Aged venous thrombi: radioimmunoimaging with fibrin-specific monoclonal antibody

Radioimmunoimaging of fresh canine venous thrombi with a murine monoclonal antibody specific for human and dog fibrin has been reported. Successful imaging of canine deep venous thrombi 1, 3, and 5 days old at the time of antibody injection is reported. Images were positive in all dogs, and the uptake of fibrin-specific antibody was equivalent to that of fresh thrombi.     

ABO compatibility can influence the results of platelet transfusion. Results of a randomized trial

Sixty consecutive patients with untreated acute leukemia alternately received either ABO-matched or ABO-mismatched random-donor platelet transfusions prepared from pooled platelet concentrate stored for 1 to 3 days. Patients were assigned randomly to receive matched or mismatched platelets as their first transfusion, and the first four transfusions were analyzed. In 40 evaluable patients, there was no significant difference (paired t test) between the 10-minute posttransfusion corrected count increments (CCI) of the initial transfusions of matched and mismatched platelets. In contrast, the second matched transfusion was significantly better than the second mismatched transfusion. This effect of ABO compatibility was particularly pronounced in a subset of patients. Six patients in whom mismatched transfusions were consistently inferior to matched transfusions had either a significant increase in anti-A or -B isoagglutinin titers following the first transfusion or elevated titers before or at the conclusion of the study. Conversely, in five patients in whom there was no apparent effect of ABO mismatching, only one had an increase in isoagglutinin titer. Platelet survival was not altered as the ratio of 18-hour to 10-minute posttransfusion CCl was 0.6 for both matched and mismatched platelet transfusions. These data demonstrate that ABO compatibility can affect the results of random-donor platelet transfusions and that patients who experience poor increments from ABO-mismatched platelets may benefit from a trial of ABO-compatible platelets before the initiation of HLA-matched platelet transfusion.     

PRIMARY MENINGOCOCCAL CONJUNCTIVITIS IN CHILDREN

SUMMARY Four cases of primary meningococcal conjunctivitis in children are reported. This represents an incidence of 2% of patients presenting with conjunctivitis to a paediatric A&E department. All were initially treated with topical chloramphenicol, followed by systemic rifampicin once the diagnosis had been established. No ocular or systemic complications developed, nor recolonisation of the conjunctiva or colonisation of the nasopharynx at follow-up (1–2 years).     

MASSIVE LOWER GASTROINTESTINAL HAEMORRHAGE SECONDARY TO METASTATIC SQUAMOUS CELL CARCINOMA OF THE LUNG

SUMMARY Clinically significant symptoms due to gastrointestinal metastases from primary lung cancers is rare. A case of life-threatening lower gastrointestinal haemorrhage secondary to metastatic squamous cell carcinoma of the lung is reported. Previous reports of such metastases are reviewed, with reference to management and prognosis. After resection of colonic metastases from squamous cell lung cancer, survival is similar to that for primary disease. It is suggested that patients with known or suspected squamous cell lung cancer presenting with lower gastrointestinal symptoms be managed as aggressively as those with no previous history of disease.     

Kinetics of peripheral blood mononuclear cell mobilization with chemotherapy and/or granulocyte-colony-stimulating factor: implications for yield of hematopoietic progenitor cell collections

BACKGROUND: Peripheral blood progenitor cells (PBPCs) are commonly collected and used to reconstitute hematopoiesis after high-dose chemotherapy. However, strategies for optimal collection and assessment of leukapheresis components are not standardized. STUDY DESIGN and METHODS: Hematopoietic progenitor cell assays were performed on 369 leukapheresis components collected from 95 patients who had received doxorubicin-based chemotherapy and/or granulocyte-colony-stimulating factor (G-CSF). Precollection patient hematologic values, leukapheresis collection values, component hematopoietic progenitor cell assays, and patient outcome measures were summarized. The kinetics of mononuclear cell (MNC) and PBPC mobilization were assessed among four patient groups. RESULTS: Patient group was a significant predictor of the peripheral blood MNC count on the day of collection (p<0.0001), and that value was a significant predictor of granulocyte-macrophage– colony-forming unit (CFU-GM) yield (p<0.0001). This relationship between the peripheral blood MNC count on the day of collection and CFU- GM yield differed according to patient group (p<0.0001). CFU-GM made up a larger fraction of peripheral blood MNCs collected from patients who received chemotherapy plus G-CSF than collected from those who received G-CSF alone. Moreover, the peripheral blood MNC count and the corresponding CFU-GM yield increased significantly on consecutive days of collection in patient groups receiving chemotherapy and G-CSF but were unchanged or decreased in patients receiving G-CSF alone. CONCLUSION: The relationship between peripheral blood MNC count and leukapheresis component CFU-GM yield differed significantly between patients who received chemotherapy and G-CSF and those who received G- CSF alone for the mobilization of PBPCs. Patient peripheral blood MNC count and component CFU-GM yield are useful for both assessing and suggesting revisions to PBPC mobilization and collection strategies.     

Cytomegalovirus-seronegative blood components for the prevention of primary cytomegalovirus infection after marrow transplantation. Considerations for blood banks

The authors report 2.5 years' experience with the use of cytomegalovirus (CMV)-seronegative blood components for the prevention of primary CMV infection after allogeneic marrow transplantation from seronegative marrow donors to 104 CMV-seronegative patients. Patients and blood donors were screened for CMV-seronegativity by a combination of passive latex agglutination, complement fixation, and indirect hemagglutination CMV antibody screening methods. Changes in blood banking procedures necessary to provide CMV-seronegative components are detailed. Providing CMV-seronegative components was a considerable undertaking; a mean, per patient, of 19 units of red cells and 105 units of platelets was required. Twenty percent of the platelet support was provided by family members and 80 percent by volunteer donors. CMV-infection was eliminated in all but one patient not considered infected at the time of transplantation. The capability to provide CMV-seronegative components depends on an adequate supply of seronegative donors, a sensitive and practical screening method for CMV antibody, a major commitment by the blood bank, and close communication between the blood bank and the patients' physicians.     

音乐疗法对门诊输液患者心理的影响

目的探讨中医五行音乐疗法对门诊输液患者心理安抚的作用与效果。方法2006年3月-2007年3月，按四时节气的不同，依据中医的五行相克理论，对治疗组的408例门诊输液患者进行音乐干预，而同期对照组396例门诊输液患者不接受音乐疗法。采用自制的调查表，获取他们对环境和服务的满意程度。结果治疗组患者，对门诊输液的满意度较对照组高，差异有统计学意义，P〈0.01。治疗组患者，对医院和本部的投诉率较对照组低，差异有统计学意义，P〈0.01。结论音乐疗法对门诊输液患者的心理有一定的安抚作用。     

组胺支气管激发试验在咳嗽变异性哮喘中的应用

目的探讨咳嗽变异性哮喘患者（CVA）组胺支气管激发试验的结果。方法对244例拟诊CVA用肺功能仪测定基础肺功能及吸入不同剂量组胺后的肺功能，对照激发前后结果。结果244例患者支气管激发试验阳性160例（65．57％），阴性77例（31．56％），可疑阳性7例（2．87％）。160例支气管激发试验阳性患者按支气管哮喘予吸入糖皮质激素及支气管舒张剂治疗，症状缓解。结论组胺支气管激发试验对咳嗽变异性哮喘的诊断具有临床意义，此方法安全适用。