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CD34+ cells and CD34+CD38- subset from mobilized blood show different patterns of adhesion molecules compared to those from steady-state blood, bone marrow, and cord blood.

As suggested previously, a down-regulation of some cellular adhesion molecules (CAMs) on CD34(+) hematopoietic progenitor cells (HPC) may contribute to their egress from bone marrow (BM) to peripheral blood (PB) by decreasing their adhesion to BM stromal cells. Besides counting the percentage of CAM-positive cells, we decided to define clearly the antigen density (AgD) of the CAM on mobilized- and steady-state CD34(+) HPC using QIFIKIT calibration beads. Five sources of cells were compared: PB and BM from normal donors (nPB, nBM) cord blood (CB), mobilized PB obtained from leukapheresis products (LKP), and mobilized BM (mBM) samples. In our study the CAM-AgD was the lowest on CD34(+) cells in LKP which, on the contrary, contained the highest percentage of CD117(+), CD54(+), CD58(+) cell subsets. As for CB, a greater proportion of CD44(+) and CD62L(+) cells was observed in LKP than in other products. The LKP-CD34(+) cell population contained a greater percentage of CD11a(+) cells when compared to mBM, but the lowest percentage of CD49d(+) and CD49e(+) cells when compared to all products. The proportion of the CD34(+)CD38(-) immature subset expressing CD11a, CD44, CD54, or CD62L was greater in LKP than in mBM; the CD62L-AgD was higher in LKP than in mBM. This quantitative analysis clearly showed a downregulation of all CAM on LKP-CD34(+). The CD44, CD62L, CD11a, and CD54 AgD decrease appears to be specifically involved in the egress of the CD34(+) subsets into PB. The control of antigen density of these adhesion molecules is likely to be clinically important for effective mobilization of HPC as well as for rapid engraftment following HPC transplant.

ADP-ribosyl Cyclase↗

Blood pressure on arising, morning blood pressure surge and blood pressure variability in white coat hypertensives and in matched normotensives and sustained hypertensives.

INTRODUCTION: It is still controversial whether subjects with white-coat hypertension (WCHT) exhibit higher cardiovascular risk compared to normotensive subjects (NT). In subjects with WCHT it is not known whether the abnormal blood pressure (BP) reaction in the office also occurs at other times of day, particularly on arising and immediately after waking, i.e. the times at which the majority of cardiovascular events are reported to occur. OBJECTIVE AND METHODS: To evaluate with 24h ambulatory BP measurement the values of morning BP surge, BP on arising and BP variability in subjects with WCHT in comparison with age-, gender- and weight-matched normotensives (BP) and untreated sustained hypertensives (BP). RESULTS: Groups of BP, WCHT and BP were matched for age, gender and body weight: BP: n=69, age 49 +/- 7 years, 54 % female, BMI 26 +/- 1, casual BP 126/79 +/- 5/4 mmHg, daytime BP 124/80 +/- 6/6 mmHg; WCHT: n=74, age 52 +/- 8 years, 57% female, BMI 26 +/- 2, casual BP 152/95 +/- 7/7 mmHg, daytime BP 126/80 +/- 5/6 mmHg; HT: n=79, age 53 +/- 7 years, 56% female, BMI 27 +/- 2, casual BP 154/97 +/- 9/8 mmHg, daytime BP 143/89 +/- 12/10 mmHg. Of the three groups, subjects with WCHT exhibited BP on arising (121/81 +/- 13/8 mmHg) similar to that of NTs (120/80 +/- 13/9 mmHg, NS), both significantly lower than that of HTs (137/92 +/- 17/10 mmHg, p < 0.01), suggesting the absence of an alerting BP reaction in WCHT at that time. By contrast, subjects with WCHT showed higher values of systolic morning BP surge vs. NTs (25 +/- 10 vs. 22 +/- 11 mmHg, p < 0.05), both lower than that observed in hypertensives (33 +/- 11 mmHg, p < 0.01 vs. NT and WCHT) and greater daytime variability (systolic BP standard variation), i.e. 12 2 vs. 10 +/- 2 mmHg, p < 0.05, both lower than that observed in hypertensives (14 +/- 3 mmHg, p < 0.01 vs. NT and WCHT). CONCLUSIONS: Although subjects with WCHT did not show any alerting blood pressure reaction on arising, morning BP surge and BP variability were greater in these subjects than in control normotensives, although lower than sustained hypertensives. Although this is still speculative, we cannot exclude the possibility that even a slight increase in morning BP surge might in the long term constitute an additional load on the circulation that could increase cardiovascular risk in subjects with WCHT compared to matched normotensives.

Adult↗

Screening for antibody to HTLV-III in blood donors of Liguria. Ligurian Committee for the Study of Infections Transmitted through Blood and Blood Products.

Anti-HTLV III had been detected in 12,689 serum samples collected within August 1985 from 12 Transfusion Centres of Liguria. In the course of the first test, carried out by ELISA using disrupted virions as antigen, 12,666 samples (99.81%) resulted non reactive; 14 (0.1%) belonged to the grey-zone and 9 (0.08%) were clearly reactive. The samples of the last two classes were tested again in the same way and, whenever the cases were suspect as positive, by Western-blot technique. All positive cases, but three, were linked with risk factors such as intravenous drug use or drug addicts partners. Even if the prevalence of blood donors anti-HTLV III positive resulted, on the whole, very low (0.063%), the investigations carried out prove the importance of regular screening of blood units for the prevention of HTLV III infection.

Acquired Immunodeficiency Syndrome↗

The clinical pathology of heartwater. III. Changes in blood clotting, blood calcium, blood protein, haematocrit and white-cell counts in sheep with experimentally induced heartwater.

Studies to evaluate changes in blood clotting, blood calcium and protein, the haematocrit and white-cell counts were undertaken in seven sheep with experimentally induced heartwater. A marked decline in thrombocyte count was recorded during the acute stage of the disease. This was associated with increases in both prothrombin time (PT) and activated partial thromboplastin time (APTT); fibrinogen increased while there was no detectable increase in fibrinogen degradation products (FDP). At the same time total serum protein (TSP), albumin and globulin dropped very sharply; total calcium showed a progressive drop but ionized calcium rose initially and was followed by a terminal decline. The total leucocyte count showed a terminal increase while the haematocrit dropped progressively.

Animals↗

[Donor exclusions, discarded blood and transfusion unsuited blood conserves of 2,13 million potential blood donors 1991 to 1994].

UNLABELLED: German authorities plan to legislate transfusion safety. We report on the efficacy of donor selection, unit pre-release testing, quality assurance and look-back efforts (LBE): Among 2,127,102 visits by 503,971 donors are 8.7% first-time donors. 96% of repeaters present our donor ID-card. We defer 5.6% repeat and 18.2% first-time donors, mostly for their own safety. 0.5% of the donors suffer a reaction. 94,000 units (4.7%) are not released due to confidential self-exclusion (1.1%), quality and safety concerns (1.7%), and positive screening tests (1.9%). Only 5.2% positive infectious disease screening tests were confirmed. HIV-prevalence of first-time donors is 0.002%; the HIV seroconversion rate for second-time donors is 0.003%. All other seroconversion rates for HBV, HCV, HIV and lues at subsequent donations are 0.001%. 23 donor-related LBE did not reveal a single HIV-infected recipient. In 106 recipient-related LBE involving 868 donors, we found 5 seroconverted donors (1 HBV, 3 HCV, 1 HIV). CONCLUSIONS: Our repeat donors present proper ID. Strict donor selection criteria result in many rejections. Donor reactions are rare. High demands on blood safety and quality result in many discards. In our hands, confidential unit exclusion does not add safety. The HIV prevalence of first-time and repeat donors is equally low. Donor seroconversions are rare. LBE rarely identify infected donors or recipients. Our current high transfusion safety is unlikely to be improved through legislative measures.

AIDS Serodiagnosis↗

Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation: joint recommendations of the European Group for Blood and Marrow Transplantation, the Center for International Blood and Marrow Transplant Research, and the American Society of Blood and Marrow Transplantation.

More than 40000 hematopoietic cell transplants (HCTs) are performed worldwide each year. With improvements in transplant technology, larger numbers of transplant recipients survive free of the disease for which they were transplanted. However, there are late complications that can cause substantial morbidity. Many survivors are no longer under the care of transplant centers, and many community health care providers may be unfamiliar with health matters relevant to HCT. The Center for International Blood and Marrow Transplant Research (CIBMTR), European Group for Blood and Marrow Transplantation (EBMT), and American Society for Bone Marrow Transplantation (ASBMT) have developed these recommendations to offer care providers suggested screening and prevention practices for autologous and allogeneic HCT survivors.

Community Health Centers↗

Ambulatory blood pressure monitoring: mean blood pressure and blood pressure load.

Ambulatory blood pressure monitoring (ABPM) is commonly used to diagnose pediatric hypertension. Using ABPM, hypertension is usually defined as a mean BP greater than the 95th percentile for height. A BP load >30% (% of BP readings greater than the 95th percentile) is also used for the diagnosis of hypertension. The objective of this study was to determine the agreement between mean BP greater than the 95th percentile and 30% BP load for the diagnosis of hypertension using ABPM. All ABPM records (n =1,009) of patients referred for hypertension to a pediatric center were retrieved. Scans were excluded if: age was >19 and height <115 cm or >185 cm. Mean BP and BP loads were calculated for 728 scans. Agreement between mean BP greater than the 95th percentile for height and various BP loads were calculated using the kappa coefficient. The kappa coefficient of agreement between mean BP greater than the 95th percentile and 30% BP load was 0.56 and 0.57 for daytime systolic and diastolic BP, respectively. The agreement between mean night-time BP greater than the 95th percentile and 30% BP load was 0.70 and 0.66 for systolic and diastolic BP, respectively. Agreement between mean BP greater than the 95th percentile and 30% BP load is only moderate to good. Maximum agreement between mean BP greater than the 95th percentile and BP load is achieved at 50% BP load.

Blood Pressure↗

Recommendations for blood pressure measurement in humans and experimental animals: part 2: blood pressure measurement in experimental animals: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.

In experimental animals, as in humans, techniques for measuring blood pressure (BP) have improved considerably over the past decade. In this document, we present recommendations for measuring BP in experimental animals with the goal of helping investigators select optimal methods for BP monitoring in the research laboratory. The advantages and disadvantages of various BP measurement methods are discussed and specific recommendations are provided for selecting the optimal technique depending on the study objective. Although indirect techniques that permit only sporadic measurements of BP may be suitable for some purposes, methods for directly measuring BP are generally preferred because of their ability to monitor the highly dynamic nature of BP in a comprehensive fashion. Selection of the methods to be used should ultimately be guided by the study objectives to insure that the techniques chosen are appropriate for the experimental questions being explored.

American Heart Association↗

Ambulatory blood pressure is superior to clinic blood pressure in predicting treatment-induced regression of left ventricular hypertrophy. SAMPLE Study Group. Study on Ambulatory Monitoring of Blood Pressure and Lisinopril Evaluation.

BACKGROUND: In cross-sectional studies, ambulatory blood pressure (ABP) correlates more closely than clinic BP with the organ damage of hypertension. Whether ABP predicts development or regression of organ damage over time better than clinic BP, however, is unknown. METHODS AND RESULTS: In 206 essential hypertensive subjects with left ventricular hypertrophy (LVH), we measured clinic supine BP, 24-hour ABP, and left ventricular mass index (LVMI, echocardiography) before and after 12 months of treatment with lisinopril (20 mg UID) without or with hydrochlorothiazide (12.5 or 25 mg UID). Measurements included random-zero, clinic orthostatic, and home BP. In all, 184 subjects completed the 12-month treatment period. Before treatment, clinic supine BP was 165 +/- 15/105 +/- 5 mm Hg (systolic/diastolic), 24-hour average BP was 149 +/- 16/95 +/- 11 mm Hg, and LVMI was 158 +/- 32 g/m2. At the end of treatment, they were 139 +/- 12/87 +/- 7 mm Hg, 131 +/- 12/83 +/- 10 mm Hg, and 133 +/- 26 g/m2, respectively (P < .01 for all). Before treatment, LVMI did not correlate with clinic BP, but it showed a correlation with systolic and diastolic 24-hour average BP (r = .34/.27, P < .01). The LVMI reduction was not related to the reduction in clinic BP, but it was related to the reduction in 24-hour average BP (r = .42/.38, P < .01). Treatment-induced changes in average daytime and nighttime BPs correlated with LVMI changes as strongly as 24-hour BP changes. No substantial advantage over clinic supine BP was shown by clinic orthostatic, random-zero, and home BP. CONCLUSIONS: In hypertensive subjects with LVH, regression of LVH was predicted much more closely by treatment-induced changes in ABP than in the clinic BP. This provides the first longitudinally controlled evidence that ABP may be clinically superior to traditional BP measurements.

Adult↗

[Artificial blood: the future of blood transfusion? II. Blood substitutes other than hemoglobin solutions].

Part 2 discusses the state-of-the-art in oxygen-transporting blood substitutes other than hemoglobin solutions (Part 1); these are the fluorocarbon emulsions, the hemoglobin liposomes and other products such as oxygen-chelating agents. The substitutes reviewed here may play an important future role; before then, their stability, ease of administration, innocuity and value in human clinical medicine must be ensured.

Animals↗

[Potential ratios among blood levels of various blood proteins in the cord blood of healthy newborn infants].

The authors have studied the correlations between IgA, IgG, IgM, C3c, C4, alpha 1-AGP and the total proteins, total globulins, alpha 1, alpha 2-globulins in normal newborn cord blood. The results indicate some significant correlations between C3c and C4, C3c, C4 and alpha 1-AGP, C3c, C4, alpha 1 1/2AGP and alpha 2-globulins, C4 and beta-globulins, C3c and alpha 1-AGP. The most significant finding has been inverse correlation between IgA and alpha 1, alpha 2-globulins, total globulins and total proteins.

Alpha-Globulins↗

[Determination of the blood pressure level in mild hypertension. Significance of 20 minute resting blood pressure measurement comparing to 24 hour ambulatory blood pressure monitoring].

Determination of the blood pressure (BP) level in patients with mild hypertension (MHT) is quite difficult, since ulcerations of BP are tremendously exaggerated in the doctor's office. It has been well known that casual BP is less reliable to estimate LVH than BPs obtained at home or work-site. Although 24 hour ambulatory BP monitoring (ABPM) has been widely accepted to overcome this problems, it is still controversial whether this method is applicable to all hypertensive subjects with special regards to its cost and effect. Therefore, our study has dealt mainly with the development of more convenient and less expensive method to get reasonable BPs. Twenty two nonmedicated patients with MHT were selected for the study. After taking casual BP in the office, the resting 20 minute BP measurements at every 2 minute interval were performed with Dynamap 950. Ten BP values thus obtained were divided into two categorical phases; early and late. The mean systolic and diastolic pressures (Ps & Pd) in the early phase were significantly higher than those in the late phase. Beside mean Ps and Pd obtained from 24 hour ABPM, 4 categorical phases based on the time of a day were defined; morning (from awaking to noon), afternoon (from noon to 6 pm), evening (from 6 pm to bed time) and night (during sleeping). Mutual correlation coefficients of these categorical BPs were calculated and compared to identify reasonably high significant correlations. The results revealed the highest BP at the office and the lowest one during sleeping. The office BPs closely resembled to the ones during afternoon period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The effects of pentobarbital, fentanyl-droperidol, ketamine-xylazine and ketamine-diazepam on arterial blood pH, blood gases, mean arterial blood pressure and heart rate in adult male rats.

Although anesthetics are known to cause respiratory and cardiovascular depression in humans, these adverse effects rarely have been investigated in laboratory rodents. This study evaluated the effects of four different injectable drugs, pentobarbital, fentanyl-droperidol (Innovar-Vet), ketamine-xylazine and ketamine-diazepam on the respiratory and cardiovascular systems of rats. Results showed marked acidosis, hypercarbia and hypoxia with high doses of Innovar-Vet, moderate respiratory depression with all dosages of pentobarbital and minimal respiratory depression with ketamine-xylazine and ketamine-diazepam. Innovar-Vet, ketamine-xylazine and pentobarbital caused profound hypotension, particularly at high dosages, while ketamine-diazepam caused the least depression in mean arterial blood pressure of all drugs evaluated. None of the drugs studied produced significant alterations in heart rate. Throughout all dosages investigated, the ketamine-diazepam combination showed the least overall effects on ventilation and perfusion of the four parenteral drug combinations studied.

Analgesics↗

Report of the Second Task Force on Blood Pressure Control in Children--1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Although the prevalence of clinical hypertension is of a far lesser magnitude in children than adults, there is ample evidence to support the concept that the roots of essential hypertension extend back into childhood. Prospective cohort data that could yield precise information about the relationship between childhood BP and cardiovascular risk are not yet available. Nonetheless, high BP in children represents a significant clinical problem which in 1977 was comprehensively addressed by the Task Force on Blood Pressure Control in Children. Contained herein, 10 years later, is the revised version of the original Task Force report including normative BP data derived from sampling more than 70,000 children, as well as advice on methodology and instrumentation for BP measurement, guidelines for detecting children with high BP, and strategies for appropriate diagnostic evaluation and pharmacologic and nonpharmacologic treatment.

Adolescent↗