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PubMed1993

Red Cross spinal injury project in Bucharest, Romania.

Inadequate medical facilities with lack of specialised drugs and other essential medical items, scientific isolation of medical staff, unavailability of orthoses and wheelchairs: such were a few of the problems identified in Bucharest in July 1991. The aim of the federation at the start of the project was to launch an action in many directions using two basic principles: using local means including human resources, and improving the existing facilities instead of erecting new buildings. Training of the staff goes side by side with the practice of total initial care. The family is taught to position and turn patients, practice chest physiotherapy and has become a major psychological and emotional support. An orthopaedic workshop has been set up to provide orthoses and to supervise the construction of wheelchairs in a local factory. The social situation of patients is assessed to initiate social integration in the community. Home visits are organised to offer advice for adaptations. The implementation of these actions is difficult in a country which has to solve many economic problems.

Home Care Services↗
PubMed2005

Safety and immunogenicity of the intradermal Thai red cross (2-2-2-0-1-1) post exposure vaccination regimen in the Indian population using purified chick embryo cell rabies vaccine.

PURPOSE: To test the immunogenicity of the WHO recommended "2-2-2-0-1-1" post-exposure rabies vaccination regimen in Indian subjects to determine the feasibility of replacing crude sheep brain nerve tissue rabies vaccine with modern tissue culture rabies vaccine at major anti-rabies treatment centers throughout India. METHODS: Purified chick embryo cell vaccine (PCECV) was administered in the dosage of 0.1 mL per site to 53 Indian subjects. RESULTS: All subjects produced rabies antibodies above 0.5 IU/mL by day 14 post-vaccination. Only minor adverse reactions including swelling (6.6%), erythema (5.4%) and pain (1.4%) were observed for which no treatment was required. CONCLUSIONS: This study demonstrated that PCECV is safe and highly immunogenic in Indian subjects when administered intradermally as 0.1 mL/site using the "2-2-2-0-1-1" post-exposure regimen.

Animals↗
PubMed1999

Experiences in HCV-NAT screening prior to releasing cellular components by the German Red Cross Blood Transfusion Service of Baden-Württemberg.

In this report we present the accumulated data on nucleic acid testing (NAT) for hepatitis C virus (HCV) RNA of blood donations by the Blood Transfusion Service of Baden-Württemberg in the period between March 1997 and March 1999. An extra barcoded blood sample was collected from each donor. Samples were tested by NAT in mini-pools of maximally 96 samples. First-time and repeat donors were tested separately. RT/HCV-PCR was performed with the COBAS HCV Amplicortrade mark, versions 1.0 and 2.0 from Roche Diagnostic Systems. Many modifications have been introduced to the original protocol since the implementation of NAT screening aiming at an increase in the sensitivity and specificity of the assay. NAT positive pools containing serologically positive samples were detected. Initially, reactive pools were identified that could not be confirmed by secondary pooling and single testing procedures. So far, no serologically negative but NAT positive sample has been found.

Blood Banks↗
PubMed2002

[Relations between military health services and humanitarian organizations--the point of view of the International Red Cross].

The classic definition of humanitarian action is any operation conducted for the purpose of helping to reduce human suffering. This concept can be expanded to include a notion of prevention. This expanded definition has opened a wide range of applications for humanitarian assistance. Military personnel are frequently involved in relief operations after natural disasters. Military logistic support is a key factor for coping with the massive needs of victims. However military intervention in humanitarian operations during wartime poses complex problems. The ICRC intervenes during military conflict and has, for several years, expressed its concern over the growing involvement of military forces in humanitarian operations. These considerations provide the backdrop for analysis of the relationship between Military Health Corps Services and the ICRC. The purpose of this article is to evaluate the need to make a clear-cut distinction between political and humanitarian objectives and thus between the actors associated with these goals. In this regard, the role of Military Health Corps Services will be presented in function of the principles underlying any humanitarian program. This article will also discuss areas of agreement and cooperation between the ICRC and Military Health Corps Services.

Altruism↗
PubMed1982

Hepatitis-associated markers in the American Red Cross volunteer blood donor population. IV. A comparison of HBV-associated serologic markers in HBsAg-positive first-time and repeat blood donors.

The present study was undertaken to determine whether there were any differences in the distribution of hepatitis B virus-(HBV) associated serologic markers among hepatitis B surface antigen-(HBsAg) positive first-time and repeat blood donors. The markers examined in samples from 412 newly identified HBsAg-positive donors (254 first-time and 158 repeat) included HBsAg titer and subtype, HBeAg/anti-HBe, and anti-HBc. Repeat donors were more frequently HBeAg-positive (25.9%) than were first-time donors (17.7%). Anti-HBc and anti-HBe were observed more often among first-time (99.6 and 76%) than repeat (91.8 and 60.8%) donors. No differences were found in the mean HBsAg titer nor in the subtype distribution in the two populations. The frequency of HBeAg positivity and the mean HBsAg titer in blood were significantly lower among first-time donors aged 30 or older as compared to those younger than 30. Such age-related tendencies did not occur among the repeat donors. The profiles of HBV makers suggest that the HBsAg-positive first-time donor group consists predominantly of long-term HBsAg carriers who may have acquired HBV at an early age, while the HBsAg-positive repeat donors have newly acquired infections.

Adolescent↗
PubMed2005

Abdominal war wounds--experiences from Red Cross field hospitals.

The traditional approach to abdominal war wounds consists of triage, eche-loned care, and mandatory laparotomy for penetrating abdominal injuries, and it remains valid in modern conventional wars with well-organized evacuation and surgical services. Expectant management of abdominal casualties can be considered under difficult circumstances with a high influx of patients exhausting the available resources. This can occur in regional conflicts associated with mass movements of people and with collapsed infrastructure. While always combined with adequate fluid resuscitation, antibiotic treatment, and other supportive care, the expectant approach in patients with penetrating abdominal injuries could be indicated for asymptomatic patients with multiple fragment wounds or for patients presenting several days post-injury in good condition. The focus of surgical resources and competence should be on the majority of patients with intestinal perforation only, who need surgery to save life--but not necessarily on an urgent basis--and who have a good chance of survival. The limited availability of blood products to correct blood loss and coagulation factor deficiencies, and the lack of sophisticated monitoring of hemodynamic variables that call into question the value of a damage-control approach for the most severely injured. Even if the bleeding could be temporarily controlled, the subsequent need for adequate resuscitation before returning the patient to the operating room could be difficult to achieve and would result in incompletely resuscitated patients being reoperated while acidotic, coagulopathic, and even hypothermic. Perhaps, in mass casualty situations these patients should be recognized during triage or at least early during operation, and aggressive surgery should be replaced with adequate expectant management with sedation and analgesics.

Abdominal Injuries↗
PubMed2000

Liver transplantation in children--the Red Cross War Memorial Children's Hospital experience.

Liver transplantation for infants and children has been available in South Africa for more than a decade. Current concerns have shifted from an initial target of early post-transplant survival to quality of life in the long term. Since 1985, 175 infants and children have been assessed, with 104 accepted for transplantation. Fifty have had orthotopic liver transplants (OLTx), 48 (3 retransplants) in Cape Town and 2 abroad. Biliary atresia was the most frequent diagnosis (52%) followed by acute liver failure (ALF) (16%). Waiting list mortality has remained high (15%), particularly for the ALF group (50%). Thirty-four patients survive 1 month--14 years post-transplant. Early post OLTx mortality was low (7%) but late morbidity and mortality (23%) were mainly due to viral infection: de novo hepatitis B (5 patients, 2 deaths), EBV-related post-transplantation lymphoproliferative disease (PTLPD) (6 patients, 4 deaths) and CMV disease (9 patients, 4 deaths). Tuberculosis prophylaxis, required in 6 cases, resulted in major morbidity in 1. Hypertension requiring medication along with some compromise of renal function has been present in all but 2 patients. However, all those of school-going age (20) attend school normally and remain in good health and only 3 of the survivors have abnormal liver function tests. Successful liver transplantation is possible in a developing country with limited resources. Scarcity of virus-free donors (HBV and HIV) leading to waiting list mortality and infrequent retransplantation along with long-term consequences of immunosuppression (infection, lymphoma and renal toxicity) remain problems.

Child↗
PubMed2004

Liver transplantation for children--the Red Cross Children's Hospital experience.

UNLABELLED: Liver transplantation for infants and children has been available in South Africa at a single centre, the only established service in Sub-Saharan Africa, for more than a decade. Current concerns have shifted from an initial target of early post-transplant survival to quality of life in the long-term. MATERIALS AND METHODS: Since 1985, 225 infants and children have been assessed, with 146 accepted for transplantation. Sixty-nine have had 71 orthotopic liver transplants (OLTx). Biliary atresia was the most frequent diagnosis (54%) followed by acute liver failure (ALF) (15%). Waiting list mortality has remained high (23%), particularly for the ALF group (50%). Forty-three were reduced size transplants with donor: recipient weight ratios ranging from 2:1 to 11:1. Twenty-seven were <10 kg. RESULTS: Fifty (74%) survive 1 month-12 years post-transplant. Actuarial survival after 1996 since HBV core antibody positive donor livers were refused and prophylactic IV ganciclovir used has been >82%. Early post-OLTx mortality was low (5%), one primary non-function, one IVC thrombosis, one PV thrombosis, but late morbidity and mortality (20%) was mainly due to viral infection: de novo hepatitis B (five patients, three deaths), EBV-related post-transplantation lymphoproliferative disease (PTLPD) (eight patients, six deaths) and CMV disease (11 patients, five deaths). Tuberculosis prophylaxis, required in six cases, resulted in major morbidity in two and mortality in one. Poor compliance played a significant role in seven deaths. Hypertension requiring medication along with some compromise of renal function has been present in all but two patients. However, all those of school-going age (25) attend school normally and remain in good health and only three of the survivors have abnormal liver function tests. CONCLUSIONS: Successful liver transplantation is possible in a developing country with limited resources. Scarcity of virus-free donors (HBV and HIV) leading to waiting list mortality and infrequent re-transplantation along with long-term consequences of immunosuppression (infection, lymphoma and renal toxicity) remain problems. Intense education of the caregiver and close follow-up, particularly of those living at long distances has partly addressed the compliance problem.

Actuarial Analysis↗
PubMed1997

[Immunological effects of erythrocyte and leukocyte transfusion. Work Group Blood Group Serology of the Medical Advisory Commission of the College for Blood Transfusion of the Netherlands Red Cross].

Immunological consequences of blood transfusion are less well-known than infectious complications although they occur more frequently. In many cases the effects in individual patients are hardly visible although fatal transfusion reactions may occur: Transfusion of red cells may induce acute or delayed haemolytic transfusion reactions. Transfusion of leukocytes may suppress the function of the immune system of the recipient (with consequences for immune tolerance in transplant patients, cancer surveillance and the occurrence of postoperative infections) but also may induce graft versus host disease.

Erythrocyte Transfusion↗
PubMedDate not supplied

Why is "Red Cross" different from "Yellow Cross"?: a neuropsychological study of noun-adjective agreement within Italian compounds.

This study investigates the performance of two Italian nonfluent aphasic patients on noun-adjective agreement in compounds and in noun phrases. A completion, a reading, and a repetition task were administered. Results show that both patients were able to correctly inflect adjectives within compounds, but not in noun phrases. Moreover, they were sensitive to constituent order (noun-adjective vs adjective-noun) within noun phrases, but less so within compounds. These results suggest differential processing for compounds as compared to noun phrases: While the latter require standard morphosyntactic operations that are often impaired in aphasic patients, the former can be accessed as whole words at the lexical level.

Adult↗
PubMed1991

Tympanoplasty surgery at the Red Cross War Memorial Children's Hospital 1986-1988.

Results of tympanoplasty surgery over a 3 year period in 96 children aged 2-12 years were analysed to better define indications for surgery and prognostic factors. Nineteen percent had a hearing loss associated with a dry perforation--grafts were successful in 84% and 71% improved hearing to less than 20 dB. Forty-two percent had a hearing loss but also troublesome recurrent infection--grafts were successful in 88% but only 65% improved hearing to less than 20 dB. Thirteen percent had troublesome recurrent infection--grafts were successful in 79%. Twenty-two percent had uncontrolled infection, a cortical mastoidectomy together with myringoplasty produced a 75% take rate. Graft take was not affected by age, type of surgery, infection status or perforation size. Poor nutritional status and postoperative infection both had negative tendencies. In this small series there was a 10% re-perforation rate.

Age Factors↗
PubMed1994

Anaesthesia for burns in children: a review of procedures practised at Red Cross War Memorial Children's Hospital, Cape Town.

Burns anaesthesia for children is a potentially hazardous procedure. We describe our technique developed over a number of years which allows a relatively large number of patients to be dealt with safety in limited theatre time. The technique involves an oral premedication with atropine (0.02 mg/kg), trimeprazine (3 mg/kg) and droperidol (0.2 mg/kg). Intramuscular ketamine (10 mg/kg) is used after an initial halothane induction and anaesthesia is maintained with intravenous ketamine, and a nitrous oxide/oxygen mixture given via nasal prongs. The advantages of the technique together with precautions and monitoring employed are discussed.

Anesthesia, General↗
PubMed2005

Adverse reactions to human rabies immune globulin manufactured by the Thai Red Cross Society.

Rabies Immunoglobulins (RIG) are an essential part of optimal management of rabies exposures [World Health Organization (WHO)]. They provide protection against the virus during the critical initial 7 days before adequate endogenous vaccine induced antibodies are formed. Even though Human Rabies Immune Globulin (HRIG) is the ideal product for post-exposure rabies treatment it, like most biological, can cause very rare adverse reactions. A retrospective review of a series of 8737 patients, who received HRIG at one institution, revealed that only 15 (0.183 %) reported transient mild adverse reactions.

Adolescent↗
PubMed1982

Post-transfusion hepatitis in Australia. Report of the Australian Red Cross study.

Post-transfusion hepatitis developed in 2% of 842 cardiac-surgery patients surveyed in Sydney (4 cases per 1000 units of transfused blood). 3 of the 18 cases were caused by hepatitis B virus even though all units of blood which contained hepatitis B surface antigen (HBsAg) had been rejected. 1 case was caused by cytomegalovirus, and there were 14 (78%) cases of non-A, non-B hepatitis. A significantly higher proportion of the units of blood given to the patients in whom non-A, non-B hepatitis developed contained antibodies against both hepatitis B core antigen and HBsAg than the units of blood given to the other patients. Rejection of blood with these markers of past exposure to hepatitis B may reduce the incidence of post-transfusion non-A, non-B hepatitis by up to a half.

Antibodies, Viral↗
PubMed1994

Analysis of risk factors for post-transfusion graft-versus-host disease in Japan. Japanese Red Cross PT-GVHD Study Group.

We distributed a questionnaire to highlight the effects of post transfusion graft-versus-host disease (PT-GVHD) and to elucidate the risk factors that would predispose people to the disease. The questionnaire described the pathogenesis and the clinical profiles of PT-GVHD and was distributed to doctors in Japan whose hospital conducted more than 1000 units of blood transfusions a year. Doctors were asked about their awareness and experience of PT-GVHD cases. Those who had seen cases of PT-GVHD were then asked to detail clinical course and laboratory data. Of the 14,083 doctors who replied to the first question, 47.4% did not realise that PT-GVHD could occur in immunocompetent hosts. From 304 cases where detailed information was supplied, 171 were considered clinically compatible with PT-GVHD. From these it seems that the risk factors linked to PT-GVHD are cardiovascular surgery, cancer, fresh and consanguineous blood transfusion, and being male. Patients with any of these factors should have some prophylactic therapy such as irradiation of blood before transfusion.

Adolescent↗
PubMed1983

Hepatitis B and the dental profession: response to hepatitis B vaccine in Canadian dental personnel. A study by the Canadian Red Cross Collaborative Group.

Reports from North America and Western Europe based on the prevalence of hepatitis B virus markers and frequency of hepatitis B in dentists indicate that this professional group is at increased risk of HBV infection. We gave hepatitis B vaccine (Merck Sharp and Dohme) to 251 dental students and faculty/staff members at faculties of dentistry in three Canadian universities. Participants received three 20 micrograms doses of vaccine, at 0, 1 and 5.5 months. Anti-HBs was detected in 42.9 per cent of persons after the first dose of vaccine, in 96.8 per cent after the second dose and in 99.6 per cent after the third dose. A follow-up of 150 persons 22 months after the first dose of vaccine indicated that high or medium levels of anti-HBs were maintained in nearly 87 per cent of the participants and only six per cent had no detectable antibody. Female vaccinees in each age group developed anti-HBs more promptly, and more of them were in the high antibody-response range in comparison to male participants. There were no unacceptable reactions to the vaccine. Our favourable experience with this vaccine would support recommendations for its routine use among dental professionals in Canada and other countries where this group is at increased risk of HBV infection.

Adult↗
PubMed1999

Cholesteatoma in children--the experience at The Red Cross War Memorial Children's Hospital in South Africa 1988-1996.

This review of experience with cholesteatoma in children, describes the presentation and features of the disease from a tertiary institution in a 'developing country'. A total of 24 out of 96 cholesteatomas in 81 children (M:F = 44:37) aged 2-12 years initially presented with mastoiditis, with intracranial complications in seven children. Three of the cholesteatomas were congenital, 56 arose from retraction pockets-11 pars flaccida, 45 pars tensa 21 were associated with either a central perforation or total atelectasis and one originated at a ventilation tube site. Open cavity surgery was undertaken in all cases-atticotomy in 14, open mastoid cavity in 82 ears. It was not always possible to preserve reasonably normal pre-operative hearing nor was it possible to improve hearing loss. Twenty-six out of 81 children did not return for follow-up. Even with open cavity surgery, recurrence of cholesteatoma occurred. Late diagnosis, extensive disease, a high rate of complications and poor follow-up are the features of this disease in 'developing' countries.

Audiometry↗