A seven-year survey of transfusion reactions in a large municipal hospital.
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Biomedical subjects
Publications and source records attributed to C S Feng.
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Results of our experience have shown that SSBO and T & S are cost effective and extremely safe. We believe that the safety in using these guidelines for hemotherapy for elective surgery depends upon a sensitive and meticulously performed T & S, a mechanism by which ABO compatibility can be affirmed and an ongoing surveillance program to monitor the proper operation of these procedures.
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The prevalence of hepatitis B infection among 697 patients in an adult psychiatric hospital was determined by testing for hepatitis B surface antigen (HBsAg) and its antibody (anti-HBs). The test results were 0.86 per cent positive for HBsAG and 20 per cent positive for anti-HBs. This assessment of the prevalence of hepatitis B in a group of elderly long-term institutional patients may be used as a guide when hepatitis B vaccination is being considered for use in a psychiatric hospital. It is noteworthy that the elimination of overcrowding in psychiatric hospitals has contributed significantly to the decline of hepatitis B infection in recent years.
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The indications and dosage of immunoglobulin prophylaxis for viral hepatitis types A and B are well defined. Hepatitis B immune globulin (HBIG) is specific and effective for hepatitis B, but its value is offset by its high cost. Immune serum globulin (ISG) is primarily for hepatitis A, but it also has been found to be effective for hepatitis B and should be considered the choice from a cost-effective point of view. There is no specific immune globulin for hepatitis non-A, non-B, and the efficacy in using ISG has been undetermined. The prerequisite for a rational approach to immunoprophylaxis for viral hepatitis is laboratory determination of serological markers, which confirms the diagnosis of the precise hepatitis type of the index case. Serological testing of the contacts or potential contacts is indicated so that chronic carriers and those with active immunity should be exempted from passive immunization. The expense of laboratory tests is compromised by situations which require the costly HBIG and when the individual is inclined to repeated hepatitis exposure. Viral hepatitis remains a major public health hazard in spite of recent advances in its prevention. Another stride in future control of viral hepatitis will depend on the introduction of vaccines for all types of hepatitis and reliable laboratory tests for the detection of hepatitis non-A, non-B.
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A modified reversed passive hemagglutination test for the detection of hepatitis B surface antigen HBsAg is described. Sera and reagent cells coated with antibody to HBsAg (anti-HBs) are loaded separately into the rotor of a miniature centrifugal fast analyzer. The rotor is centrifuged briefly to transfer the components into its cuvettes. After mixing, the suspensions are allowed to stand at room temperature for 30 min, following which the rotor is again centrifuged and the absorbance of each cuvette is monitored. Cells suspended in serum containing HBsAg leave the light path more rapidly than cells suspended in sera free of antigen. The magnitude of change in absorbance varies directly with the concentration of the antigen. In 45 sera tested by the conventional V-plate technique, findings were as follows: 21 positive, 19 false positive and 5 negative. The automated procedure unequivocally differentiated the 21 positives; results for the false positive and negative specimens were identical and clearly distinguishable from the positive results. The automated procedure enhances specificity, offers equivalent sensitivity, and results that are quantitative and objective.
Centrifugal analysis can be used to detect hepatitis B surface antigen, antibody to rubella virus, and fibrin-related antigen. The procedure is performed with the same reagents used in conventional hemagglutination studies. Positive and negative reactions are distinguished by the rates of erythrocyte clearance in the centrifugal field (delta A/delta time); positive cells move more rapidly than negative cells, and this difference varies directly with the concentration of detectable antigen or antibody. This phenomenon is thought to be a result of the greater adhesion of negative cells to the cuvette's surface. Sensitivity and specificity are greater in the centrifugal analysis technique than in the more conventional hemagglutination tests. False-positive reactions are eliminated and the quantitative data are accurate and reproducible.
A variant of type B blood was found in three members of a family from El Salvador. In two members, both genotype BO, the blood and saliva had the characteristics of the phenotype Be1 . In the third member, genotype A2B, the red cell B antigen was stronger than in his BO genotype relatives. Thus, in this family, the presence of the A2 gene appeared to enhance the expression of the B gene.
The Lui elution and the heat elution techniques are the most simple techniques available for eluting antibodies from red cells. Both are very effective for eluting ABO antibodies. We compared the two techniques and found the Lui technique superior in that it more efficiently eluted ABO antibodies, required less hands-on time, and allowed more flexibility in the procedure. We therefore recommend the Lui elution technique as the method of choice for eluting ABO antibodies, especially for the evaluation of hemolytic disease of the newborn.
Four commercial test kits for detecting cytomegalovirus (CMV) antibodies (indirect hemagglutination assay, indirect fluorescent antibody technique, enzyme immunoassay, and passive latex agglutination technique) were compared according to their technical demand, hands-on time, turnaround time, concordance with other techniques, reagent cost per test, and objectivity. The indirect hemagglutination assay, the enzyme immunoassay, and the passive latex agglutination technique produced identical results in 85 donors, detecting 63 positive and 22 negative samples. The indirect fluorescent antibody technique showed discrepant results in four samples. The passive latex agglutination technique rated best overall since it was technically the easiest and required the least hands-on and turnaround times; the short turnaround time (10 minutes) rendered the latex technique a more flexible test for blood bank use because both scheduled and emergency CMV screening of donors could be accommodated. The comparatively high reagent cost of the latex test kit could be offset by savings on technologist time.
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