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Packed red cell units (n = 10) were filtered and divided equally. One-half unit from each donor was irradiated (x) (3500 cGy). On Days 0, 14, 28, and 42, ATP, K+, Na+, lactate dehydrogenase (LDH), plasma-free hemoglobin (PFH), and pH were determined. The reduction in ATP was greater in the irradiated than the nonirradiated (y) units by Day 42 (mean x-y: -70, p = 0.0005). The increase in K+ was greater in the irradiated than nonirradiated units on Days 14, 28, and 42 (mean x-y: 17-20, p = 0.0001). Decrease in pH and increases in LDH and PFH were significant (p less than 0.05) on Day 42 only. K+ increases added only 1.7 to 2.0 mmol per unit, a difference felt to be clinically insignificant. The changes noted in ATP, pH, LDH, and PFH are significant but minimal on Day 42 and imply that viability changes would also be minimal. These biochemical data support the storage of irradiated units for at least 28 days. 相似文献
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Interdisciplinary Discrepancies Between Parenteral Nutrition Macronutrient Prescribing and Recommendations: Is Body Mass Index a Factor? 下载免费PDF全文
Katie L. Elliott MS RD CDE Jay Kandiah PhD RD CD Todd A. Walroth PharmD BCPS 《JPEN. Journal of parenteral and enteral nutrition》2017,41(5):759-765
Background: Formal nutrition training in medical schools and residencies is lacking and needed. Registered dietitians (RDs) are formally trained in nutrition support and considered experts in the nutrition field. Our purpose was to examine prescribing and recommending discrepancies of parenteral nutrition macronutrients between medical residents (MRs) and RDs and compare results with the ASPEN clinical care guidelines. We also looked at discrepancies among obese patients, due to their increased risk of mortality. Materials and Methods: The primary end point of this retrospective review was discrepancies in nonprotein calories (NPCs) and grams of protein (PRO) between MRs and RDs. The secondary end point was discrepancies in NPCs and PRO between MRs and RDs among patients stratified by body mass index category. Results: MRs prescribed 300 NPCs more versus RDs (P < .001). When compared with RDs, MRs prescribed fewer NPCs for underweight patients and more for obese patients (P < .001). The same analysis found that the PRO discrepancies significantly varied by body mass index classification as well (P = .022). When these results were compared with the ASPEN clinical care guidelines, RDs adhered closer to the guidelines than did MRs in terms of permissive underfeeding of obese patients. Conclusion: It is widely accepted that MRs are in need of increased formal training, and the results of our study confirm this need and suggest a short‐term solution of increasing order‐writing privileges for the RD. RDs with this privilege may adhere more closely to clinical care guidelines and therefore increase patient safety. 相似文献
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Peritoneal interleukin-10 increases with decrease in activated CD4+ T lymphocytes in women with endometriosis 总被引:6,自引:5,他引:6
Ho HN; Wu MY; Chao KH; Chen CD; Chen SU; Yang YS 《Human reproduction (Oxford, England)》1997,12(11):2528-2533
This study was performed to determine whether peritoneal T cells are
suppressed in the CD4+ or CD8+ T cell subpopulation and whether they are
Th1 or Th2 predominant in women with endometriosis. Immune cells in the
peritoneal fluid (PF) were obtained from women undergoing laparoscopy for
endometriosis or tubal ligation. Three-colour flow cytometry was utilized
for immunophenotyping of peritoneal fluid mononuclear cells (PFMC).
Concentrations of interleukin (IL)-4, IL-5 and interferon-gamma (IFN-gamma)
produced by PFMC with and without mitogen stimulation and concentrations of
IL-10 and IL-12 were measured in PF. The peritoneal T lymphocytes were
predominantly of the Th1 type that produced much more IFN-gamma but less
IL-4 or IL-5 in women with or without endometriosis. The decrease in
peritoneal lymphocytes was significant in the HLA-DR+ CD4+ CD3+
subpopulation and the concentrations of peritoneal IL-10 and IL-12 were
significantly elevated in women with early stage endometriosis. There was
impaired IL- 5 production by PFMC after phytohaemagglutinin stimulation in
women with advanced stage endometriosis. We concluded that the activated
peritoneal CD4+ Th1 cells from the women with endometriosis were decreased
in number. The suppression of these T cells may be due to the elevation of
IL-10 and IL-12 in the peritoneal fluid.
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Perle Feldman MDCM CCFP FCFP Rivka Cymbalist CD Saraswathi Vedam RM MSN FACNM SciD Andrew Kotaska MD FRCSC 《分娩》2010,37(3):245-251
Abstract: The stories in this Roundtable Discussion are related by two women whose babies were born recently in Canadian hospitals. Each woman had undergone a cesarean delivery for her first child, and whereas Sophia delivered her second baby by vaginal birth after a cesarean (VBAC), Marie was unable to find a practitioner or hospital that would allow her to have a VBAC for her second birth. The women describe how they feel about their choices and experiences. Their two accounts and the issues that they raise are discussed in commentaries by a family physician, midwife, doula, and obstetrician. (BIRTH 37:3 September 2010) 相似文献