scholarly journals Blood Donors’ Age, Haemoglobin Type, G6PD Status, and Blood Group Impact Storability of CPDA-1 Banked Whole Blood: A Repeated-Measure Cohort Study in Cape Coast, Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Patrick Adu ◽  
Gilbert Appiah Kubi ◽  
Amos Kumi ◽  
Raphael E. K. Gbedoho ◽  
Festus Ansah Kwakye ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Group ◽  
Whole Blood ◽  
Sub Saharan Africa ◽  
Repeated Measure ◽  
Full Blood Count ◽  
Donor Blood ◽  
Haemoglobin Type ◽  
Free Haemoglobin ◽  
The Impact

Background. The high prevalence of haemoglobin variants and glucose 6-phosphate dehydrogenase disorder (G6PDd) in sub-Saharan Africa means that substantial proportions of donor blood units carry these red cell abnormalities. Aim. This study investigated the impact that inherited haemoglobin variants and/or G6PD status have on whole blood banked at 4–6°C for 35 days. Method. This repeated-measure cohort study was undertaken on 103 donor blood units collected into blood bag containing CPDA-1 anticoagulant. On days 0, 7, 14, 21, and 35, full blood count, osmotic-induced haemolysis, and plasma K+ levels were estimated. Also, on day 0, G6PD status, haemoglobin variants, % foetal haemoglobin, and blood group of donor units were determined using methaemoglobin reductase, cellulose acetate electrophoresis, modified Bekte alkali denaturation assay, and slide haemagglutination test, respectively. Result. Overall, although plasma K+ levels increased during storage, donor units from individuals ≥20 years, G6PD normal, Hb AC, or blood group B had comparatively higher percentage change in plasma K+ during storage. Osmotically induced haemolysis of donor units was significantly decreased in Hb AC (compared with Hb A or AS) donor units on days 7, 14, 21, and 35 (p<0.0001 in each case). G6PDd donor units had comparatively reduced osmotic-induced lysis compared with G6PD normal units, reaching a statistical significance on day 35 (p=0.043). Also, Hb AC units had comparatively nonstatistically higher plasma K+ at all time points (compared with Hb A or AS). Furthermore, whereas donor units from individuals ≥20 years showed significantly higher median free haemoglobin on day 21 (compared to donor <20 years), when donor units were stratified per Hb variants, only Hb AS units had median free haemoglobin below the 0.8% threshold after 35 days’ storage. Conclusion. Age of donor, blood group, Hb AC variant, and G6PD status may be important considerations in the storability of whole blood.

scholarly journals Transfusion of Uncrossmatched Group O Erythrocyte-containing Products Does Not Interfere with Most ABO Typings

2020 ◽  
Vol 132 (3) ◽  
pp. 525-534 ◽  
Author(s):  
Mark H. Yazer ◽  
Philip C. Spinella ◽  
Leilani Doyle ◽  
Richard M. Kaufman ◽  
Robyn Dunn ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Whole Blood ◽  
Retrospective Cohort ◽  
Hospital Setting ◽  
Blood Type ◽  
Patient Records ◽  
Study Results ◽  
The Impact

Abstract Background Group O erythrocytes and/or whole blood are used for urgent transfusions in patients of unknown blood type. This study investigated the impact of transfusing increasing numbers of uncrossmatched type O products on the recipient’s first in-hospital ABO type. Methods This was a retrospective cohort study. Results of the first ABO type obtained in adult, non–type O recipients (i.e., types A, B, AB) after receiving at least one unit of uncrossmatched type O erythrocyte-containing product(s) for any bleeding etiology were analyzed along with the number of uncrossmatched type O erythrocyte-containing products administered in the prehospital and/or in hospital setting before the first type and screen sample was drawn. Results There were 10 institutions that contributed a total of 695 patient records. Among patients who received up to 10 uncrossmatched type O erythrocyte-containing products, the median A antigen agglutination strength in A and AB individuals on forward typing (i.e., testing the recipient’s erythrocytes for A and/or B antigens) was the maximum (4+), whereas the median B antigen agglutination strength among B and AB recipients of up to 10 units was 3 to 4+. The median agglutination strength on the reverse type (i.e., testing the recipient’s plasma for corresponding anti-A and -B antibodies) was very strong, between 3 and 4+, for recipients of up to 10 units of uncrossmatched erythrocyte-containing products. Overall, the ABO type of 665 of 695 (95.7%; 95% CI, 93.9 to 97.0%) of these patients could be accurately determined on the first type and screen sample obtained after transfusion of uncrossmatched type O erythrocyte-containing products. Conclusions The transfusion of smaller quantities of uncrossmatched type O erythrocyte-containing products, in particular up to 10 units, does not usually interfere with determining the recipient’s ABO type. The early collection of a type and screen sample is important. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Correlation between blood group type and Catheter-associated urinary tract infections (CA-UTI) in critically ill patients: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Khalid Al Sulaiman ◽  
Nouf Al Qahtani ◽  
Mashael Al Muqrin ◽  
Maram Al Dossari ◽  
Ali Al Wabel ◽  
...  
Keyword(s):  
Cohort Study ◽  
Critically Ill ◽  
Blood Group ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Group Type ◽  
Mechanical Ventilation Duration ◽  
Blood Group Type ◽  
Tract Infections ◽  
The Impact

Abstract Background: CA-UTI consider one of the most common hospital acquired infections. Several risk factors for CA-UTI have been identified. There is no enough evidence regard the impact of ABO type and the risk of CA-UTI acquisition. The aim of this study is to investigate the correlation between ABO types and the risk of having recurrent, reinfection CA-UTI, and MDR reinfection in critically ill.Methodology: A retrospective cohort study of adult ICU patients through 2018 in ICU at tertiary hospital who have confirmed CA-UTI to investigate the correlation between ABO type with the susceptibility of recurrent, reinfection and MDR reinfection CA-UTI in critically ill. 1730 patients were reviewed to screen patients for inclusion into the study,203 patients have confirmed CA-UTI using 2010 IDSA guideline definition.81patients meeting inclusion/exclusion criteria were enrolled. Patients were divided into two groups based on ABO type (O-group Vs. Non-O group). We considered a P value of < 0.05 as statistically significant.Results: Among 81 patients, 37 patients (45.6%) had O blood group type. Patients with O blood group type were associated with lower rate of recurrent CA-UTI (OR 0.28, 95% CI 0.085-0.952, P = 0.0414), multidrug resistant (MDR) organisms (OR 0.05, 95% CI 0.003-0.752, P = 0.0304), shorter ICU LOS (Est (SE): -0.024 (0.045), P = <0.001) and mechanical ventilation duration (Est. (SE): -0.41 (0.066), P = <0.001) compared with non-O blood group type. On the other hand, neither CA-UTI reinfection (OR 1.47, 95% CI 0.357-6.054, P = 0.5538) nor ICU mortality (OR 0.70, 95% CI 0.219-2.257, P = 0.5538) were statistically significant.Conclusion: Patients with non-O group type were statistically significant associated with higher rate of recurrent CA-UTI and MDRO. These data confirm the need for randomized controlled trials with a larger sample size to clarify and confirm our study findings.

scholarly journals 71 Changes in Muscle Strength in Older Patients During Hospitalisation: A Prospective Repeated Measures Cohort Study

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i22-i23 ◽  
Author(s):  
P Hartley ◽  
R Romero-Ortuno ◽  
I Wellwood ◽  
C Deaton
Keyword(s):  
Cohort Study ◽  
Muscle Strength ◽  
Repeated Measures ◽  
Older Patients ◽  
Sedentary Time ◽  
Knee Extension ◽  
Functional Mobility ◽  
Repeated Measure ◽  
Knee Extension Strength ◽  
The Impact

Abstract Introduction Hospital associated deconditioning is a well-established phenomenon. Whilst mechanisms are not well understood, one is thought to be skeletal muscle wasting and/or loss of muscle strength. The primary aim of this study was to investigate changes in knee-extension muscle strength in older patients during and after an acute-hospital admission. We also aimed to explore the potential contributions of frailty, acute-illness severity and sedentary activity, with changes in knee-extension strength. Methods This was a prospective repeated-measures cohort study. Measurements of muscle strength and functional mobility were taken at recruitment, on day 7 of admission (or at discharge if earlier) and again 4-6 weeks post-hospitalisation. During the first 7 days of admission, daily measurements of muscle strength were taken. Results We recruited 70 participants, of which 65 had at least one repeated measure in hospital. Median age was 84 years, and participants participated in the study for a median of 6 days whilst in hospital, on average participants were ‘active’ for less than 4% of the day. Knee-extension strength significantly reduced by approximately 11% during hospitalisation, but no significant changes occurred post-hospitalisation. A repeated-measures mixed model included 292 observations from 62 participants and showed a significant decrease in the reduction in muscle strength as patients' sedentary time decreased on days 2 to 7 of the study. Additionally, the model showed that a higher frailty score, higher baseline knee-extension strength, lower baseline c-reactive protein levels were associated with greater loss in knee-extension strength during hospitalisation. Association between change in functional mobility after hospitalisation and change in knee-extension strength during hospitalisation was non-significant. Conclusion Our findings provide an important link in understanding the mechanisms and relative contributions of risk factors to hospital associated deconditioning. Further research is needed to confirm these findings and examine the impact of reducing sedentary time on muscle strength during and post-hospitalisation.

scholarly journals The IMpact of Vertical HIV infection on child and Adolescent SKeletal development in Harare, Zimbabwe (IMVASK Study): a protocol for a prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031792
Author(s):  
Ruramayi Rukuni ◽  
Celia Gregson ◽  
Cynthia Kahari ◽  
Farirayi Kowo ◽  
Grace McHugh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hiv Infection ◽  
Bone Mineral ◽  
Prospective Cohort Study ◽  
Muscle Function ◽  
Prospective Cohort ◽  
Sub Saharan Africa ◽  
Close Link ◽  
Z Scores ◽  
The Impact

IntroductionThe scale-up of antiretroviral therapy (ART) across sub-Saharan Africa (SSA) has reduced mortality so that increasing numbers of children with HIV (CWH) are surviving to adolescence. However, they experience a range of morbidities due to chronic HIV infection and its treatment. Impaired linear growth (stunting) is a common manifestation, affecting up to 50% of children. However, the effect of HIV on bone and muscle development during adolescent growth is not well characterised. Given the close link between pubertal timing and musculoskeletal development, any impairments in adolescence are likely to impact on future adult musculoskeletal health. We hypothesise that bone and muscle mass accrual in CWH is reduced, putting them at risk of reduced bone mineral density (BMD) and muscle function and increasing fracture risk. This study aims to determine the impact of HIV on BMD and muscle function in peripubertal children on ART in Zimbabwe.Methods and analysisChildren with (n=300) and without HIV (n=300), aged 8–16 years, established on ART, will be recruited into a frequency-matched prospective cohort study and compared. Musculoskeletal assessments including dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, grip strength and standing long jump will be conducted at baseline and after 1 year. Linear regression will be used to estimate mean size-adjusted bone density and Z-scores by HIV status (ie, total-body less-head bone mineral content for lean mass adjusted for height and lumbar spine bone mineral apparent density. The prevalence of low size-adjusted BMD (ie, Z-scores <−2) will also be determined.Ethics and disseminationEthical approval for this study has been granted by the Medical Research Council of Zimbabwe and the London School of Hygiene and Tropical Medicine Ethics Committee. Baseline and longitudinal analyses will be published in peer-reviewed journals and disseminated to research communities.

scholarly journals Clinical prediction tools to identify patients at highest risk of myeloma in primary care: a retrospective open cohort study

2021 ◽  
Vol 71 (706) ◽  
pp. e347-e355
Author(s):  
Constantinos Koshiaris ◽  
Ann Van den Bruel ◽  
Brian D Nicholson ◽  
Sarah Lay-Flurrie ◽  
FD Richard Hobbs ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Clinical Practice ◽  
External Validation ◽  
Area Under The Curve ◽  
Full Blood Count ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Clinical Prediction ◽  
The Impact

BackgroundPatients with myeloma experience substantial delays in their diagnosis, which can adversely affect their prognosis.AimTo generate a clinical prediction rule to identify primary care patients who are at highest risk of myeloma.Design and settingRetrospective open cohort study using electronic health records data from the UK’s Clinical Practice Research Datalink (CPRD) between 1 January 2000 and 1 January 2014.MethodPatients from the CPRD were included in the study if they were aged ≥40 years, had two full blood counts within a year, and had no previous diagnosis of myeloma. Cases of myeloma were identified in the following 2 years. Derivation and external validation datasets were created based on geographical region. Prediction equations were estimated using Cox proportional hazards models including patient characteristics, symptoms, and blood test results. Calibration, discrimination, and clinical utility were evaluated in the validation set.ResultsOf 1 281 926 eligible patients, 737 (0.06%) were diagnosed with myeloma within 2 years. Independent predictors of myeloma included: older age; male sex; back, chest and rib pain; nosebleeds; low haemoglobin, platelets, and white cell count; and raised mean corpuscular volume, calcium, and erythrocyte sedimentation rate. A model including symptoms and full blood count had an area under the curve of 0.84 (95% CI = 0.81 to 0.87) and sensitivity of 62% (95% CI = 55% to 68%) at the highest risk decile. The corresponding statistics for a second model, which also included calcium and inflammatory markers, were an area under the curve of 0.87 (95% CI = 0.84 to 0.90) and sensitivity of 72% (95% CI = 66% to 78%).ConclusionThe implementation of these prediction rules would highlight the possibility of myeloma in patients where GPs do not suspect myeloma. Future research should focus on the prospective evaluation of further external validity and the impact on clinical practice.

Conflicts in Biafra, Katanga and Cabinda as a result of the geopolitical legacy of colonialism

2020 ◽  
Vol 2020 (10-3) ◽  
pp. 238-246
Author(s):  
Olga Dzhenchakova
Keyword(s):  
Democratic Republic ◽  
Economic Factor ◽  
Colonial Period ◽  
Sub Saharan Africa ◽  
Negative Consequences ◽  
Post Colonial ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
The Republic ◽  
The Impact

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.

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