D-Lactate concentrations in blood,urine and sweat before and after exercise

Summary The purpose of this study was to investigate changes in the concentrations of D-lactate, L-lactate, pyruvate and methylglyoxal (MG) in body fluids after exercise. Eight untrained male students and five male students who were boat club members engaged in the exercise. Each subject performed runs of short and long duration. Compared to pre-exercise values plasma concentrations of D-lactate, L-lactate and pyruvate increased after running; in trained men by 3.6, 5.0, 3.4 times after short runs and by 1.5, 4.6, 2.0 times after long runs, and in untrained men by 3.0, 12.0, 1.6 times after short runs and 2.5, 5.6, 1.6 times after long runs, respectively. In all cases, the increase of L-lactate was always higher than that of D-lactate after running. The MG contents in red blood cells decreased markedly after running, especially in the untrained students. After short runs the MG concentration had decreased to 13% in the untrained men and 30% in the trained men, and after long runs the concentration had decreased to 41% in the untrained and 60% in the trained men. The MG in plasma and red blood cells appeared to have been utilized during relatively anaerobic exercise, especially by the untrained subjects. The D-lactate and related substances were also determined in urine, but the concentration of these substances showed no relationship to exercise. The D-lactate concentration in sweat samples tripled after short periods of running but the relative concentration to sodium ion concentration was not altered. The L-lactate, pyruvate, and MG concentrations in sweat increased after short duration running but their concentrations relative to sodium ion concentration were decreased significantly.     

Towards equitable and sustainable availability of blood products in Zimbabwe: An analysis of strengths,weaknesses, opportunities and challenges

Blood transfusion can be a lifesaving intervention in a number of medical emergencies. To attain sustainable and equitable availability of blood products, it is important to understand the strengths, weaknesses, opportunities, and challenges of the national blood services programme. We, therefore, with this letter to the editor, discuss some of the strengths, weaknesses, opportunities and threats to the Zimbabwean programme since its inception. Despite several strengths and opportunities that the national blood services of Zimbabwe (NBSZ) leverages on, we argue that among other challenges, donor shortages and an upsurge of transfusion transmittable infections in the eligible donor population continue to be the biggest threats to the achievement of the programme objectives. These can be addressed through expanding the blood donor base and the catchment area. Additionally, improving the level of knowledge and attitude towards blood donation in the communities is critical for driving the sustainable and equitable distribution of safe blood products to the population.     

Assessment of blood supply and usage pre- and during COVID-19 pandemic: A lesson from non-voluntary donation

BackgroundEnsuring steady stream of safe blood is the ultimate goal of blood transfusion practice. The current COVID-19 pandemic has affected almost every part of life and economy. Consequently, this study sets off to assess the effect of the pandemic on blood supply and blood transfusion in the University of Calabar Teaching Hospital.MethodsData from the Donor Clinic and Blood Group Serology Unit of the University of Calabar Teaching Hospital were retrospectively extracted to evaluate supply and use of blood before and during COVID-19 pandemic.ResultA total of 1638 donors were recorded within the study period. Age range 15–29 and 30–44 years constituted majority of the subjects (58.9% and 33.4%, respectively). The donor pool were male-dominated. Commercial donors (61.7%) and family replacement donors (30.6%) constituted majority of the donor pool. Most of the donor pool were students (37.1%), public servants (22.8%) and artisans (18.6%). A concomitant decrease of 26.1% and 18.9% were recorded in blood donation and request during the COVID-19 pandemic.ConclusionBlood supply was not significantly affected in our study center as both requests and donations decreased. Consideration for improving family replacement donation was advised.     

输血质控督查问题及解决对策

目的 通过抽查输血病案,发现临床输血管理不规范行为,探索解决方案。方法 对2017年1月~2018年12月我院输血科和医务处抽检的720份输血病案进行督查,按照我院《临床用血管理考核实施细则》进行考核,包括输血标本的采集、交叉配血是否符合要求、输血前评估、输血申请审核、大量用血审批、输血治疗知情同意书、输血前感染性标志物检测、血液交接、血液运输冷链管理、输血过程监控、不良反应回报等。结果 存在缺陷的输血病案共182份,占受检总数25.28%;缺陷病历排名前5位分别为输血申请不规范（64例）、输血后疗效评价欠缺（44例）、输血治疗同意书填写不完整（26例）、输血病程记录不完整（12例）、血液冷链运输不符合要求（8例）,占缺陷病案的84.62%;手术科室输血病案存在问题占缺陷病案总数62.64%,非手术科室缺陷输血病案占37.46%;医生记录的缺陷占缺陷病案总数91.75%,护理人员记录仅占7.02%。结论 我院临床医生记录的输血病案存在问题较多,建议严格按照临床操作技术规范执行,确保输血各个环节质量,以保证患者的用血安全。     

正常人的血液粘弹性和触变性研究

应用ＬｏｗＳｈｅａｒ４０流变仪对正常人的血液粘弹性、触变性等指标进行测定与分析，得到了全血滞后环和应力衰减曲线，发现应力的变化在突加一个切变率后并不是单纯的指数衰减，而是先经过０６ｓ左右的振荡过程，然后才开始指数衰减。弹性模量Ｇ′及耗散模量Ｇ″随振荡频率的变化在三个频点出现局部极大（极小）值，在０８Ｈｚ时Ｇ′、Ｇ″都达到谷值，应力与应变的相位差δ达到极小值，说明此振荡频率下血液的粘性分量与弹性分量之比达到最小。在０２Ｈｚ、３３Ｈｚ时Ｇ′达到谷值，Ｇ″保持上升趋势，相位差δ达到局部峰值，说明此二个振荡频率下血液的粘性分量与弹性分量之比达到最大。血液粘度的测量结果表明同心圆筒式粘度计在测量不同切变率范围（０～２００ｓ－１）的全血粘度时稳定性较锥板式差，而且在较高切变率时（１６０２００ｓ－１）数据不稳定。因此在进行一般的全血粘度测量时仍以锥板式为好。     

Zeroing in on the root cause of the clots in a blood bag: Reinforcing improvement in blood collection practices

Blood clots in the packed red blood cell [PRBC] unit can sometimes go unrecognized and could eventually give rise to flow problems while administering the same. We herein report our observation of a moderately elongated threadlike clot in a PRBC unit prepared from a whole blood donated by a young Indian male donor. The PRBC unit was returned to us from the ward by the nursing staff citing “flow issues”. In fact, this warranted the initiation of root-cause analysis of the entire event led by two faculty members, one post-graduate student and the technical supervisor at our blood centre.     

Specific resistance of blood at body temperature II

The specific resistance values for samples of goat, sheep, camel, monkey, baboon, cat and pig blood at 37°C are given for a range of packed-cell volumes extending from 0 to 70%. The relationship is presented in the form p=Aeα^H, when p is the specific resistance, A and α are constants and H is the packed-cell volume in percent. In addition, values for the change in resistivity with the addition of saline are presented to allow electrical calibration for conductivity cells when saline is used as the indicator in cardiac-output studies.     

Éthique et transfusion sanguine – Échos d’un séminaire –

This paper brings together the abstracts and proceedings of a seminar held on the topic of “ethics and transfusion”, October 15, 2013 at the National Institute of Blood Transfusion, Paris.     

Ultrafiltration of circulating blood in vivo

Summary A method of continuous ultrafiltration of circulating blood in the intact rat is described. Thus, the serum concentrations of substances can be continuously followed, whose measurement in whole blood is made impossible by the corpuscular and macromolecular elements. As an example, conductivity curves in portal venous blood of the conscious rat after intraduodenal hydration are presented.     

广州某团体血糖与血尿酸的调查研究

目的：通过调查空腹血糖和血尿酸水平,了解高血糖和高尿酸血症的患病率,探讨高血糖和高尿酸血症的关系．方法：558例空腹血糖和血尿酸测定．结果：空腹血糖男性302例5．13±1.04mmol／L,女性256例5．36±1．46mmol／L,女性较男性高（P＜0．05）．血尿酸男性304．6±79.0μmol／L,女性204.8±68．7μmol／L,男性较女性高（P＜0．001）．高血糖患病率8.1％（45／558）,其中男性6.0％（18／302）,女性10.5％（27／256）,高血糖患病率女性高于男性（P＜0．05）．高尿酸血症患病率4．1％（23／558）,其中男性7．0％（21／302）,女性0.8％（2／256）,高尿酸血症患病率男性高于女性（P＜0.005）．70～86岁组男女空腹血糖与血尿酸均有明显的相关性（男性r=0.601,P＜0．05;女性r=0．474,P＜0．05）．结论：空腹血糖水平和高血糖患病率随增龄而增高．血尿酸水平和高尿酸血症患病率男性明显高于女性．高血糖合并高尿酸血症多见于50岁以后．血糖与血尿酸的相关性与高龄有关．     

不同覆盖面抗荷服充气对心血管系统的作用

在 1Gz条件下,用多体段阻抗仪与无创血压监测仪(Finapres 2300),观察了65％大覆盖面抗荷服(65％ECGS)、附压力袜的90％大覆盖面抗荷服(90％ECGSs)、KH—3抗荷服及KH—5抗荷服充气时,被试者的胸、腹、大腿及小腿血液容积与血流量的变化,以及血压的变化。结果显示,在6.7～33.3kPa充气压力下,穿65％ECGS与90％ECGSs时的胸部血液容积、血流量的增加幅度,以及大腿、小腿的血液容积、血流量的减小幅度均显著大于穿KH—3、KH—5时(p<0.05或p<0.01);穿65％ECGS与90％ECGSs时的平均动脉压分别比穿KH—3时高10.0％及12.9％(p<0.05或p<0.01)。以上结果表明,65％ECGS与90％ECGSs对心血管系统作用明显高于KH—3及KH—5:一方面,能显著降低下体血液容积,增加胸部血液容积,提高心输出量;另一方面,能显著降低下体动脉血流。故65％ECGS与90％ECGSs的升高血压作用明显大于KH—3及KH—5。     

2014年至2018年成都市某三级综合医院血液报废原因分析

目的通过回顾性分析该院近5年来血液报废情况,分析血液报废的原因,寻找血液报废的解决办法,加强血液制品管理,最大限度节约和保护血液资源。方法统计该院2014年至2018年血液的入库量及报废量,按年限、品种、原因、血型分类整理,统计各自所占比例并做出分析。结果从2014年至2018年总共报废血液217袋,报废率为4.56‰。报废的血液制品中,以红悬及血浆为主,都是83袋,两者占血液总报废量的76.50%;报废原因以血液过期、絮状物、出库未用、血袋破损为主,其所占比例分别为23.96%、23.50%、14.75%、13.36%;报废血液不同血型中,报废量从多到少依次是O型、A型、B型、AB型。结论针对血液报废的各种原因,制定有效的措施以降低血液报废率,同时需加强与血站和临床的沟通,达到降低血液报废的目的。     

动脉血压和血流量关系的数值仿真研究

用血液动力学描述的动脉血压与血流的定量关系是相当复杂的,而且数学分析也十分困难。用一个等价的仿真数学模型描述这种数值关系,揭示了动脉血管血液分层流动的生理本质。利用几组真实数据完成了数值仿真分析,并得出关于血液分层流动定量关系的一些重要结论。本研究结果对于循环生理学的定量研究以及某些心血管系统疾病的临床诊断、分析有着重要的参考价值。     

The orbital venous plexus as a sampling site for coagulation testing: The continuing saga

Papers have recently been published regarding the acceptability of samples obtained from the orbital venous plexus for coagulation testing (Dameron et al. 1992; Edwards and Fuller 1993; Matsuzawa et al. 1994; Salemink et al. 1994). Meetings of the committee for International Harmonisation for Clinical Pathology Testing (IHCPT) have highlighted the concerns of sampling from the orbital venous plexus (OVP), both ethical considerations and validity of data. In response to a letter to the editor (Weingand, 1994) and to enable informed and objective discussion of this topic, this paper presents coagulation data on samples obtained from the OVP, collected by several pharmaceutical companies using a variety of systems.     

Effect of bleeding site on coagulation results in the Charles river outbred albino SD rat

The UK Home Office currently advises that the amount of blood to be taken during a toxicology study is limited to 15% of an animal's blood volume (equivalent to approximately 1 ml per 100 g of the animal's bodyweight) in a 28 day period. At SmithKline Beecham, blood samples for routine haemtology and clinical chemistry analyses during a study have been obtained from the orbital sinus (OS). Adequate samples can be obtained for all routine assays with the exception of coagulation tests, and the possibility has been investigated of taking terminal coagulation samples from the posterior vena cava (PVC) as part of the post-mortem procedures, and compared the prothrombin (PT) and activated partial thromboplastin (APTT) times obtained on blood samples from each source. There was no biologically significant difference between samples taken from OS and PVC.Originally presented at ECCP 93.     

Blood supply management – experience and recommendations from Africa

The background is the need to understand the challenges of achieving sufficient blood supply in Africa. The aim is to show that a lot can be achieved with good systems and adequate resources applied. The Materials & Methods is reporting on the blood supply data systems used to analyse and manage blood collection and distribution in SANBS. The results show that with use of data a good system can be developed. The conclusion reflects the need to share information accross Africa.     

The blood supply management amid the COVID-19 outbreak

Due to the government's early intervention such as mass lockdown and curtailment strategies towards mass gatherings, amid the COVID-19 outbreak, the organization of the voluntary blood donation camps have been suspended. It's most significant impact on the blood community has been a dramatic decrease in the number of blood donors. Therefore, our blood stock has almost dried up and put our inventory in a state of jeopardy. Additionally, all the elective surgeries and non-urgent clinical interventions have also been deferred during this time. This has led to a drop in the blood collection, demand as well as the issue at our blood center. With this backdrop, we intended to assess the effect of this mass lockdown on our blood supply management, particularly in two phases [phase-I prior to the outbreak] and phase-II [during the outbreak]. Transitioning back to the normal conditions would most likely depend on the extent and the time duration of this pandemic and associated behavioural change, which is foreseen to remain in effect well beyond the original estimates.     

Regulation of blood services in Africa

Blood and blood products save lives and are a part of the WHO Essential Medicines List. Access to safe and quality-assured blood and blood products are essential for health systems strengthening and it is a global concern. Their use is associated with infectious and immunologic risks. At global level, many resolutions have been adopted by the World Health Assembly that urged Member States to ensure regulatory control of access to quality-assured blood and blood products along the entire transfusion chain. The WHO has also developed an action framework to advance universal access to blood. As part of the implementation of these resolutions and guidelines, the WHO Regional Office for Africa and some partners provided support to countries in the region to strengthen their capacity to establish an effective blood regulatory system through organization of regional training workshops on blood regulation, benchmarking of blood regulatory systems, internship at Paul Ehrlich Institut and establishment of the African Blood Regulators Forum. The current status of blood regulation reveals that there are weak transfusion legislation and blood regulatory systems in most African countries, since many national blood transfusion services still rely on self-regulation. However, the national regulatory authorities have reached the maturity level 3 in two countries (Ghana and Tanzania), but only the experience from Ghana has been described in this paper. Like in other low- and middle-income countries, the regulatory systems for associated substances and medical devices including IVDs are not well established in the African region. Misunderstanding by different stakeholders, lack of legislation that provides legal basis, weak capacity and insufficiency of resources are main challenges facing countries to establish an effective national blood regulatory system. To address these challenges, strong advocacy with governments and collaboration with partners are needed to strengthen national blood regulatory systems.     

Ethics in transfusion medicine: Are the intricate layers of ethics all universal? A global view

Ethical principles have been considered, and in several respects regulated, along the entire blood procurement chain from donor motivation to transfusion to the patient. Consent of donors and voluntary non-remunerated donation are fields which have been addressed by codes of ethics and legislation. Caring for donor health is an area of further development of ethical standards. In part, blood products have also become a market, where commercial principles may synergize, but also creating issues in equality and maintaining human dignity that challenge societal solutions. At the bedside, the main global challenge remains to procure enough blood products for each patient in medical need. Allocation of rare blood, ethical evaluation of transfusion triggers, attitudes towards refusing blood transfusion and provision of blood products to remote settings are areas which should receive consideration.