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Biomedical subjects

R Schutz

Publications and source records attributed to R Schutz.

13 recordsLinked to original sources
PubMed1998

Improved blood preservation with 0.5CPD erythro-sol. Coagulation factor VIII activity and erythrocyte quality after delayed separation of blood.

BACKGROUND AND OBJECTIVES: Delay between blood collection and the separation of its components may result in lowered yield of factor VIII (FVIII) and loss of 2,3-biphosphoglycerate (2,3-BPG). This study was to see whether the use of 0.5 CPD resulted in better preservation of FVIII and maintenance of 2,3-BPG. MATERIALS AND METHODS: 55 units of blood were collected in 0.5CPD and 48 in CPD SAG-M. Ten of the collections were paired, so that the same donors were bled in a single session partly in an 0.5CPD system and partly in CPD SAG-M. After collection, the blood was promptly cooled to 20 degrees C and stored at that temperature for up to 24 h. RESULTS: Preservation of FVIII activity was significantly better in 0.5CPD compared with CPD. The content of von Willebrand factor was stable in the anticoagulant solutions for 24 h at that temperature. Plasma separated from both media had how levels of prothrombin fragment 1 + 2 and complement activation. Paired collections substantiated previous reports that red cell storage is significantly improved in 0.5CPD compared with CPD SAG-M with respect to 2,3-BPG and haemolysis. CONCLUSIONS: Red cell metabolism and oxygen-releasing capacity are kept at acceptable levels in 0.5CPD blood for 24 h at 20 degrees C before component separation. The concentration of red cell 2,3-BPG remained at normal or slightly subnormal levels during further storage in 0.5CPD at 4 degrees C for 2-4 weeks before gradual decay to an average of 39% at 48 days.

2,3-Diphosphoglycerate↗
PubMed1996

[Struma ovarii--a case report].

A 43-year old women was admitted to our hospital for investigation and treatment of a right ovarian tumour. Presenting symptoms and signs included recurrent pelvic pain since half a year, nervousness and intercurrent insomnia. At operation a solid cystic tumour was found arising from the right ovary. Histologically a combination tumour was found to consist of a multilocular cystadenoma and a true struma ovarii as a rare neoplasia of teratomatous nature.

Adult↗
PubMed1993

Excluding blood donors at high risk of HIV infection in a west African city.

OBJECTIVE: To examine the potential impact of deferral of blood donors at high risk of HIV infection in a west African city where blood is screened for HIV antibodies but no other special measures are taken to protect the blood supply. DESIGN: Cross sectional study. SETTING: National Blood Transfusion Centre and Project RETRO-CI, an international collaborative AIDS research project, Abidjan, Côte d'Ivoire. SUBJECTS: 1257 male first time blood donors. INTERVENTIONS: Blood donors were interviewed about demographic and behavioural characteristics and tested for HIV antibodies by enzyme immunoassay and, if positive, synthetic peptide based tests. MAIN OUTCOME MEASURES: HIV antibody status in relation to presence of behavioural risk factors; calculation of sensitivity, specificity, and predictive values of specific criteria for excluding HIV infected donors. RESULTS: The overall prevalence of HIV infection was 11.4%. The most important risk factors for HIV positivity were prostitute contact and being aged 30-39 years. For identifying seropositive donors individual criteria had sensitivity, specificity, and positive predictive values ranging from 15% to 98%, 38% to 91%, and 17% to 30% respectively. Prostitute contact in the past five years would have excluded 31% of all donors and 73% of HIV infected donors. 27% of those excluded would have been HIV positive. CONCLUSIONS: The widespread assumption that donor deferral is not feasible in sub-Saharan Africa needs reassessment. In Abidjan this approach was well accepted and potentially effective. Donor deferral requires evaluation as a strategy for improving blood safety in resource poor areas with high rates of HIV infection.

Adolescent↗
PubMed1992

Risk of HIV infection from transfusion with blood negative for HIV antibody in a west African city.

OBJECTIVE: To estimate the risk of infection with HIV (HIV 1 or HIV 2, or both) from transfusion of a screened unit of blood in a high prevalence area in west Africa. DESIGN: Retrospective cohort study for January-July 1991. SETTING: National Blood Transfusion Centre, Abidjan, Côte d'Ivoire. SUBJECTS: Repeat donors (5831 units of blood) and first time donors (5076 units) in the first five months of 1991. MAIN OUTCOME MEASURES: Prevalence and estimated incidence of HIV infection in repeat and first time donors; estimated rate of potentially infected, HIV antibody negative units; and rate of (false negative) potentially infected units assuming a laboratory test sensitivity of 99%. RESULTS: Overall HIV prevalence was 11.0% in first time donors and 2.1% in repeat donors. In the first seven months of 1991, 29 HIV antibody positive (27 HIV 1, 1 HIV 2, 1 dually reactive) donors with a seronegative unit of blood earlier in the year were identified; 26 had donated blood eight weeks or less before their estimated dates of seroconversion and may have been infectious (minimum rate 26/5831 (4.5/1000 potentially infected units)). Estimated incidence of infection in repeat donors was 1.2-2.5%. Laboratory test insensitivity would result in an estimated 1.1/1000 false negative units from first time donors and 0.2/1000 units from regular donors. The overall rate of potentially infected units (all donors, seroconversions, and errors) was estimated at 5.4-10.6/1000. CONCLUSIONS: The risk of HIV infection from a single unit of blood remains substantial (5.4-10.6/1000 units). To prevent infection from blood transfusion in areas of high incidence and prevalence of HIV all but absolutely essential transfusions should be avoided, and donors with low incidence of HIV infection should be selected.

Blood Donors↗
PubMed1992

[Generalized histoplasmosis due to Histoplasma duboisii with mediastino-pulmonary infection. Cure after 15 months of treatment with ketoconazole].

We report a case of a young burkinabian, who presented with the disseminated african form of histoplasmosis, Histoplasma duboisii. There was pulmonary mediastinal disease with superficial lymphadenopathy and also hepatic involvement. The diagnosis was achieved by a histological examination of the peripheral glands and micrological examination of the expectorate. A clinical cure (despite the radiological persistence of enlarged but stable left hilar glands) with the follow up 10 months was achieved after 15 months of treatment with ketoconazole in a dose which was increased to 10 mg/kg/day.

Biopsy↗
PubMed1992

[Treatment of empyema and pyopneumothorax of infectious origin and chronic evolution by drainage-lavage with iodized polyvinylpyrrolidone].

Thirty five patients, twenty nine men and six women with a mean age of twenty six and suffering from a pyothorax 23% or a pyopneumothorax 77% of whom 41% had a bronchopleural fistula on chronic evolution (greater than one month before drainage), had been treated using drainage and lavage with iodised polyvinylpyrrolidine without local or general antibiotics. This treatment enabled thirty four patients to be cured with some moderate radiological sequelae, a 50% restitution "ad integrum". The importance of the sequelae was correlated with increased aged (P less than 0.001), a delay before drainage (P less than 0.001) and a prolonged duration of drainage (P less than 0.01), to multiple organisms (P less than 0.01) and the presence of a pneumothorax (P less than 0.02) and to a tuberculous origin of the effusion (P less than 0.01). These two latter factors were the cause of a prolongation of the duration of drainage (P less than 0.01). Tuberculous patients who on average were older (P less than 0.05) and had a prolonged period of drainage (P less than 0.01) presented with major immediate radiological sequelae (P less than 0.01). In conclusion the technique of drainage using iodised polyvinylpyrrolidine gave excellent results in cases of non-tuberculous pyothorax in young subjects, but gave less impressive results in subjects suffering from tuberculosis, because of the significant radiological sequelae.

Adolescent↗
PubMed1984

An orifice formula independent of mitral pressure gradient for the evaluation of prosthetic mitral valve obstruction.

We have studied an hydraulic orifice equation capable of quantifying the obstructive properties of mitral prostheses from data of a potentially less invasive nature than is required by conventional methods. The results indicate that effective prosthetic orifice area may be computed by the pressure independent equation A = 21SV/DFP2, where A is the effective prosthesis orifice area in cm2, SV is the stroke volume in ml and DFP is the diastolic filling period in s min-1. Areas computed with the pressure independent equation correlate with the results of the modified Gorlin formula (given in the appendix) at a level of r = 0.91 for a series of 17 cases within a range of effective valve areas of 0.50 cm2 to 1.60 cm2. These results suggest that simplified nontraumatic procedures may be developed to screen and follow patients with prosthetic valve implants.

Adolescent↗
PubMed1983

[Explosion of intestinal gas during surgery].

Two cases of colonic gas explosion during surgery are reported. The treatment of the lesions required a partial colectomy in one case and a total colectomy in the other case. The different factors involved in such accidents are discussed. Three factors are necessary to trigger off an explosion of intestinal gases: the presence of combustible gases (hydrogen, methane), the presence of combustive gases (oxygen, nitrous oxide) and an initiating heat source (endoscopic or surgical electrocautery). The mannitol used for bowel cleansing undergoes partial colonic bacterial fermentation increasing the intraluminal concentration of hydrogen. During anaesthesia the oxygen-nitrous oxide mixture increases the intestinal concentration of these two major combustive gases. Electrocautery provides the spark triggering the explosion. The use of mannitol for colonic preparation should be questioned; the use of electrocautery to open the colon is advised against.

Aged↗
PubMed1982

Acute effects of alcohol in patients with congestive heart failure.

We evaluated the acute effects of moderate alcohol consumption in eight patients with New York Heart Association Functional Class III-IV congestive heart failure. Hemodynamic and echocardiographic variables were measured at baseline and then repeated at 30-minute intervals after ingestion of alcohol, 0.9 g/kg body weight, in the form of 80 proof vodka. Mean peak blood alcohol levels (+/- SE) at 60 minutes were 117 +/- 8 mg/dL. A significant reduction in mean arterial pressure, pulmonary artery and pulmonary artery wedge pressures, and systemic vascular resistance occurred over the first 90 minutes. Neither cardiac index, stroke volume index, stroke work index, nor echocardiographic variables were significantly changed. In patients with heart failure, a single moderate dose of alcohol reduces afterload by dilating arterial resistance vessels. No evidence of acute deterioration in cardiac performance was seen. In such patients occasional consumption of moderate dose alcohol can be safely tolerated.

Adult↗
PubMed1978

Self-management programmes with mentally retarded workers: implications for developing independent vocational behaviour.

Three research studies were conducted to investigate the differential effects of externally administered, self-administered and self-determined reinforcement contingencies on the work production rates of developmentally disabled workers. The results of Expt. I indicated that Client 1, a profoundly retarded male, would work at equivalent rates under externally administered or self-administered reinforcers. Experiment II indicated that a severely retarded male would also work at a high work rate under a self-determined reinforcement contingency. The results of Expt. III replicated these findings in a more controlled design. Different tasks adapted from community workshops were utilized in each study. The implications of these studies for developing independent vocational behaviour in the retarded were discussed.

Adolescent↗
PubMed1976

The effect of apomorphine and haloperidol on the RNA content of brain structures of the rat.

At a dose of 0.5 mg/kg, apomorphine caused an increase of the RNA content of the septal nucleus of rats (n. medialis + n. lateralis + n. accumbens); after 2.5 mg/kg this effect became more marked and, in addition, there was an increase of RNA in the caudate nucleus. All effects were antagonized by 0.5 mg/kg of haloperidol. These data suggest that apomorphine acts, at different dose levels, on different sites of the brain. This might be related to the also different behavioral effects of apomorphine at those two dose levels. Haloperidol on its own caused a fall of RNA in the amygdaloid nucleus which was not counteracted by any of the two doses of apomorphine. Neither drug had any influence on hypothalamic RNA concentration.

Amygdala↗