Prevalence of HLA sensitization in female apheresis donors

BACKGROUND: Transfusion-related acute lung injury (TRALI) is a serious complication of plasma-containing blood components. Studies have implicated HLA antibodies along with biologically active lipids in stored blood in the pathogenesis of TRALI. It has been proposed that the exclusion of HLA-untested, multiparous donors of plasma-rich components, including plasma and single-donor apheresis platelets, would substantially reduce the risk of TRALI. STUDY DESIGN AND METHODS: To investigate the feasibility of such an exclusion, 332 female plateletpheresis donors with a record of over 9000 donations, none of which were associated with TRALI, were studied. RESULTS: Seventeen percent of female donors demonstrated HLA sensitization. Parity and HLA sensitization were significantly correlated (p<0.0001), with sensitized donors having an average of 2.9 (+/− 0.6 95% CI) prior pregnancies and unsensitized donors having an average of 1.8 (+/− 0.2 95% CI) prior pregnancies. The percentage of HLA-sensitized women with 0, 1 to 2, and > or = 3 pregnancies was 7.8, 14.6, and 26.3, respectively. CONCLUSION: These findings confirm the hypothesis that multiparous women (> or = 3 pregnancies) represent an increased potential risk for TRALI. However, the exclusion of multiparous plateletpheresis donors would eliminate one-third of our female donor pool. Screening such donors for HLA sensitization may represent the optimal approach for identifying donors at risk for causing TRALI, but this still would result in the deferral of 8 percent of female plateletpheresis donors. At present, prospective screening to identify donors at risk for causing TRALI is not justified.     

Fatal Airway Injuries during Operation Enduring Freedom and Operation Iraqi Freedom

Objective. To determine if a single mailing from the local volunteer fire department can increase the number of homes with proper, visible address numbering. Proper numbering is essential in rapidly locating a house during an emergency response. Methods. The study was conducted at a suburban/rural fire department providing EMS andfire suppression services to a 22 square mile area with residential mailboxes located at the street. During a hazard identification pre-plan tour, each house was examined andassigned a classification: (A) No number visible on the house or mailbox (improper); (B) Number on only one side of the mailbox (improper); (C) Number on both sides or the end of the mailbox, or visible on the house (proper). The homeowners of all residences with improper numbering (A or B) were sent a one-page letter, discussing the need for proper numbering. The tour was repeated six weeks later to determine whether deficiencies had been corrected. It was prospectively determined that a 25% improvement was sought. Results. During the pre-plan tour, 73 houses were classified as type A, 454 as type B, and1706 as type C. At the re-visit, 135 (26%) of the type A andB homes had been properly numbered. Correction of deficiencies was better at type A homes (37, or 51%) than at type B homes (98, or 22%) (p < 0.001 by Chi-square). Conclusion. For houses with improper numbering, a single mailing from the fire department can be effective in encouraging residents to post proper numbers.     

马缨丹叶的化学成分研究

自马缨丹(Lantana camara L.)叶中分离到六个化合物。经光谱(UV,IR,MS,¹HNMR,¹³CNMR)和化学分析,分别鉴定为齐墩果酮酸(oleanonic acid,Ⅰ),马缨丹甲素(lantadene A,Ⅱ),马缨丹乙素(lantadene B,Ⅲ),lantanilic acid(Ⅳ),icterogenin(Ⅴ)和4′,5-二羟基-3,7-二甲氧基黄酮-4′-O-β-D-吡喃葡萄糖甙(4′,5-dihydroxy-3,7-dimethoxyflavone-4′-O-β-D-glucopyranoside,Ⅵ)。Ⅵ是新化合物,命名为马缨丹黄酮甙(camaroside)。     

Simulated pulmonary nodules: detection with dual-energy digital versus conventional radiography

Performance of a prototype dual-energy digital chest radiography unit in detecting calcified and noncalcified simulated pulmonary nodules was compared with that of a highly optimized, conventional system. Nodules ranging in size (0.5, 1.0, and 1.6 cm), in number (five to 11), and in calcium content (0-25 mg) were superimposed over the lungs of a frozen, unembalmed, human chest phantom. For each technique, six observers examined 50 posteroanterior projections with different randomized nodule locations. Detection consisted of locating and assigning a level of confidence to each perceived nodular opacity. The resulting plots of the true-positive fraction versus the mean number of false-positive calls per projection indicate that for both calcified and noncalcified nodules, the digital unit performed significantly better (P less than .01).     

Suppression of peroxisomal membrane protein defects by peroxisomal ATP binding cassette (ABC) proteins

X-Linked adrenoleukodystrophy (X-ALD) is a neurodegenerative disorder characterized by reduced peroxisomal very long chain fatty acid (VLCFA) beta-oxidation. The X - ALD gene product (ALDP) is a peroxisomal transmembrane protein with an ATP binding cassette (ABC). ALDP and three other ABC proteins (PMP70, ALDR, P70R) localize to the peroxisomal membrane. The function of this family of peroxisomal membrane proteins is unknown. We used complementation studies to begin analysis of their role in VLCFA beta-oxidation and on the peroxisomal membrane. Expression of either ALDP or PMP70 restores VLCFA beta- oxidation in X-ALD fibroblasts, indicating overlapping functions. Their expression also restores peroxisome biogenesis in cells that are deficient in the peroxisomal membrane protein Pex2p. Thus it is likely that complex protein interactions are involved in the function and biogenesis of peroxisomal membranes that may contribute to disease heterogeneity.      

Utilization of Primary Care versus Specialized Care in Children with and without Chronic Illness: A Population-Based Study

ABSTRACT. Children's utilization of curative care was studied to analyse the division of responsibilities between undifferentiated primary care and specialized care. All chronically ill ( n = 510), a control group ( n = 287) and the total population 0–15 years of age ( n = 6080) in a primary care district were studied using register data. Chronically ill children comprised 8.4% of the total child population and were registered for 1/10 of the primary health care visits, 1/3 of the specialized visits, 1/3 of the hospitalizations and 112 of the in-patient days of all children. The yearly ambulatory visits were 3.7/child in the chronically ill and 1.5/child in the control group, of which 1/3 and 2/3, respectively, were to primary care. Utilization of specialized care increased with disability. Chronically ill children visited primary care mainly for acute respiratory infections but seldom for allergic or other chronic conditions.     

Carcinoma coexisting with Manson's schistosomiasis

Summary The coexistence of extensive infestation bySchistosoma mansoni and adenocarcinoma of the rectum in a young native of Puerto Rico is described. No claim for causal relationship can be made on this isolated experience. Nevertheless, it is suggested that the link between inflammation and neoplasia, if such a link exists, is in the nature of hyperplastic polypoid granulomas resulting from an undefined stimulus acting in a susceptible tissue.Acknowledgment is made of the preparation of the photomicrographs at the direction of Dr. Robert C. Horn, Jr.