Mercaptoethanol-Stable Antibody Test Predicting Hemolytic Disease of the Newborn Due to ABO Incompatibility

Abstract. Maternal sera were titrated after 2-mercaptoethanol treatment for anti-A and anti-B agglutinations by the saline and the anti-globulin methods; the results were expressed in titration scores. Each case was graded into mercaptoethanol-stable antibody (MESA) grade 1: A and B mothers with compatible infants; 2: mothers with unaffected incompatible infants; 3: mothers with mild hemolytic disease of the infant, and 4: mothers with severe hemolytic disease of the infant. 925 cases were submitted for the ABO incompatibility tests in 2 years; the babies' sequelae were reported in 131 ABO-incompatible cases. If the tests were done in late pregnancy, severe cases of hemolytic disease of the newborn corresponded to mothers' antenatal antibodies in MESA grade 4, and mild cases to MESA grade 3.     

Automated Irregular Antibody Screening on a Modified 15-Channel Blood-Grouping Machine

Abstract. The addition to a 15-channel blood-grouping machine of two singlechannel antibody screening systems, based on the principles described by Marsh and Lalezari has produced a modified machine capable of detecting most clinically significant irregular blood group antibodies with a sensitivity equal to normal manual screening tests.     

Automated Screening Test for High Titre: Tetanus Antibody in Donor Plasma

Abstract. A test has been devised for use on a Technicon blood-grouping autoanalyser which identifies high titre tetanus antibody in donor plasma by a passive haemagglutination method. The method of sensitization of red cells with tetanus toxoid is described.     

Aortic Root Dissection Due to an Automated Fastener Device

Minimally invasive aortic valve replacement through a right thoracotomy is frequently performed in patients with aortic valve disease. The Cor-Knot Device (LSI Solutions) is an automated fastener that secures valve sutures.This case report is for a patient who developed postcardiotomy shock during a minimally invasive aortic valve surgery. The patient was found to have an aortic root dissection involving 90% of the aortic root circumference, including bilateral coronary ostia. The autopsy revealed that the aortic damage could be explained by a direct aortic intimal tear from the distal tip of the device shaft. The device was most likely not in perfect apposition to the sewing ring because of the restricted angle and space between the ribs.     

Haemolytic Disease of the Newborn Due to Rhesus Anti-ē Antibody

Abstract. Haemolytic disease of the newborn due to rhesus anti-ē alone is a rare occurrence. This condition is described in the second child of an R₂R₂ mother who had not previously been transfused. The antibody was of IgG subclasses IgG₁+IgG3 and was detectable on the baby's cells for 4 months after birth. The anaemia was mild and persisted for the same period.     

Screening Blood Donors for High Titre Antibody to Herpes Varicella-Zoster

As a method of increasing supplies of varicella-zoster immunoglobulin, semi-automated screening of blood donors for high titre complement-fixing antibody was initiated. This was compared with the previously used method of donor selection based on a history of varicella or zoster in the past 6 months. About one-third of the "history" donors had titres of greater than or equal to 1 in 64 and generally these levels declined rapidly. In contrast, although only 1.1% of donors in random screening had antibody titres greater than or equal to 1 in 64, these levels usually remained high during repeated donation, enabling the production of pools entirely composed of high titre plasma packs.     

Chronic Autoimmune Neutropenia Due to Anti-NA1 Antibody

Abstract. A 12-month-old child neutropenic since the age of 8 months, was referred to our institute for a sepsis from Candida albicans. On exploring the cause of neutropenia, an anti-NA₁ antibody could be detected in the patient's serum. This antibody seemed to be responsible for the neutropenia because the child's PMN type was NA₁+. The reactivity of the autoantibody with the patient's own granulocytes was confirmed by direct and indirect immunofluorescence studies performed on blood and marrow cells. A reduced number of T lymphocytes with poor PHA responsivity has been interpreted as the possible cause of the autoimmune disease. Steroid therapy did not cure the neutropenia but the child's general condition improved.     

Anticore Antibody Screening of Transfused Blood

Aliquots of 130 HB8Ag negative units of blood which were administered to 26 recipients were tested under code for anti-HBc by a solid phase radioimmunoassay technqiue. 14 of the 26 recipients developed posttransfusion hepatitis (PTH), including 6 cases of hepatitis B. Anti-HBc was detected in 7 or 5.3% of 130 donor units. Of the 14 patients acquiring PTH, 6 received a unit of anti-HBc-positive blood. Type B hepatitis occurred in 4 of the 7 anti-HBc recipients, and non-type B hepatitis in 2. Only 1 of 12 recipients who failed to develop PTH had received a unit containing anti-HBc.     

An IgG, Gentamicin Sulfate-Dependent Antibody Found during Prenatal Antibody Screening

The serum of a prenatal patient was found to contain an IgG antibody that reacted with all red cells suspended in solutions containing the antibiotic gentamicin sulfate. The antibody was nonreactive with red cells suspended in media containing chloramphenicol, neomycin, hydrocortisone or inosine. Since gentamicin sulfate is used in the suspending medium of some commercial reagent red cell products, difficulties in the interpretation of antibody detection and identification tests may arise when patient sera contain gentamicin-dependent antibodies.     

Automated Red Cell Antibody Analysis. A Parallel Study

Abstract. The AutoAnalyzer method of red blood cell antibody detection can be adapted to identify the serological specificity of these same antibodies. In the present study, 1,152 AA-positive sera obtained during AA screening were investigated. In 217 (19%) of these sera blood group antibodies were identified by manual techniques. Since the AA techniques are generally more sensitive than manual methods an attempt was made to identify antibodies by the AA methods in 823 sera which were negative manually. The low-ionic strength-Polybrene (LISP) method was found to be suitable for antibody identification because of its sensitivity in the detection of most red cell antibodies and the small technical deviations of OD from the base-line. The bromeline-methyl cellulose (BMC) technique is less sensitive and often more difficult to interpret in antibody identification. In some cases, however, this method was the only one that gave positive reactions. In 214 instances antibodies were identified by the AA techniques, about half of which were anti-D's, the others being RBC antibodies of more or less rare varieties. The relative frequency of these rare antibodies was higher in the group of manual-negative sera, 47 versus 21%, normally found. Positive identification but no clear-cut blood type antibody was found in 155 cases (19%). Indications were obtained that some of the reactions were due to HL-A antibodies. Antibodies to HL-A7 and HL-A5 were found to react with red cells. In addition the AA techniques seemed to be more sensitive to detect RBC autoantibodies than standard manual methods. However, the usefulness of the AA techniques for routine antibody identification is diminished by the relative slowness of the machine.     

Carbon Dioxide Insufflation Reduces Discomfort Due to Flexible Sigmoidoscopy in Colorectal Cancer Screening

Background: Flexible sigmoidoscopy is currently recommended as a screening modality for colorectal cancer. However, a substantial number of patients experience discomfort because of the procedure, possibly limiting compliance and thus screening success. During endoscopy, air is commonly used to insufflate the bowel. Carbon dioxide rather than air insufflation has been shown to reduce procedurerelated pain and discomfort in colonoscopy. The aim of the present study was to evaluate whether carbon dioxide insufflation reduces discomfort during and after flexible sigmoidoscopy for colorectal cancer screening. Methods: In a randomized, double-blinded design, 230 consecutive participants in a population-based flexible sigmoidoscopy colorectal cancer screening trial were assigned to have their examination performed with either carbon dioxide or air insufflation. Patients were asked to grade discomfort experienced both during and in the hours after the procedure on a visual analogue scale. Results: Carbon dioxide insufflation significantly reduced the amount of discomfort at 1, 3 and 6 h after the sigmoidoscopy. One hour after the examination, 84% of patients in the CO 2 group reported no discomfort, compared to 64% in the air group ( P = 0.006). No differences between the groups were observed during the examination. Conclusions: Carbon dioxide insufflation significantly reduced postexamination discomfort. The use of carbon dioxide rather than air insufflation may contribute to better public acceptance for flexible sigmoidoscopy screening.     

Screening of Blood Donors for Antibody to Human Immunodeficiency Virus Type I by Sensitive Particle Agglutination Assay

A particle agglutination (PA) assay for antibody to human immunodeficiency virus type I (anti-HIV) was used to screen blood donors and to test leukemia and hemophilia patients. Results by PA showed complete agreement with the results of two kinds of enzyme immunoassay (EIA), and the false-positive rate was the same as or lower than with the EIAs. The sensitivity of PA was 10- to 100-fold higher than that of the EIAs. This simple sensitive assay takes less time and fewer personnel than the EIAs, and has been used for massive screening of blood donors in our blood center.     

The Automated Screening of Irregular Blood Group Antibodies

Summary. Antomated antibody screening has been performed on donor bloods for six months, using a filter paper model Antoanalyzer and a specially built automatic pooler for an antiglobulin technie. This combined system screens donor blood for antibodies which react by either enzymes or anti-human globulin methods. The method appears to be fast and sensitive and to be adaptable to the procedures at a large blood center.     

Importance of Dose Timing to Achieving Undetectable Viral Loads

Little is known about the importance of dose timing to successful antiretroviral therapy (ART). In a cohort comprised of Chinese HIV/AIDS patients, we measured adherence among subjects for 6 months using three methods in parallel: self-report using a visual analog scale (SR-VAS), pill count, and electronic drug monitors (EDM). We calculated two adherence metrics using the EDM data. The first metric used the proportion of doses taken; the second metric credited doses as adherent only if taken within a 1-h window of a pre-specified dose time (EDM ‘proportion taken within dose time’). Of the adherence measures, EDM had the strongest associations with viral suppression. Of the two EDM metrics, incorporating dose timing had a stronger association with viral suppression. We conclude that dose timing is also an important determinant of successful ART, and should be considered as an additional dimension to overall adherence.     

Red Blood Cell Antibody Screening with Groupamatic System

Abstract. The trypsin-polybren-citrate (TPC) technique is based on Lalezari's method and has been developed on the Groupamatic equipment to allow the screening of irregular alloantibodies which are not detectable on this machine by the present routine techniques. TPC screening has two main advantages: it gives more reliable results for Rh, Kell, Lewis and P antibodies than bromelin-methyl-cellulose, and it permits the screening of Duffy and Kidd antibodies. However, although the TPC technique contributes to an improved quality of the automated screening of blood donor samples, it should not be used as the only method when recipient samples are concerned.     

Red Cell Antibody Screening with the Groupamatic System

These data comprise 1,231,024 routine tests carried out over a 5-year period on voluntary blood donors. The percentage of positive results on the machines varies from 1 to 3% of the total number of samples tested. Antibodies identified either by manual or automated techniques make up 15--20% of the positive screening reactions. Rhesus, Luewis and P systems prevail, whilst Duffy, Kidd and Ltheran systems are absent. This screening has three main advantages: the supply of plasma for our production of test sera, or therapeutic immunoglobulins; protection of the recipient; partial information on the donor's immunohaematological state, especially for the risk of giving him incompatible blood sometimes in the future.