Blood component therapy and changing transfusion triggers

Transfusion trigger points and appropriate blood component therapy must be continuously evaluated by the anesthesia team during a surgical procedure. This article examines the composition of homologous blood, the storage of blood products, and transfusion reactions. Additionally, the incidence of transfusion transmitted infections is explored. Finally, a review of the current recommendations for transfusions in the clinical setting is provided.     

Effect of crude fat and crude protein on reproduction and weaning growth in four strains of inbred mice

Diets made from natural ingredients were fed to four inbred strains of mice (BALB/cAnN, C3H/HeN, C57BL/6N and DBA/2N) to study the effects of different concentrations of dietary crude protein, 18% and 24% with crude fat concentrations of 4%, 8%, and 12% on reproduction and weanling growth. The parameters measured included the number of litters and pups born, the number of litters and pups weaned, weanling mortality and weanling weight. Neither crude protein nor crude fat concentrations had significant effects on any of the reproductive parameters tested. However, a significant fat x protein interaction was observed for reproduction. These results indicate that the absolute concentrations of crude protein and crude fat in diets for inbred mouse production are not as important as the ratio of these two nutrients. There was also a differential response in reproduction among the strains due to the level of fat which indicates different dietary requirements for fat among these four inbred strains for maximum reproduction. In contrast to the results for reproduction, crude protein and crude fat independently had significant effects on weanling weight, but there was no effect due to the ratio of the nutrients. There was a significant increase in the weanling growth rate for all four strains as the dietary fat level increased, but a decrease in growth rate as the protein level increased. The reduced growth rate due to the increased protein was not of the same magnitude for all four strains which indicates specific protein requirements among the strains for weanling growth.     

Etiology of growth failure in a clinic population

To identify the basis of growth failure, the background of preschool children whose growth fell below 97 per cent of their peers was compared with that of those who demonstrated a higher level of growth achievement. A questionnaire administered at the home of each child documented living conditions, health history, and other family characteristics. Families of the growth-retarded children had higher income, higher credit payments, and used higher dollar values of Food Stamps. A greater percentage of the growth-retarded children were low-birth-weight infants. However, neither low birth weight nor any other one factor consistently predicted poor growth achievement. The need for adequate growth standards to correctly diagnose achievement remains a primary need in the field of nutritional assessment.     

Comparison of the quasifree charge-exchange reaction for 12C and 54Fe

Serotonin (5-hydroxytryptamine, 5-HT) in blood is stored in platelets and has vascular and platelet stimulating effects when released into plasma. Accurate measurements of 5-HT in plasma are complicated by inadvertent platelet activation causing sampling artifacts and by analytical problems when determining trace levels. We developed an assay for plasma 5-HT based on solid-phase extraction (Sep-Pak C18), aqueous acetylation, pentafluoropropionylation, and negative ion chemical ionization gas chromatography-mass spectrometry. The method was able to recover 5-HT from plasma by > 90% and to quantitate with a precision of 7.5% at a level of 0.5 nmol/l. It was used to define blood sampling and sample handling procedures giving low and consistent values for 5-HT. A good blood sampling technique, adequate platelet stabilization in the test tube, and rapid high speed centrifugation of the blood resulted in low plasma levels of both 5-HT and beta-thromboglobulin (a platelet release product). Using these procedures plasma 5-HT levels in healthy volunteers were found to be 0.77 +/- 0.38 (mean +/- S.D.; range 0.27-1.49) nmol/l (n = 18), which is 4-100-fold lower than previously reported values.     

The impact of HIV on infectiousness of pulmonary tuberculosis: a community study in Zambia

Isolated ventral and dorsal rat spinal roots incubated in normal (2.5 mM) or high glucose (25 mM) concentrations or in high concentrations of other hexoses were exposed transiently to hypoxia (30 min) in a solution of low buffering power. Compound nerve action potentials, extracellular direct current potentials, and interstitial pH were continuously recorded before, during, and after hypoxia. Ventral roots incubated in 25 mM D-glucose showed resistance to hypoxia. Dorsal roots, on the other hand, revealed electrophysiological damage by hyperglycemic hypoxia as indicated by a lack of posthypoxic recovery. In both types of spinal roots, interstitial acidification was most pronounced during hyperglycemic hypoxia. The changes in the sensitivity to hypoxia induced by high concentrations of D-glucose were imitated by high concentrations of D-mannose. In contrast, D-galactose, L-glucose, D-fructose, and L-fucose did not have such effects. Resistance to hypoxia, hypoxia-generated interstitial acidification, and hypoxia-induced electrophysiological damage were absent after pharmacological inhibition of nerve glycolysis with iodoacetate. These observations indicate 1) that enhanced anaerobic glycolysis produces resistance to hypoxia in hyperglycemic peripheral nerves and 2) that acidification may impair the function of peripheral axons when anaerobic glycolysis proceeds in a tissue with reduced buffering power.