ISSN:0733-2459    

DOI:10.1002/jca.2920080202

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractWe studied the efficiency of platelet collection by the Mobile Collection System (MCS) using two types of experimental protocols and evaluated the effect of storage at 22°C on the platelet concentrates (PC). MCS is a new blood cell separator that combines discontinuous flow features with a new computerized operating system and can be used to harvest either full units of apheresis PC (SDPprotocol) or half units of PC together with one to two units of plasma (PLPprotocol). On the average, 1.98 × 1011± 0.46 × 1011(mean ± SD) platelets were obtained by the PLP protocol and 3.01 × 1011± 0.70 × 1011and 4.2 × 1011± 1.12 × 1011by the early and later versions of the SDP protocols, respectively. The mean number of WBC per PC ranged from 3.3 to 4.7 × 108. During the storage period pH stayed above 7.0. On the average, the production of one molecule of lactate corresponded to the consumption of 0.538 molecules of glucose, indicating that less than 8% of glucose was consumed by the oxidative pathway. There were only small increases in LDH and B thromboglobulin concentrations. Furthermore, the ability of platelets to recover from osmotic shock and to aggregate following exposure to dual agonists declined only slightly during storage, indicating that both viability and function of platelets collected by the MCS were preserved during storage. © 1993 Wil

ISSN:0733-2459    

DOI:10.1002/jca.2920080203

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractTwo patients with paraprotein‐associated peripheral polyneuropathy were treated successfully using immunoadsorption of patient's plasma with staphylococcal protein A. Both had previously been treated with immunosuppressive agents or plasma exchange, and were rapidly relapsing at the time of their protein A immunoadsorption therapy. One patient was treated “on‐line” with a blood cell separator, and one was treated “off‐line.” Both responded well to therapy with minimal toxicity. Serum levels of circulating immune complexes were elevated in one patient and remained so during and after therapy. Immunoadsorption with protein A should be investigated as a therapeutic option for patients with paraprotein‐associated peripheral polyneuropathy. The therapy is relatively easy to administer, particularly “off‐line,” and was well tolerated by our patients. More experience, including formal clinical trials, will be required to properly define the indications for, and mechanism of response to, this therapy.

ISSN:0733-2459    

DOI:10.1002/jca.2920080204

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractBabesiosis is a malaria‐like parasitic disease causing subclinical or mild illness in most cases. Splenectomized patients, however, may experience a more severe course. Although generally responsive to antibiotic therapy, several cases of severe babesiosis refractory to appropriate antibiotic therapy have been reported to respond promptly and dramatically to red blood cell (RBC) exchange transfusion. Although the role of HIV coinfection in babesiosis is uncertain, two previously reported cases raise a concern that it may predispose to a more severe clinical course. We report a third case of severe babesiosis in an HIV‐positive splenectomized man, following travel to an endemic area. Antibiotic therapy, though initially effective, ultimately failed to prevent severe disease. RBC exchange transfusion resulted in prompt clinical improvement, which has been sustained during 26 months of follow‐up. Although the patient has since developed various sequelae of HIV infection, including disseminated Kaposi's sarcoma, CMV retinitis, and enteritis, there has been no recurrence of observable parasitemia. In severe babesiosis, RBC exchange transfusion, combined with appropriate antibiotic therapy, appears to be a rapidly effective therapeutic modality which can induce sustained remissions. © 1993 Wiley‐L

ISSN:0733-2459    

DOI:10.1002/jca.2920080205

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractTo compare donor demographics and motivations for donation, we surveyed 159 consecutive whole blood donors (WD) and 146 consecutive plateletpheresis donors. All donors had donation experiences of at least 2 gallons (i.e., 16 previous donations). Evaluation of answers to fixed‐response and open‐ended questions revealed no difference between the two groups in age, type of wages, compensation by employer, “time off” for donation, and church or volunteer organization memberships. The two groups differed in that the platelet donor (PD) group had a higher percentage of males than females (PD group 72.6% males and 27.4% females versus WD group 59% males and 41% females [chi‐square = .01]).PDs most often began donating platelets because they were asked (22.6%), demonstrating the importance of active recruitment. When asked why they do not donate platelet products by apheresis, highly committed WDs reported lack of time (25%), lack of knowledge (“Don't know about it,” 21%), lack of recruitment (“No one asked,” 18.5%), or lack of awareness (“Never thought about it,” 5%) as reasons.Factors centering on time constraints, lack of knowledge or awareness about platelet donation by apheresis, and lack of active recruitment prohibit highly committed WDs from entering into plateletpheresis programs.

ISSN:0733-2459    

DOI:10.1002/jca.2920080206

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractAbsolute iron deficiency is treated by correcting the causative lesion and then, traditionally, administering sufficient amounts of ferrous salt to return the haemoglobin level to normal and replenish body stores. The bioavailability of ferric compounds has been questioned and accordingly their therapeutic role remains controversial. A special problem is posed by regular blood donation, where the frequency of phlebotomy is limited by the haemoglobin level, which, in turn, requires maintenance of an adequate supply of iron from dietary sources. Since this latter situation may not always occur, it would be of practical benefit to have a form of supplementation that is effective and can be taken without side effects. These issues were prospectively examined in a consecutive series of otherwise healthy blood donors who developed absolute iron deficiency anaemia and were then randomly allocated to receive 60 mg of this metal as ferrous sulphate twice a day (Group 1: n = 51), 100 mg as chewable ferric polymaltose daily (Group 2: n = 53), or the latter product twice a day (Group 3: n = 55). Serial studies showed that 80% of patients in Groups 1 and 3 had reached normal haemoglobin levels by 12 weeks, but this figure was only 50% in Group 2. Similarly, the proportion of patients improving their percentage saturation of transferrin to within the normal range was significantly better in Groups 1 and 3 than in Group 2 (P<.01). However, body iron stores, reflected in serum ferritin level, was significantly better in Group 1 (P<.01); there was no difference in this respect between Groups 2 and 3. Toxicity was more severe in those receiving ferrous sulphate, with 20% having to discontinue participation owing to nausea and vomiting, whereas this was mild in those receiving ferric polymaltose and none withdrew from the trial for this reason. It can be concluded that the two forms of iron are equally bioavailable for hemoglobin regeneration, but at 12 weeks of study ferrous sulphate was superior in reconstituting stores, as reflected in the serum ferritin level. Since the ferric iron complex is associated with only minimal side effects, it may be useful in selected populations and, in the context of blood donors, valuable as a means of maintaining positive balance, thereby diminishing the number of donors rejected because of their having developed phlebotomy‐iron deficiency anaemia. © 1993 Wiley‐Liss,

ISSN:0733-2459    

DOI:10.1002/jca.2920080207

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractAs part of gathering data for its Networking Directory, the Registry/Directory Committee of the American Society for Apheresis solicited data on the types of apheresis procedures performed, equipment used, and diseases treated in the year 1991. In this voluntary solicitation of the 266 centers responding, 94% were from the United States. For those centers reporting exact numbers of procedures performed out of all institutions doing the procedures 48, 221 therapeutic and 330,702 donor procedures were reported. The dominant type of equipment being used is the centrifugal type.For therapeutic procedures plasma exchange is the most prevalent procedure and for donor procedures it is plateletpheresis. For therapeutics, Guillain‐Barre syndrome was the most prevalent disease treated by plasmapheresis and leukemias by cytapheresis. The survey methodology proved to be valuable in gathering the data on a voluntary basis. With subsequent surveys and refinement of its methodology the apheresis practices in the United States could be assessed quantitatively to provide information on the number and types of procedures being carried out. Such information is required to assess the impact of apheresis technology on health care, to project trends, and to review the cost impact of this technology. © 1993 Wiley‐Liss,

ISSN:0733-2459    

DOI:10.1002/jca.2920080208

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

ISSN:0733-2459    

DOI:10.1002/jca.2920080209

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractThis is a review of events when the medical community realized that AIDS was an infectious disease which might be transmitted by blood transfusions and the response by the various organizations and agencies to curb the potential spread of HIV via blood products. It became possible through a number of approaches to make the blood supply safe so that today the likelihood of transmission of HIV by blood transfusion is extremely unlikely. © 1993 Wiley‐Liss, I

ISSN:0733-2459    

DOI:10.1002/jca.2920080210

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY

摘要:

AbstractHIV was introduced into the blood supply at least 4 years before there was any clinical illness in hemophiliacs. While viral removal and inactivation techniques of plasma products have improved, contamination with a very stable virus is still a possibility. © 1993 Wiley‐Liss, I

ISSN:0733-2459    

DOI:10.1002/jca.2920080211

出版商:John Wiley&Sons, Inc.    

年代:1993

数据来源: WILEY