Leukocyte-reduced transfusions in cardiac surgery results of an implementation trial

An implementation trial of leukocyte-reduced transfusions in cardiac surgery (primary coronary artery bypass graft and valve replacement) was performed from July to December 1998; comparisons were made with data from the same period in 1997. Patients from both periods were similar in important preoperative and intraoperative variables (age, sex, weight, number of units of RBCs transfused, ejection fraction). The mean total number of complications was statistically significantly decreasedfrom 0.26 complications per patient in the non-leukocyte-reduced to 0.19 in the leukocyte-reduced recipients. Overall, the mean +/- ISD costs of care per patient decreasedfrom 1997 ($27,615 +/- $33,973) to 1998 ($27,038 +/- $24,107). Mean costs decreased $1,700 per patient for recipients of leukocyte-reduced blood in 1998 compared with recipients of non-leukocyte-reduced blood in 1997 Mean costs increased $4,000 per patient in patients who did not receive transfusions in 1998 compared with 1997. Hospitalization costs decreased when leukocyte-reduced transfusions were implemented for patients undergoing cardiac surgery in our institution. Implementation of leukocyte reduction may be cost neutral or cost saving in at least some settings.     

Development of a competitive enzyme-linked immunosorbent assay for detecting cytomegalovirus antibody

A competitive enzyme-linked immunosorbent assay (ELISA) for detecting cytomegalovirus (CMV) antibody was developed. The competitive ELISA was five times more sensitive than the complement fixation test (CFT) and twice as sensitive as indirect ELISA. Testing of paired sera from cardiac transplant patients taken before and after transplantation showed good correlation between results of competitive and indirect ELISA and CFT. The competitive ELISA was more successful than CFT or indirect ELISA in detecting passively acquired antibody, but detection of CMV antibody by competitive ELISA immediately after primary CMV infection was unreliable, possibly because of the high affinity of the monoclonal antibody chosen for the horseradish peroxidase conjugate. However, competitive ELISA may well prove to be more suitable than indirect ELISA for detecting CMV antibody in blood donations.     

Disposition of amino acid synaptic transmitters, acetylcholine and substance P in the LM-suprageniculate nuclear complex of the cat's thalamus.

Immunocytochemical analysis with antibodies raised against aspartate, glutamate, gamma-aminobutyrate (GABA), choline acetyltransferase (ChAT), and substance P (SP) have allowed the transmitter characterisation and distribution of cells of the lateralis medialis-nucleus suprageniculatus (LM-SG) complex to be made at the level of the light microscope. We have found that the intranuclear distributions of aspartate and glutamate differed substantially from that of GABA, as well as there being specific and, in some cases, major differences in the respective populations of cells labelled with all three amino-acid-sensitive antibodies. ChAT-labelled elements were disposed very similarly to acetylcholinesterase (AChE)-positive subregions of the nuclear complex, while SP labelling was comparatively weak, albeit present, throughout the region. These data provide an important first step towards the further understanding of the details of the neurochemical and functional identity of the LM-SG complex.     

REM sleep deprivation increases preference for novelty in rats.

As a further test of the hypothesis that REM deprivation decreases fear, the behavior of 40 male rats was measured in a Y-maze adapted to test for preference for novelty. Prior to this test, the animals were exposed for 4 days to one of four treatments, i.e., either a dry environment control, a wet environment control, a 2-day REM deprivation period or a 4-day REM deprivation period. During the test both number of grid crossing in the novel and non-novel arms of the Y-maze and three indices of emotionality were recorded. The results were congruent with data we had reported earlier and offered convincing evidence in support of the hypothesis.     

Shadowing program to increase student awareness of hospital pharmacy practice

A shadowing program designed to acquaint second-year pharmacy students with the professional responsibilities of a hospital pharmacist is described. The program developed by the Toledo Area Society of Hospital Pharmacists allowed second-year pharmacy students to "shadow" a staff pharmacist for three to four hours. The program required the cooperation of area hospital pharmacists to develop rotations at each site. Eight hospitals provided shadow rotations for 87 students during the program's first offering. Reactions were positive from both students and pharmacists. Direct pharmacist-student interaction, low cost, and flexibility were important factors in the program's success. The shadowing program has proven to be an effective method of introducing hospital pharmacy career options to prepharmacy students.     

Aortic arch dissection with an aberrant right subclavian artery: surgical treatment

Acute dissection of the aortic arch with an aberrant subclavian artery is a rare finding. This report documents the successful treatment of this unusual problem. A 56-year-old man, brought into the emergency room with severe epigastric, chest, and interscapular pain, was treated medically until stabilized. Operation was then recommended and accepted; whereupon, dissection and control of the arch vessels, including the aberrant right subclavian artery, was accomplished. At follow-up, 3 months after discharge, the patient is active, without pain, and his blood pressure is well controlled.     

Differential effects of α-β-methylene ATP on responses to nerve stimulation in SHR and WKY tail arteries

Summary The effects of ,-methylene-adenosine triphosphate, (,-methylene ATP, a P₂-receptor desensitising agent) have been evaluated on vasoconstrictor responses elicited by exogenous agonists or electrical field stimulation in isolated perfused SHR or WKY tail arteries and on tritium release elicited by electrical field stimulation in SHR-tail arteries pre-labeled with ³H-noradrenaline.Exposure to ,-methylene ATP (0.1 mol/l) significantly inhibited vasoconstrictor responses to electrical field stimulation in SHR tail arteries. These inhibitory effects were not further increased at a higher concentration of ,-methylene ATP (1 mol/l). In WKY tail arteries, ,-methylene ATP (1 mol/l) failed to significantly inhibit vasoconstrictor responses to electrical stimulation.In SHR tail arteries prelabelled with ³H-noradrenaline, ,-methyleneATP (1 mol/l) did not inhibit the stimulation evoked release of tritium. However, at this concentration, ,-methylene ATP significantly antagonized the vasoconstrictor responses of SHR tail arteries induced by exogenous ATP (1 mol/l), ,-methylene ATP (30 mol/l), a stable agonist at P₂-receptors, or 60 mmol/l KCl. These effects of ,-methylene ATP on contractile responses to KCl were not observed in WKY-tail arteries.In tail arteries obtained from reserpine pretreated SHR, despite a 85–95% decrease in endogenous noradrenaline tissue content, the vasoconstrictor responses induced by periarterial field stimulation were greatly diminished, but not abolished. These residual responses to periarterial field stimulation were not antagonized by prazosin (0.1 mol/l), but were practically abolished by the addition of ,-methylene ATP (1 mol/l).In tail arteries from WKY rats pretreated with reserpine, exposure to prazosin (0.1 mol/l) further reduced the residual responses elicited by electrical field stimulation. In these WKY-tail arteries, addition of ,-methylene ATP (1 mol/l) did not further inhibit the remaining vasoconstrictor response obtained in the presence of prazosin.While our results suggest a significantly greater cotransmitter role for ATP with noradrenaline in tail arteries of SHR compared with control normotensive WKY rats, additional effects of ,-methylene ATP not involving P₂ receptors cannot be entirely excluded.