led to approval of epoetin in this setting. However, the epoetin doses (300 U/kg subcutaneously × 14 days) used in these trials, and their subsequent inclusion in labelling for the use of this product, are costly to administer. A recent study has indicated that weekly administration of epoetin 600 U/kg over 4 weeks is just as effective but less costly than a daily regimen over 2 weeks. The most cost-effective regimen that has been shown to minimise allogeneic exposure is preoperative epoetin therapy with 600 U/kg/ week × 2 plus 300 U/kg on the day of surgery, coupled with acute normovolaemic haemodilution in patients undergoing radical retropubic prostatectomy. A similar regimen of epoetin therapy in patients undergoing coronary artery bypass grafting (2500 U/kg in divided doses over 2 weeks preoperatively) coupled with ‘blood pooling’, has also been described. ‘Low dose’ epoetin therapy coupled with acute normovolaemic haemodilution is cost-equivalent to the predonation of 3 autologous blood units, and may replace this strategy as a standard of care in the elective surgical setting. [ABSTRACT FROM AUTHOR]
- Published
- 1998
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28. Altered Major Histocompatibility Complex Proteins and Peptides for the Induction of Tolerance After Organ Transplantation.
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Chueh, C. and Kahan, B.D.
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HOMOGRAFTS , *MAJOR histocompatibility complex , *TRANSPLANTATION immunology - Abstract
Transplantation tolerance is defined as permanent acceptance of an allograft without the need for nonspecific immunosuppressants, which predispose patients to infectious and neoplastic complications. Our approach uses chemically modified antigenic proteins to modify the first signal that triggers allorecognition. The first signal, which is generated by the trimolecular interaction between the T cell receptor, the antigen-presenting major histocompatibility complex (MHC) protein and the antigenic peptide, is distinguished from a second signal that results from the co-stimulatory interactions between T lymphocytes and antigen-presenting cells and the third signal that results from the stimulatory effects of cytokines. Previous studies in animal models have utilised pretransplant inoculation of the recipient with various types of donor-type cells, such as erythrocyte, bone marrow, transfectant or transgenic cells, or extracted transplantation antigens, which have been prepared by sonication, autolysis/proteolysis, detergent treatment or salt (3 mol/L KCl) extraction, which appears to be the most efficient method. Antigens extracted from natural cells induce tolerance in animal models when administered in pretreatment regimens via the intrathymic route (in conjunction with T cell depletion) or via the intravenous route (after preconditioning by total lymphoid irradiation). Exposure to synthetic allopeptides representing sequences from the hypervariable or the constant regions of either class I or class II MHC molecules produces variable effects on in vivo and in vitro alloimmune reactions. In addition to the interactions between peptides and MHC proteins and/or T cell receptor sites, at least some peptides act by binding to receptors of the heat shock protein family, thereby increasing intracellular calcium concentrations without inducing co-stimulatory signals, and/or by interacting directly with unique surface receptors on natural killer cells. However, several factors intrinsic to peptides may limit their use for tolerance induction in vivo. First, peptides are rapidly cleared by non-immunological mechanisms from the circulation, requiring the use of large quantities. Second, peptides are unable to contact the host system in a fashion that reflects the immunogenicity/tolerogenicity of the epitope on the native molecules. Third, peptides are unable to be processed by antigen-presenting cells. Our approach to tolerance induction uses allochimaeric MHC proteins, which are constructed by engrafting selected donor-type tolerogenic epitopes onto host-type MHC molecular backbones. When delivered in rat models via the intrathymic, intraportal or oral gavage route, allochimaeric class I MHC molecules induce immunodominant responses, namely they overwhelm all other responses toward foreign epitopes. Although most peritransplant antigen treatment regimens require concomitant administration of subtherapeutic doses of nonspecific immunosuppressants, some constructs induce tolerance without adjunctive immunosuppressive therapy. One critical requirement for tolerance induction by allochimaeric MHC antigens is the presence of host rather than third-party flanking amino acid sequences. The allochimaeric sequences seem to steer the host response toward tolerance by directly binding to immune cell receptors that deliver a ‘self’ signal (T cell receptor hypothesis), by directing endosomal catheptic activity to yield tolerogenic rather than immunogenic peptides (peptide hypothesis), or by altering the interactions in the tri-molecular complex, thereby interfering with the usual participation of the MHC molecule on the antigen-presenting cell (supertolerogen hypothesis). [ABSTRACT FROM AUTHOR]
- Published
- 1998
- Full Text
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29. Conocimiento de los profesionales de enfermería sobre la normativa de transfusión de hemocomponentes
- Author
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Vargas, Zeidy Maria and Calderon Rios, Angie
- Subjects
knowledge ,profissionais-de-enfermagem ,blood-transfusion ,Conocimiento ,conhecimento ,nurse ,Transfusión ,transfusão-hemocomponente ,normativa ,hemocomponente ,profesionales enfermería - Abstract
This article is the first part of an investigation; the objective was to evaluate the knowledge and compliance of established regulations for the transfusion of blood components in a Class A Social Security hospital in Costa Rica by nurses. There was a population of 206 nurses working in the medical, surgical, gynecology, maternity, neurosurgery, medical, and surgical intensive care units. 124 participants stratified the sample. The research is quantitative, cross-sectional / retrospective. A self-administered instrument was used for data collection with the aspects of transfusion regulations; for data analysis the Surveymonkey system was used. The results showed that there is an important percentage of nurses who do not know basic aspects of the institutional regulations for blood transfusion. It is concluded that it is necessary to socialize the legislation, so as to offer safety to the user and nurses in the transfusion process. Este artículo es la primera parte de una investigación, el objetivo fue evaluar el conocimiento y cumplimiento de la normativa establecida para la transfusión de hemocomponentes en un hospital Clase A de la Seguridad Social en Costa Rica por parte de enfermeras (os). Se contó con una población de 206 enfermeras (os) que laboran en los servicios de medicina, cirugía, ginecología, maternidad, neurocirugía, unidad de cuidado intensivo médico y quirúrgico. La muestra fue estratificada de 124 participantes. La investigación es cuantitativa, transversal/retrospectivo. Se utilizó un instrumento autoadministrado para la recolección de datos con los aspectos de la normativa transfusional; para el análisis de datos se utilizó el sistema Surveymonkey. Los resultados evidenciaron que existe un porcentaje importante de enfermeras (os) que desconocen aspectos básicos de la normativa institucional para la transfusión sanguínea. Se concluye que es necesario socializar la normativa, de manera que se ofrezca seguridad al usuario y enfermeras (os) en el proceso transfusional. Este artigo é a primeira parte de uma investigação; o objetivo é avaliar o conhecimento e o cumprimento das normas estabelecidas para a transfusão de hemocomponentes em um hospital de Classe A da Previdência Social em Costa Rica por enfermeiras. Se cont com população de 206 profissionais de enfermagem que trabalhavam nos serviços de medicina, cirurgia, ginecologia, maternidade, neurocirurgia, unidade de terapia intensiva médica e cirúrgica. Uma amostra estratificada de 124 participantes foi obtida. A pesquisa é de abordagem quantitativa, transversal / retrospectiva. Utilizou-se um instrumento de coleta de dados autoadministrado com aspectos das normas de transfusão e a análise dos dados foi realizada com o sistema Surveymonkey. Os resultados mostraram que existe um percentual significativo de enfermeiras que desconhecem aspectos básicos dos regulamentos institucionais para a transfusão de hemocomponentes. Conclui-se que é necessário socializar os regulamentos, de forma a oferecer segurança ao usuário e aos enfermeiras no processo de transfusão.
- Published
- 2018
30. Multicentre study of the impact of factors that may affect long-term survival following pancreaticoduodenectomy for distal cholangiocarcinoma
- Author
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Laetitia Courtin-Tanguy, Laurent Sulpice, Jean Robert Delpero, Benjamin Darnis, Nicolas Regenet, Jean Yves Mabrut, Olivier Turrini, Damien Bergeat, Stéphanie Truant, Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre de Recherche en Cancérologie de Marseille (CRCM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), Alimentation Adaptations Digestives, Nerveuse et Comportementales (ADNC), Institut National de la Recherche Agronomique (INRA)-centre de rennes, CHU Pontchaillou [Rennes], Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer (JPArc - U837 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille 2 - Faculté de Médecine -Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre de Recherche en Cancérologie de Marseille ( CRCM ), Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Paoli-Calmettes-Aix Marseille Université ( AMU ), Alimentation Adaptations Digestives, Nerveuse et Comportementales ( ADNC ), Institut National de la Recherche Agronomique ( INRA ) -centre de rennes, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer (JPArc) - U1172 ( JPArc ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lille-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ), Institut Paoli Calmettes, Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre d'Investigation Clinique [Rennes] ( CIC ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille
- Subjects
Male ,Time Factors ,Blood transfusion ,Multivariate analysis ,Databases, Factual ,medicine.medical_treatment ,isgps definition ,030230 surgery ,Gastroenterology ,Cholangiocarcinoma ,0302 clinical medicine ,Risk Factors ,risk-factors ,Medical record ,Middle Aged ,Pancreaticoduodenectomy ,3. Good health ,030220 oncology & carcinogenesis ,Female ,France ,hemorrhage ,medicine.medical_specialty ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery ,prognostic-factors ,Disease-Free Survival ,Actuarial survival ,03 medical and health sciences ,Internal medicine ,Long term survival ,medicine ,Humans ,cancer ,Aged ,Retrospective Studies ,[ SDV ] Life Sciences [q-bio] ,Hepatology ,business.industry ,fungi ,Cancer ,Retrospective cohort study ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,medicine.disease ,blood-transfusion ,enhanced recovery ,Bile Duct Neoplasms ,surgery isgps ,business ,postoperative pancreatic fistula ,international study-group - Abstract
International audience; Background - Although the peri-operative mortality following pancreaticoduodenectomy (PD) for distal cholangiocarcinoma (DCC) has decreased, the post-operative morbidity remains high. The aim of this study was to evaluate the impact of factors that may affect the long term survival for patients with DCC following PD. Methods - All patients who underwent PD for DCC between January 2000 and December 2015 in 5 tertiary referral centers underwent retrospective medical record review. Factors likely to influence overall (OS) and disease-free (DFS) survivals were assessed by univariate and multivariate analysis. Results - A total of 201 on 217 patients who underwent PD for DCC were included for further analysis. The median OS was 39 months, with actuarial survival rates at 1, 3, and 5 years of 85%, 53% and 39%. Recurrence occurred in 123 (61%) patients. The median DFS was 16 months, with actuarial survival rates at 1, 3 and 5 years of 60%, 37% and 28%. Following multivariate analysis, peri-operative blood transfusions (PBT) were associated to worse OS (HR = 2.25 [1.31-3.85], P = 0.003) and DFS (HR = 2.08 [1.24-3.5], P = 0.005). Conclusion - This study confirms the negative impact of PBT on the oncologic result following PD for DCC.
- Published
- 2018
31. Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): a prospective, multicentre study in 69 neonatal intensive care units
- Author
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Bas, Ahmet Yagmur, Demirel, Nihal, Koc, Esin, Isik, Dilek Ulubas, Hirfanoglu, Ibrahim Murat, Tunc, Turan, Sari, Fatma Nur, Karatekin, Guner, Koklu, Esad, Altunhan, Huseyin, Turgut, Hatice, Narter, Fatma, Tarakci, Nuriye, Tekgunduz, Kadir Serafettin, Ozkiraz, Servet, Aydemir, Cumhur, Ozdemir, Ahmet, Cetinkaya, Bilin, Kazanci, Ebru, Tastekin, Ayhan, Calkavur, Sebnem, Ozyurt, Banu Mutlu, Demirelli, Yasar, Asker, Huseyin Selim, Mutlu, Birgul, Uygur, Ozgun, Ozkan, Hilal, Armangil, Didem, Ozlu, Ferda, Mert, Mustafa Kurthan, Ergin, Hacer, Ozcan, Beyza, Bas, Evrim Kiray, Okulu, Emel, Acunas, Betul, Celik, Ulker, Uslu, Sait Ilker, Mutlu, Mehmet, Demir, Nihat, Eroglu, Funda, Gokmen, Zeynel, Beken, Serdar, Bayraktar, Bilge Tanyeri, Hakan, Nilay, Kucuktasci, Kazim, Orman, Aysen, Comert, Serdar, Ertugrul, Sabahattin, Ustun, Nuran, Sahin, Ozlem, Terek, Demet, Kale, Yusuf, Konak, Murat, Yurttutan, Sadik, Aydemir, Ozge, Zenciroglu, Aysegul, Sarici, Dilek, Guzoglu, Nilufer, Hamilcikan, Sahin, Gursoy, Tugba, Tuzun, Funda, Ors, Rahmi, Arslan, Selda, Akdag, Arzu, Memisoglu, Asli, Yasa, Beril, Hekimoglu, Berna, Turan, Ozden, Aylanc, Hakan, Takci, Sahin, Celik, Tolga, Sahin, Suzan, Kilic, Ilknur, Kara, Caner, Tunay, Zuhal Ozen, Celik, Gokhan, Gozen, Ibrahim, Satirtav, Gunhal, Polat, Nihat, Oral, Ayse Yesim, Tokgoz, Mine, Keles, Sadullah, Bilgin, Burak, Ugurbas, Silay Canturk, Karaca, Cagatay, Keskek, Nedime Sahinoglu, Ekinci, Dilbade Yildiz, Balci, Ozlem, Altan, Emir Volkan, Bakbak, Sevda, Ceylan, Nihan Aksu, Kimyon, Sabit, Alyamac, Gunay, Ture, Gamze, Yildiz, Meral, Calis, Feyza, Sizmaz, Selcuk, Sukgen, Emine, Cetin, Ebru Nevin, Ozcimen, Muammer, Demir, Semra Tiryaki, Atila, Huban, Ozal, Altan, Tufaner, Gokhan, Yucel, Ozlem Eski, Kola, Mehmet, Seven, Erbil, Ozdek, Sengul, Durukan, Ali Hakan, Kal, Ali, Celebi, Ali Riza Cenk, Koytak, Ibrahim Arif, Alacamli, Goksu, Esme, Arif, Catak, Onur, Perente, Irfan, Sahin, Alparslan, Akcakaya, Aylin Ardagil, Kiray, Gulunay, Nalcaci, Serhat, Aksoy, Umit, Bakbak, Berker, Comez, Aysegul, Gursoy, Huseyin, Kabatas, Emrah Utku, Petricli, Ikbal Seza, Yumusak, Mehmet Erhan, Kirgiz, Ahmet, Uludag, Gunay, Yaman, Aylin, Dadaci, Zeynep, Karatas, Ali, Celiker, Hande, Cebeci, Zafer, Esenulku, Mahmut Cenap, Akkoyun, Imren, Ersan, Ismail, Demir, Selim, Kadayifcilar, Sibel, Unsal, Ayse Ipek Akyuz, Hocaoglu, Mumin, Grp, T. R.-R.O.P. Study, Ege Üniversitesi, Zonguldak Bülent Ecevit Üniversitesi, Çukurova Üniversitesi, Çocuk Sağlığı ve Hastalıkları, KOYTAK, İBRAHİM ARİF, Uludağ, Günay (ORCID & YÖK ID 175586), Gürsoy, Tuğba (ORCID 0000-0002-6084-4067 & YÖK ID 214691), Baş, Ahmet Yağmur, Demirel, Nihal, Koç, Esin, Işık, Dilek Ulubaş, Hirfanoğlu, İbrahim Murat, Tunç, Turan, Sarı, Fatma Nur, Karatekin, Güner, Köklü, Esad, Altunhan, Hüseyin, Turgut, Hatice, Narter, Fatma, Tarakçı, Nuriye, Tekgündüz, Kadir Şerafettin, Özkiraz, Servet, Aydemir, Cumhur, Özdemir, Ahmet, Çetinkaya, Bilin, Kazancı, Ebru, Taştekin, Ayhan, Calkavur, Şebnem, Özyurt, Banu Mutlu, Demirelli, Yaşar, Asker, Hüseyin Selim, Mutlu, Birgul, Uygur, Özgün, Özkan, Hilal, Armangil, Didem, Özlü, Ferda, Mert, Mustafa Kurthan, Ergin, Hacer, Özcan, Beyza, Baş, Evrim Kıray, Okulu, Emel, Acunas, Betül, Çelik, Ülker, Uslu, Sait İlker, Mutlu, Mehmet, Demir, Nihat, Eroğlu, Funda, Gökmen, Zeynel, Beken, Serdar, Bayraktar, Bilge Tanyeri, Hakan, Nilay, Küçüktaşçı, Kazım, Orman, Ayşen, Cömert, Serdar, Ertuğrul, Sabahattin, Üstün, Nuran, Şahin, Özlem, Terek, Demet, Kale, Yusuf, Konak, Murat, Yurttutan, Sadık, Aydemir, Özge, Zenciroğlu, Aysegül, Sarıcı, Dilek, Güzoğlu, Nilüfer, Hamilçıkan, Şahin, Tüzün, Funda, Örs, Rahmi, Arslan, Selda, Akdağ, Arzu, Memişoğlu, Aslı, Yasa, Beril, Hekimoğlu, Berna, Turan, Özden, Aylanc, Hakan, Takçı, Şahin, Çelik, Tolga, Şahin, Suzan, Kılıç, İlknur, Kara, Caner, Tunay, Zuhal Özen, Çelik, Gökhan, Gözen, İbrahim, Satırtav, Günhal, Polat, Nihat, Oral, Ayşe Yeşim, Tokgöz, Mine, Keleş, Sadullah, Bilgin, Burak, Uğurbaş, Silay Cantürk, Karaca, Çağatay, Keşkek, Nedime Şahinoğlu, Ekinci, Dilbade Yıldız, Balcı, Özlem, Altan, Emir Volkan, Bakbak, Sevda, Ceylan, Nihan Aksu, Kimyon, Sabit, Alyamaç, Günay, Türe, Gamze, Yıldız, Meral, Çalış, Feyza, Sızmaz, Selçuk, Sukgen, Emine, Çetin, Ebru Nevin, Özçimen, Muammer, Demir, Semra Tiryaki, Atila, Huban, Özal, Altan, Tufaner, Gökhan, Yücel, Özlem Eski, Kola, Mehmet, Seven, Erbil, Özdek, Şengül, Durukan, Ali Hakan, Kal, Ali, Çelebi, Ali Riza Cenk, Koytak, İbrahim Arif, Alaçamlı, Göksu, Esme, Arif, Çatak, Onur, Perente, İrfan, Şahin, Alparslan, Akçakaya, Aylin Ardagil, Kıray, Gülünay, Nalçacı, Serhat, Aksoy, Ümit, Bakbak, Berker, Çömez, Ayşegül, Gürsoy, Hüseyin, Kabataş, Emrah Utku, Petricli, İkbal Seza, Yumuşak, Mehmet Erhan, Kırgız, Ahmet, Yaman, Aylin, Dadacı, Zeynep, Karataş, Ali, Çeliker, Hande, Cebeci, Zafer, Esenülkü, Mahmut Cenap, Akkoyun, İmren, Ersan, İsmail, Demir, Selim, Kadayıfçılar, Sibel, Ünsal, Ayşe İpek Akyüz, Hocaoğlu, Mümin, School of Medicine, Department of Internal Medicine, MÜ, Kırıkkale Üniversitesi, Selçuk Üniversitesi, Bas, Ahmet Yagmur, Koc, Esin, Isik, Dilek Ulubas, Hirfanoglu, Ibrahim Murat, Tunc, Turan, Sari, Fatma Nur, Karatekin, Guner, Koklu, Esad, Altunhan, Huseyin, Tarakci, Nuriye, Tekgunduz, Kadir Serafettin, Ozkiraz, Servet, Ozdemir, Ahmet, Cetinkaya, Bilin, Kazanci, Ebru, Tastekin, Ayhan, Calkavur, Sebnem, Ozyurt, Banu Mutlu, Demirelli, Yasar, Asker, Huseyin Selim, Uygur, Ozgun, Ozkan, Hilal, Ozlu, Ferda, Ozcan, Beyza, Bas, Evrim Kiray, Acunas, Betul, Celik, Ulker, Uslu, Sait Ilker, Eroglu, Funda, Gokmen, Zeynel, Kucuktasci, Kazim, Orman, Aysen, Comert, Serdar, Ertugrul, Sabahattin, Ustun, Nuran, Sahin, Ozlem, Yurttutan, Sadik, Aydemir, Ozge, Zenciroglu, Aysegul, Sarici, Dilek, Guzoglu, Nilufer, Hamilcikan, Sahin, Gursoy, Tugba, Tuzun, Funda, Ors, Rahmi, Akdag, Arzu, Memisoglu, Asli, Hekimoglu, Berna, Turan, Ozden, Takci, Sahin, Celik, Tolga, Sahin, Suzan, Kilic, Ilknur, Tunay, Zuhal Ozen, Celik, Gokhan, Gozen, Ibrahim, Satirtav, Gunhal, Oral, Ayse Yesim, Tokgoz, Mine, Keles, Sadullah, Ugurbas, Silay Canturk, Karaca, Cagatay, Keskek, Nedime Sahinoglu, Ekinci, Dilbade Yildiz, Balci, Ozlem, Alyamac, Gunay, Ture, Gamze, Yildiz, Meral, Calis, Feyza, Sizmaz, Selcuk, Cetin, Ebru Nevin, Ozcimen, Muammer, Ozal, Altan, Tufaner, Gokhan, Yucel, Ozlem Eski, Ozdek, Sengul, Celebi, Ali Riza Cenk, Koytak, Ibrahim Arif, Alacamli, Goksu, Catak, Onur, Perente, Irfan, Sahin, Alparslan, Akcakaya, Aylin Ardagil, Kiray, Gulunay, Nalcaci, Serhat, Aksoy, Umit, Comez, Aysegul, Gursoy, Huseyin, Kabatas, Emrah Utku, Petricli, Ikbal Seza, Yumusak, Mehmet Erhan, Kirgiz, Ahmet, Uludag, Gunay, Dadaci, Zeynep, Karatas, Ali, Celiker, Hande, Esenulku, Mahmut Cenap, Akkoyun, Imren, Ersan, Ismail, Kadayifcilar, Sibel, Unsal, Ayse Ipek Akyuz, Hocaoglu, Mumin, OMÜ, Tıp Fakültesi, and Acibadem University Dspace
- Subjects
Male ,BLOOD-TRANSFUSION ,Pediatrics ,Turkey ,INFANTS ,Logistic regression ,0302 clinical medicine ,Risk Factors ,FOR-GESTATIONAL-AGE ,Prevalence ,Birth Weight ,Infant, Very Low Birth Weight ,Prospective Studies ,Prospective cohort study ,[Anahtar Kelime Yok] ,Neovascularisation ,Incidence ,Incidence (epidemiology) ,Gestational age ,Retinopathy of prematurity ,Clinical Science ,Sensory Systems ,Female ,Infant, Premature ,Child health (paediatrics) ,Retina ,Treatment medical ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Birth weight ,Gestational Age ,Sepsis ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Neonatal Screening ,Intensive Care Units, Neonatal ,030225 pediatrics ,Intensive care ,medicine ,Humans ,Retinopathy of Prematurity ,business.industry ,Child Health (paediatrics) ,Infant, Newborn ,[No Keywords] ,Infant ,medicine.disease ,eye diseases ,Ophthalmology ,For-Gestational-Age ,TR-ROP Study ,030221 ophthalmology & optometry ,Treatment Medical ,Blood-Transfusion ,WEIGHT ,Weight ,Infants ,Severity of Retinopathy ,business ,Medicine - Abstract
Background To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition., Methods A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)=1500 g or gestational age (GA) 1500 g or GA> 32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses., Results The TR-ROP study included 6115 infants: 4964 (81%) with a GA 32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW=1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW, Conclusions Screening of infants with a GA
- Published
- 2018
32. The impact of external donor support through the U.S. President's Emergency Plan for AIDS Relief on the cost of red cell concentrate in Namibia, 2004-2011
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COUNTRIES ,BLOOD-TRANSFUSION ,costing ,blood safety ,DONATIONS ,PEPFAR ,HEALTH ,SUB-SAHARAN AFRICA ,Namibia - Abstract
BACKGROUND: External assistance can rapidly strengthen health programmes in developing countries, but such funding can also create sustainability challenges. From 2004-2011, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) provided more than $8 million to the Blood Transfusion Service of Namibia (NAMBTS) for supplies, equipment, and staff salaries. This analysis describes the impact that support had on actual production costs and the unit prices charged for red cell concentrate (RCC) units issued to public sector hospitals.MATERIALS AND METHODS: A costing system developed by NAMBTS to set public sector RCC unit prices was used to describe production costs and unit prices during the period of PEPFAR scale-up (2004-2009) and the 2 years in which PEPFAR support began to decline (2010-2011). Hypothetical production costs were estimated to illustrate differences had PEPFAR support not been available.RESULTS: Between 2004-2006, NAMBTS sold 22,575 RCC units to public sector facilities. During this time, RCC unit prices exceeded per unit cost-recovery targets by between 40.3% (US$16.75 or N$109.86) and 168.3% (US$48.72 or N$333.28) per year. However, revenue surpluses dwindled between 2007 and 2011, the final year of the study period, when NAMBTS sold 20,382 RCC units to public facilities but lost US$23.31 (N$170.43) on each unit.DISCUSSION: PEPFAR support allowed NAMBTS to leverage domestic cost-recovery revenue to rapidly increase blood collections and the distribution of RCC. However, external support kept production costs lower than they would have been without PEPFAR. If PEPFAR funds had not been available, RCC prices would have needed to increase by 20% per year to have met annual cost-recovery targets and funded the same level of investments as were made with PEPFAR support. Tracking the subsidising influence of external support can help blood services make strategic investments and plan for unit price increases as external funds are withdrawn.
- Published
- 2015
33. Does a Platelet Transfusion Independently Affect Bleeding and Adverse Outcomes in Cardiac Surgery?
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Peter M. Rosseel, Esther K. Hogervorst, Fabienne M.A. van Hout, Eveline L. A. van Dorp, Nan van Geloven, Nardo J. M. van der Meer, Leo M.G. van de Watering, Anneke Brand, Mohamed Bentala, and Johanna G. van der Bom
- Subjects
Male ,medicine.medical_specialty ,BLOOD-TRANSFUSION ,Blood transfusion ,medicine.medical_treatment ,Hemorrhage ,RE-EXPLORATION ,Comorbidity ,Platelet Transfusion ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,ARTERY-BYPASS SURGERY ,MORBIDITY ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Intensive care ,Outcome Assessment, Health Care ,medicine ,Odds Ratio ,Humans ,030212 general & internal medicine ,Cardiac Surgical Procedures ,Propensity Score ,Aged ,Netherlands ,Retrospective Studies ,Mechanical ventilation ,RISK ,COMPLICATIONS ,Intraoperative Care ,CLINICAL-PRACTICE GUIDELINE ,ANTIPLATELET THERAPY ,business.industry ,MORTALITY ,Retrospective cohort study ,Odds ratio ,ASSOCIATION ,Middle Aged ,Surgery ,Cardiac surgery ,Anesthesiology and Pain Medicine ,Platelet transfusion ,Anesthesia ,Propensity score matching ,Female ,business - Abstract
Background Conflicting results have been reported concerning the effect of platelet transfusion on several outcomes. The aim of this study was to assess the independent effect of a single early intraoperative platelet transfusion on bleeding and adverse outcomes in cardiac surgery patients. Methods For this observational study, 23,860 cardiac surgery patients were analyzed. Patients who received one early (shortly after cardiopulmonary bypass while still in the operating room) platelet transfusion, and no other transfusions, were defined as the intervention group. By matching the intervention group 1:3 to patients who received no early transfusion with most comparable propensity scores, the reference group was identified. Results The intervention group comprised 169 patients and the reference group 507. No difference between the groups was observed concerning reinterventions, thromboembolic complications, infections, organ failure, and mortality. However, patients in the intervention group experienced less blood loss and required vasoactive medication 139 of 169 (82%) versus 370 of 507 (74%; odds ratio, 1.65; 95% CI, 1.05 to 2.58), prolonged mechanical ventilation 92 of 169 (54%) versus 226 of 507 (45%; odds ratio, 1.47; 94% CI, 1.03 to 2.11), prolonged intensive care 95 of 169 (56%) versus 240 of 507 (46%; odds ratio, 1.49; 95% CI, 1.04 to 2.12), erythrocytes 75 of 169 (44%) versus 145 of 507 (34%; odds ratio, 1.55; 95% CI, 1.08 to 2.23), plasma 29 of 169 (17%) versus 23 of 507 (7.3%; odds ratio, 2.63; 95% CI, 1.50–4.63), and platelets 72 of 169 (43%) versus 25 of 507 (4.3%; odds ratio, 16.4; 95% CI, 9.3–28.9) more often compared to the reference group. Conclusions In this retrospective analysis, cardiac surgery patients receiving platelet transfusion in the operating room experienced less blood loss and more often required vasoactive medication, prolonged ventilation, prolonged intensive care, and blood products postoperatively. However, early platelet transfusion was not associated with reinterventions, thromboembolic complications, infections, organ failure, or mortality.
- Published
- 2017
34. Rapid and Correct Prediction of Thrombocytopenia and Hypofibrinogenemia With Rotational Thromboelastometry in Cardiac Surgery
- Author
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Patty J. Nelemans, Rick J. H. Wetzels, Gerhardus J.A.J.M. Kuiper, Marcus D. Lancé, Yvonne M. C. Henskens, Erik A M Beckers, Rik H. G. Olde Engberink, ACS - Amsterdam Cardiovascular Sciences, Nephrology, Graduate School, RS: CAPHRI School for Public Health and Primary Care, RS: CARIM - R1 - Thrombosis and haemostasis, RS: GROW - Oncology, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, RS: CAPHRI - Clinical epidemiology, Fysiologie, Biochemie, Anesthesiologie, Intensive Care, MUMC+: DA CDL Algemeen (9), and Epidemiologie
- Subjects
Male ,BLOOD-TRANSFUSION ,medicine.medical_specialty ,hypofibrinogenemia ,COAGULATION ,thromboelastometry ,Fibrinogen ,THERAPY ,Cohort Studies ,HEMORRHAGE ,Hemoglobins ,Fibrinogen levels ,HEMODILUTION ,Predictive Value of Tests ,MANAGEMENT ,Humans ,Medicine ,Blood Transfusion ,Platelet ,Prospective Studies ,Cardiac Surgical Procedures ,Prospective cohort study ,TRAUMA ,Aged ,ROTEM ,Platelet Count ,business.industry ,Area under the curve ,Blood Coagulation Disorders ,Middle Aged ,Hypofibrinogenemia ,Afibrinogenemia ,Thrombocytopenia ,Thrombelastography ,Cardiac surgery ,REPLACEMENT ,Thromboelastometry ,laboratory time ,Anesthesiology and Pain Medicine ,FIBRINOGEN LEVELS ,ROC Curve ,Area Under Curve ,Anesthesia ,Female ,Cardiology and Cardiovascular Medicine ,business ,cardiac surgery ,medicine.drug - Abstract
Objectives: In the present study, the authors have investigated whether rotational thromboelastometry (ROTEM) could predict thrombocytopenia and hypofibrinogenemia in cardiac surgery using the clot amplitude after 5 minutes (A5). Another parameter, PLTEM, in which the contribution of fibrinogen is eliminated by subtracting a fibrin-specific ROTEM test (FIBTEM) from an extrinsically-activated ROTEM test (EXTEM), was investigated. Furthermore, the turnaround time of ROTEM was compared to conventional laboratory tests.Design: Prospective cohort study.Setting: Single academic medical center.Participants: Ninety-seven patients undergoing cardiac surgery between July 2011 until August 2012.Interventions: The correlations between EXTEM/FIBTEM A5, A10, and maximal clot formation (MCF), EXTEM/PLTEM (A5/A10, and MCF) and platelet count, and FIBTEM (A5/A10, and MCF) and fibrinogen were evaluated using the Pearson's correlation coefficient and receiver-operating characteristic curves. Turnaround times of ROTEM tests and conventional laboratory tests were assessed in the central laboratory.Measurements and Main Results: EXTEM AS and FIBTEM A5 showed an excellent correlation with A10 (R:0.99/1.00) and MCF (R:0.97/0.99). The correlation between EXTEM AS and platelet count (R:0.74) was comparable with the correlation of A10 (R:0.73) and MCF (R:0.70) with platelet count. FIBTEM AS predicted fibrinogen levels (R:0.87) as well as A10 (R:0.86) and MCF (R:0.87). PLTEM AS (R:0.85) correlated better with platelet count than EXTEM A5 (R:0.74; p = 0.04) and showed significantly better area under the curve values than EXTEM for predicting thrombocytopenia (A5 p = 0.012, A10 p = 0.019). Turnaround time for ROTEM tests, 12 minutes, was comparable with emergency requests for platelet count, 13 minutes, and shorter than emergency requests for fibrinogen levels, 37 minutes.Conclusions: Implementation of PLTEM and FIBTEM AS in ROTEM-guided transfusion protocols may improve transfusion management.
- Published
- 2014
35. Modelling the risk of transfusion transmission from travelling donors
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Welling Oei, Mart P. Janssen, Tonderai Mapako, Marinus van Hulst, and Mirjam Kretzschmar
- Subjects
Emerging infectious diseases ,BLOOD-TRANSFUSION ,IMPACT ,NETHERLANDS ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Communicable Diseases, Emerging ,Disease Outbreaks ,Dengue fever ,law.invention ,0302 clinical medicine ,law ,INFECTION ,Medicine ,030212 general & internal medicine ,Chikungunya ,Non-U.S. Gov't ,Travel ,Research Support, Non-U.S. Gov't ,Blood transfusion ,3. Good health ,Infectious Diseases ,Transmission (mechanics) ,Italy ,Transmission risk ,Travellers’ risk ,Medical emergency ,Q Fever ,Risk assessment ,Travellers' risk ,Research Article ,DENGUE ,Q fever ,Risk management tools ,Research Support ,Risk Assessment ,Q-FEVER ,03 medical and health sciences ,MALARIA ,Journal Article ,Humans ,Estimation ,business.industry ,Outbreak ,Models, Theoretical ,medicine.disease ,DEFERRALS ,Immunology ,Chikungunya Fever ,business - Abstract
Background The EUFRAT (European Up-Front Risk Assessment Tool) was developed as an online risk assessment tool (http://eufrattool.ecdc.europa.eu) to help decision-makers assess the transmission risk of emerging infectious diseases (EID) through blood transfusion. The aim of this study is to extend the methodology developed in the EUFRAT project to quantify the transfusion transmission (TT) risk from travelling donors. Methods A generic model for estimating the TT risk from a group of travelling donors that visited an EID risk area was developed. In addition, the new model distinguishes projected future transmissions from those that have already occurred. As an illustration the model was applied to the outbreaks of chikungunya in Italy in 2007 and Q fever in the Netherlands in 2007–2009. Results Formulas for calculating the travelling donors’ TT risk were derived. For the chikungunya outbreak in Italy an early intervention (at the end of week 7 after the start of the outbreak, so after only 19 % of all cases) would have been required to prevent only 41 % of all expected transmissions at that time. For Q fever, in which the transmission of chronic Q fever is considered, even at the end of the third annual outbreak’s peak 47 % of all (chronic) Q fever transmissions could still be prevented. Conclusions The updated model allows estimation of the infection transmission risk from travelling donors. In combination with the distinction between past and future transmissions, these estimates provide valuable information to support decisions concerning communication with the public and/or the implementation of safety interventions. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1452-z) contains supplementary material, which is available to authorized users.
- Published
- 2016
36. The Effects of Host Age on the Transport of Complement-Bound Complexes to the Spleen and the Pathogenesis of Intravenous Scrapie Infection
- Author
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Karen L. Brown, Neil A. Mabbott, Anton Gossner, and Simon W. F. Mok
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Male ,BLOOD-TRANSFUSION ,Aging ,FOLLICULAR DENDRITIC CELLS ,PrPSc Proteins ,CREUTZFELDT-JAKOB-DISEASE ,animal diseases ,Scrapie ,SUSCEPTIBILITY ,Pathogenesis ,Mice ,0302 clinical medicine ,Aged, 80 and over ,Mice, Knockout ,0303 health sciences ,education.field_of_study ,Transmissible spongiform encephalopathy ,Age Factors ,Marginal zone ,LYMPHORETICULAR PRION PROTEIN ,3. Good health ,medicine.anatomical_structure ,Host-Pathogen Interactions ,Female ,ZONE B-CELLS ,MARGINAL-ZONE ,Prions ,Immunology ,Population ,Spleen ,Biology ,Microbiology ,03 medical and health sciences ,Immune system ,Virology ,medicine ,Animals ,Humans ,TONSIL SPECIMENS ,education ,030304 developmental biology ,Follicular dendritic cells ,Biological Transport ,Complement System Proteins ,medicine.disease ,nervous system diseases ,Mice, Inbred C57BL ,MICE ,Disease Models, Animal ,Insect Science ,LYMPHOID-TISSUES ,Dendritic Cells, Follicular ,030215 immunology - Abstract
Infections with variant Creutzfeldt-Jakob disease (vCJD) have almost exclusively occurred in young patients, but the reasons for this age distribution are uncertain. Our data suggest that the pathogenesis of many peripherally acquired transmissible spongiform encephalopathy (TSE) agents is less efficient in aged individuals. Four vCJD cases linked to transfusion of vCJD-contaminated blood or blood products have been described. Three cases occurred in elderly patients, implying that intravenous exposure is more efficient in aged individuals than other peripheral routes. To test this hypothesis, young (6 to 8 weeks old) and aged (600 days old) mice were injected intravenously with a TSE agent. In aged and young mice, the intravenous route was more efficient than other peripheral routes of TSE agent exposure. However, in aged mice, disease pathogenesis was significantly reduced. Although most aged mice failed to develop clinical disease during their life spans, many showed histopathological signs of TSE disease in their brains. Thus, the effects of age on intravenous TSE pathogenesis may lead to significant levels of subclinical disease in the population. After peripheral exposure, many TSE agents accumulate upon follicular dendritic cells (FDCs) in lymphoid tissues before they infect the brain. In aged spleens, PrP C expression and TSE agent accumulation upon FDCs were reduced. Furthermore, the splenic marginal zone microarchitecture was substantially disturbed, adversely affecting the delivery of immune complexes to FDCs. This study is the first to suggest that the effects of aging on the microarchitecture and the function of the splenic marginal zone significantly influence the pathogenesis of an important pathogen.
- Published
- 2012
37. Sustained postoperative anaemia is associated with an impaired outcome after coronary artery bypass graft surgery
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Jan G.P. Tijssen, Rudolf A. de Boer, Imagine Investigators, Richard Baillot, Lennaert Kleijn, B. Daan Westenbrink, Jean L. Rouleau, Wiek H. van Gilst, W. Warnica, Cardiovascular Centre (CVC), Amsterdam Cardiovascular Sciences, and Cardiology
- Subjects
Male ,medicine.medical_specialty ,BLOOD-TRANSFUSION ,Time Factors ,Angiotensin-Converting Enzyme Inhibitors ,Kaplan-Meier Estimate ,CONVERTING ENZYME-INHIBITOR ,Risk Assessment ,Hemoglobins ,Risk Factors ,RISK-FACTOR ,Tetrahydroisoquinolines ,Internal medicine ,medicine ,Humans ,Outpatient clinic ,Coronary Artery Bypass ,Risk factor ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Chi-Square Distribution ,Ejection fraction ,Interventional cardiology ,business.industry ,Incidence (epidemiology) ,MORTALITY ,Quinapril ,Anemia ,Middle Aged ,CHRONIC HEART-FAILURE ,Cardiac surgery ,Surgery ,Logistic Models ,Treatment Outcome ,Cardiovascular Diseases ,Cardiothoracic surgery ,Cardiology ,SURVIVAL ,Female ,HEMATOCRIT ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,medicine.drug ,CARDIAC-SURGERY - Abstract
Objective To investigate the association between sustained postoperative anaemia and outcome after coronary artery bypass graft (CABG) surgery.Design Retrospective analysis of the IMAGINE trial, which tested the effect of the ACE inhibitor quinapril on cardiovascular events after CABG.Setting Thoracic surgery clinic/outpatient department.Patients 2553 stable patients with left ventricular ejection fraction >40% 2-7 days after scheduled CABG.Interventions Randomisation to quinapril or placebo.Main outcome measures Cox regression analysis for the association between postoperative anaemia and cardiovascular events and the effect of quinapril on the incidence of anaemia.Results Postoperative anaemia was sustained for >50 days in 44% of patients. Sustained postoperative anaemia was associated with an increased incidence of cardiovascular events during the first 3 months (adjusted HR (adjHR) 1.77, 95% CI 1.10 to 2.85, p=0.012) and during the maximum follow-up of 43 months (adjHR 1.37, 95% CI 1.14 to 1.65, p=0.008). When haemoglobin (Hb) was considered as a continuous variable, every 1 mg/dl decrease in Hb was associated with a 13% increase in cardiovascular events (adjHR 0.87, 95% CI 0.81 to 0.95, p=0.003) and a 22% increase in all-cause mortality (adjHR 0.78, 95% CI 0.60 to 0.99, p=0.034). Quinapril was associated with a slower postoperative recovery of Hb levels and a higher incidence of cardiovascular events in patients with anaemia (adjHR 1.60, 95% CI 1.1 to 2.4, p=0.024).Conclusions Postoperative anaemia is common, frequently persists for months after CABG surgery and is associated with an impaired outcome. In patients with anaemia, ACE inhibitors slowed recovery from postoperative anaemia and increased the incidence of cardiovascular events after CABG.
- Published
- 2011
38. Microcebus murinus retina: A new model to assess prion-related neurotoxicity in primates
- Author
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Valérie Forster, Guy Lenaers, Joan Torrent, Carl Arndt, Chadi Soukkarieh, Nadine Mestre-Francés, Serge Picaud, Jean-Michel Verdier, Mécanismes moléculaires dans les démences neurodégénératives (MMDN), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)
- Subjects
BLOOD-TRANSFUSION ,CREUTZFELDT-JAKOB-DISEASE ,[SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology ,chemistry.chemical_compound ,0302 clinical medicine ,Cells, Cultured ,PEPTIDE PRP106-126 ,Neurons ,0303 health sciences ,biology ,Cell Death ,PROTEIN-FRAGMENT ,ALZHEIMERS-DISEASE ,medicine.anatomical_structure ,Parvalbumins ,Neurology ,IMMUNOCYTOCHEMICAL ANALYSIS ,Prion ,Neurotoxicity Syndromes ,Cheirogaleidae ,Amyloid fibril ,ADULT HUMAN ,Rhodopsin ,Microcebus murinus ,Prions ,Central nervous system ,BOVINE SPONGIFORM ENCEPHALOPATHY ,Retina ,lcsh:RC321-571 ,03 medical and health sciences ,Microscopy, Electron, Transmission ,In vivo ,Glial Fibrillary Acidic Protein ,medicine ,In Situ Nick-End Labeling ,Neurotoxicity ,Animals ,Vimentin ,CELL-TYPES ,Ganglion cell layer ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,030304 developmental biology ,Analysis of Variance ,Primate ,Retinal ,IN-VITRO ,biology.organism_classification ,medicine.disease ,Peptide Fragments ,Disease Models, Animal ,chemistry ,Apoptosis ,sense organs ,Neuroscience ,030217 neurology & neurosurgery - Abstract
No effective treatment currently exists for prion diseases and therefore the development of experimental non-human primate models of prion neurotoxicity, to better understand the underlying mechanism and to test new treatments relevant to humans, represents an urgent medical need. However, the establishment of such models is challenging due to animal welfare and cost considerations. We describe here the use of Microcebus murinus retina, in primary cultures and in vivo, as a new experimental primate model to rapidly examine the effects in the central nervous system of PrP106-126, a neurotoxic fragment of the human prion protein. We demonstrate that PrP106-126 triggered rod photoreceptor cell loss by apoptosis and a change in morphology of microglial cells in mixed neuronal-glial cultures of retinal cells. In addition, 2 days after intravitreal injection of PrP106-126, retinas showed a significant increase in the number of apoptotic nuclei, mainly in the ganglion cell layer. (C) 2010 Elsevier Inc. All rights reserved.
- Published
- 2010
39. Neonatal transfusions
- Author
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H. V. New, S. J. Stanworth, C. P. Engelfriet, H. W. Reesink, Z. K. McQuilten, H. F. Savoia, E. M. Wood, S. Olyntho, F. Trigo, S. Wendel, Y. Lin, H. Hume, J. Petäjä, T. Krusius, S. Villa, S. Ghirardello, J. von Lindern, A. Brand, J. E. Hendrickson, C. D. Josephson, R. G. Strauss, N. L. C. Luban, W. Paul, Other departments, Gastroenterology and Hepatology, and University of Groningen
- Subjects
BIRTH-WEIGHT INFANTS ,BLOOD-TRANSFUSION ,Blood Safety ,Graft vs Host Disease ,Blood Component Transfusion ,Global Health ,CONTROLLED-TRIAL ,GUIDELINES ,Infant, Newborn, Diseases ,Directed Tissue Donation ,PRETERM INFANTS ,VERSUS-HOST-DISEASE ,Humans ,Blood Transfusion ,ANEMIA ,PREMATURE-INFANTS ,Risk Management ,Australia ,Infant, Newborn ,Transfusion Reaction ,Hematology ,General Medicine ,HEMOLYTIC-DISEASE ,United States ,Europe ,Hematocrit ,Practice Guidelines as Topic ,Intensive Care, Neonatal ,Virus Inactivation ,GAMMA-IRRADIATION - Published
- 2009
40. Severe Anemia in Malawian Children
- Author
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Paul J.M. Hulshof, Malcolm E. Molyneux, Kirk A. Rockett, Imelda Bates, J. C. J. Calis, Anna Richardson, Kamija S. Phiri, Dominic P. Kwiatkowski, E. Brian Faragher, Ajib I Phiri, Michael Boele van Hensbroek, Marcel G.H.M. Beld, Luis E. Cuevas, Rob J de Haan, Lisette van Lieshout, Yik Y Teo, Mirriam Khoka, Bernard J. Brabin, Pelani Malange, AII - Amsterdam institute for Infection and Immunity, General Paediatrics, Paediatric Infectious Diseases / Rheumatology / Immunology, APH - Amsterdam Public Health, Clinical Research Unit, Medical Microbiology and Infection Prevention, Paediatric Intensive Care, Other departments, Nursing, and Global Health
- Subjects
Male ,Malawi ,vitamin-a supplementation ,Pediatrics ,Bacteremia ,HIV Infections ,Severity of Illness Index ,hemic and lymphatic diseases ,Odds Ratio ,iron status ,education.field_of_study ,Anemia, Iron-Deficiency ,Anemia ,General Medicine ,Nutrition Disorders ,Causality ,young-children ,Child, Preschool ,severe malaria ,Female ,medicine.medical_specialty ,Population ,ancylostoma-duodenale ,macromolecular substances ,Glucosephosphate Dehydrogenase ,Hookworm Infections ,northern ghana ,Severity of illness ,medicine ,Humans ,salmonella bacteremia ,Vitamin B12 ,education ,VLAG ,Global Nutrition ,Wereldvoeding ,business.industry ,Case-control study ,Infant ,necator-americanus ,Odds ratio ,blood-transfusion ,medicine.disease ,Confidence interval ,Malaria ,Vitamin A deficiency ,Case-Control Studies ,Multivariate Analysis ,Research Article (New England Journal of Medicine) ,plasmodium-falciparum ,business - Abstract
Background Severe anemia is a major cause of sickness and death in African children, yet the causes of anemia in this population have been inadequately studied. Methods We conducted a case-control study of 381 preschool children with severe anemia (hemoglobin concentration
- Published
- 2008
41. The impact of external donor support through the U.S. President's Emergency Plan for AIDS Relief on the cost of red cell concentrate in Namibia, 2004-2011
- Author
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Pitman, John P., Bocking, Adele, Wilkinson, Robert, Postma, Maarten J., Basavaraju, Sridhar V., von Finckenstein, Bjorn, Mataranyika, Mary, Marfin, Anthony A., Lowrance, David W., Sibinga, Cees Th. Smit, Microbes in Health and Disease (MHD), Methods in Medicines evaluation & Outcomes research (M2O), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Value, Affordability and Sustainability (VALUE)
- Subjects
Male ,COUNTRIES ,Acquired Immunodeficiency Syndrome ,BLOOD-TRANSFUSION ,Erythrocytes ,Databases, Factual ,costing ,DONATIONS ,Blood Donors ,PEPFAR ,Namibia ,blood safety ,Costs and Cost Analysis ,Financial Support ,Humans ,Original Article ,Female ,HEALTH ,Erythrocyte Transfusion ,SUB-SAHARAN AFRICA - Abstract
BACKGROUND: External assistance can rapidly strengthen health programmes in developing countries, but such funding can also create sustainability challenges. From 2004-2011, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) provided more than $8 million to the Blood Transfusion Service of Namibia (NAMBTS) for supplies, equipment, and staff salaries. This analysis describes the impact that support had on actual production costs and the unit prices charged for red cell concentrate (RCC) units issued to public sector hospitals. MATERIALS AND METHODS: A costing system developed by NAMBTS to set public sector RCC unit prices was used to describe production costs and unit prices during the period of PEPFAR scale-up (2004-2009) and the 2 years in which PEPFAR support began to decline (2010-2011). Hypothetical production costs were estimated to illustrate differences had PEPFAR support not been available. RESULTS: Between 2004-2006, NAMBTS sold 22,575 RCC units to public sector facilities. During this time, RCC unit prices exceeded per unit cost-recovery targets by between 40.3% (US$16.75 or N$109.86) and 168.3% (US$48.72 or N$333.28) per year. However, revenue surpluses dwindled between 2007 and 2011, the final year of the study period, when NAMBTS sold 20,382 RCC units to public facilities but lost US$23.31 (N$170.43) on each unit. DISCUSSION: PEPFAR support allowed NAMBTS to leverage domestic cost-recovery revenue to rapidly increase blood collections and the distribution of RCC. However, external support kept production costs lower than they would have been without PEPFAR. If PEPFAR funds had not been available, RCC prices would have needed to increase by 20% per year to have met annual cost-recovery targets and funded the same level of investments as were made with PEPFAR support. Tracking the subsidising influence of external support can help blood services make strategic investments and plan for unit price increases as external funds are withdrawn.
- Published
- 2015
42. Erythropoietin in traumatic brain injury : study protocol for a randomised controlled trial
- Author
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Samir Haddad, Rinaldo Bellomo, Alistair Nichol, Olivier Huet, Lorraine Little, Markus B. Skrifvars, Craig French, Yaseen M. Arabi, Jacques Duranteau, Jeffrey J. Presneill, D. James Cooper, and Department of Diagnostics and Therapeutics
- Subjects
Adult ,medicine.medical_specialty ,BLOOD-TRANSFUSION ,Adolescent ,Traumatic brain injury ,education ,Medicine (miscellaneous) ,Randomised controlled trials ,law.invention ,Study Protocol ,Randomized controlled trial ,Quality of life ,Clinical Protocols ,GLASGOW OUTCOME SCALE ,law ,QUALITY-OF-LIFE ,Thromboembolism ,Outcome Assessment, Health Care ,medicine ,Humans ,Pharmacology (medical) ,ANEMIA ,Intensive care medicine ,Erythropoietin ,Cause of death ,Aged ,Outcome ,EPOETIN-ALPHA ,business.industry ,Glasgow Outcome Scale ,Head injury ,HEAD-INJURY ,Ultrasonography, Doppler ,Middle Aged ,RECOMBINANT-HUMAN-ERYTHROPOIETIN ,medicine.disease ,EFFICACY ,3126 Surgery, anesthesiology, intensive care, radiology ,3. Good health ,Critical care ,Brain Injuries ,Data Interpretation, Statistical ,Sample Size ,Cohort ,business ,CRITICALLY-ILL PATIENTS ,medicine.drug - Abstract
Background Traumatic brain injury is a leading cause of death and disability worldwide. Laboratory and clinical studies demonstrate a possible beneficial effect of erythropoietin in improving outcomes in the traumatic brain injury cohort. However, there are concerns regarding the association of erythropoietin and thrombosis in the critically ill. A large-scale, multi-centre, blinded, parallel-group, placebo-controlled, randomised trial is currently underway to address this hypothesis. Methods/design The erythropoietin in traumatic brain injury trial is a stratified prospective, multi-centre, randomised, blinded, parallel-group, placebo-controlled phase III trial. It aims to determine whether the administration of erythropoietin compared to placebo improves neurological outcome in patients with moderate or severe traumatic brain injury at six months after injury. The trial is designed to recruit 606 patients between 15 and 65 years of age with severe (Glasgow Coma Score: 3 to 8) or moderate (Glasgow Coma Score: 9 to 12) traumatic brain injury in Australia, New Zealand, Kingdom of Saudi Arabia, France, Finland, Germany and Ireland. Trial patients will receive either subcutaneous erythropoietin or placebo within 24 hours of injury, and weekly thereafter for up to three doses during the intensive care unit admission. The primary outcome will be the combined proportion of unfavourable neurological outcomes at six months: severe disability or death. Secondary outcomes will include the rate of proximal deep venous thrombosis detected by compression Doppler ultrasound, six-month mortality, the proportion of patients with composite vascular events (deep venous thrombosis, pulmonary embolism, myocardial infarction, cardiac arrest and cerebrovascular events) at six months and quality of life with health economic evaluations. Discussion When completed, the trial aims to provide evidence on the efficacy and safety of erythropoietin in traumatic brain injury patients, and to provide clear guidance for clinicians in their management of this devastating condition. Trial registration Australian New Zealand Clinical Trials registry: ACTRN12609000827235 (registered on 22 September 2009). Clinicaltrials.gov: NCT00987454 (registered on 29 September 2009). European Drug Regulatory Authorities Clinical Trials: 2011-005235-22 (registered on 18 January 2012). Electronic supplementary material The online version of this article (doi:10.1186/s13063-014-0528-6) contains supplementary material, which is available to authorized users.
- Published
- 2015
43. Automated erythrocytapheresis in severe falciparum malaria: A critical appraisal
- Author
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Jan G. Zijlstra, Jellie Nieuwenhuis, John H. J. M. Meertens, Jack J. M. Ligtenberg, Tjip S. van der Werf, and Jaap E. Tulleken
- Subjects
Erythrocytapheresis ,BLOOD-TRANSFUSION ,medicine.medical_specialty ,Erythrocytes ,Blood transfusion ,Veterinary (miscellaneous) ,medicine.medical_treatment ,EXCHANGE-TRANSFUSION ,Exchange Transfusion, Whole Blood ,automated erythrocytapheresis ,Salvage therapy ,Exchange transfusion ,HYPERPARASITEMIA ,CELL EXCHANGE ,Intensive care ,parasitic diseases ,medicine ,Humans ,Malaria, Falciparum ,Intensive care medicine ,CEREBRAL MALARIA ,ADJUNCT ,biology ,business.industry ,Plasmodium falciparum ,medicine.disease ,biology.organism_classification ,exchange transfusion ,Surgery ,critical care ,Infectious Diseases ,Cerebral Malaria ,Insect Science ,falciparum malaria ,Parasitology ,business ,Malaria - Abstract
Imported falciparum malaria is increasing in Western countries. In patients with severe disease, exchange transfusion has been added to antimalarial and conventional supportive therapy to increase removal of parasitized erythrocytes, but hemodynamic compromise limits its use; automated erythrocytapheresis may be advantageous. We review published reports of patients with severe falciparum malaria treated by automated erythrocytapheresis combined with standard therapy and add three more cases to the literature. No studies have been conducted to evaluate its clinical efficacy, and this adjunct therapy should therefore be considered as salvage therapy. Apheresis of red cells appears feasible, safe and effective in rapidly reducing parasite count. (c) 2006 Elsevier B.V. All rights reserved.
- Published
- 2006
44. Automated erythrocytapheresis in severe falciparum malaria
- Subjects
critical care ,BLOOD-TRANSFUSION ,CELL EXCHANGE ,ADJUNCT ,EXCHANGE-TRANSFUSION ,falciparum malaria ,automated erythrocytapheresis ,HYPERPARASITEMIA ,exchange transfusion ,CEREBRAL MALARIA - Abstract
Imported falciparum malaria is increasing in Western countries. In patients with severe disease, exchange transfusion has been added to antimalarial and conventional supportive therapy to increase removal of parasitized erythrocytes, but hemodynamic compromise limits its use; automated erythrocytapheresis may be advantageous. We review published reports of patients with severe falciparum malaria treated by automated erythrocytapheresis combined with standard therapy and add three more cases to the literature. No studies have been conducted to evaluate its clinical efficacy, and this adjunct therapy should therefore be considered as salvage therapy. Apheresis of red cells appears feasible, safe and effective in rapidly reducing parasite count. (c) 2006 Elsevier B.V. All rights reserved.
- Published
- 2006
45. Safety and efficacy of a single bolus administration of recombinant factor VIIa in liver transplantation due to chronic liver disease
- Author
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Robert J. Porte, Giuliano Testa, Sukru Emre, Helena Isoniemi, Elisabeth Erhardtsen, Raymond M. Planinsic, Goran B. Klintmalm, Luis Grande, Jan van der Meer, Angel Candela, Peter Billeskov Schelde, R. Mark Ghobrial, Faculteit Medische Wetenschappen/UMCG, and Groningen Institute for Organ Transplantation (GIOT)
- Subjects
Adult ,Male ,BLOOD-TRANSFUSION ,Blood transfusion ,medicine.medical_treatment ,APROTININ ,COAGULATION ,Hemorrhage ,Factor VIIa ,Liver transplantation ,Chronic liver disease ,Placebo ,Drug Administration Schedule ,Liver disease ,Double-Blind Method ,Preoperative Care ,medicine ,Humans ,HEMOSTASIS ,Adverse effect ,Transplantation ,Hepatology ,biology ,Dose-Response Relationship, Drug ,business.industry ,Factor VII ,Middle Aged ,medicine.disease ,Recombinant Proteins ,Liver Transplantation ,Treatment Outcome ,surgical procedures, operative ,TRANSFUSION REQUIREMENTS ,TISSUE FACTOR ,Recombinant factor VIIa ,Anesthesia ,Hemostasis ,Chronic Disease ,biology.protein ,Surgery ,Female ,TRIAL ,business ,Erythrocyte Transfusion ,Liver Failure - Abstract
Orthotopic liver transplantation (OLT) can be associated with excessive blood loss. As a result, there may be increased risk of adverse outcomes. Activated recombinant factor VII (rFVIIa) has demonstrated the ability to improve hemostasis in a variety of disorders; however, there has been a limited amount of research into its use in OLT. The purpose of this dose-finding study was to examine the efficacy and safety of rFVIIa in the reduction of bleeding in patients undergoing OLT. In this double-blind trial, patients with end-stage liver disease scheduled for OLT were randomized to 1 of 4 parallel study groups. They received a single intravenous bolus of rFVIIa (20, 40, or 80 μg/kg) or placebo prior to surgery. The primary assessment endpoint was the total number of red blood cell (RBC) units transfused perioperatively. Safety was evaluated by adverse events reported. Eighty-three comparable patients were randomized to receive study product, with 82 ultimately undergoing OLT. There were no significant differences in required RBC units between the placebo and rFVIIa study groups. The number of adverse events was comparable between study groups. In conclusion, rFVIIa has a good safety profile in patients undergoing OLT. However, the doses studied did not have any effect on the number of RBC transfusions required. (Liver Transpl 2005;11:895–900.)
- Published
- 2005
46. Hemoglobin levels and 30-day mortality in patients after myocardial infarction
- Subjects
RISK ,BLOOD-TRANSFUSION ,myocardial infarction ,CARDIOVASCULAR-DISEASE ,30-day mortality ,CORONARY STENOSIS ,CRITICALLY ILL PATIENTS ,TRIAL ,hemoglobin ,ANEMIA ,HEMATOCRIT ,CHRONIC HEART-FAILURE ,ERYTHROPOIETIN - Abstract
Background: Anemia is an independent risk factor for cardiovascular (CV) outcomes in patients with coronary artery disease and heart failure. However, the effect of hemoglobin levels on short-term CV mortality in patients with acute myocardial infarction (MI) remains unclear.Methods: In a retrospective study we analyzed 1841 consecutive patients admitted with the diagnosis of acute MI. The primary end-point of the study was 30-day mortality. Patients were categorized according to the hemoglobin level on admission (10 g/dl or less, or greater than 10 g/dl).Results: The overall 30-day mortality was 10.3%. The mortality was 21.6% in patients with hemoglobin levels on admission 10 g/dl (p Conclusions: Lower levels of hemoglobin are associated with higher short-term mortality in patients with acute MI. Specific therapeutic strategies in anemic patients with MI should be further considered. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
- Published
- 2005
47. Bovine spongiform encephalopathy in sheep?
- Subjects
great-britain ,scrapie-associated fibrils ,animal diseases ,prp accumulation ,blood-transfusion ,strain variation ,Centraal Instituut voor DierziekteControle - Lelystad ,nervous system diseases ,Central Institute for Animal Disease Control ,infected sheep ,abnormal prion protein ,molecular analysis ,natural scrapie ,creutzfeldt-jakob-disease - Abstract
Bovine spongiform encephalopathy (BSE) in sheep has not been identified under natural conditions at the time of writing and remains a hypothetical issue. However, rumours about the possible finding of a BSE-like isolate in sheep have led to great unrest within the sheep industry, among the general public and within governmental and regulatory bodies. The difficulties of implementing a proper risk assessment and pre-emptive measures, in the absence of a confirmed case, are described. The authors attempt to list what is known about experimental BSE in sheep, the distribution of infectivity in the host, some aspects of risk assessment and management and the most promising methods for differentiating BSE from scrapie in the same host. As for the latter, new and promising methods are being developed and appear suitable for initial screening of isolates of transmissible spongiform encephalopathies, but in the absence of proper validation, use of the 'classical' strain-typing in a mouse panel is still indicated.
- Published
- 2003
48. Clinical trial on the effect of tranexamic acid on bleeding and fibrinolysis in primary hip and knee replacement.
- Author
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Alvarez J, Santiveri FJ, Ramos MI, Gallart L, Aguilera L, and Puig-Verdie L
- Subjects
- Aged, Aged, 80 and over, Antifibrinolytic Agents pharmacology, Double-Blind Method, Female, Humans, Male, Middle Aged, Prospective Studies, Tranexamic Acid pharmacology, Antifibrinolytic Agents therapeutic use, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee, Blood Loss, Surgical prevention & control, Fibrinolysis drug effects, Tranexamic Acid therapeutic use
- Abstract
Background: Tourniquet-induced ischaemia could increase fibrinolysis and enhance tranexamic acid (TXA) efficacy in total knee arthroplasty (TKA) compared to total hip arthroplasty (THA). The aims of this study are to compare the effect of TXA on bleeding and fibrinolysis in both types of surgery, and to record thromboembolic complications., Methods: A prospective double-blind study was conducted on patients scheduled for TKA or THA who received TXA (2 bolus of 10mg/kg) or placebo. Bleeding and fibrinolysis were evaluated. Doppler-ultrasound and computed tomography were performed in order to assess any thromboembolic complications., Results: A total of 44 patients were included (11 THA and 11 TKA treated with TXA; 11 THA and 11 TKA as controls). Blood losses were significantly lower in the TXA group (mean 921mL vs 1,383mL in THA and 969mL vs 1,223mL in TKA), and no transfusions were needed with TXA, whereas 5 blood units were transfused in controls. TXA was equally effecting in reducing bleeding in both surgeries (33% in THA and 21% in TKA). The significant mean increase in D-dimers from baseline to 6 hours after surgery (1,004 ug/L to 10,284 ug/L in THA and 571 ug/L to 6,480 ug/L in TKA) was attenuated by TXA (1,077 ug/L to 2,590 ug/L in THA and 655 ug/L to 2,535 ug/L in TKA). There were no differences in thromboembolic episodes., Conclusions: Prophylactic use of tranexamic acid is equally effective in reducing bleeding in TKA and THA. Both surgeries have a similar effect on fibrinolysis., (Copyright © 2019 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
- Full Text
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49. Study on the microbial safety of an infusion set for contrast-enhanced imaging
- Author
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Huaijun Wang, Marlein Miranda Cona, Junjie Li, Raymond Oyen, Matthias Bauwens, Yicheng Ni, Alfons Verbruggen, Walter Coudyzer, Yi-Chao Zheng, Yuanbo Feng, Feng Chen, MUMC+: DA BV Medische staf (6), RS: NUTRIM - R1 - Metabolic Syndrome, and Beeldvorming
- Subjects
Male ,medicine.medical_specialty ,BLOOD-TRANSFUSION ,Microbial safety ,Infusion set ,CREUTZFELDT-JAKOB-DISEASE ,TRANSMISSION ,media_common.quotation_subject ,medicine.medical_treatment ,Serum albumin ,Contrast Media ,automatic injector ,Equipment Reuse ,Medicine ,Contrast (vision) ,PARTICLES ,Animals ,Radiology, Nuclear Medicine and imaging ,Tissue Distribution ,Vein ,Saline ,Infusion Pumps ,media_common ,biology ,business.industry ,General Medicine ,Infusion catheter ,Equipment Design ,Surgery ,Equipment Failure Analysis ,medicine.anatomical_structure ,Blood circulation ,biology.protein ,microbiological contamination ,Equipment Contamination ,Rabbits ,business ,Nuclear medicine ,CT ,MRI - Abstract
OBJECTIVES: Multiple uses of automatic contrast injection systems may impose septic risks on patients. The purpose of this experiment was to verify whether a newly developed replaceable patient-delivery system may allow multiple uses of the system but without such risks. METHODS: Twelve patient-delivery systems were tested according to a multiple-use approach using an automatic contrast injection system consisting of dual syringes and one filling and injecting set. Two protocols with normal saline only (n = 6) or contrast media plus normal saline (n = 6) loaded in the injection system were performed. Each patient-delivery system was connected through an infusion catheter to the ear vein of a rabbit that was intravenously preinjected with a diffusible radiotracer (99m)Tc-dimercaptopropionyl-human serum albumin. Aliquots were sampled from the filling and injecting set, patient line, and animal blood for radioactive analysis after the replacement of each patient-delivery system. RESULTS: For the protocol performed using only normal saline, radioactivity was found in the blood circulation of the rabbit (1655903 +/- 593221 CPM) and in the patient line (52894 +/- 33080 CPM), but, virtually, in none of samples from the filling and injecting set (8 +/- 3 CPM), relative to the background (7 +/- 3 CPM) (P = 0.726). Similarly, experimental results attained using contrast plus saline show radioactivity in the blood circulation of the rabbit (1119107 +/- 183174 CPM) as well as in the patient line (32991 +/- 20232 CPM) but in none of samples from the filling and injecting set (6 +/- 6 CPM), relative to the background (6 +/- 4 CPM) (P = 0.955). CONCLUSIONS: The tested patient-delivery system proves convenient and safe. It allows multiple uses of the contrast injection system and avoids the risk of cross contamination.
- Published
- 2012
50. Μεσογειακή αναιμία - Νοσηλευτική παρέμβαση
- Author
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Λαβδανίτη, Μαρία, Δαμιανού, Χρυσή, Μπουραζάνα, Δήμητρα, Λαβδανίτη, Μαρία, Δαμιανού, Χρυσή, and Μπουραζάνα, Δήμητρα
- Abstract
Πτυχιακή εργασία--Σχολή Επαγγελμάτων Υγείας και Πρόνοιας--Τμήμα Νοσηλευτικής, 2009, αα 1147, Η εργασία αυτή είχε σαν σκοπό με οδηγό την πλούσια βιβλιογραφία που υπάρχει, να παρουσιάσει τη νόσο της μεσογειακής αναιμίας όσο γίνεται πληρέστερη, για να δώσει στον αναγνώστη μια σαφή εικόνα επί του θέματος. Η Μεσογειακή Αναιμία, γνωστή παλαιότερα ως «Αναιμία του Cooley» -φόρος τιμής στον Αμερικανό επιστήμονα Cooley που την πρωτοανέφερε- ή β-Μεσογειακή Αναιμία έχει επικρατήσει σήμερα να αναφέρεται παγκόσμια ως β-Θαλασσαιμία. “Παρουσιάζεται με τις μορφές της ομόζυγου β-Θαλασσαιμίας, ετερόζυγου β-Θαλασσαιμίας και ενδιάμεσης β-Θαλασσαιμίας’’. Πρόκειται για μια “χρόνια κληρονομική νόσο των ερυθρών αιμοσφαιρίων, η πιο γνωστή ίσως από τις κληρονομικές ασθένειες’’ και σύμφωνα με τον Παγκλάτσο (2002) “ η β-Μεσογειακή Αναιμία είναι μία αιμολυτική αιμοσφαιρινοπάθεια χαρακτηριζόμενη από αναιμία (μικροκυτταρική, υπόχρωμη, με βραχύβια ερυθροκύτταρα) προκαλούμενη από ανεπάρκεια σύνθεσης αιμοσφαιρίνης’’. Η Μεσογειακή Αναιμία και άλλες Αιμοσφαιρινοπάθειες, όπως η Δρεπανοκυτταρική Αναιμία κ.α. το 1990 περιγράφτηκαν από τον καθηγητή κ. Φέσσα ως το κυριότερο ιατροκοινωνικό πρόβλημα στην Ελλάδα, παρόλο που οι Έλληνες επιστήμονες άρχισαν να ασχολούνται με τη Θαλασσαιμία έγκαιρα, μετά την αρχική περιγραφή της νόσου στα μέσα του 1930. Είναι πλέον αναγκαία η εκπαίδευση των νοσηλευτών σε θέματα γενετικής, ώστε να μπορέσουν να ανταπεξέλθουν επάξια στο ρόλο τους, όχι μόνο στο κομμάτι που αφορά στη νοσηλευτική φροντίδα των ασθενών, αλλά και στη συμβουλευτική νοσηλευτική ασθενών. Είναι απαραίτητη η εφαρμογή προγραμμάτων πρόληψης σε όλο τον κόσμο, ώστε να εξαλειφθεί η γέννηση ατόμων με Θαλασσαιμικό σύνδρομο και ιδιαίτερα η γέννηση ατόμων με Μεσογειακή αναιμία. Η πρόληψη εξακολουθεί να παραμένει η πιο αποτελεσματική μέθοδος για την αντιμετώπιση του προβλήματος της Μεσογειακής Αναιμίας.
- Published
- 2013
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