Generation of IL-8 and TNF-alpha in platelet concentrates during storage

Platelet transfusion is accompanied by febrile nonhemolytic transfusion reactions. The generation of cytokines [like IL-1 beta, IL-6, IL-8, and TNF-alpha] in platelet concentrates by white cells is suggested to be responsible for febrile nonhemolytic transfusion reactions. The number of white cells in the platelet concentrates is crucial to cytokine generation. This study was performed to determine whether WBC reduction in platelet concentrates by prestorage leukodepletion filters or inactivation by gamma radiation reduced the levels of these cytokines during storage for 3 days. Each of the platelet concentrates [n = 54] was prepared from a single random donor by platelet-rich plasma. This was then divided into four groups: 1] unfiltered, nonirradiated random-donner platelet concentrates [n = 13]; 2] unfiltered, gamma-irradiated random-donner platelet concentrates [n = 16]; 3] filtered, nonirradiated random- donner platelet concentrates [n = 14]; and 4] filtered, gamma-irradiated random-donner platelet concentrates [n = 11]. Cytokine levels in platelet concentrates supernatants were measured by ELISA kits according to the manufacturer's recommendations. Our results showed that IL-8 was detected in unfiltered, nonirradiated, and gamma-irradiated random-donner platelet concentrates but not in the filtered random-donner platelet concentrates. TNF-alpha was only detected in unfiltered, nonirradiated units. Compared with unfiltered platelet concentrates, prestorage filtration prevented a rise in the IL-8 and TNF-alpha on day 3 of storage. The concentration of IL-1 beta was lower than the minimum concentration value of the kit used for this purpose. IL-6 was detected only in 7 units of all filtered platelet concentrates on day 3. These data indicate that gamma irradiation can not prevent generation of IL-8 in platelet concentrates during storage, but prestorage leukoreduction of platelet concentrates can prevent accumulation of IL-6, IL-8, and TNF-alpha during storage

Development of a community-based care system model for senior citizens in Tehran

In Iran a considerable percentage of old people "living" in society need to receive specialized health services. In order to respond to these care needs, developing and implementing health and social care systems with consideration of relevant factors such as existing resources and facilities; social and cultural issues and characteristics of each group of elders [healthy elders, frails, home-bound] seems to be necessary. At the development phase of the care model in this study methodological triangulation is used including: 1. Comprehensive review of current and related literature. 2. Conduction of an ethnographic study on a number of Tehranian elders and their families. 3. Seeking opinions of a group of experts on this issue using nominal group technique, and analysis and synthesis of the collected data were employed to develop a community based care system for elders. The preliminary results of employing this care system and examination of expected outcomes such as enhancing quality of life and hope in elders, reflects the efficiency of this system, although further complementary studies and particularly cost benefit analyses are strongly recommended