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At least 379 records · Page 21Linked to original sources
PubMed1999

Blood group distribution in an urban population of patient targeted blood donors.

BACKGROUND: The frequencies of ABO and Rhesus D blood groups vary from one population to another. OBJECTIVE: To determine the frequencies of the ABO and Rhesus D blood groups and to assess the preparedness of the hospital based patient targeted blood donor unit in the provision of blood and blood products and also to determine the blood groups of patients attending the antenatal clinic over the same period. DESIGN: A retrospective study using data from the hospital's blood transfusion unit. SETTING: The Aga Khan Hospital, Nairobi. SUBJECTS: All persons donating blood and attending the antenatal clinic between October 1997 and December 1997 were included in the study. RESULTS: Blood group O was found to be most frequent: 49% in indigenous African donors and ANC attendants, 45% in the general donor population and 34% among Asian donors. The frequency of blood group B was 33% in the Asian donors, 27% in all donors, 25% in African donors, and 24% in ANC attendants. Group AB was seven per cent in Asian donors, five per cent in both the general donor population and the ANC attendants and four per cent in the African donors. The frequency of blood group A was 26% in Asian donors, 23% in all donors and 22% in both the African donors and ANC attendants. Ninety four per cent of the indigenous African donors were Rhesus D positive, 97% of the ANC attendants were Rhesus D positive and 90% of the Asian donors were Rhesus D positive. CONCLUSION: The blood groups of blood and blood products available at the hospital based transfusion unit closely correlate with those of the general population. A positive bias towards the rarer blood groups AB and Rh D negative is noted. The Rhesus D antigen has a high prevalence in indigenous Africans.

ABO Blood-Group System↗
PubMed2006

[Correlations of blood lead levels in infant, in maternal blood and in breast milk].

OBJECTIVE: To understand the correlation of blood lead levels in infant, in maternal blood and in breast milk as to providing evidence for prevention of potential infant hazard from lead. METHODS: Lead levels were measured by using graphite stove atom absorption spectrographic methods in maternal breast milk, maternal blood and infant blood in infants aged 0 to 11 months and their mothers between November and December 2002 in Xiamen City. Blood samples were collected from both mother and infant's fingertips. Questionnaires were also used to collect information about childbirth, mothers, families and other related environmental factors. RESULTS: All 177 infants and their mothers were enrolled in the study. Infant blood lead levels reached a range from 0.12 micromol/L to 1.36 micromol/L, with a geometric mean (GM) of 0.37 micromol/L. There were 46 infants (21.64%) having blood lead levels over 0.48 micromol/L. And the maternal blood lead levels ranged from 0.21 micromol/L to 2.38 micromol/L (GM = 0.50 micromol/L). Among the 177 infants, 160 (93.8%) were breastfed; breast milk was collected from 105 (63.3%) of these mothers. Infant blood lead level was significantly correlated with the levels of maternal blood lead and breast milk lead, which indicated that maternal blood lead level might influence the infant blood lead levels through the breast milk. Blood lead levels in infants living in old business district and the breast milk lead levels of their mothers were higher than those in any other areas (P < 0.01); partial correlation analysis showed that infant blood lead levels were positively associated with the maternal blood lead level, infant's age and mother's work, and negatively associated with mother's height. CONCLUSION: The infant blood lead levels should not only relate to the maternal blood lead and the breast milk lead levels, so regards should be had to the other environmental factors, when selecting the feeding pattern and family rearing behaviors.

Adult↗
PubMed1993

[Concentration of mitomycin C in portal blood and peripheral blood after intra venous, intraperitoneal or intrapelvic administration].

Immediately before closing the abdomen in a curative operation for colorectal cancer, 20 mg of Mitomycin C (MMC) was administered by intravenous, intraperitoneal or intrapelvic routes, and portal blood and peripheral blood were simultaneously collected to investigate the disposition of MMC. After intravenous administration, the MMC concentration in portal and peripheral bloods changed at the same levels, showing a biphasic pattern. The maximum concentration (Cmax) seen shortly after administration was about 2 micrograms/ml. The blood halflife in phase alpha was about 5 min, and that in phase beta about 30 min. After intraperitoneal administration, the MMC concentration in portal blood was over 60 min higher than that in peripheral blood. Cmax in portal blood, seen within 5 min after administration, was about 0.5 micrograms/ml, and that in peripheral blood was about 0.2 micrograms/ml around 10 min. The half-life was about 30 min in both types of blood. After intrapelvic administration, the MMC concentration in portal blood changed at higher levels than in peripheral blood, as after intraperitoneal administration. The Cmax in portal blood, obtained within about 5 min, was about 0.3 micrograms/ml, and that in peripheral blood was about 0.1 micrograms/ml at 12 min. The half-life was about 30 min in both types of blood. As described above, the disposition of MMC was investigated on the basis of the concentration in portal and peripheral blood. As a result, intravenous MMC showed a similar change, whereas intraperitoneal or intrapelvic MMC was higher in portal blood than in peripheral blood, indicating that the disposition of MMC was different with the route of administration.

Colorectal Neoplasms↗
PubMed2006

24-h blood pressure monitoring in normal tension glaucoma: night-time blood pressure variability.

Systemic arterial hypotension, hypertension and altered ocular blood flow are known risk factors in glaucoma. In this study, 24-h ambulatory blood pressure monitoring was performed in patients with normal tension glaucoma (NTG) and controls to evaluate blood pressure variability. In all, 51 patients with NTG and 28 age-matched controls were included in this prospective study. A 24-h ambulatory blood pressure monitoring (SpaceLabs Medical Inc., Redmond, USA) was performed and systolic, diastolic and mean arterial blood pressures were measured every 30 min during daytime (0800-2000) and night time (0000-0600). To evaluate blood pressure variability a variability index was defined as the s.d. of blood pressure measurements. Night-time blood pressure depression ('dip') was calculated (in percent of the daytime blood pressures). Patients with NTG exhibited higher night-time diastolic (P = 0.01) and mean arterial blood pressure values (P = 0.02) compared to controls, whereas systolic blood pressure data were not significantly different. The variability indices of night-time systolic, diastolic and mean arterial blood pressure measurements were significantly increased in patients with NTG compared to controls (P < 0.05). The night-time blood pressure depression of systolic (P = 0.47), diastolic (P = 0.11) and mean arterial blood pressures (P = 0.28) was not significantly different between patients with NTG and controls. In conclusion, patients with NTG showed increased variability of night-time blood pressure measurements compared to controls. Increased fluctuation of blood pressure may lead to ocular perfusion pressure fluctuation and may cause ischaemic episodes at the optic nerve head.

Aged↗
PubMed1997

Acute normovolemic hemodilution can replace preoperative autologous blood donation as a standard of care for autologous blood procurement in radical prostatectomy.

UNLABELLED: Predonation of autologous blood (PAD) is a standard of care for patients undergoing radical prostatectomy, but recent studies have shown that PAD is not cost-effective. Acute normovolemic hemodilution (ANH) is an alternative autologous blood procurement technique that is much less costly than PAD. We compared the efficacy and costs of ANH alone to ANH combined with PAD. Two hundred-fifty patients who predonated fewer than 3 units of autologous blood before radical prostatectomy underwent ANH to a target hematocrit of 28%. Perioperative hematocrit levels, transfusion outcomes and costs, and postoperative outcomes were compared for patients who predonated 0, 1, or 2 units of blood before surgery. A computer model was used to estimate the savings in red blood cells (RBC) associated with each autologous intervention. ANH alone resulted in a 21% allogeneic transfusion rate and contributed a mean net savings of 112 mL RBC in blood conservation (equivalent to 0.6 unit of blood). The addition of 1 or 2 units of PAD reduced allogeneic exposure rates to 6% or 0%, respectively. Overall, patients who predonated blood had a mean net loss of 198 mL of RBC (equivalent to 1 blood unit), due to both an absence in compensatory erythropoiesis and to the wastage of 60% of the blood units donated. Patients who underwent ANH alone had a 60% reduction in mean total transfusion costs ($103 +/- $102) compared with patients who predeposited 2 units of autologous blood in addition to ANH ($269 +/- $11, P < 0.05). We conclude that ANH can replace PAD as an autologous blood option because it is less costly and equally effective. A combination of ANH and PAD can further decrease allogeneic blood exposure, but it increases transfusion costs and wastage. IMPLICATIONS: A patient's own blood can be obtained for use in surgery by predonation or acute normovolemic hemodilution on the day of surgery. Both blood collection techniques decrease the need for blood bank transfusions, but acute normovolemic hemodilution is less expensive and more convenient for patients.

Aged↗
PubMed2000

Prediction of stroke by ambulatory blood pressure monitoring versus screening blood pressure measurements in a general population: the Ohasama study.

OBJECTIVE: To investigate the association between 24 h, daytime and night-time ambulatory blood pressures and first symptomatic stroke, to compare their predictive powers for stroke with that of casual (screening) blood pressure, and to compare the predictive power for stroke between daytime and night-time blood pressures, in a general population in Ohasama, Japan. DESIGN: A prospective cohort study. SUBJECTS AND METHODS: We obtained ambulatory blood pressure on 1,464 subjects aged > or = 40 years without history of symptomatic stroke, then followed-up their stroke-free survival. There were 74 first symptomatic stroke during the follow-up period (mean = 6.4 years). The prognostic significance of blood pressure for stroke risk was examined by a Cox proportional hazards regression model adjusted for possible confounding factors. RESULTS: The non-parametric and parametric analysis indicated that 24-h, daytime and night-time ambulatory blood pressures were linearly related with stroke risk. The likelihood ratio analysis demonstrated that these ambulatory blood pressures were significantly better related to stroke risk than did screening blood pressure, and that daytime blood pressure better predicted stroke risk than did night-time blood pressure. CONCLUSIONS: The present study which prospectively investigated the relation between ambulatory blood pressure and first symptomatic stroke risk in a general population demonstrated that (i) ambulatory blood pressure values were linearly related to stroke risk; (ii) ambulatory blood pressures had the stronger predictive power for stroke risk than did screening blood pressure; and (iii) daytime blood pressure better related to stroke risk than did night-time blood pressure.

Blood Pressure↗
PubMed2006

The median whole-blood donation time in the best-case scenario: findings at one blood center.

BACKGROUND: Whole-blood donation times in a donor population when there are no impediments to blood donation at any point can be used to determine the shortest median whole-blood donation time. This statistic is relevant to blood donors and collection staff. STUDY DESIGN AND METHODS: Small, over-staffed blood drives in August 2004 were evaluated via operation records and supervisor interviews to determine if there were any impediments to whole-blood donation at any point in the process. Four-hundred ninety-two whole-blood donations from 33 blood drives were not impeded and were evaluated for whole-blood donation times. Registration records (entry time) and blood donor records (phlebotomy start and end time) provided three objective time points for the process, the median post-phlebotomy interval at the phlebotomy station was estimated, and 10 minutes was assigned for the refreshment period. RESULTS: The median donation time for the whole-blood donation process was 50 minutes. The 25 to 75 percent range was 46 to 56 minutes, and the 10 to 90 percent range was 42 to 64 minutes. First-time blood donors had blood donation times that were 5 to 6 minutes longer than in repeat blood donors (55.5 min vs. 50 min), and women had slightly longer donation times than men (51 min vs. 49 min). Five percent of the donors had donation times that exceeded 69 minutes. CONCLUSION: The median whole-blood donation time and range under the best circumstances was defined based on the process in place in our blood center in August 2004.

Blood Banks↗
PubMed1996

Prevalence of hypertension and rate of blood pressure control as assessed by home blood pressure measurements in a rural Japanese community, Ohasama.

A cross-sectional community survey using home blood pressure measurements was performed in northern Japan to estimate the prevalence of definite hypertension, white coat hypertension and the success of blood pressure control in patients receiving antihypertensive drugs. A total of 1334 subjects (mean age +/- SD, 53.8 +/- 17.3 years; 8-91 years) participated in the screening and home blood pressure measurement program. They measured blood pressure at home at least 3 times (mean measurement frequency, 20.8 +/- 8.3 times). Of these 1334 subjects, 314 (65.1 +/- 8.9 years) were taking drugs (treated group) while 1020 (50.3 +/- 17.8 years) were not (untreated group). The WHO criteria were used to categorize screening blood pressure. Criteria for diagnosis of hypertension by home blood pressure measurements were as follows: definitely hypertensive (systolic blood pressure > or = 144 mmHg and/or diastolic blood pressure > or = 89 mmHg) and normotensive (104 < systolic blood pressure < or = 131 mmHg and 60 < diastolic blood pressure < or = 79 mmHg). Of the 1018 subjects identified as normotensive on screening measurements, home measurements indicated that 73 (7.2%) were hypertensive and 765 (74.7%) were normotensive or lower. Of the 112 subjects identified as hypertensive on screening measurements, home measurements showed that 42 (37.5%) were hypertensive and 30 (26.8%) were normotensive or lower. Of the 314 treated subjects, 45 (14.3%) were identified as hypertensive by screening measurements and 88 (28.0%) as hypertensive by home measurements. Only 20 (44.4%) of the former 45 subjects were also defined as definitely hypertensive by home measurements. Of the 1020 untreated subjects, 67 (6.6%) were hypertensive by screening measurements and 84 (8.2%) by home measurements. Only 22 (32.8%) of the former 67 subjects were classified as hypertensive by home measurements. Of the 67 untreated subjects identified as hypertensive by screening measurements, 20 (29.9%) were normotensive or lower by home measurements, suggesting that these subjects were "white coat" hypertensives. The study first confirmed based on the large community data that there are large discrepancies between screening (casual) blood pressure and home blood pressure measurements for recognition of hypertension and normotension. Determination of blood pressure levels by home blood pressure measurements may predict prognosis of hypertension differently from that by screening blood pressure measurements. Further prospectively study is needed to validate the prognostic value of home blood pressure measurements.

Adolescent↗
PubMed2002

Quality indicators of blood utilization: three College of American Pathologists Q-Probes studies of 12,288,404 red blood cell units in 1639 hospitals.

OBJECTIVES: To determine the normative rates of blood unit crossmatched to transfused (C:T) ratios, red blood cell (RBC) unit wastage, and RBC unit expiration that exist in hospital communities throughout the United States, and to examine hospital blood bank practices associated with more desirable (lower) rates. DESIGN: In 3 separate studies, participants in the College of American Pathologists Q-Probes laboratory quality improvement program collected data retrospectively on the number of transfusion crossmatches performed in their institutions and the number of RBC-containing units that were transfused into patients, the number of units that expired (outdated) prior to being utilized, and the number that were wasted due to mishandling. Participants also completed questionnaires describing their hospitals' and blood banks' laboratory and transfusion practices. SETTING AND PARTICIPANTS: One thousand six hundred thirty-nine public and private institutions, well more than 80% of which were known to be located in the United States. MAIN OUTCOME MEASURES: Quality indicators of blood utilization (namely, the C:T ratio, the rate of RBC unit expiration, and the rate of RBC unit wastage). RESULTS: Participants submitted data on 12,288,404 RBC unit transfusions. The C:T ratios were 1.5 or less in the top-performing 10% of participating institutions (90th percentile and above), 1.8 to 1.9 in the midrange of participating institutions (50th percentile), and 2.4 or greater in the bottom-performing 10% of participating institutions (10th percentile and below). Red blood cell unit expiration rates were 0.1% or less at the 90th percentile and above, 0.3% to 0.9% at the 50th percentile, and 3.5% or greater at the 10th percentile and below. Red blood cell unit wastage rates were 0.1% or less at the 90th percentile and above, 0.1% to 0.4% at the 50th percentile, and 0.7% or greater at the 10th percentile and below. Depending on which quality indicator was examined, lower values (ie, better performances) were found in institutions that had fewer than 200 hospital beds, no teaching programs, no on-site full-time medical directors of transfusion services, did not utilize maximum surgical blood order schedules, set C:T threshold goals of 2.0 or less, monitored categories of health care workers responsible for RBC wastage, monitored requests for RBC components by transfusion indication, did not accept short-dated units from blood distribution centers, and if they did accept short-dated units, were allowed to return those units to the distribution centers. CONCLUSIONS: Hospital blood bank personnel can achieve C:T ratios below 2.0, RBC unit expiration rates below 1.0%, and RBC unit wastage rates below 0.5%. Lower C:T ratios and/or RBC unit expiration rates were associated with blood bank personnel setting C:T thresholds of 2.0 or less, monitoring requests for blood components by transfusion indication criteria, monitoring categories of health care workers responsible for blood wastage, not accepting short-dated units from blood distribution centers, and if short-dated units were accepted, being allowed to return those units to the blood distribution center. These practices were not associated with lower blood wastage rates.

Blood Banks↗
PubMedDate not supplied

Stress-induced alterations of blood pressure and 24 h ambulatory blood pressure in adolescents.

OBJECTIVE: To examine the extent to which ambulatory blood pressure was predicted by blood pressure levels exhibited during talking segments of a laboratory protocol and by resting blood pressures in male and female adolescents from three ethnic groups: African, European and Hispanic Americans. DESIGN: This was a laboratory-field study incorporating an experimental study of reactivity of blood pressure during a laboratory protocol and an observational study of 24h ambulatory blood pressure (ABP) monitoring. METHODS: Resting blood pressure, reactivity of blood pressure, 24h ABP, and activity, height, and maturation of a multi-ethnic sample of 373 male and female adolescents aged 11-16 years were measured. A mixed-effects model for repeated measures was the statistical approach, with systolic and diastolic blood pressures as separate, dependent variables. RESULTS: Percentiles of ABP by sex, ethnic group, and height are presented. High and mixed blood pressure reactors in the laboratory had higher levels of 24h ABP and higher levels of blood pressure load during the daytime. African Americans had higher ABP than did European and Hispanic Americans. CONCLUSIONS: Blood pressure measured during laboratory tasks that require talking might be useful as a screening device to identify adolescents with high blood pressures. Further study will be necessary in order to quantify the sensitivity of the laboratory protocol as an indicator of high blood pressure compared with casual measurement of blood pressures. If laboratory patterns of blood pressure could be used to predict which individuals have high levels of blood pressure during the course of daily activities, the laboratory protocol would be a useful screening tool, identifying high-risk individuals.

Adolescent↗
PubMed1994

[Determinants of homologous blood utilization in addition to autologous blood transfusion--a multivariate study].

Since April 1989, we have been using autologous blood donation in order to avoid homologous blood transfusion as much as possible. To determine the factors which influence the necessity for homologous blood transfusion as well as autologous blood donation. Of them 77.6% (group 1) required autologous blood only, but others needed homologous blood transfusion as well as autologous blood. Using an invert analysis, preoperative factors that showed significant differences were age, body weight, number of autologous blood donations, amount of donated autologous blood, preoperative Hb and Ht. Among operative factors, aortic cross clamping time, cardiopulmonary bypass time, amount of concentrated blood from CPB circuit, amount of transfused autologous blood and amount of drainage demonstrated significant differences between groups. Univariately significant factors were studied by multivariate discriminant analysis. Total amount of drainage proved to be the best contributor of non-homologous blood transfusion surgery, followed by preoperative Hb, body weight, amount of concentrated blood from CPB circuit and amount of donated autologous blood in order of contribution Understanding these factors, homologous blood transfusion requirement may be greatly reduced. This is thought to be the largest series of autologous blood donation in Japan.

Analysis of Variance↗