Biomedical subjects

M U Heim

Publications and source records attributed to M U Heim.

60 records · Page 4Linked to original sources

PubMedDate not supplied

Influence of antibiotics on posttransfusion platelet increment.

BACKGROUND: Fever has been identified as a major cause of platelet refractoriness. However, it is regularly attended by the administration of antibiotics, and thus it cannot be determined whether fever, the administration of antibiotics, or both are responsible for the reduced platelet increment. The present study was undertaken to discern the effect of body temperature and antibiotics on transfusion success. STUDY DESIGN AND METHODS: Single-donor platelet transfusions (n = 400) were monitored retrospectively. Besides other influencing factors (e.g., spleen size, number of previous transfusions, diagnosis, bone marrow transplantation), body temperature and the administration of antibiotics were documented from the patients' records. To distinguish the effects of fever and antibiotics, a general mixed model of variance was used for analysis. RESULTS: Besides the well-known factors of splenomegaly, hepatomegaly, bone marrow transplantation, and pretransfusion storage time, both body temperature and antibiotics independently reduced the corrected count increment. Among the various antibiotics, amphotericin B, ciprofloxacin, and vancomycin had the greatest influence. CONCLUSION: The administration of antibiotics has a negative effect on the corrected count increment, independent of the presence of fever. Besides amphotericin B, which has previously been shown to influence the corrected count increment, vancomycin and ciprofloxacin reduce it significantly. Because these antibiotics are widely used in patients with bone marrow failure, these observations should be proven by further prospective in vivo and in vitro studies.

Adolescent↗

PubMedDate not supplied

[Postoperative haemorrhagia in a girl with congenital factor XI deficiency - successful treatment with desmopressin (DDAVP, Minirin(R))].

UNLABELLED: The rare factor XI deficiency is associated with different profuse bleeding without correlation to the severity of reduction of factor XI. Accordingly, traumata or surgical procedures may cause unexpected excessive bleeding in asymptomatic patients. After surgery of a nine-year-old girl with factor XI deficiency (8 per cent) profuse bleeding occurred which could only be stopped after infusion of desmopressin. After administration the factor XI activity was increased to 31 per cent, the factor VIII even to 290 per cent over the normal range. We suppose that the favorable clinical effectiveness is not only related to the increasing factor XI activity but also to the elevation of the factor VIII/von-Willebrand-complex. CONCLUSION: It is recommended to give desmopressin as firstline therapy of bleeding by factor XI deficiency since the only effective alternative such as substitution of factor XI by transfusion of fresh frozen plasma is associated with the risk of transmission of virus infections.

Child↗

PubMedDate not supplied

[Progress in the therapy of children with congenital hemolytic anemias by transfusion of neocyte concentrations. Initial experiences in the separation and transfusion of young erythrocytes, obtained with the cell separator Fenwal CS-3000].

Transfusion-induced hemochromatosis remains a major therapeutic complication in the management of patients with chronic hemolytic anemias. Red cell units harvested with blood cell separators have an average estimated mean cell age of 30 days, compared to 60 days for unfractionated blood. Our initial experience with transfusion of neocytes indicates that the amount of transfused erythrocytes can be reduced on 60 per cent. Further studies must demonstrate the clinical benefit. When combined with modern iron chelator regimens, it may be possible to achieve consistently negative iron balance prior to the onset of hemochromatosis which would allow patients to probably lead a normal life-span.

Anemia, Hemolytic, Congenital↗

PubMedDate not supplied

[Autologous transfusion in scoliosis operations: preoperative autologous blood donations and intraoperative mechanical autotransfusion].

Autologous transfusion was used to reduce the high demand for blood accompanied with scoliosis surgery. Half of the blood loss could be saved by intraoperative autotransfusion (35 patients). This resulted in a corresponding reduction in homologous transfusion. An elimination of the need for homologous blood could be achieved only by the combination of preoperative blood donation and intraoperative autotransfusion (37 patients). With freezing the predeposit blood was independent of storage time and autologous plasma was available. Thus, the risks of transfusion can be avoided.

Adolescent↗

PubMedDate not supplied

Single-donor platelet concentrates: changes of surface glycoproteins during storage.

Storage of single-donor platelet concentrates is currently limited to 5 days. During this period, however, numerous morphologic and biochemical changes have been observed. These changes result in functional impairment of stored platelets. The present study describes increased binding of a monoclonal antibody against GMP 140 on the surface of stored single-donor platelets revealing an activation process. In contrast, binding of monoclonal antibodies directed against glycoprotein complex (GP) IIb-IIIa and ligand-induced binding site (LIBS1) is slightly diminished during storage. When platelets are stimulated with ADP GMP 140, GP IIb-IIIa, and LIBS1 are expressed to a higher extent than on the surface on nonstimulated platelets. The quantity exposed, however, depends upon the storage time. It is significantly reduced when platelets are stored for longer than 1-2 days. The present data indicate that storage of single-donor platelet concentrates affects fibrinogen binding, cell to cell cohesion, and release reaction. The results are in good agreement with conventional aggregation and in vitro bleeding time measurements.

Antigens, CD↗

PubMedDate not supplied

Influence of blood transfusion on recurrence, survival and postoperative infections of laryngeal cancer.

Clinical and experimental studies indicate, that blood transfusion can modify the recipient's immune system. While beneficial to renal allograft survival, these immunomodulating effects may, however, prove detrimental to cancer patients. Recently, an adverse relationship between blood transfusion and cancer recurrence was reported in colon, lung, breast, kidney and gastric cancer. Moreover, a higher postoperative infection rate was observed when blood units were administered intraoperatively. We retrospectively reviewed the records of 174 patients with squamous cell carcinoma of the larynx undergoing curative resection between 1979 and 1985. One hundred and forty-one patients received blood transfusions, 33 did not. Recurrence rate (16.7%) was significantly related to clinical stage (p = 0.008) and lymph node status (p = 0.000); cumulative survival time depended significantly on clinical stage (p = 0.003), lymph node status (p = 0.004) and tumor size (p = 0.017). In contrast, when corrected for these baseline prognostic factors, no significant correlation could be detected between blood transfusion and cancer relapse. Also, survival time did not depend on blood transfusions. No correlation could be found between postoperative infection rate and intraoperative application of blood transfusion (p = 0.694). The present study does not support the hypothesis that blood transfusion adversely affects the prognosis of patients with laryngeal cancer. It indicates, that risk factors other than blood transfusion have a greater influence on recurrence and survival time.

Adult↗