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1.
Background
Massive transfusion is the clinical scenario where the presumed adverse effects of stored blood are expected to be more evident because the whole patient's blood volume is replaced by stored blood.Objective
To analyse the association between age of transfused red blood cells (RBC) and survival in massively transfused patients.Methods
In this retrospective study, clinical and transfusion data of all consecutive patients massively transfused between 2008 and 2014 in a large, tertiary-care hospital were electronically extracted from the Transfusion Service database and the patients’ electronic medical records. Prognostic factors for in-hospital mortality were investigated by multivariate logistic regression.Results
A total of 689 consecutive patients were analysed (median age: 61 years; 65% males) and 272 died in-hospital. Projected mortality at 2, 30, and 90 days was 21%, 35% and 45%, respectively. The odds ratio (OR) for in-hospital mortality among patients who survived after the 2nd day increased with patient age (OR: 1.037, 95% CI: 1.021–1.054; per year P < 0.001), with the number of RBC unit transfused in the first 48 hours (OR: 1.060; 95% CI: 1.038–1.020 per unit; P < 0.001), and the percentage of such RBC stored for more than 28 days (1.010, 95% CI: 1.005–1.018 per percent point; P = 0.01).Conclusion
Mortality after massive transfusion was associated with a higher proportion of old RBCs transfused in the first 48 hours. Other factors associated with poor prognosis were older patient's age and larger volumes of transfused RBCs. 相似文献2.
Objectives
Studies on blood transfusion reveal that specific rules are not always respected by healthcare professionals. This study aims to better understand the intention to apply the blood transfusion rules, and to examine, within the framework of the theory of planned behavior, the barriers and facilitators.Methods
In total, 2604 healthcare professionals from 13 French public hospitals responded to this survey. The questionnaire included measures related to attitudes, pressure from colleagues/physicians/institutions, and factors related to the intention to apply haemovigilance rules.Results
The majority of healthcare professionals (67 %) received blood transfusion safety training, 56 % reported compliance of blood transfusion procedures, and 24 % would never meet them or occasionally. The regression analyzes show that the factors related to training, age, frequency of blood transfusion explain very little behavioral intention. Professionals’ attitudes (utility and perceived value of behavior) (β = 0.42) and peer pressure (β = 0.21) are major predictors. The barriers related to habits/beliefs (β = ?0.12), lack of time (β = ?0.12), pressure from institutions (β = ?0.05) also contribute, but to a lesser extent.Conclusions
The results confirm the theory of planned behavior showing that the intention to apply specific blood transfusion rules is related to attitude and social norms. These findings may encourage the development of networks of referents in healthcare units, and actions of prevention on the usefulness of blood transfusion rules. 相似文献3.
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S. Achargui A. Zidouh S. Abirou F.Z. Merhfour S. Monsif S. Amahrouch A. El Ghobre M. El Halhali H. Temmara A. El Hryfy M. Motqi A. Satty M. Kandili M. Aghri K. Hajjout M. Benajiba 《Transfusion Clinique et Biologique》2017,24(4):422-430
Red blood cell immunization can lead to delays or even an impasse in a transfusion.
Objectives
Determine the specificities of the most common of alloantibodies and their associations to correct management of red blood cell transfused.Methods and materials
A retrospective study between 2013 and 2015 in immunohematology laboratories at the Blood Transfusion Center of Rabat in Morocco. The following data were studied: frequency, specificities of alloantibodies, blood group involved in alloimmunization and difficult of management of transfusion in case with association of alloantibodies.Results
Five hundred of alloantibodies were identified in 425 people (372 patients/pregnant women and 53 blood donors). The alloantibodies were directed against the following antigen: RH1 (50.8 %), RH3 (11.4 %), KEL 1 (8.2 %), RH2 (7.6 %), RH4 (4.6 %), MNS1 (4 %), MNS3 (2.6 %), Jka (2.4 %) and Fya (2.2 %). Only one alloantibody was identified in 85 % of cases. In 15 %, at least, two alloantibodies were found. The most common associations were directed against: anti-(D + C) (25), anti-(E + K) (4), anti-(E + c) (3) and anti-(D + C + E) (3). The rhesus system is the most involved in alloimmunization. Frequency of specific associations of alloantibodies was identified: Fya?/Jkb? (18.23 %), Fyb?/Jkb? (11.7 %), Jka?/S? (8.70 %), Jka?/Fyb? (5.20 %), Fyb?/s? (3.40 %) and Fyb?/Jkb?/s? (0.85 %).Conclusions
Red blood cell immunization is a serious problem in transfused patients. This study proves the data of literature, the interest of using RH-Kel1 red cell units compatibles among women in age to procreate and for the transfused patients to reduce the rate of immunization. Associations of antibodies with low frequency suggest a promotion of donation. 相似文献6.
B.M.M. Sumbu B. Longo-Mbenza S. Ahuka-Mundeke J.M. Muwonga G. Mvumbi-Lelo H.M. Maphana D. Kayembe Nzongola-Nkasu F.M. Kalumbu 《Transfusion Clinique et Biologique》2018,25(1):26-34
Study objectives
The screening of anti-Human Immunodeficiency Virus antibodies is mandatory in every blood donor admitted to the Blood Bank of Kinshasa University Clinics since 1984. However, no compiled data are available to date. The objective of this study was to establish the trend, prevalence, viral co-infections, and determinants of Human Immunodeficiency anti-Virus serology in blood donors admitted between 2003–2006 and 2008–2013.Patients and methods
A retrospective analysis was carried out at University Kinshasa Clinics, using blood donors’ records during 2003–2006 and 2008–2013. The prevalence of the human immunodeficiency virus per year, age, sex and type of blood donors were estimated. Independent predictors of human immunodeficiency virus seropositivity were also identified.Results
Out of 26,341 blood donors, 2.2% (n = 576/26,341) were seropositive for Human Immunodeficiency Virus. Age < 25 years (OR = 1.7; 95% CI: 1.4–2; P < 0.0001) and Hepatitis C virus seropositivity (OR = 3; 95% CI; 1.8–4.9; P < 0.001) emerged as independent predictors of Human Immunodeficiency Virus seropositivity.Conclusion
This study shows a strong association between the Human Immunodeficiency Virus and hepatitis C and younger age respectively. Further studies are needed to ensure safety of Blood donation in Democratic Republic of Congo. 相似文献7.
S. Bakrim A. Ouarour K. Jaidann M. Benajiba A. Masrar 《Transfusion Clinique et Biologique》2018,25(1):35-43
Background
Blood donation in Morocco and more particularly in the northwest region is carried out without prior determination of the pre-donation hemoglobin. In addition, we note the lack of scientific research that reports data on the red blood cells, leukocytes and platelet lines in donated blood at the regional or even national level.Aims
To study hemogram profile in blood donors taken from the Northwest region of Morocco in order to provide decision makers of the National Center of Blood Transfusion and Hematology with valid scientific arguments to complete the criteria to donate whole blood, by the hemogram.Methods
Prospective study, conducted in 15797 volunteer blood donors (BD) aged between 18 and 60 years, collected during mobile or fixed collections carried out by the Regional Blood Transfusion Center of Tangier and Tetouan from November 2014 to May 2016. The hemogram was performed using a Sysmex KX21N® and the analysis of the data was done by the software SPSS 20.0.Results
According to the World Health Organization, anemia corresponds to a hemoglobin level less than 12 g/dL in women and less than 13 g/dL in men. We found that 14.5 % of women (n = 1054) and 3.0 % of men (n = 245) were anemic and anemia was hypochromic microcytic in 58,66 % of these BD. Analysis of the white line showed leucopenia in 2.05 % of BD and 807 cases of leukocytosis (5.27 % of BD). Platelet study showed thrombocytopenia in 3.97 % of BD and thrombocytosis in 151BD (0.99 % of cases).Conclusion
This study shows the interest of systematic pre-donation hemoglobin measurement and periodic realization of the hemogram among BD in the Northwest region of Morocco. 相似文献8.
M.-L. Langlais M. Dargère C. Le Niger D. Goetghebeur 《Transfusion Clinique et Biologique》2019,26(1):38-47
The purpose of this study was to assess appropriateness of red blood cell (RBC) transfusion in the emergency department before and after a specific protocol.
Methods
A retrospective monocenter study was realized during two six-month periods at the emergency unit. A protocol based on the French national guidelines (HAS) in 2014 was set up between the two periods. All the adult patients, except in a context of massive transfusion, were included in the study. The principal criteria analysed was the rate of appropriate transfusion.Results
Ninety-five patients were included during the first period (group 1) and 98 during the second one (group 2). The rate of appropriateness was the same in the two groups (81% for the group 1 and 81.6% for the group 2). The inappropriate indications were more frequent with older patients (74.6 ± 15.2 years in the group 1 and 79.5 ± 8.5 in the group 2, P = 0.01) and patients suffering from a stable coronary artery disease (18.5% in the group 1 and 38.9% in the group 2, P = 0.008).Conclusion
The rate of appropriate red blood cells transfusion, already high at the beginning of the study, could not be significantly improved with the institution of a specific protocol. It is necessary to continue medical training. 相似文献9.
E. Atilla P.A. Atilla S.C. Bozdag M.K. Yuksel S.K. Toprak P. Topcuoglu B.N. Akay H. Sanli H. Akan T. Demirer M. Beksac O. Arslan M. Ozcan G. Gurman O. Ilhan 《Transfusion Clinique et Biologique》2017,24(4):454-457
Objectives
Extracorporeal photo-chemotherapy (ECP, photopheresis) is an approved treatment modality for mycosis fungoides (MF). Our aim is to present our ECP data for MF.Methods
We retrospectively evaluated 50 MF patients who received ECP for clinical activity, toxicity, and response and outcome rates, and we compared these with combination therapies.Results
The overall response rate (ORR) was 42% (21/50), while the median time to response was 11 months (range, 3–48 months). Ten of the responders (48%) had 3 or more treatment lines prior to ECP. Eight patients (16%) had adverse events related to ECP. The overall survival (OS) of 50 patients was 72 months (range, 3–211). There was no statistically significant difference in the OS in early-stage vs late-stage patients (77 vs 69 months, P = 0.077). The stage 3 and 4 patients received an average of 31 cycles compared to 55 cycles in stage 1 and 2 patients (P = 0.006). The increased extent of ECP was not correlated with the response. Combined treatment with ECP significantly improved the OS (84 months vs 62 months, P = 0.005).Discussion
A low frequency of side effects and improved OS observed in combination therapy makes ECP a favorable option for treating MF. 相似文献10.
L. Essola L. Kouégnigan Rérambiah R. Obame H. Issembè A. Sima Zué 《Transfusion Clinique et Biologique》2017,24(2):52-55
Objectives
To evaluate if the association of injectable iron and tranexamic acid allows a significant saving in transfusion, in cases of myomectomies and hysterectomies.Patients and method
This is a prospective, non randomized study done over 8 months (from January 2013 to August 2013). Were included, patients undergoing hysterectomy or myomectomy who had a hemoglobin level greater than or equal to 8 g/dl and less than 12 g/dl. Two groups were compared: group A consisting of patients for whom a pack red cells was ordered and the group B which patients received intravenous iron preoperatively and tranexamic acid perioperatively. The level of hemoglobin, pre- and postoperative, the average number of blood units per patient and estimated blood loss was compared. The transfusion economy was evaluated.Results
During this period, 87 patients with a mean age of 40 ± 9 years (range: 23 and 70 years) were included according to our criteria: 44 patients in group A and 43 patients in group B. Initial mean hemoglobin in both groups was 9.1 ± 0.7 g/dl. In group B, after iron administration, the mean hemoglobin was 11.3 ± 0.7 g/dl. The average number of red blood cells received intraoperative patient in group A was 1.54 ± 0.51. The estimated blood loss was significant greater (P = 0.0002) in group A (571.6 ± 237.1 ml) than in group B (213.7 ± 131.7 ml). No transfusion was performed in group B.Conclusion
The association intravenous iron and tranexamic acid resulted in the reduction of transfusion requirements in our setting. It could be integrated in the strategy for sparing blood transfusion in scheduled surgery with hemorrhagic risks. 相似文献11.
P. Moncharmont G. Barday H. Odent-Malaure H. Benamara 《Transfusion Clinique et Biologique》2018,25(2):105-108
Objectives
Transfusion in environments other than inpatient hospitalisation requires a specific management of the patient, particularly concerning adverse transfusion reactions. A three-year study was carried out in order to appreciate the nature of adverse transfusion reactions and their incidence in these patients.Material and methods
Adverse transfusion reaction reports of outpatient clinic, ambulatory hospital, health and dialysis centres and home-transfused patients in the Auvergne Rhône Alpes region were obtained. Diagnosis of adverse transfusion reactions, their incidence, their degree of severity, the imputability of the blood component concerned were evaluated.Results
From 1 January 2014 to 31 December 2016, 3,284 reports were notified. Excluding allo-immunisations, 416 reports were obtained, including 376 (90.4%) in outpatient clinic. The febrile non-haemolytic transfusion reaction was the most frequent adverse transfusion reaction (119 cases, 28.6%) followed by allergy (112 cases, 26.9%). A transfusion-associated circulatory overload was notified in 26 cases (6.3%). Among the 416 reports, 363 were non-severe and in 251, a red blood cell concentrate was involved (60.3%). The imputability of the blood product was certain in 50 cases (12.0%) only.Conclusion
With the exception of inpatient hospitalisation and allo-immunisation, the majority of adverse transfusion reactions was notified in outpatient clinic. The febrile non-haemolytic transfusion reaction was the most frequent. 相似文献12.
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E. Levine N. Beroul A. Cortey A. Damais Cepitelli H. Gouezec S. Pujol B. Wibaut B. Marti 《Transfusion Clinique et Biologique》2018,25(4):249-256
Background
Blood transfusion is common in neonatology, especially in preterm or low birth weight infants. Recommendations were proposed by the French National Authority of Health (HAS) in 2014 and 2015 for red blood cells and platelet transfusion respectively, but an heterogeneity of practical attitudes persist. The objective of this survey is to evaluate transfusion practices in neonatal intensive care units.Methods
Investigation of practice of neonatal transfusion was organized among 68 neonatal intensive care unit (level 3) between September 2016 and May 2017, by mailing survey focused on systematic training of nurses, patient identification, immunohematology, information and technical aspects of blood components administration.Results
Twenty-three neonatal intensive care units among the 68s answered the questionnaire. One thousand five hundred sixty seven neonates were transfused and 3382 blood products were administered. The results highlight a consensual attitude concerning the procedures of patient identification, immunohematology tests and blood products administration. However, heterogeneity remains concerning information of the parents or the person with parental authority, immediate and delayed follow-up and devices used for the transfusion. However HAS guidelines (2014 and 2015) appear to be well applied by clinicians for blood products, specifications and calcul of transfused volume based on gestational age and weight. 相似文献14.
Objectives
This study aimed to investigate the changes of platelet (PLT) function and coagulation time before and after plateletpheresis donation.Material and methods
The healthy donors were divided into four groups according to the annual number of plateletpheresis donation: 20 times group, 15 times group, 10 times group and 5 times group. The healthy non-blood donors were selected as controls. The donation interval was 14 days. The blood samples were collected before plateletpheresis donation and after 30 min, 7 d, and 14 d of donation for determination of coagulation time, PLT function, plasma protein, serum iron and blood routine change.Results
After 30 min of plateletpheresis donation, the PLT function decreased and the coagulation time was prolonged. However, PLT function recovered to the pre-collection after 7 d of plateletpheresis donation and coagulation time recovered to the pre-collection after 14 d of plateletpheresis donation. Additionally, there was no difference regarding blood coagulation time and PLT function among blood donors and controls. The plasma protein and serum iron levels in 20 times and 15 times groups were within the normal reference range.Conclusion
The frequency of plateletpheresis donation will not affect PLT function, coagulation time, plasma protein and serum iron in donors. 相似文献15.
K. Nebie S. Sawadogo E. Kafando E.M. Bationo H. Dahourou S. Ouattara K. Kienou S. Nana L. Kaba C. Fretz E.L. Murphy 《Transfusion Clinique et Biologique》2017,24(4):431-439
Objectives
In Burkina Faso, blood components must comply with national standards. Then, all Transfusion services must implement a quality control process to ensure compliance. Our study aims to establish the main characteristics of blood components of the regional transfusion center of Ouagadougou, and evaluate the capability of this center to improve its manufacturing process.Methods
We conducted from marsh to December 2014 a pre-post study, assessing blood components’ characteristics before and after the implementation of a six months’ improvement plan. The assessed parameters were: volume, hematocrit (Ht) and hemoglobin (Hb) levels in RBCs; volume and the number of platelets in PPCs; and volume and concentration of clotting factor VIII in fresh frozen plasma (FFP), respectively. Three hundred and twelve RBCs and 280 PCs were randomly selected for the first series of controls, and 215 RBCs, 54 PCs and 60 FFP were selected for the second series of controls. We compared the mean values of the components parameters and the overall non-compliance rates for each series.Results
The average Hb level of RBCs was respectively 47.8 ± 8.9 g and 54.7 ± 7.2 g in the first and second series compare to a standard of ≥ 40 g. Non-compliance rates of Hb level decreased significantly from 17.6% to 1.4%. For PCs units, the mean number of platelets was 0.14 ± 0.10 × 1011 and 0.30 ± 0.15 × 1011 in the first and second period compare to a standard of 0.5 × 1011. Non-compliance rates for platelets number were high 97.1% and 72.2%.Conclusion
The study demonstrates that only RBCs complied with national standards. The study also demonstrates the capability of CRTSO to improve blood components’ processing even if for PCs and FFP, NC rates remain high. QC must be maintained and expanded to the others regional blood centers of the country. 相似文献16.
Luqman Aribidesi Olayaki Isiaka Abdullateef Alagbonsi Hawau Olaide Abdulkadir Felix Oluwaseyi Idowu 《Journal of the Anatomical Society of India》2017,66(1):67-71
Introduction
Cryptorchidism has been associated with spermatotoxicity and oxidative stress while melatonin is a well-known anti-oxidant. This study investigated the possible ameliorative effect of melatonin on cryptorchidism-induced spermatotoxicity and oxidative stress.Methods
Thirty six male Wistar rats were randomised into sham-operated (n = 18) and bilaterally cryptorchid (n = 18) groups, each of which were subdivided into 3 oral treatment groups (n = 6 rats each) that received normal saline, low dose (4 mg/kg) and high dose (10 mg/kg) melatonin.Results
Cryptorchidism reduced sperm parameters, oestradiol, luteinising hormone, follicle stimulating hormone and glutathione peroxidase activity, but increased testosterone and lactate dehydrogenase activity. The cryptorchidism-induced spermatotoxicity and oxidative stress were ameliorated by low dose of melatonin but exacerbated by its high dose.Discussion
Melatonin’s effect on cryptorchidism-induced spermatotoxicity is dose-dependent. 相似文献17.
R.M. Sumudu Himesha B Medawela Dugganna Ralalage Dilini Lalanthi Ratnayake Wijeyapala Abesinghe Mudiyanselage Udari Lakshika Abeyasinghe Ruwan Duminda Jayasinghe Kosala Nirmalani Marambe 《Educación Médica》2018,19(2):72-76
Background
Possibility of guessing in Multiple Choice questions (MCQ) when assessing undergraduates is considered a weakness. There are limited studies on the use of “Fill in the Blanks” (FIB) to overcome this issue.Objective
To assess the effectiveness of FIB in MCQ for assessing final year dental undergraduates.Methods and materials
A total of 134 final year dental undergraduates were randomly assigned to Group A and B. Group A was given a questionnaire with fifteen single best answer MCQ questions, and then the FIB questionnaire (which included the same questions in FIB form). At the same time Group B was given the FIB questionnaire initially, and then the MCQ questionnaire in the given period of time. The mean scores of the two groups were then compared.Results
Group A obtained a mean score of 10.94 (SD ± 3.203) for MCQ, and 10.48 (SD ± 2.993) for FIB, whereas Group B obtained a mean score of 6.8 (SD ± 2.949) for FIB and 10.05 (SD ± 2.619) for MCQ. There was a statistically significant difference in the mean scores obtained for the two types of tests between Group A (P = .04) and Group B (P = .0001). The difference in the mean scores obtained for the FIB were statistically significant (P = .0001) between the groups, whereas the results were not statistically significant for MCQ (P = .127).Conclusion
MCQ results revealed that the knowledge of the two groups was similar. The differences in the scores obtained for the two types of assessment tools suggest further research is needed to investigate the factors that led to the above observation. 相似文献18.
19.
Objective
We examine whether patients have a preference for affective (i.e., focused on patient’s emotions) or cognitive (i.e., focused on the process that led to the error) apologies that are dependent on the apologizing physician’s gender. We hypothesize patients will prefer gender-congruent apologies (i.e., when females offer affective apologies and males offer cognitive apologies).Methods
We randomly assigned analogue patients (APs: participants instructed to imagine they were a patient) to read a scenario in which a female or male physician makes an error and provides a gender-congruent or incongruent apology. APs reported on their perceptions of the physician and legal intentions.Results
An apology-type and gender congruency effect was found such that APs preferred apologies congruent with the gender of the apologizing physician. An indirect effect of congruency on legal intentions through physician perceptions was confirmed (b = ?0.24, p = 0.02).Conclusion
Our results suggest that physician gender plays a role in patient reactions to different apology types.Practice implications
Apology trainings should incorporate how physician characteristics can influence how patients assess and respond to apologies. 相似文献20.
Erika Celis-Aguilar Edgar Dehesa-López Adrián Martínez-González 《Educación Médica》2018,19(4):217-222