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1.
Egarit Noulsri Surada Lerdwana Kulvara Kittisares Attakorn Palasuwan Duangdao Palasuwan 《Transfusion and apheresis science》2017,56(4):585-590
Background
Cell-derived microparticles (MPs) are currently of great interest to screening transfusion donors and blood components. However, the current approach to counting MPs is not affordable for routine laboratory use due to its high cost.Aim
The current study aimed to investigate the potential use of flow-rate calibration for counting MPs in whole blood, packed red blood cells (PRBCs), and platelet concentrates (PCs).Methods
The accuracy of flow-rate calibration was investigated by comparing the platelet counts of an automated counter and a flow-rate calibrator. The concentration of MPs and their origins in whole blood (n = 100), PRBCs (n = 100), and PCs (n = 92) were determined using a FACSCalibur. The MPs’ fold-changes were calculated to assess the homogeneity of the blood components.Results
Comparing the platelet counts conducted by automated counting and flow-rate calibration showed an r2 of 0.6 (y = 0.69x + 97,620). The CVs of the within-run and between-run variations of flow-rate calibration were 8.2% and 12.1%, respectively. The Bland–Altman plot showed a mean bias of ?31,142 platelets/μl. MP enumeration revealed both the difference in MP levels and their origins in whole blood, PRBCs, and PCs. Screening the blood components demonstrated high heterogeneity of the MP levels in PCs when compared to whole blood and PRBCs.Conclusions
The results of the present study suggest the accuracy and precision of flow-rate calibration for enumerating MPs. This flow-rate approach is affordable for assessing the homogeneity of MPs in blood components in routine laboratory practice. 相似文献2.
Wei Chen Jennifer P. Ha Hong Hong Robert W. Maitta 《Transfusion and apheresis science》2018,57(4):507-511
Background
Heparin-induced-thrombocytopenia (HIT) is a disease mediated by antibodies to platelet factor 4 (PF4)-heparin complexes. Immature platelet fraction (%-IPF) and absolute immature platelet count (A-IPC) measure newly-released platelets into circulation and can prove useful in differentiating patients with thrombocytopenic presentations due to consumptive or hypoproduction processes. Therefore, we evaluated utility of A-IPC in a cohort of thrombocytopenic patients suspected of HIT.Patients and Methods
Twenty-six thrombocytopenic patients (<150?×?109/L) tested for anti-PF4-heparin and 36 non-thrombocytopenic controls were included. Platelet count, %-IPF, and A-IPC were determined at time of anti-PF4-heparin testing.Results
Sixteen patients tested anti-PF4-heparin negative and 10 tested positive. Patients with positive anti-PF4-heparin did not differ in A-IPC from normal range (7.2?±?2.9?×?109/L vs. 7.1?±?3.2?×?109/L respectively; p?=?0.97). However, there was a significant A-IPC decrease in patients negative for anti-PF4-heparin compared to normal range and those testing anti-PF4-heparin positive (4.2?±?3.1?×?109/L vs. 7.1?±?3.2?×?109/L vs. 7.2?±?2.9?×?109/L respectively, p?<?0.01). An A-IPC of greater than 5?×?109/L characterized 80% of anti-PF4-heparin positive cases.Conclusion
A-IPC measurements can complement anti-PF4-heparin testing of patients suspected of HIT while potentially predicting anti-PF4-heparin immunoassay results. 相似文献3.
Chenna Deepika Mohandoss Murugesan Shamee Shastry 《Transfusion and apheresis science》2018,57(1):54-57
Background
Fluid shifts from interstitial to intravascular space during blood donation helps in compensating the lost blood volume. We aimed to determine the volume of fluid shift following donation in donors with and without pre-donation fluid intake.Methods
We studied the fluid shift in 325 blood donors prospectively. Donors were divided in groups- with no fluid intake (GI) and either water (GII) or oral rehydrating fluids (GIII) before donation. Fluid shift following donation was calculated based on the difference between the pre and post donation blood volume. The influence of oral fluid intake, age, gender and body mass index (BMI) on volume of fluid shift was analyzed.Results
The fluid shift was significant between donors without fluids (GI: 127?±?81?ml) and donors with fluid intake (GII & III: 96?±?45?ml) (p?<?0.05). The difference was not significant between donors with water intake (GII: 106?±?52?ml) and oral rehydrating fluid intake (GIII: 87?±?41?ml). The shifted fluid volume increased with increasing BMI and decreased with increasing age in females. The fluid shift increased in females than in males.Conclusion
The age, gender, BMI and VVR did not significantly contribute to the volume of fluid shift following donation. As per our observation, the oral fluids before donation might not contribute to increase in fluid shift in blood donors after donation. 相似文献4.
Mustafa Serkan Durdu Mehmet Cakici Fatih Gumus Gunseli Cubukcuoglu Deniz Sinem Civriz Bozdag Evren Ozcinar Nur Dikmen Yaman Osman Ilhan Kemalettin Ucanok 《Transfusion and apheresis science》2018,57(6):762-767
Objective
Apheresis is performed for treatment of numerous diseases by removing auto-antibodies, antigen-antibody complexes, allo-antibodies, paraproteins, non-Ig proteins, toxins, exogenous poisons. In current study, we present our experience of using therapeutic plasma exchange (TPE) in patients with different types of clinical scenarios.Methods
Between January 2013 and May 2016, we retrospectively presented the results of 64 patients in whom postoperative TPE was performed in ICU setting after cardiac surgery. Patients were grouped into four as; 1-sepsis (n?=?26), 2-hepatorenal syndrome(n?=?24), 3-antibody mediated rejection(AMR) following heart transplantation(n?=?4) and 4-right heart failure(RHF) after left ventricular asist device(LVAD)(n?=?10). Hemodynamic parameters were monitored constantly, pre- and post-procedure peripheral blood tests including renal and liver functions and daily complete blood count (CBC), sedimentation, C-reactive protein and procalcitonin (ng/ml) levels were studied.Results
The mean age was 61?±?17.67 years old and 56.25% (n?=?36) were male. Mean Pre TPE left ventricular ejection fraction (LVEF) (%), central venous pressure (CVP)(mmHg) pulmonary capillary wedge pressure (PCWP)(mmHg) and pulmonary arterial pressure (PAP)(mmHg) were measured as 41.8?±?8.1, 15.5?±?4.4, 17.3?±?3.24 and 39.9?±?5.4, respectively. Procalcitonin (ng/ml) level of patients undergoing TPE due to sepsis was significantly reduced from 873?±?401?ng/ml to 248?±?132?ng/ml. Seventeen (26.5%) patients died in hospital during treatment, mean length of intensive care unit (ICU) stay(days) was 13.2?±?5.1.Conclusion
This study shows that TEP is a safe and feasible treatment modality in patients with different types of complications after cardiac surgery and hopefully this study will lead to new utilization areas. 相似文献5.
Question
What is the effectiveness and what are the adverse effects.Design
Systematic review with meta-analysis.Participants
Patients with shoulder or upper extremity pain or dysfunction.Intervention
Trigger point dry needling (TDN) compared to control, another intervention or another needling technique.Outcome measures
Primary outcome measures included shoulder or upper limb pain, shoulder or upper limb dysfunction.Results
Eleven randomized trials involving 496 participants were appraised. There was very low evidence that trigger point dry needling of the shoulder region is effective for reducing pain and improving function in the short term. There is some evidence that needling both active and latent trigger points is more effective than needling an active trigger point alone for pain immediately and 1-week after treatment (SMD = ?0.74, 95%CI = ?1.2 to ?0.3; and SMD = ?1.0, 95%CI = ?1.52 to ?0.59).Conclusion
There is very low evidence to support the use of TDN in the shoulder region for treating patients with upper extremity pain or dysfunction. Two studies reported adverse effects to TDN interventions. Most common adverse effects included bruising, bleeding, and pain during or after treatment. Future studies are likely to change the estimates of the effectiveness of TDN for patients with upper extremity pain or dysfunction.PROSPERO: CRD42016045639. 相似文献
6.
J.Manuel Bello–López Carlos Bonilla Cisneros Angel Martínez-Albarrán 《Transfusion and apheresis science》2018,57(1):82-87
Introduction
Oncohematological disorders are the main cause of morbidity in the Mexican population from 1 to 19 years old, where megakaryoblastic and promyelocitic leukemias are more frequent. Considering that the success of a transplant is multifactorial, the criterion of compatibility in the HLA system is crucial and even more so when the source of HSC is bone marrow.Objective
To determine the frequency of the HLA genotype in Mexican candidates who require a bone marrow transplant from related donors and the probability to find donors.Materials and methods
One hundred twenty-six candidates for bone marrow transplant and related donors were tested for HLA class I (–A*, ?B* alleles) and class II (–DRB1* allele) in intermediate–resolution, as the first phase in the choice of the possible donor. The criteria to identify donors were determined by antigen–matched in each HLA haplotype as follows: 4/6, 5/6 and 6/6 at the HLA–A*, HLA–B*, and HLA–DRB1* alleles.Results
Of all the candidates analyzed, 57.93%, at least one bone marrow donor was identified; in 53 cases, no donor was found. The average size of the families was 4.79?±?1.06 members. A higher percentage of compatibility with grade 6/6 (31.6%) was identified with brothers, followed by sisters in 25.3%. The probability to find at least one compatible potential donor was 1.51?±?0.92 donors.Conclusion
In the first phase to select donors, Mexican patients studied in this work, have a compatible donor, however the grade of resolution test influenced in the probability identified. 相似文献7.
Federico Bigazzi Francesco Sbrana Daniele Berretti Sabina Zambon Antonia Fabris Maurizio Fonda Giovanni B. Vigna Giovanna D’Alessandri Stefano Passalacqua Beatrice Dal Pino Mascia Pianelli Roberta Luciani Andrea Ripoli Daniela Rafanelli Enzo Manzato Luigi Cattin Tiziana Sampietro 《Transfusion and apheresis science》2018,57(5):661-664
Background
Lipoprotein apheresis (LA) is the elective therapy for homozygous and other forms of Familial Hypercholesterolemia, Familial Combined Hypercholesterolemia, resistant/intolerant to lipid lowering drugs, and hyper-lipoproteinemia(a). Lipoprotein(a) [Lp(a)] has been classified as the most prevalent genetic risk factor for coronary artery disease and aortic valve stenosis.Aim
Our multicenter retrospective study has the aim to analyze the incidence of adverse cardiovascular events (ACVE) before and during the LA treatment, in subjects with elevated level of Lp(a) (>60?mg/dL) [hyper-Lp(a)] and chronic ischemic heart disease.Methods
We collected data of 23 patients (mean age 63?±?9 years, male 77%; from hospital of Pisa 11/23, Pistoia 7/23, Verona 2/23, Padova 2/23 and Ferrara 1/23), with hyper-Lp(a), pre-apheresis LDL-cholesterol <100?mg/dL, cardiovascular disease, on maximally tolerated lipid lowering therapy and LA treatment (median 7 years, interquartile range 3–9 years). The LA treatment was performed by heparin-induced LDL precipitation apheresis (16/23), dextran-sulphate (4/23), cascade filtration (2/23) and immunoadsorption (1/23). The time lapse between first cardiovascular event and beginning of apheresis was 6 years (interquartile range 1–12 years).Results
The recorded ACVE, before and after the LA treatment inception, were 40 and 10 respectively (p?<?0.05), notably, the AVCE rates/year were 0.43 and 0.11 respectively (p?<?0.05) with a 74% reduction of event occurrence.Conclusions
Our data confirm long-term efficacy and positive impact of LA on morbidity in patients with hyper-Lp(a) and chronic ischemic heart disease on maximally tolerated lipid lowering therapy. 相似文献8.
Shin-ichiro Fujiwara Naohito Fujishima Heiwa Kanamori Masumi Ito Tatsuya Sugimoto Shoko Saito Takeshi Sakaguchi Koichi Nagai Hidekazu Masuoka Kazuhiro Nagai Akie Morita Shuichi Kino Asashi Tanaka Yuichi Hasegawa Akihiko Yokohama Keizo Fujino Shigeyoshi Makino Mayumi Matsumoto Kazuo Muroi 《Transfusion and apheresis science》2018,57(6):746-751
Background
Plasma removal by washing is an effective approach to prevent transfusion reactions by platelet concentrates (PCs). Recently, washed PCs were released by the Japanese Red Cross Society (JRCS).Materials and methods
This retrospective multicenter study evaluated the efficacy and safety of released washed PCs (RWPCs) between September 2016 and January 2017 in Japan. The RWPCs were prepared by washing leukoreduced apheresis PCs with the platelet additive solution, BRS-A, using automated cell processors.Results
Clinical data were obtained from 91 patients and 1210 RWPC transfusions at 50 institutions. The median number of RWPC transfusions per patient was 8 (range, 1–91). RWPCs were used in 94.5% of the patients with a history of recurrent or severe transfusion reactions for preventing such reactions. Responses of RWPCs were evaluated as complete response (91.6%), partial response (8.2%), no-change (0.2%), and progression (0%) and overall response was equal across subgroups divided by patients’ profiles. The median corrected count increment (CCI) at 1 and 24?h post-transfusion were 13.5 (range, 1.9–35.4)?×?109/L and 3.5 (range, ?13 to 53.6)?×?109/L, respectively, and median CCI at 24?h was 5.5 (range, ?13 to 53.6)?×?109/L in patients without risk factors associated with platelet transfusion refractoriness. Transfusion reactions to RWPCs were observed in only nine transfusions (0.7%), all of which were mild allergic reactions.Conclusion
This study demonstrated that RWPCs were effective and safe in patients with a history of transfusion reactions. Further prospective studies on efficacy together with cost-benefit analysis in RWPCs are needed. 相似文献9.
Background
For Australian apheresis platelet donations, in-centre haematology analysers provided the platelet count used to program the platelet collection machines. When the haematology analysers were not functional, historical platelet counts from previous donations were used. This study aimed to confirm that the routine use of historical platelet counts for programming apheresis collection machines would maintain platelet yields within the donated units and that haematology analysers could be removed.Study design
A staggered implementation for the routine use of mean historical platelet counts to program apheresis platelet collection machines was conducted. The donors’ full blood counts following donation were tested centrally for comparison to the historical mean. The component yields when using on-the-day platelet counts to program platelet collection were compared with those collected using historical platelet counts. For historical platelet counts to be deemed successful, the target was for 90% of the mean historical donor platelet counts to have less than 20% variance from the on-the-day platelet count.Results
Over 96% of the mean historical platelet counts were within 20% variance of the platelet count on the day of donation. The component yield (platelet count x109 cell/unit) before analyser removal was 273.3?±?32.0 (n?=?2639) and post-removal was 282.8?±?38.8 (n?=?2689).Conclusion
The removal of haematology analysers from donor centres and replacement with mean historical platelet counts was successful in maintaining platelet yields. Replacement of the haematology analysers with historical platelet counts simplified regulatory compliance, reduced staff workload and costs associated with analyser registration. 相似文献10.
Naoki Akazawa Kazuhiro Harada Naomi Okawa Kimiyuki Tamura Atsushi Hayase Hideki Moriyama 《Physiotherapy》2018,104(4):438-445
Objective
To examine the relationships between muscle mass, intramuscular adipose and fibrous tissues of the quadriceps, and gait independence in chronic stroke survivors.Design
Cross-sectional study.Setting
Hospital-based research.Participants
Seventeen chronic stroke survivors who were unable to walk independently (non-independent walker group) and 11 chronic stroke survivors who were able to walk independently (independent walker group) participated in this study. In addition, 25 healthy older adults (healthy group) were enrolled.Interventions
None.Main outcome measures
The muscle mass and intramuscular adipose and fibrous tissues of the rectus femoris and vastus intermedius were assessed based on muscle thickness and echo intensity of ultrasound images, respectively.Results
The thicknesses of the rectus femoris and vastus intermedius on the paretic and non-paretic sides in the non-independent walker group were significantly lower than those in the healthy group (mean difference ?0.5 to ?0.2 cm; P < 0.001–0.037). The paretic side in the non-independent walker group had significantly higher rectus femoris and vastus intermedius echo intensity compared with the healthy group (mean difference 15.8–17.4; P = 0.007–0.025). The thickness of the rectus femoris on the non-paretic side was significantly lower in the independent walker group than in the healthy group (mean difference ?0.3 cm; P = 0.001).Conclusions
These results suggest that chronic stroke survivors who are unable to walk independently are likely to experience secondary changes in skeletal muscle on both the paretic and non-paretic sides. 相似文献11.
Krzysztof Bartnik Martyna Maciejewska Roiya Farhan Elżbieta Urbanowska Małgorzata Król Maria Król Magdalena Feliksbrot Wiesław Wiktor-Jędrzejczak Emilian Snarski 《Transfusion and apheresis science》2018,57(3):401-405
Background
Recently, novel protocol utilizing Continuous Mononuclear Cell Collection (cMNC) have been introduced for leukapheresis. We compared the efficacy of cMNC with an older protocol – mononuclear cell collection (MNC) for CD34+ cell collection in unrelated donors with negative stem cell collection predictors.Material and methods
Retrospective data from a series of 258 consecutive unrelated hematopoietic stem cell donors was included in this single-center study (80 donors collected with cMNC and 178 with MNC). The donors with poor predictors for collection such as low number of circulating CD34+ cells and/or weight disproportion were assigned to the cMNC arm.Results
The cMNC protocol yielded a higher number of CD34?+?cells per donor body weight (7.63?×?106/kg vs 6.82?×?106/kg, p?=?0.027). One apheresis was sufficient for collection of target cell number in 89% individuals from both groups despite negative predictors in the cMNC group. In donors with CD34?+?cell count <100/μL and a body weight disproportion between donor and recipient one apheresis was sufficient in 83% of donors in cMNC group and in 58% in MNC group (p?=?0.0345) with collection efficiency CE2% values of 61% for cMNC and 62% for MNC (p?=?0.77).Conclusion
cMNC protocol is more efficient in donors with low pre-apheresis CD34+ cell count and weight disproportion between donor and recipient. This suggests that the use of cMNC in unrelated donors could possibly further improve the results of HSC collections. 相似文献12.
Lia Ferreira Isabel Palma Conceição Bacelar José Alexandre Queirós Anselmo Madureira José Carlos Oliveira Maria Helena Ramos Helena Cardoso 《Transfusion and apheresis science》2018,57(5):676-680
Background
Low-density lipoprotein cholesterol (LDL-C) and lipoprotein(a) (Lp(a)) are established causal risk factors for cardiovascular disease (CVD). Lipoprotein apheresis is often required for treatment of patients with a high risk for CVD due to hypercholesterolemia and/or hyperlipoproteinemia(a).Aim
To describe our experience with lipoprotein apheresis in patients with severe hypercholesterolemia or with hyperlipoproteinemia(a).Methods
We retrospectively investigated patients treated with Lipoprotein apheresis using direct adsorption of lipoproteins (DALI) technique, between December 2008 and March 2018, in our center. Adverse events, acute and long term reductions in lipid parameters were analyzed.Results
Between December 2008 and March 2018, a total of 950 treatments were performed in five patients, four with heterozygous familial hypercholesterolemia (HeFH), all on maximally tolerated cholesterol-lowering drug therapy and in one patient with hyperlipoproteinemia(a) and progressive CVD.In the four patients with HeFH we obtained mean acute reductions in LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C) of 62.0?±?7.8% and 60.4?±?6.8%, respectively. Regarding long-term efficacy we achieved a mean reduction of 43.1% in LDL-C and of 41.2% in non-HDL-C. In the patient with hyperlipoproteinemia(a) we attained mean acute reductions of 60.4?±?6.4% in Lp(a) and of 75.4?±?7.3% in LDL-C per session and long term reductions in Lp(a) and LDL-C of 67.4% and 40.5%, respectively. Adverse events were recorded in only 1.2% of treatments.Conclusion
Lipoprotein apheresis is an efficient and safe treatment in severely hypercholesterolemic patients who are refractory to conservative lipid-lowering therapy or with hyperlipoproteinemia(a) and progressive CVD. 相似文献13.
Introduction
Cobalamin deficiency may result in hematologic characteristics similar to thrombotic microangiopathy (TMA). To facilitate diagnosis, we reviewed reported cases of acquired cobalamin deficiency presenting with TMA features (c.def-TMA).Methods
A literature search identified reports of c.def-TMA. Deficiency was defined as B12 levels of <118?pmol/L. Corrected reticulocyte counts and reticulocyte production indexes were calculated. Clinical features were presented as proportion abnormal and results summarized as medians and interquartile ranges (IQR).Results
Patient level data was extracted from 41 identified cases. Median age (years) was 43 (30–55) with 21/41 (51%) being female. Cobalamin deficiency was noted in 35/40 (87.5%) but fold increases in MMA and HC were 30 and 6, respectively. The etiology was pernicious anemia in 28/41 (68%) cases. Anemia was both universal and severe, with hemoglobin levels of 55?g/L (4.7–6.6). Hypersegmented neutrophils were noted in 23/37 (62%), schistocytes in 29/38 (76%) and median LDH levels 3981?U/L (2004–5467). The RPI was <3.0% in all patients. Thrombocytopenia occurred in 33/41 (80.5%) with a median platelet count of 91?×?109/L (42–112). Plasma infusion or exchange was initiated in 14/41 (34%) with associated complications in 2 cases.Conclusion
Reticulocytopenia (RPI of <3.0%) was a universal finding that aids in differentiating c.def-TMA from other causes of hemolysis. C.def-TMA was associated with severe anemia, generally mild-moderate thrombocytopenia, and significant elevations in LDH. 相似文献14.
Objective
This systematic review to aimed to evaluate the effects of orthopaedic manual therapy (OMT) on pain, improving function, and physical performance in patients with knee osteoarthritis (OA).Data sources
Four databases (PubMed, Web of Science, CENTRAL, and CINAHL) were searched.Study selection
Trials were required to compare OMT alone or OMT in combination with exercise therapy, with exercise therapy alone or control.Data extraction
Data extraction and risk assessment were done by two independent reviewers. Outcome measures were visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, WOMAC function score, WOMAC global score, and stairs ascending-descending time.Results
Eleven randomized controlled trials were included (494 subjects), four of which had a PEDro score of 6 or higher, indicating adequate quality. The results of the meta-analysis indicated that reduction of VAS score in OMT compared with the control group was statistically insignificant (SDM: ?0.59; 95% CI: ?1.54 to ?0.36; P = 0.224). The reduction of VAS score in OMT compared with exercise therapy group was statistically significant (SDM: ?0.78; 95% CI: ?1.42 to ?0.17; P = 0.013). The reduction of WOMAC pain score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.79; 95% CI: ?1.14 to ?0.43; P = 0.001). Similarly, the reduction of WOMAC function score in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.85; 95% CI: ?1.20 to ?0.50; P = 0.001). However, the reduction of WOMAC global score in OMT compared with the exercise therapy group was statistically insignificant (SDM: ?0.23; 95% CI: ?0.54 to ?0.09; P = 0.164). The reduction of stairs ascending-descending time in OMT compared with the exercise therapy group was statistically significant (SDM: ?0.88; 95% CI: ?1.48 to ?0.29; P = 0.004).Conclusions
This review indicated OMT compared with exercise therapy alone provides short-term benefits in reducing pain, improving function, and physical performance in patients with knee OA.Review registration
PROSPERO 2016:CRD42016032799. 相似文献15.
Background
Physiotherapy is a routine component of postoperative management following total knee arthroplasty (TKA). As the demand for surgery increases it is vital that postoperative physiotherapy interventions are effective and efficient.Objectives
Determine the most beneficial active physiotherapy interventions in acute hospital and inpatient rehabilitation for improving pain, activity, range of motion and reducing length of stay for adults who have undergone TKA.Data sources
Electronic databases MEDLINE, CINAHL, PUBMED and EMBASE.Study eligibility criteria
Randomised controlled trials investigating the effect of active physiotherapy interventions in the acute hospital or inpatient rehabilitation setting for adults who have undergone TKA.Study appraisal and synthesis methods
Risk of bias for individual studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Standardised Mean Differences (SMD) or Mean Differences (MD) and 95% confidence intervals were calculated and combined in meta-analyses. Quality of meta-analyses was assessed using the Grades of Research, Assessment, Development and Evaluation approach.Results
Accelerated physiotherapy regimens were effective for reducing acute hospital length of stay (MD ?3.50 days, 95% CI ?5.70 to ?1.30). Technology-assisted physiotherapy did not show any difference for activity (SMD ?0.34, 95% CI ?0.82 to 0.13). From high quality individual studies pain, activity and range of motion improved with accelerated physiotherapy regimens and activity improved with hydrotherapy.Limitations
Lack of blinding and small sample sizes across the included trials.Conclusion
After TKA, there is low level evidence that accelerated physiotherapy regimens can reduce acute hospital length of stay.Systematic review registration number PROSPERO (Registration number CRD42014013414) http://www.crd.york.ac.uk/PROSPERO. 相似文献16.
Elias Kyriakou Nikolaos Nearchakos Stefanos Bonovas Efstathia Makri Katerina Pantavou Georgios K. Nikolopoulos Christine Kottaridi Argyri Gialeraki Panagiota Douramani Maria Taichert Violetta Kapsimali Argirios E. Tsantes 《Transfusion and apheresis science》2018,57(4):544-548
Background
Flow cytometry (FC) and Nageotte hemocytometry represent the most widely accepted methods for counting residual white blood cells (rWBCs) in leucocyte-reduced (LR) blood components. Our aim was to study the agreement between the two methods, under real working blood bank conditions.Materials and methods
94 freshly produced LR red blood cell (RBC) units were tested for rWBC concentrations by FC and Nageotte. To assess the precision of each method, we calculated the intra-assay coefficients of variation (CV), and followed the Bland-Altman methodology to study the agreement between the two methods.Results
CV was 18.5% and 26.2% for the Nageotte and the FC, respectively. However, the agreement between the duplicate observations, using the binary cut-off threshold of 1?×?106 WBCs per unit to define the results as “pass/fail”, was 71.9% for the Nageotte and 93.3% for the FC. Linear regression analysis did not show any correlation (R-squared?=?0.01, p?=?0.35) between the two methods, while the Bland-Altman analysis for the measuring agreement showed a bias toward a higher Nageotte count of 0.77?×?106 leucocytes per unit (p?<?0.001) with the 95% limits of agreement (d ± 2?sd) ranging from –0.40?×?106 to 1.94?×?106 leucocytes per unit.Conclusion
The absence of agreement between Nageotte and FC method, with the differences within d ± 2?sd being of high clinical importance, suggests that the two methods cannot be used for clinical purposes interchangeably. The Nageotte seems unsuitable for quality control even with a pass-fail criterion, under real working blood bank conditions. 相似文献17.
Roman Małachowski Olga Grzybowska-Izydorczyk Nelly Besson Anna Szmigielska-Kapłon Mateusz Nowicki Agnieszka Wierzbowska 《Transfusion and apheresis science》2017,56(4):563-565
Introduction
Thrombocytapheresis is an alternative treatment beneficial in rare circumstances, when cytoreductive agents are contraindicated, drug therapy gave no response or the expected response would be too slow. Here we present a case of a pregnant woman who underwent 5 thrombocytaphereses using Spectra Optia device to reduce circulating platelets (PLT) count and prepare for Cesarian section.Patient characteristics and performed treatment
A 39-year-old woman with diagnosed chronic myeloid leukemia (CML) was treated with interferon because of too high PLT count. The treatment was well tolerated but the effect was not satisfactory (PLT count remained high). Because of high risk of bleeding during childbirth, the healthcare providers decided to perform thrombocytapheresis to reduce circulating PLT count below 1000 × 10E3/μl, and to prepare the patient for a planned Cesarean section. The results are presented as mean ± SD.Results
Five therapeutic aphereses procedures were performed, with a Spectra Optia device (TerumoBCT). A mean of 1.3 ± 0.3 total blood volume was processed and we observed a mean PLT drop of 42.3 ± 17.7%. Each apheresis procedure resulted in a PLT level ≤1000 × 10E3/μl. PLT CE1 was high 50.6 ± 2.6% and reproducible. The white blood cell (WBC) loss was low (18.5% ± 11.0%). No adverse effects were observed.Conclusion
Therapeutic platelet depletion using the Spectra Optia? Apheresis System can be effective and safe during pregnancy. Thrombocytapheresis procedures were reproducible and Spectra Optia system successfully adjusted settings to each procedure conditions. Thrombocytapheresis seems to be a viable and safe option even in pregnant women. 相似文献18.
Jeong-Oh Yoon Min-Hyeok Kang Jun-Seok Kim Jae-Seop Oh 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(2):161-167
Design
This is a cross-sectional study.Setting
University research laboratory.Participants
Fifteen healthy adults (mean age: 27.47 years) volunteered for this study.Intervention
The individuals performed standard bridge exercise and modified bridge exercises with right leg-lift (single-leg-lift bridge exercise, single-leg-lift bridge exercise on an unstable surface, and single-leg-lift hip abduction bridge exercise).Main outcome measures
During the bridge exercises, electromyography of the rectus abdominis, internal oblique, erector spinae, and multifidus muscles was recorded using a wireless surface electromyography system. Two-way repeated-measures analysis of variance (exercise by side) with post hoc pairwise comparisons using Bonferroni correction was used to compare the electromyography data collected from each muscle.Results
Bilateral internal oblique muscle activities showed significantly greater during single-leg-lift bridge exercise (95% confidence interval: right internal oblique = ?8.99 to ?1.08, left internal oblique = ?6.84 to ?0.10), single-leg-lift bridge exercise on an unstable surface (95% confidence interval: right internal oblique = ?7.32 to ?1.78, left internal oblique = ?5.34 to ?0.99), and single-leg-lift hip abduction bridge exercise (95% confidence interval: right internal oblique = ?17.13 to ?0.89, left internal oblique = ?8.56 to ?0.60) compared with standard bridge exercise. Bilateral rectus abdominis showed greater electromyography activity during single-leg-lift bridge exercise on an unstable surface (95% confidence interval: right rectus abdominis = ?9.33 to ?1.13, left rectus abdominis = ?4.80 to ?0.64) and single-leg-lift hip abduction bridge exercise (95% confidence interval: right rectus abdominis = ?14.12 to ?1.84, left rectus abdominis = ?6.68 to ?0.16) compared with standard bridge exercise. In addition, the right rectus abdominis muscle activity was greater during single-leg-lift hip abduction bridge exercise compared with single-leg-lift bridge exercise on an unstable surface (95% confidence interval = ?7.51 to ?0.89). For erector spinae, muscle activity was greater in right side compared with left side during all exercises (95% confidence interval: standard bridge exercise = 0.19–4.53, single-leg-lift bridge exercise = 0.24–10.49, single-leg-lift bridge exercise on an unstable surface = 0.74–8.55, single-leg-lift hip abduction bridge exercise = 0.47–11.43). There was no significant interaction and main effect for multifidus.Conclusions
Adding hip abduction and unstable conditions to bridge exercises may be useful strategy to facilitate the co-activation of trunk muscles. 相似文献19.
Maurício Oliveira Magalhães Josielli Comachio Paulo Henrique Ferreira Evangelos Pappas Amélia Pasqual Marques 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2018,22(1):82-91
Background
Low back pain (LBP) is a major health and economic problem worldwide. Graded activity and physiotherapy are commonly used interventions for nonspecific low back pain. However, there is currently little evidence to support the use of one intervention over the other in the medium-term.Objective
To compare the effectiveness of graded activity exercises to physiotherapy-based exercises at mid-term (three and six months’ post intervention) in patients with chronic nonspecific LBP.Methods
Sixty-six patients were randomly allocated to two groups: graded activity group (n = 33) and physiotherapy group (n = 33). These patients received individual sessions twice a week for six weeks. Follow-up measurements were taken at three and six months. The main outcome measurements were intensity pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire).Results
No significant differences between groups after three and six month-follow ups were observed. Both groups showed similar outcomes for pain intensity at three months [between group differences: ?0.1 (95% confidence interval [CI] = ?1.5 to 1.2)] and six months [0.1 (95% CI = ?1.1 to 1.5)], disability at three months was [-0.6 (95% CI = ?3.4 to 2.2)] and six months [0.0 (95% CI = ?2.9 to 3.0)].Conclusion
The results of this study suggest that graded activity and physiotherapy have similar effects in the medium-term for patients with chronic nonspecific low back pain. 相似文献20.
Rainer Moog Remo Rothe Nicole Arlt Thomas Burkhardt 《Transfusion and apheresis science》2018,57(2):228-232