Comparison of Hemoglobin Correction Effects According to Storage Period and Other Factors in the Transfusion of Packed Red Blood Cells in Neonatal Intensive Care Unit Patients

PURPOSE: Preterm infants frequently require red blood cell (RBC) transfusions in neonatal intensive care units (NICU). Storage RBCs undergo many changes during storage periods. We aimed to compare the hemoglobin (Hb) correction effect according to the period of RBC storage and investigate the factors influencing Hb correction. METHODS: This retrospective study reviewed the medical records of 289 patients who received RBC transfusion more than once in the NICU of Kosin University Gospel Hospital between February 2006 and March 2016. The subjects were classified into two storage groups: short-term (≤7 days, n=88) and long-term (>7 days, n=201), according to the period of RBC storage. We checked Hb levels by complete blood cell count tests conducted within 2 days before and 5 to 9 days after the first transfusion. We compared the Hb difference between the two groups and analyzed the factors influencing Hb correction. RESULTS: Excluding the use of an invasive ventilator, there was no significant difference between the two groups in terms of clinical characteristics. There was no significant difference in the Hb correction effect between the two groups (P=0.537). Birth weight greater than 1,500 g, higher weight at transfusion, and larger volume of transfusion were significant prognostic factors affecting greater changes in Hb. In addition, surgery experience, higher Hb level at transfusion, and additional blood tests were found to be significantly associated with less changes in Hb. CONCLUSION: The RBC storage period did not affect the Hb correction effect. The Hb correction effect may be diminished in infants with lower birth weight and lower weight at transfusion under unstable clinical conditions.

Esperança e qualidade de vida de envelhescentes que se relacionam com pessoas do mesmo sexo / Hope and quality of life of mature people who have a relationship with same sex people / La esperanza y la calidad de vida de envejecientes que se relacionan con personas del mismo sexo

Esta pesquisa teve como objetivo comparar os níveis de esperança e a qualidade de vida de uma amostra de indivíduos envelhescentes (na faixa dos 40 aos 65 anos) que se relacionam com pessoas do mesmo sexo de maneira secreta e aberta à sociedade. Os instrumentos utilizados para coleta de dados foram: Escala de Esperança de Herth (EEH) e WHOQOL-bref. A amostra foi dividida em grupos: (a) GAon (n = 52): envelhescentes que se relacionam com pessoas do mesmo sexo de forma aberta à sociedade; (b) GFoff (n = 51): envelhescentes que mantém a homossexualidade de maneira secreta. Os dados mostraram que o GFoff apresenta escores qualidade de vida (domínios psicológico, relações sociais e meio ambiente) e esperança mais elevados quando comparados com o GAon.

This research aimed to compare the levels of hope and quality of life of a sample of mature individuals (in the range of 40 to 65 years old) who have relationship to same sex people in a secret and open manner to society. The instruments used for data collection were: Hope Scale of Herth (EEH) and WHOQOL-bref. The sample was divided into groups: (a) GAon (n = 52): aging people who have relationship with same sex people in an open society; (b) GFoff (n = 51): aging people who maintains their homosexual status in a secret manner. The data showed that the GFoff presents higher scores of quality of life (psychological, social relationships and environment) and higher hope compared to the GAon group.

Esta investigación tuvo como objetivo comparar los niveles de la esperanza y la calidad de vida de una muestra de individuos maduros (en el rango de 40 a 65 años) que tienen relación con personas del mismo sexo de una manera secreta y abierta a la sociedad. Los instrumentos utilizados para la recolección de datos fueron: Esperanza Escala de Herth (EEH) y WHOQOL-BREF. La muestra se dividió en grupos: (a) GAon (n = 52): personas de edad avanzada que tienen relación con personas del mismo sexo en una sociedad abierta; (b) GFoff (n = 51): personas de edad avanzada, que mantiene su condición homosexual de manera secreta. Los datos mostraron que la GFoff presenta puntajes más altos de calidad de vida (psicológico, relaciones sociales y medio ambiente) y una mayor esperanza en comparación con el grupo GAon.

Preservação da fertilidade e dos ovários em mulheres com tumores anexiais benignos / Preservation of the fertility and the ovaries in women with benign adnexal tumors

OBJETIVO: Avaliar a preservação da fertilidade e dos ovários em mulheres submetidas à cirurgia por tumor anexial benigno. MÉTODOS: Para este estudo observacional com coleta prospectiva foram incluídas 206 mulheres operadas no CAISM-Unicamp de fevereiro de 2010 a janeiro de 2014. A preservação da fertilidade foi definida como tumorectomia ou anexectomia unilateral sem histerectomia em mulheres na pré-menopausa. A preservação ovariana foi considerada quando pelo menos um ovário ou parte dele foi preservado. RESULTADOS: Das 206 mulheres com tumores anexiais benignos, 120 (58%) estavam na pré-menopausa e 86 (42%) na pós-menopausa. Na pré-menopausa, foram encontrados 36 (30%) tumores de células germinativas, 31 (26%) neoplasias epiteliais e 11 (9%) do cordão sexual e estroma. Na pós-menopausa foram identificados 35 (41%) neoplasias epiteliais, 27 (31%) do cordão sexual e estroma e 8 (9%) de células germinativas. Entre as 36 mulheres com tumores ovarianos não neoplásicos, 21 (58%) apresentavam endometriomas e 8 (22%) cistos funcionais. Das 22 mulheres com tumores extra ovarianos, o leiomioma uterino foi o achado mais frequente (50%). Entre as pacientes com ≤35 anos, 26 (57%) foram submetidas à tumorectomia e 18 (39%) a anexectomia unilateral com preservação do útero e anexo contralateral. Mulheres com ≤35 anos foram mais frequentemente operadas por laparoscopia que esteve associada a maior taxa de preservação de fertilidade quando comparada com a laparotomia (p<0,01). Observou-se que 26 das pacientes submetidas à histerectomia com anexectomia (28%) bilateral estavam na pré-menopausa. CONCLUSÕES: Embora se observe uma tendência em realizar apenas tumorectomia em mulheres com ≤35 anos, uma proporção significativa de mulheres jovens ainda é ...

PURPOSE: To evaluate the sparing of fertility and ovaries in women submitted to surgical treatment for benign adnexal tumors. METHODS: Between February 2010 and January 2014, 206 patients were included in this observational study as they were submitted to surgical treatment for benign ovarian tumors at CAISM, a tertiary hospital. Fertility sparing surgery was defined as tumorectomy or unilateral salpingoophorectomy without hysterectomy in premenopausal women. Preservation of the ovary occurred when at least one ovary or part of it was mantained. RESULTS: Of the 206 women with benign tumors, 120 (58%) were premenopausal and 86 (42%) were postmenopausal. There were 36 (30%) ovarian germ cell tumors, 31 (26%) epithelial neoplasms and 11 (9%) sex-cord stromal tumors among premenopausal women. In the group of postmenopausal women, 35 (41%) epithelial neoplasms, 27 (31%) sex-cord stromal tumors and 8 (9%) ovarian germ cell tumors were identified. Among 36 women with non-neoplastic ovarian tumors, 21 (58%) had endometriomas and 8 (22%) functional cysts. Among 22 women with extra-ovarian tumors, uterine leiomyomatosis was the most frequent finding (50%). In the group of women who were ≤35 years old, 26 (57%) were treated by tumorectomy and 18 (39%) were submitted to unilateral salpingoophorectomy with sparing of the uterus and the contralateral ovary. Women who were ≤35 years old were more frequently operated by laparoscopy which was associated with a higher number of fertility sparing procedures when compared to laparotomy (p<0.01). Twenty-six (28%) women submitted to hysterectomy with bilateral salpingoophorectomy were premenopausal. CONCLUSION: Although there is a trend to perform only tumorectomy in women who are ≤35 years old, a significant number of young women is still treated by salpingoophorectomy. Among 36- to 45-year-old women, only 70% had their fertility spared, while 20% had both ovaries removed. ...

Separación de poblaciones de glóbulos rojos senescentes por gradientes preformados de Percoll / Separation of populations of senescent red blood cells by Percoll performed gradients

Los mecanismos que determinan la senescencia de los eritrocitos han sido extensamente estudiados, sin embargo, no se han logrado conclusiones definitivas debido a la ausencia de una técnica que permita el aislamiento de grupos etáreos bien definidos. Los métodos más comúnmente empleados se basan en el aumento de densidad de los eritrocitos durante el envejecimiento. En este trabajo desarrollamos una técnica para la separación de glóbulos rojos de distintas edades empleando gradientes preformados de Percoll, un polímero sintético con propiedades fisicoquímicas adecuadas para trabajar con células vivas. En las suspensiones eritrocitarias obtenidas se realizaron determinaciones hematológicas, actividades de enzimas antioxidantes y el ensayo de eritrofagocitosis. Los valores de los parámetros hematológicos evaluados fueron significativamente mayores en las suspensiones de glóbulos rojos jóvenes. Las actividades enzimáticas mostraron una disminución de la capacidad antioxidante en las poblaciones de eritrocitos senescentes. Este proceso favorecería la interacción de los hematíes envejecidos con las células fagocíticas, demostrada median­te el ensayo de eritrofagocitosis. Los resultados obtenidos indican que el método de gradientes de Percoll permite una adecuada separación de las suspensiones eritrocitarias de distintas edades, con una eficiencia comparable a la observada en la técnica de centrifugación diferencial considerada de referencia.

The mechanisms that determine the senescence of the erythrocytes have been extensively studied; however. definitive conclusions have not been achieved mainly because of the lack of a technique that allows the isolation of well-defined etarian groups. The methods most commonly used for separating erythrocytes from different ages are based on the increase in density that these cells present during their aging. In the present work we have developed a technique for obtaining red blood cells from different ages using Percoll preformed gradients, a synthetic polymer with adequate physic-chemic properties to work with lives cells. In the erythrocytes suspensions we have made hematological determinations. activities of antioxidants enzymes and the essay of erythrophagocytosis. The values of the hematological parameters were significantly higher in the suspensions of young red blood cells. In the measurements of the enzymatic activity we observed a decrease of the antioxidant capacity in the populations of senescent erythrocytes. This process would promote the interaction between the old erythrocytes and the phagocyte cells, demonstrated by the erythrophagocytosis essay. The results obtained indicate that the method Percoll density gradients allows an appropriate separation of the erythrocytes suspensions of different ages with a comparable efficiency to that observed in the technique differential centrifugation, considered as reference.

Age-dependent increase in green autofluorescence of blood erythrocytes.

Green auto-fluorescence (GAF) of different age groups of mouse blood erythrocytes was determined by using a double in vivo biotinylation (DIB) technique that enables delineation of circulating erythrocytes of different age groups. A significant increase in GAF was seen for erythrocytes of old age group (age in circulation more than 40 days) as compared to young erythrocytes (age less than 15 days). Erythrocytes are removed from blood circulation by macrophages in the reticulo-endothelial system and depletion of macrophages results in an increased proportion of aged erythrocytes in the blood. When mice were depleted of macrophages for 7 days by administration of clodronate loaded liposomes, the overall GAF of erythrocytes increased significantly and this increase could be ascribed to an increase in GAF of the oldest population of erythrocytes. Using the DIB technique, the GAF of a cohort of blood erythrocyte generated during a 5 day window was tracked in vivo. GAF of the defined cohort of erythrocytes remained low till 40 days of age in circulation and then increased steeply till the end of the life span of erythrocytes. Taken together our results provide evidence for an age dependent increase in the GAF of blood erythrocytes that is accentuated by depletion of macrophages. Kinetics of changes in GAF of circulating erythrocytes with age has also been defined.

Estudo epidemiológico de prevalência de demência em Ribeirão Preto / Epidemiological survey of prevalence of dementia in Ribeirão Preto

O objetivo deste estudo foi estimar a prevalência de demência em idosos de Ribeirão Preto. A coleta dos dados foi realizada em duas fases: comunitária e hospitalar. Na primeira fase, 1.145 idosos foram entrevistados, dos quais 217 foram convocados para a segunda fase. Comprometimento cognitivo e funcional (CCF) foi diagnosticado em 217 sujeitos; a taxa de prevalência foi 18,9 por cento. “Idade alta”, “escolaridade baixa”, “AVC”, “epilepsia” e “depressão” se mostraram associadas a CCF. Demência foi diagnosticada em 69 sujeitos; a taxa de prevalência foi 6,0 por cento. “Idade alta”, “AVC”, “epilepsia” e “artrite” (esta com relação inversa) associaram-se significativamente à demência (houve uma tendência de associação entre analfabetismo e demência...

The objective of this study was to estimate prevalence of dementia in an elderly sample, in Ribeirão Preto. Data were obtained in two phases: community and hospital. 1.145 elderly persons were evaluated in first phase, and 217 in second phase. 217 subjects presented cognitive and functional impairment (CFI); prevalence rate was 18,9 per cent. “Higher age”, “low education”, “stroke”, “epilepsy” and “depression” were associated with CFI. 69 subjects presented dementia; prevalence rate was 6,0 per cent. “Higher age”, “stroke”, “epilepsy” and “arthritis” (inverse relation) were associated with dementia (illiteracy showed a tendency of association with dementia)...

Escasa hemoglobina glucosilada y su posible relación con mayor tiempo de almacenamiento eritrocitario en solución aditiva AS-1 / Relationship between glucosilate hemoglobin and storage time of erythrocytes in AS-1 additive solution

La solución aditiva AS-1 permite un almacenamiento eritrocitario mayor que otras soluciones. Su composición hace esperable altos niveles del prooxidante HbA1c. Durante el almacenamiento hay una disminución de la actividad de la G6PD. Este trabajo busca evidencia sobre las ventajas de la solución AS-1 en los mecanismos prooxidantes y/o antioxidantes. Objetivo: Describir el comportamiento de la HbA1c, la actividad de G6PD, FRAP y otros parámetros habituales de lesión de eritrocitos en AS-l. Métodos: En 9 unidades de glóbulos rojos empaquetados en AS-1, fue determinada la HbA1c, la actividad de G6PD y el FRAP del sobrenadante, junto con otras variables indicativas de deterioro. Los datos fueron agrupados por día de muestreo (1,14,28,42) y analizados mediante diferencia sobre medias (ANOVA). Resultados: La concentración promedio de HbA1c fue de 5,37 por ciento en el día uno y de 5,58 por ciento en el 42, sin representar aumento significativo. La actividad de G6PD disminuyó en un 59,42 por ciento durante los 42 días (12,31 Vs 5,0, p<0,05) y un se produjo un aumento significativo del FRAP (320 Vs 556 um p<0.05). Conclusiones: El no aumento de HbA1c representa escaso incremento del daño oxidativo,que sumado al aumento del FRAP permiten una mejor preservación de eritrocitos en AS-l, a pesar de la disminución de la actividad de G6PD. Esto permite suponer que dentro de las ventajas de la solución AS-l, se encuentra el evitar la acumulación de HbA1c y el permitir un aumento de los mecanismos antioxidantes inespecíficos mediante procesos que deberán ser estudiados.

Determinación de IgG en eritrocitos senescentes por un ensayo enzimático con consumo de antiglobulina / Determination of senescent red blood cells bound IgG using an enzyme test based an the consuption of antiglobulin

Durante el envejecimiento de los GR se acumula IgG autóloga sobre la membrana eritrocitaria. Esta IgG esta dirigida a un neo antígeno de senescencia, ubicado en la proteína banda 3. El objetivo de este trabajo fue determinar pequeñas cantidades de IgG en la membrana del GR utilizando un inmunoensayo con antiglobulina conjugada con una enzima. Las suspensiones de GRSe y GRJ fueron incubadas con anti-IgG humana conjugada con fosfatasa alcalina. Se transfirieron alícuotas a microplacas sensibilizadas con IgG humana. Se agregó el sustrato de la enzima y se midió la IgG libre. Las concentraciones de IgG unida a la membrana eritrocitaria en GRSe (13.31 x 10-4(g/(L(1.57 x 10-4) fueron significativamente mayores (p(0.0001) que los valores observados en GR (3.35 x 10-4(g/(L(1.39 x 10-4). Los resultados obtenidos indican que esta metodología constituye una herramienta útil para determinar pequeñas contidades de IgG unida a la membrana eritrocitaria.

Labeling and survival studies on rabbit RBC / 中国应用生理学杂志

<p><b>AIM</b>To establish a simple and effective method for RBCs labeling and survival assays, and the qualities of rabbit RBCs preserved in GMA solution at 4 degrees C were verified.</p><p><b>METHODS</b>The bloods were taken through the ear arteries of the rabbits. The RBCs were labeled by fluorescein isothiocyanate (FITC), and were reinjected to the same rabbit through ear veins. The percentage of FITC labeled RBCs was assayed by FACS at a series of times after injection. The SAS software was employed to analyze the data and establish the regression equations. The 24-hour recovery and the half-life span of the labeled RBCs were calculated according to the equations.</p><p><b>RESULTS</b>The 24-hour recovery and the half-life span of the labeled RBCs in the control group were 93.76% +/- 5.40% and 22.50% +/- 4.37 days respectively, which was in agreement with the previous papers. The 24-hour recovery and the half-life span of the labeled RBCs in the GMA group were 89.13% +/- 7.10% and 11.41% +/- 1.63 days respectively, which was coincident with the infusion conditions.</p><p><b>CONCLUSION</b>Compared with other methods of RBCs labeling in vivo, FITC labeling was thought to be easier and cheaper to use, which could facilitate the analysis of the biological character of the labeled cells, and could be used to trace the fate of labeled cells.</p>

Characterization of Binding and Phagocytosis of Oxidatively Damaged Erythrocyte to Macrophage

BACKGROUND: Scavenger receptors are thought to be involved in the recognition of oxidized low-density lipoprotein (oxLDL) and oxidized erythrocyte (oxRBC). However, there are controversies about the kind of receptors and ligands related to the binding. Macrophages lacking class A scavenger receptor show identical binding of oxRBC with wild-type ones. METHODS: RBCs were oxidized with ascorbic acid and CuSO4. Lipid oxidation was measured indirectly by measuring TBARS semiquantitatively. The binding and phagocytosis were measured by counting the number of oxRBC bound or taken up after incubation at 4 degrees C or 37 degrees C for 60 minutes to 100 macrophages differentiated from human monocytic leukemia cell line. RESULTS: The degree of oxidation and the binding of oxRBCs were dependent on the concentration of CuSO4. The binding and phagocytosis of oxRBC were inhibited by 99% with oxLDL. Fucoidan, competing class A scavenger receptor, inhibited the binding by more than 90%. The binding of oxRBC was higher at 37 degrees C than at 4 degrees C by 3 times. The binding of oxRBCs was maximal at pH 6.5 and higher than at physiologic pH by 2.8 times. At pH 8.5 and 9.5, binding decreased by 67 and 88%, respectively. CONCLUSION: OxRBCs might bind and be taken up to macrophages not mainly through class A nor B scavenger receptors, but through other scavenger receptors and/or pathways. These processes are dynamic and ionic strength might be involved.

Senescent erythrocytes: modification of rheologic properties, antigenic expression and interaction with monocytes

Human erythrocytes have a well-defined lifespan of 120 days. Their eventual removal from circulation is a complex process affected by many cellular parameters, making them susceptible to sequestration in the spleen and other organs. The purpose of this study was to investigate putative changes in rheologic properties, antigenic expression and interaction with monocytes of senescent erythrocytes (SE). SE and young erythrocyte (YE) fractions were obtained by differential centrifugation from 20 healthy donor blood samples. Membrane rheomechanic properties (by difractometric method), ABO and MN antigens reactivity and erythrophagocytosis by peripheral monocytes were investigated in each fractions. SE showed a little decrease in the deformability index and an increase of both membrane elastic modulus and surface viscosity. The studies performed indicate a decreased expression in the antigens of both blood group systems studied (p < 0.01) and an increased rate of erythrophagocytosis by monocytes in SE compared to YE (p < 0.01). The significant modifications in the biomechanic properties of senescent red blood cell membrane and the loss antigenic expression could lead to physiological phagocytosis.

Estudos sobre eritrócitos e plaquetas: preservaçäo, morfologia e fisiopatologia / Studies about erythrocytes and platelets: preservation, morphology and physiopathology

Com o estudo da morfologia, da estrutura, do metabolismo e de processos oxidativos que acometem os eritrócitos e as palquetas, é possível tanto desenvolver metodologias adequadas à sua preservaçäo por longos períodos, como aumentar a compreensäo de alteraçöes patológicas em eritrócitos e plaquetas. Dessa forma, pode-se, por exemplo, obter amostras estáveis adequadas ao controle de qualidade em Laboratório de Análises Clínicas, melhorar, monitorar unidades de componentes do sangue preparadas para transfusäo, ou desenvolver métodos laboratoriais para melhor compreensäo ou para o diagnóstico das doenças hemolíticas, entre outras. Neste trabalho, estudou-se amostras de eritrócitos preservados in vitro, em diferentes condiçöes, em relaçäo a alteraçöes morfológicas, metabólicas, hematimétricas e da composiçäo das proteínas da membrana celular. Amostras estáveis para os valores do eritrograma durante cerca de 14 semanas, denominadas GACE, se mostraram adequadas a um Programa de Controle e Qualidade Externo que envolveu 20 Laboratórios de Análises Clínicas no Estado do Paraná. Durante a preservaçäo de eritrócitos, observou-se alteraçöes gradativas em relaçäo à proteínas da membrana eritrocitária, à morfologia e a diversos metabólitos e enzimas, demonstrando que a fixaçäo parcial dos eritrócitos com glutaraldeído, apesar de alterar substancialmente a estrutura da membrana e atividades enzimáticas do eritrócito mantém a forma eritrocitária por longo tempo e inibe a hemólise

Autoimmune hemolytic anemia.

Immune hemolytic anemia can be either isoimmune or autoimmune. Autoimmune hemolytic anemias (AIHA) consist of group of disorders whose common characteristics are the presence of an antibody which in turn causes short red blood cell (RBC) life. The rate and site of hemolysis and hence the clinical manifestations depends on the type of antibody attached and its propensity to fix complement. Antibodies of the IgG class are most commonly responsible for AIHA in children. Rh erythrocyte antigen is involved in more than 70% of cases. Since the antibody has its maximal activity at 37 degrees C, the resultant hemolysis is called warm antibody induced hemolytic anemia. This is a severe life threatening condition, the clinical features are: sudden onset of pallor, jaundice and dark urine. The cornerstone of diagnosis is a positive Coomb's antiglobulin test in the presence of hemolysis. Coomb's test has false negative and false positive rates in about 2-4% and 8% of all cases respectively. The modalities for treatment of warm AIHA include blood transfusion, steroid therapy, intravenous gammaglobulin, plasma-pheresis and splenectomy. The choice depends on the severity of the disease and child's response to therapy.

Electrophoretic analysis of polypeptides and glycopeptides of erythrocyte membrane sampled from rats simulating mild insulin dependent diabetes mellitus.

In order to understand the molecular mechanism of reduced life span of diabetic erythrocyte, polypeptides and glycopeptides were analyzed by disc gel preparative sodium dodecyl sulphate polyacrylamide gel electrophoresis. An additional glycopeptide (244.5 kDa) and two additional polypeptides (39.81 and 144.5 kDa) were observed on glycopeptide and polypeptide gel profiles of mild insulin dependent diabetes mellitus (mIDDM) sample as compared to control. On the basis of molecular weight, their position on gel profile and their widely accepted nomenclature they were termed as glycosylated-ankyrin, membrane accreted glyceraldehyde-3-phosphate dehydrogenease (G 3-PD) and stress induced band 2.3 peptide. Earlier we have reported an increase in heterogeneity associated with increase in the population of aged fragile cells having altered membrane bound cation dependent ATPases, cytosolic dehydrogenase and hexokinase activities of mIDDM simulating rat erythrocyte sample. Significance of above observation in view of our earlier observation is discussed to explain the molecular mechanism of reduced life span of diabetic erythrocytes.

Effect of experimental diabetes on the activities of hexokinase, glucose-6-phosphate dehydrogenase and catecholamines in rat erythrocytes of different ages.

Hexokinase and glucose-6-phosphate dehydrogenase were assayed in various circulating age fractions i.e., young, middle-aged and old red cell from control, diabetic and insulin-treated diabetic rats. An increase in the activity of hexokinase was observed in three age-wise separated fractions of red cells from diabetic animals in comparison to control. The activity of glucose-6-phosphate dehydrogenase on the other hand decreased in separated ageing fractions of diabetic red cells when compared to control. Reversal of these two enzymes were observed in insulin-treated diabetic rats. The levels of glycosylated haemoglobin and catecholamines were found to increase with ageing red cells in controls and also increased in red cells plasma.

Estudio dinámico esplénico en citopenias hematológicas / Dynamic splenic study in hematologic cytopenias

Para valorar la contribución del bazo en anemias y trombocitopenias se usaron glóbulos rojos autólogos fragilizados por calor (GRFC) o sensibilizados con IgG anti-D (GR-IgG) marcados con Tc. Se midió la cinética de captación en bazo durante 60 minutos post inyección, usando una cámara gamma, se determinó el Tiempo Medio Esplénico (TME): 50 por ciento de la actividad máxima. Los estudios Dinámico Esplénico (DE) con GRFC y/o con GR-IgG, fueron comparados con la ferroeritroquinesis y la sobrevida plaquetaria con captaciones externas. 31/32 (97 por ciento) pacientes anémicos con sobrevida eritrocitaria acortada, con destrucción esplénica; tenían TME acortado con GRFC. En 9 pacientes anémicos se encontró paralelismo entre el TME con GR-IgG y la sobrevida eritrocitaria, (p=0.047). En 62 pacientes trombocitopénicos evaluados con el DE con GRFC, no se encontró paralelismo entre la sobrevida plaquetaria y el TME. En 15 pacientes con trombocitopenia no se halló paralelismo entre la sobrevida plaquetaria y el TME con GR-IgG, esto se corrige si se separan los 2 hiperesplenismos. El estudio DE es una herramienta útil, rápida y barata para evaluar la contribución esplénica en la anemia. El DE con GRFC no tiene sensibilidad suficiente para reemplazar el estudio de sobrevida plaquetaria, el DE con GR-IgG corrige esa falencia.

Recidivas locales luego de tratamiento conservador del cáncer de la mama / Local recurrence after conservative surgery and radiotherapy for breast cancer

OBJETIVOS: Estudiar las recidivas locales postratamiento conservador, analizando forma de presentación, correlación con otros factores e incidencia sobre el pronóstico. MATERIAL Y METODO: Trescientos ochenta y ocho casos de cáncer mamario con seguimiento de 6 a más de 120 meses (Ma 57), estadios 0) (sólo comedocarcinomas), I, II y casos tratados así luego de quimioinducción. RESULTADOS Y COMENTARIOS: Se observaron 29 casos de recidiva (R) equivalentes al 7,50 por ciento; 5,25 por ciento (69 por ciento del total) fueron glandulares puras (RG), y 2,25 por ciento glándulo-cutáneas (RGC). El 82,6 por ciento apareció en el mismo cuadrante (incluyendo el 100 por ciento de las RGC). Según la edad, el mayor índice de R (IR) se dió entre las menores de 46 años (13,7 por ciento); P<0,025). Sólo los tumores de más de 4 cm mostraron IR diferenciable (13,9 por ciento; P<0,05). No hubo diferencias significativas en los IR evaluados en función de grado histológico (marcó sí una fuerte tendencia), invasión vascular peritumoral, componente intraductal asociado o extensivo, o estadio final; el grado nuclear correlacionó con IR prácticamente en los límites de significación. La Ma de tiempo hasta la recurrencia mamaria (THRM) fue de 27 meses en general, de 12 para las RGC y de 39 para las RG. La curva del número de pacientes libres de enfermedad decae regularmente hasta los 3 años y luego se aplana ligeramente. Estas curvas comparadas por estadios son reconociblemente inferiores para el II respecto a 0 y I sólo hasta los 3 años, luego la diferencia no es significativa. Todas las RGC fueron tratadas con mastectomía, y 40 por ciento de las RG con resección local. Entre éstas se dió un 25 por ciento de segundas recidivas. Desarrolló enfermedad metastásica (EM) el 16,1 por ciento de las 359 pacientes que no recidivaron, y el 31,0 por ciento de las que sí lo hicieron; no obstante, este porcentual está fuertemente influido por 67 por ciento de enfermas con RGC que desarrollaron EM, puesto que en el grupo con RG sólo evolucionaron a EM el 15 por ciento.

Evaluation of the intraperitoneal route for the transfusion of erythrocytes using rats and dogs

Se evaluó la transfusión intraperitoneal en ratas y perros con vía alternativa para la reposición de sangre. Se inyectaron eritrocitos marcados con 59Fe a 5 perros en un volumen equivalente al 50% de la masa eritrocitaria teórica de los animales. Otros 3 perros y 12 ratas fueron inyectados con volúmenes de eritrocitos proporcionales al 9% del volumen globular de los animales. La máxima incorporación de eritrocitos a la circulación sanguínea de las ratas fue de 96ñ7% a las 48h. El T 1/2 de sobrevida de las células fue de 29 días. La máxima actividad promedio en todos los perros fue de 91.2ñ6% a las 96 h post-transfusión. Se verificó destrucción al azar de los eritrocitos y el tiempo medio de sobrevida se estimó en 66 días. La transfusión se efectuó en unos 15 segundos en las ratas y entre 2 y 4 minutos en los perros. En la necropsia se observaron reacciones serosas mínimas. El procedimiento es recomendable por su rapidez, seguridad y sencillez