In-service training with videotape is useful in teaching transfusion medicine principles

BACKGROUND: Failure to follow the basics of patient identification caused the ABO-incompatible transfusion and death of an anesthetized patient. An investigation found that the medical center's transfusion policy, while adequate, was not being disseminated uniformly to all personnel. STUDY DESIGN AND METHODS: With the help of the hospital's medical media department, a 23-minute videotape was produced emphasizing the importance of patient identification during phlebotomy and blood administration. Each department involved in blood transfusion was separately trained for a total of 182 persons trained. To assess whether learning had occurred, a 10-question quiz was administered both before and after the video was presented. A one-tailed t test was performed, and p < 0.05 was considered significant. RESULTS: The overall pre-video test mean was 8.0 and the post-video test mean was 9.5. The difference was highly significant at p < 0.00005. Except for the Transfusion Medicine Service, which had a perfect score on the pre- video test, all departments improved their scores with p values ranging from less than 0.00005 to 0.014. CONCLUSION: This study demonstrates that learning did occur. Videotape is useful for in-service training and can be used for teaching on a variety of topics in transfusion medicine.     

Frequency and patterns of abnormality detected by iodine-123 amine emission CT after cerebral infarction

Single photon emission computed tomography (SPECT) was performed in 31 patients with cerebral infarction and 13 who had had transient ischemic attacks, using iodine-123-labeled N,N,N'-trimethyl-N'-(2-hydroxyl-3-methyl-5-iodobenzyl)-1,3-propanediamin e (I-123-HIPDM) as the radiopharmaceutical. SPECT scans were compared with computed tomographic (CT) scans. SPECT was as sensitive as CT in detecting cerebral infarction (94% vs. 84%). The abnormalities were larger on the SPECT scans than on the CT scans in 19 cases, equal in seven, and smaller in five (SPECT abnormalities greater than or equal to CT abnormalities in 86% of cases). Fifteen of 30 patients with hemispheric infarction had decreased perfusion (decreased uptake of I-123-HIPDM) to the cerebellar hemisphere contralateral to the cerebral hemisphere involved by the infarction (crossed cerebellar diaschisis). Nine of these 15 patients had major motor deficits, while only one of the 15 without crossed cerebellar diaschisis had a major motor deficit.     

Estimation of the magnitude of the HIV epidemic among homosexual men: Utilization of survey data in predictive models

A group of 709 randomly selected males aged 18–55 years living in the city of Amsterdam, the Netherlands, were questioned about sexual lifestyle and related behavior. A substantial proportion (10%) of these men appeared to be homo- or bisexual. Of these homo- and bisexual men, 16.5% were predicted to be HIV seropositive, using their behavioral information in logistic regression models derived from a second study among 506 homo- or bisexual volunteers who were questioned and tested for HIV antibodies as well.Generalizing the results of the sample, the magnitude of the homo - and bisexual population in Amsterdam is estimated to be 21,500 (95% confidence interval: 17,000–26,000) of whom 3500 are HIV seropositive. This is in agreement with estimations on the basis of AIDS surveillance data. The study shows that in the absence of serological data it is possible to estimate HIV prevalence, given that the relation between the presence of HIV antibodies and sexual activity or indicators for sexual activity is known. Since serological data are lacking in many occasions, this method may be of help to estimate HIV prevalence in other geographic locations and risk groups.     

Post-traumatic abnormalities of the pubic bone simulating malignancy

Three cases are presented in which unusual healing patterns of pubic features simulated malignant processes. Consideration of trauma as an etiologic factor in such cases may obviate the need for extensive clinical and histologic evaluation.     

皮炎消净饮I号冲剂治疗异位性皮炎的实验研究

目的：研究皮炎消净饮I号冲剂（PYXJY1）治疗异位性皮炎（AD）的作用机理。方法：①动物实验：二硝基氯苯（DNCB）所致豚鼠耳肿试验,致敏处真皮内单核细胞和淋巴细胞聚集试验;醋酸所致小鼠腹腔毛细血管通透性增加试验。②实验室检测：单克隆抗体免疫荧光标记法检测AD患有治疗前后的CD4／CD8（TH／Ts）水平。结果：PYXJY1可明显抑制二硝基氯苯所致豚鼠耳肿胀及其真皮内单核细胞和淋巴细胞聚集,抑制醋酸所致小鼠腹腔毛细血管通透性的增加,作用与氢化可的松相似。使AD患者升高的CD4／CD8降低至正常。结论：PYXJY1具有良好的抗炎和迟发变态反应作用,并可调节AD患者CD4／CD8水平,对AD有较好的治疗效果。     

Pharmacological inhibition of EGFR tyrosine kinase affects ILK-mediated cellular radiosensitization in vitro

Purpose: Integrin-linked kinase (ILK) mediates signals from β integrins and links integrins to epidermal growth factor receptor (EGFR). Previous studies have identified an antisurvival effect of ILK in irradiated cells. The aim of this study was to evaluate the role of EGFR tyrosine kinase (tk) activity for ILK-mediated radiosensitization.

Materials and methods: Human FaDu squamous cell carcinoma (SCC) cells stably transfected with hyperactive ILK (ILK-hk) and ILK^fl/fl and ILK^?/? mouse fibroblasts were treated with the pharmacological EGFR-tk inhibitor BIBX1382BS without or in combination with single doses of X-rays. Clonogenic radiation survival, protein expression and phosphorylation (EGFR, v-akt murine thymoma viral oncogene homolog 1 (Akt), p42/44 mitogen-activated protein kinase), DNA-double strand break (DSB) repair measured by γH2AX foci, cell morphology and cell cycle distribution were examined.

Results: Expression of ILK-hk or ILK^fl/fl status resulted in significant radiosensitization relative to vector controls or ILK^?/?. Following BIBX1382BS, clonogenic survival of normal fibroblasts and vector controls remained unaffected while ILK-hk-related radiosensitization was significantly diminished. In contrast to BIBX1382BS, which did not affect DNA-DSB repair, ILK-hk-mediated radiosensitization was associated with reduced DNA-DSB repair. At 10 days after BIBX1382BS treatment, FaDu transfectants, in contrast to fibroblasts, showed reduced cell size, accumulation of G1 phase cells and reduced Akt-serine(S)473 phosphorylation.

Conclusions: Our findings confirm ILK as a cell type-independent antisurvival factor in irradiated cells, which actions in terms of radiosensitization critically depend on proper EGFR-tk activity.     

hs-CRP is a potential predictor of no-reflow in patients with AMI after emergency PCI

The paper aims to determine whether the inflammation,a powerful risk factor that has been demonstrated for the development of coronary artery disease,plays a role in no-reflow phenomenon in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods We prospectively analyzed 656 patients with AMI after primary PCI.Based on post-PCI angiography data,patients were divided into two groups:the no-reflow group (TIMI=2,n =60) and the reflow group (TIMI=3,n =596).Results Our results showed that the inflammatory factors including leukocyte count (×109/L) (10.90±4.04 vs.9.12±2.98 P =0.002),hs-CRP (5.04±0.71 vs.4.70±0.75 P =0.001) and other factor platelet count (×109/L) (210.96±33.42 vs.196.41±46.06 P =0.033) in no-reflow group are significantly higher than those in reflow group,major adverse cardiac events happened in the patients with no-reflow are higher than in reflow patients no matter in hospital or at the end of follow-up.We also found the left ventricular ejection fraction (LVEF) dramatically decreased (58.65±9.34 vs.51.29±11.38,P＜0.001) and left ventricular end-diastolic dimension (LVEDD) significantly increased (49.94±6.75 mm vs.54.66±6.68mm,P＜0.001) in no-reflow patients at the end of follow-up.Conclusions Our results suggest that inflammation factors function in no-reflow phenomenon,and no-reflow is a serious complication after primary PCI which predicts poor left ventricular systolic functional recovery and mortality in patients with AMI.(J Geriatr Cardiol 2008;5:217-222)