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PubMed1996

A survey of red cell use in 45 hospitals in central Ontario, Canada.

BACKGROUND: The purpose of this survey was to establish baseline information on blood component use in relation to patient diagnoses, procedures, and demographics and to identify patterns of blood use that may be used for blood program planning and transfusion audits. STUDY DESIGN AND METHODS: A cross-sectional survey of the transfusion of blood components in teaching and nonteaching hospitals in central Ontario between September 1991 and August 1992 was carried out. Coders of hospital medical records routinely record demographics, procedures, diagnoses, and other relevant information. A protocol was created by which medical records coders could add the components transfused to the discharge abstract for this study. Red cell use is reported here. RESULTS: Of the 61 hospitals invited to participate, from which 547,279 patients were discharged during the 12-month period of the study, 45 (74%) agreed to participate. Information was collected on 439,373 discharged patients. Of these, 26,611 (6.1%) received at least 1 unit of red cells. Of a total of 101,116 red cell units transfused, more than 74 percent were used in patients discharged with neoplasms, gastrointestinal diseases, circulatory system diseases, and trauma. High-transfusion-use procedures included operations and procedures on the digestive and cardiovascular systems, diagnostic and therapeutic procedures, musculoskeletal system, and hemic or lymphatic system procedures. CONCLUSION: This survey provides baseline blood transfusion information for a specific period that can help determine the need for hospital audits and maximum surgical blood-order schedule guideline reviews. This information is relevant to current recommendations to reduce patient's exposure to blood components. These transfusion data will assist in blood program planning based on known disease trends, demographics, and population changes.

Cross-Sectional Studies↗
PubMed1981

Acute experimental canine ehrlichiosis. II. Sequential reaction of the hemic and lymphoreticular system of selectively immunosuppressed dogs.

The lymphoreticular response of dogs to Ehrlichia canis infection was studied after immunosuppressive therapy with cyclophosphamide or antilymphocyte serum. Immunosuppression did not increase mortality, nor did it prevent or significantly modify the clinical manifestations of acute ehrlichiosis. The clinical, hematologic and serum biochemical characteristics of acute ehrlichiosis appeared seven or more days later in immunosuppressed than in immunologically intact infected dogs. Immunosuppressive therapy generally attenuated the lesions of acute ehrlichiosis. Lymphoreticular tissues were partially depleted of lymphocytes, as would be expected following cyclophosphamide therapy, but the hemopoietic tissue of cyclophosphamide-treated principals was much more cellular than that of the controls, perhaps demonstrating a direct stimulatory effect E. canis infection on bone marrow. Antilymphocyte serum therapy reduced cellularity of the thymic-dependent areas in both the spleen and lymph nodes, but B-cell areas were not affected. The B-cell areas did not increase in activity during infection in the antilymphocyte serum-treated dogs, suggesting the need for an intact T-cell compartment for the lymphocytic proliferation that occurs in nonsuppressed infected dogs. Renal vasculitis and lympho-plasmacytosis were absent and the pulmonary and hepatic lesions were not as pronounced in the dogs given antilymphocyte serum as in immunologically competent infected dogs.

Animals↗
PubMed1979

Plasma thyrotropin-releasing hormone, prolactin, thyrotropin, and thyroxine concentrations following the intravenous or oral administration of thyrotropin-releasing hormone.

In a further evaluation of the use of oral thyrotropin-releasing hormone (TRH) in puerperally lactating women, a radioimmunoassay for its measurement has been developed. Its concentration in plasma as well as that of prolactin (PRL), thyrotropin (TSH) and thyroxine (T4) were measured following either intravenous or oral administration of TRH. Basal concentrations of TRH in 14 normally cycling women ranged from less than 5 to 17 pg/ml. Two luteal phase studies produced peaks in plasma TRH 5 to 10 minutes after 100 micrograms of TRH administered intravenously with a return to basal concentrations within 2 to 3 hours. In 10 normally menstruating women, ingestion of 10 mg of TRH orally resulted in plasma TRH which peaked at 423 +/- 123 pg/ml (standard error of the mean) at 30-minutes. Plasma PRL, TSH, and T4 also increased and remained slightly elevated at 4 hours. These 8-hour studies were performed in a puerperal lactating woman who had ingested 10 mg of TRH orally twice a day for 7 days prior to blood sampling. TRH concentrations declined throughout each day while TSH rose slightly in the first 1 to 2 hours but remained within normal limits. The prolonged administration of 10 mg of TRH orally twice daily to three puerperally lactating women resulted in elevations in plasma TRH 2 to 3 hours following hormone administration, yet no significant increases in plasma TSH were observed. Both endogenous TRH and TSH were measured before and after 22 nursing events in nine puerperally lactating women. There was no change in the concentration of either substance and all values were similar to those obtained in normally menstruating women.

Administration, Oral↗
PubMed1987

Plasma levels of cortisol and corticosteroid binding globulin during use of Norplant-2 implants.

Plasma levels of cortisol and corticosteroid binding globulin (CBG) were studied during one year in eleven healthy women using NORPLANT-2 implants. NORPLANT-2 implants release approximately 50 ug of levonorgestrel/day. A significant diurnal variation of cortisol levels was found during the study. No significant change in cortisol levels compared to pretreatment levels was found. Levels of CBG showed no diurnal variation, but decreased significantly during use of the implants. This was most probably due to a direct effect of the levonorgestrel, as the levels of estradiol did not change compared to pretreatment levels, except for the values after 6 months that were significantly lower than pretreatment levels. A "free cortisol index" calculated as: level of cortisol/level of CBG, was unchanged during treatment compared to pretreatment levels. It is concluded that although CBG levels were reduced, no significant change in cortisol patterns was seen during use of the implants.

Adult↗
PubMed1993

One year contraception with a single subdermal implant containing nomegestrol acetate (Uniplant).

One single silastic capsule containing nomegestrol acetate, Uniplant, was inserted subcutaneously in 100 women of reproductive age who desired to avoid conception. Insertions and removals of the capsules were made in the gluteal region following intracutaneous local anesthesia with 2% procaine. Eighty women completed one year of use. Eleven women bore the implant for 6-11 months. A total of 1,085 women-months were recorded. One pregnancy occurred, resulting in a Pearl Index of 1.1. Bleeding episodes similar to menstruation occurred in all women but the degree of regularity varied from subject to subject. Amenorrhea developed in the range of 14-18% during the first six months of use but declined to less than 10% during the last six months. Menorrhagia likewise was higher in the first six months (18% in the first month) but fell to less than 10% during the last six months. Spotting was 5% or less. Of the twenty women who did not complete one year of use, nine discontinued because they found other methods were either more practical or less revealing. Three discontinued because of bleeding irregularities, three desired to become pregnant, one became pregnant. Other complaints included dizziness, headache, increased blood pressure, loss of libido, painful breasts and nausea. Over half of the women indicated their desire to continue using the single implant as a contraceptive.

Adult↗
PubMed1996

Androgen levels in women using a single implant of nomegestrol acetate.

This study was undertaken to evaluate the effects of a single implant containing nomegestrol acetate (Uniplant) on plasma levels of sex hormone-binding globulin (SHBG), testosterone, free testosterone, androstenedione and on blood pressure, body weight, and the development of acne vulgaris. Plasma levels of sex hormone-binding globulin, testosterone, free testosterone and androstenedione were measured. Blood pressure and body weight were determined. The development of acne vulgaris was evaluated. Total testosterone and androstenedione decreased significantly during two years of Uniplant use but all levels were within the normal range. There were no significant differences in sex hormone-binding globulin and free testosterone during 24 months of Uniplant use. All changes observed in this study were within normal range. SHBG was not affected by Uniplant use. No significant increase in androgen levels and in the development of acne vulgaris was observed in these women using nomegestrol acetate implant during two years. Based on these results, it is possible to conclude that Uniplant had no androgenic effect in women during this study.

Acne Vulgaris↗
PubMed1982

Effects of progestogens on the cardiovascular system.

The progestogenic component of combined oral contraceptives (OCs) may contribute to the increased risk of stroke and ischemic heart disease in women who take these preparations. This effect is likely to be mediated, at least in part, through elevators in blood pressure. The progestogenic component of OCs does not appear to influence the risk of venous thromboembolism. In terms of reducing the risks of arterial disease in women taking OCs, the safest preparations will be those which minimize the dose of both estrogen and progestogen.

Adult↗
PubMed1984

Regulatory effect of contraceptive steroids on the release of tissue-type plasminogen activator in vitro.

The release of tissue-type plasminogen activator (t-PA) from incubated specimens of human veins was investigated by an immunoradiometric determination of the concentration of t-PA in the medium. The initial release of t-PA was strongly correlated to the weight of the incubated specimens. T-PA was not demonstrable after the third day of incubation. The addition of d-norgestrel (83.3 ng/ml) to the medium significantly stimulated the release of t-PA; whereas, ethinylestradiol (16.6 ng/ml) did not have an effect.

Adult↗
PubMed1995

The effects of nomegestrol acetate subdermal implant (Uniplant) on carbohydrate metabolism, serum lipoproteins and on hepatic function in women.

This study was undertaken to assess possible variations in body weight, blood pressure, fasting glucose, HbA1C, insulin, total cholesterol, HDL-C, LDL-C, triglycerides, SGPT, SGOT, GGT and bilirubin in women bearing a single subdermal Silastic implant containing 55 mg (10%) of nomegestrol acetate during two years. A total of eighteen volunteers of reproductive age who desired to avoid conception were enrolled in this study. Subjects were healthy women with no contraindications to hormonal contraception. All women were investigated before starting treatment and were followed up for one year. At the end of one year the capsules were removed and a new capsule was inserted. Fasting blood samples were drawn at 8:00 to 8:30 am twice prior to implant insertion and then at the first, third, sixth and twelfth months and every six months thereafter. Body weight increased from 54.9 +/- 1.5 kg at admission to 55.3 +/- 2.0 kg at 12 months of use (p < 0.05) and to 56.0 +/- 2.7 kg at 24 months of use. A slight increase in both systolic and diastolic blood pressure was recorded at month 12 (p < 0.01). At month 24, blood pressure was not significantly different from admission values. All levels were within the normal range. Insulin, HbA1C, LDL-C and GGT remained unchanged during twenty-four months of Uniplant use. A significant decrease in total cholesterol (p < 0.05) was observed in the third month while a significant decrease in HDL-C (p < 0.01) was observed only in the sixth month of Uniplant use.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1975

The effects on platelet aggregation of oral prostaglandin E2 used for the induction of labour.

Secondary ADP induced platelet aggregation was inhibited in 17 patients after the administration of oral prostaglandin E2 tablets for the induction of labour. Primary ADP induced aggregation was shown to be inhibited by oral prostglandin E2 when the platelets responded to the lower concentration of 0-5 mug/ml of ADP. This inhibition was not detectable when the higher concentration of 1-0 mug/ml ADP was necessary. There would appear to be a decreased risk of thrombosis initiated by platelet aggregation as a result of using oral PGE2 tablets for inducing labour.

Adenosine Diphosphate↗