Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

Background and aims  

There still is a lack of prospective studies on bone mineral development in patients with a history of early onset Anorexia nervosa (AN). Therefore we assessed associations between bone mass accrual and clinical outcomes in a former clinical sample. In addition to an expected influence of regular physical activity and hormone replacement therapy, we explored correlations with nutritionally dependent hormones.     

跨专业团队合作式自我管理教育对体检高血压患者的干预效果研究

目的 探讨跨专业团队合作式自我管理教育在体检高血压患者干预中的应用效果。方法 选取2019年4—6月在武汉某三级综合性教学医院的100名体检的高血压患者为研究对象,实施跨专业团队合作式自我管理教育。分别在干预前、干预3个月末、干预6个月末评估患者低密度脂蛋白胆固醇控制达标率、高血压治疗态度与信念评分、高血压治疗依从性评分、血压控制达标率。结果 干预前、干预3个月末、干预6个月末高血压患者低密度脂蛋白胆固醇及血压控制达标率比较差异具有统计学意义（P<0.001）。干预前、干预3个月末、干预6个月末高血压患者坚持治疗态度与信念、服药治疗态度与信念、治疗性生活方式态度与信念、持续治疗困扰与顾虑得分比较差异有统计学意义（P<0.001）。干预前、干预3个月末、干预6个月末高血压患者遵医服药行为、不良服药行为、日常生活管理行为、烟酒嗜好管理行为得分比较差异有统计学意义（P<0.001）。结论 跨专业团队合作式自我管理教育对体检高血压患者进行健康管理,可提高患者治疗的态度与信念及治疗依从性,从而提高患者血压及低密度脂蛋白胆固醇控制达标率。     

Bacterial contamination rates following processing of bone marrow and peripheral blood progenitor cell preparations

BACKGROUND: The performance of cultures to assess possible bacterial contamination of bone marrow and peripheral blood progenitor cell preparations is required by the standards of the American Association of Blood Banks. STUDY DESIGN AND METHODS: Consecutive (n = 893) bone marrow and peripheral blood progenitor cell preparations were cultured for assessment of possible contamination by microorganisms. RESULTS: Consecutive bone marrow and peripheral blood progenitor cell preparations (n = 893) were cultured; the overall positive rate detected was 2.5 percent (22/893). The isolates predominantly were skin contaminants (gram-positive cocci) and so-called water-borne organisms (gram-negative rods). The 6.0-percent rate of positivity in 317 bone marrow preparations was higher than the 0.5-percent rate in 576 peripheral blood progenitor cell preparations (p < 10(-6)). Culture- positive preparations were transfused to 16 patients at this institution; however, none of these transfusions led to documented sepsis with the contaminating organism. CONCLUSION: The culture method described here complies with the standards of the American Association of Blood Banks. Contamination can be detected in both bone marrow and peripheral blood progenitor cell preparations. When contaminated preparations are transfused, there are few complications that can be attributed to the contamination.     

Blood counts in healthy donors 1 year after the collection of granulocyte-colony-stimulating factor-mobilized progenitor cells and the results of a second mobilization and collection

BACKGROUND : Granulocyte–colony-stimulating factor (G–CSF)-mobilized blood cells are being used for allogeneic transplants, but the long-term effects of G–CSF on healthy individuals are not known. Furthermore, it is not certain how many CD34+ cells can be collected in a second mobilization and collection procedure. STUDY DESIGN AND METHODS : Nineteen people were given 2, 5, 7.5, or 10 μg of G–CSF per kg per day for 5 days, and blood progenitor cells were collected by apheresis on the sixth day; this was done on two occasions separated by at least 12 months. Blood counts obtained before and after each course of G–CSF and the quantity of cells collected were compared. RESULTS : There were no differences in white cell (WBC), platelet, red cell, and WBC differential counts measured before each course of G–CSF, and all the values were in the normal range. In a subset of 12 people who received 7.5 or 10 μg of G–CSF per kg per day for both courses, the numbers of neutrophils, mononuclear cells, and CD34+ cells in the blood after each course were similar (34.1 ± 7.31 × 10⁹/L vs. 36.4 ± 12.3 × 10⁹/L, p = 0.24; 6.59 ± 2.28 × 10⁹/L vs. 5.63 ± 2.11 × 10⁹/L, p = 0.24; and 92.0 ± 55.6 × 10⁶/L vs. 119.2 ± 104.6 × 10⁸/L; p = 0.48, respectively), as were the quantities of mononuclear cells (31.0 ± 8.4 × 10⁹ vs. 31.0 ± 6.1 × 10⁹; p = 0.64) and CD34+ cells (417 ± 353 × 10⁶ vs. 449 ± 286 × 10⁶; p = 0.53) collected in the two apheresis procedures. Furthermore, there was a positive correlation between the quantity of CD34+ cells collected from each of the 12 people per liter of whole blood processed in the two procedures (r² = 0.86, p<0.001). CONCLUSION : One year after the administration of G–CSF to healthy people, their blood counts were normal and unchanged from pretreatment counts. If healthy people donate blood progenitor cells after a second G–CSF course, the quantity of CD34+ cells collected will be similar to that obtained in the first collection.     

Hereditary dysfibrinogenemia in a patient with thrombotic disease

A new case of congenital dysfibrinogenemia, in which the patient has severe thrombotic disease, is reported. The abnormal fibrinogen molecules are characterized by normal fibrinopeptide release with thrombin and defective polymerization in the formation of fibrin. Clotting times with ancrod and reptilase are significantly prolonged. All other coagulation tests (except those for fibrinogen function) are normal, and the patient has no other underlying disease. The apparent paradox of defective fibrinogen, which clots abnormally and is yet associated with thrombotic disease, can be explained by further analysis of the patient's fibrinogen. The two important functional properties of this fibrinogen are: (1) it forms fibrin gels that are extremely rigid, and (2) the fibrin is highly resistant to lysis by plasmin. Thus, although the abnormal fibrinogen forms defective clots, the fibrin that is formed cannot be removed by the fibrinolytic system. These results provide a molecular explanation for the thrombotic disease in this patient. This abnormal fibrinogen appears to have unique characteristics and has been designated as fibrinogen Chapel Hill Ill.