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John Freedman

Publications and source records attributed to John Freedman.

41 records · Page 3Linked to original sources

A rabbit model for monitoring in vivo viability of human platelet concentrates using flow cytometry.

BACKGROUND: Viability in vivo of novel platelet components cannot be readily determined in human transfusions. Elaboration of valid animal models may be useful for this purpose. STUDY DESIGN AND METHODS: Viability of platelet concentrates (PCs) WBC reduced before storage was determined by flow cytometry in rabbits whose reticuloendothelial system was inhibited by ethyl palmitate administration. PCs stored at 22 degrees C for 2 and 5 days (D2- and D5-PCs) or refrigerated PCs (3-6 days at 22 degrees C plus 1-4 days at 4 degrees C, RF-PCs) were transfused into rabbits. Five parameters of PC viability in vivo were calculated from human platelet survival curves: survival time, recovery 0.5 and 24 hours after transfusion (R0.5, R24), maximal recovery (Rmax), and total recovery for 0 to 24 hours (RSigma). RESULTS: No differences in viability of D2- and D5-PCs were found. In contrast, viability of RF-PCs was significantly lower than that of D2-PCs, as was revealed with diverse sensitivity by four parameters: RSigma > R24 > R0.5=survival time (p < 0.001, p < 0.01, and p < 0.05, respectively). CONCLUSION: The rabbit model elaborated is sufficiently sensitive to reveal differences in human platelet viability in vivo between conventional and cold-damaged PCs. It may be useful for comparing viability of different platelet components that cannot be readily tested in human transfusions.

Animals↗

Sepsis- and endotoxemia-generated cytokines do not trigger activation of human platelets.

OBJECTIVE: To analyze the effect of cytokines generated in sepsis and endotoxemia (tumor necrosis factor [TNF]-alpha and interleukins [IL]-1beta, -6, and -8) on activation of human platelets and to study the effect of cytokines on platelet activation in the presence of alpha-thrombin, a potent inducer of coagulation and platelet activation generated in sepsis and endotoxemia. DESIGN: flow cytometric study of platelet activation induced by cytokines and/or thrombin in the whole blood and platelet-rich plasma (PRP) of healthy volunteers. SETTING: Research laboratory in a Canadian hospital. SUBJECTS: Nine healthy volunteers recruited from laboratory staff. MEASUREMENTS AND MAIN RESULTS: Venous blood samples were obtained into acid-citrate-dextrose anticoagulant. Whole blood and PRP were diluted with appropriate buffer optimized for analyzing platelet activation by flow cytometry. TNF-alpha, IL-1beta, IL-6, and IL-8 were added to blood or PRP in concentrations ranging from 1 to 100 ng/mL and incubated for 15 mins at 37 degrees C in the presence or absence of a submaximal concentration of human alpha-thrombin (0.025 units/mL). Samples were stained with fluorescent antibodies against markers of platelet activation (P-selectin [CD62], lysosomal protein [CD63], and fibrinogen and von Willebrand factor receptors [CD41 and CD42b, respectively]) and analyzed by flow cytometry. The data obtained show that none of these cytokines trigger activation of resting platelets in whole blood or PRP and do not modulate the effect of thrombin on platelet activation as measured by quantitation of CD62, CD63, and CD42b markers on the platelet surface. CONCLUSIONS: Cytokines TNF-alpha, IL-1beta, IL-6, and IL-8, which are extensively produced in sepsis and endotoxemia, do not trigger activation of resting human platelets directly or indirectly by mediating processes in white or red blood cells. The cytokines did not affect thrombin-induced platelet activation.

Cytokines↗

A six sigma approach to maximizing productivity in the cardiac cath lab.

Cardiac catheterization laboratories represent one of the most significant capital investments for hospitals. Historically, hospitals could achieve an economic return fairly rapidly on this capital investment because of the relatively high contribution margin on many of the procedures performed in the department. However, recent changes in DRG assignments, declines in Medicare reimbursement, and the advent of new technologies, such as drug-coated stents, pose a threat to achieving planned economic return. In response, many hospitals are pursuing strategies to improve throughput in the cardiac cath lab and maximize the number of procedures performed. The case example in this article describes how a busy cardiac catheterization lab in the southeastern United States successfully applied the Six Sigma methodology to improving productivity and increasing available capacity.

Cardiac Catheterization↗