A comparative study of reducing the extracellular potassium concentration in red blood cells by washing and by reduction of additive solution

BACKGROUND: Extracellular potassium concentration (K(+)) increases in the supernatant of whole and packed red blood cell units (pRBCs) with duration of refrigerated storage in citrate-phosphate-dextrose-adenine (CPDA-1) and additive solution (AS). Studies have shown that to avoid hyperkalemia, washed pRBCs are preferred if relatively fresh pRBCs are not available. To determine whether a simpler procedure, AS reduction, results in lowering of K(+) in pRBCs comparable to that achieved by washing, the K(+) levels by both methods were compared. STUDY DESIGN AND METHODS: Pre- and post-K(+) levels were measured in 6 washed and 11 AS-reduced pRBC units. Each unit was weighed, hematocrit was determined, K(+) was measured, and total K(+) was calculated. Washed units were 3 to 21 and AS-reduced units were 4 to 30 days old. Statistical analysis was performed with a t test. RESULTS: There was no significant difference (p > 0.35) in the initial K(+) between the two groups (mean +/- SD, 36.95 +/- 13.16 mEq/L before washing and 39.78 +/- 19.94 mEq/L before AS reduction). Washing and AS reduction both led to a significant decrease in K(+) levels (2.15 +/- 0.10 mEq/L after washing and 4.41 +/- 3.04 mEq/L after AS reduction, each p < 0.0005). Washing, however, was significantly better than AS reduction in reducing K(+) in stored pRBCs (p < 0.05). CONCLUSIONS: Washing pRBCs results in very low levels of K(+). AS reduction also significantly reduces K(+) levels. Selection of the method of K(+) reduction will depend on the stringency of K(+) reduction needed, the time constraints, and the availability of facilities and staff for washing.     

Necrotizing enterocolitis as a prognostic factor for the neurodevelopmental outcome of preterm infants - match control study after 2 years

Purpose

Necrotizing enterocolitis (NEC) in very low birth weight infants is a risk factor for developmental delay. To our knowledge, there are no studies published investigating the neurodevelopmental outcome of patients with NEC comparing surgically treated and conservatively treated patients versus match paired controls. The aim of this retrospective case control study was to measure the neurodevelopmental outcome of patients with NEC who were treated surgically or conservatively

The effect of isolated soy protein adjunctive with flaxseed oil on markers of inflammation,oxidative stress,acute phase proteins,and wound healing of burn patients; a randomized clinical trial

Introduction

The objective was to determine the effect of isolated soy protein (ISP) and flaxseed oil (FO) on inflammatory and oxidative stress indices, acute phase proteins, and wound healing of burn patients.

A Clinical Scoring System to Predict the Clinical Sequelae of Computed Tomography Diagnosed Intussusception

World Journal of Surgery - Intussusception in adults is increasingly diagnosed on cross-sectional imaging with a lack of clear recommendations on management. The presence of an underlying lead...     

A systematic review of surveillance after endovascular aortic repair

Objective

The objective of this systematic review and meta-analysis was to evaluate the optimal modality and frequency of surveillance after endovascular aortic repair (EVAR) in adult patients with abdominal aortic aneurysms.

The degeneration of adjacent intervertebral discs negatively influence union rate of osteoporotic vertebral fracture: A multicenter cohort study

Background

With the increasing aging population in developed countries, there has been an associated increased prevalence of osteoporotic vertebral fracture (OVF). Many previous reports have attempted to predict the risk of delayed union associated with OVF. However, the role of endplate failure and the degeneration of adjacent intervertebral discs, and their association with delayed union has received little attention. The aim of this study was to evaluate the endplate fracture and disc degeneration rank as risk factors for delayed union.

Lateral fixation: an alternative surgical approach in the prevention of complete atypical femoral fractures

Little evidence is available on how to treat incomplete atypical fractures of the femur. When surgery is chosen, intramedullary nailing is the most common invasive technique. However, this approach is adopted from the treatment of other types of ordinary femoral fracture and does not aim to prevent the impending complete fracture by interrupting the mechanism underlying the pathology. We suggest a different surgical approach that intends to counteract the underlying biomechanical conditions leading to a complete atypical fracture and thus could be better suited in selected cases. Here, we share an alternative surgical approach and present two cases treated accordingly.     

Adaptive step goals and rewards: a longitudinal growth model of daily steps for a smartphone-based walking intervention

Adaptive interventions are an emerging class of behavioral interventions that allow for individualized tailoring of intervention components over time to a person’s evolving needs. The purpose of this study was to evaluate an adaptive step goal + reward intervention, grounded in Social Cognitive Theory delivered via a smartphone application (Just Walk), using a mixed modeling approach. Participants (N = 20) were overweight (mean BMI = 33.8 ± 6.82 kg/m²), sedentary adults (90% female) interested in participating in a 14-week walking intervention. All participants received a Fitbit Zip that automatically synced with Just Walk to track daily steps. Step goals and expected points were delivered through the app every morning and were designed using a pseudo-random multisine algorithm that was a function of each participant’s median baseline steps. Self-report measures were also collected each morning and evening via daily surveys administered through the app. The linear mixed effects model showed that, on average, participants significantly increased their daily steps by 2650 (t = 8.25, p < 0.01) from baseline to intervention completion. A non-linear model with a quadratic time variable indicated an inflection point for increasing steps near the midpoint of the intervention and this effect was significant (t² = ?247, t = ?5.01, p < 0.001). An adaptive step goal + rewards intervention using a smartphone app appears to be a feasible approach for increasing walking behavior in overweight adults. App satisfaction was high and participants enjoyed receiving variable goals each day. Future mHealth studies should consider the use of adaptive step goals + rewards in conjunction with other intervention components for increasing physical activity.