Hemostasis Using Prothrombin Complex Concentrate in Patients Undergoing Cardiac Surgery: Systematic Review with Meta-Analysis

ABSTRACT Objective: The purpose of present study was to comprehensively explore the efficacy and safety of prothrombin complex concentrate (PCC) to treat massive bleeding in patients undergoing cardiac surgery. Methods: PubMed®, Embase, and Cochrane Library databases were searched for studies investigating PCC administration during cardiac surgery published before September 10, 2022. Mean difference (MD) with 95% confidence interval (CI) was applied to analyze continuous data, and dichotomous data were analyzed as risk ratio (RR) with 95% CI. Results: Twelve studies were included in the meta-analysis. Compared with other non-PCC treatment regimens, PCC was not associated with elevated mortality (RR=1.18, 95% CI=0.86-1.60, P=0.30, I2=0%), shorter hospital stay (MD=-2.17 days; 95% CI=-5.62-1.28, P=0.22, I2=91%), reduced total thoracic drainage (MD=-67.94 ml, 95% CI=-239.52-103.65, P=0.44, I2=91%), thromboembolic events (RR=1.10, 95% CI=0.74-1.65, P=0.63, I2=39%), increase in atrial fibrillation events (RR=0.73, 95% CI=0.52-1.05, P=0.24, I2=29%), and myocardial infarction (RR=1.10, 95% CI=0.80-1.51, P=0.57, I2=81%). However, PCC use was associated with reduced intensive care unit length of stay (MD=-0.81 days, 95% CI=-1.48- -0.13, P=0.02, I2=0%), bleeding (MD=-248.67 ml, 95% CI=-465.36- -31.97, P=0.02, I2=84%), and intra-aortic balloon pump/extracorporeal membrane oxygenation (RR=0.65, 95% CI=0.42-0.996, P=0.05, I2=0%) when compared with non-PCC treatment regimens. Conclusion: The use of PCC in cardiac surgery did not correlate with mortality, length of hospital stay, thoracic drainage, atrial fibrillation, myocardial infarction, and thromboembolic events. However, PCC significantly improved postoperative intensive care unit length of stay, bleeding, and intra-aortic balloon pump/ extracorporeal membrane oxygenation outcomes in patients undergoing cardiac surgery.

Observation on the effect of modified buffy coat centrifugal canning method on improving the quality of platelet concentrates / 中国输血杂志

【Objective】 To evaluate the quality of platelet concentrates (PCs) prepared by traditional and modified buffy coat centrifugal canning methods, and to explore the effect of modified buffy coat centrifugal canning method on improving the quality of PCs. 【Methods】 The buffy coat centrifugal canning methods was divided into traditional group and modified group. In the traditional group, the buffy coat component bag and empty bag were directly combined layer by layer and vertically canned for light centrifugation. In the modified group, a foam spacer was added between the buffy coat component bag and the empty bag for light centrifugation layer by layer. The effects of the two groups of centrifugal canning methods on the preparation quality of PCs were observed. 【Results】 The platelet content in PCs prepared by the modified buffy coat centrifugal canning method was significantly higher than that in the traditional group, and the mixed amount of red blood cells was lower than that in the traditional group (P0.05), the qualified rates of platelet content and mixed red blood cell in the modified group were higher than those in the traditional group (P<0.05). 【Conclusion】 The modified centrifugal canning method with buffy coat can improve the quality of PCs, which is convenient and cheap, and is worth popularizing.

Impact of the COVID-19 pandemic on blood supply: A comparative cross-sectional study of the pre-pandemic and pandemic era

Objective@#The study aimed to determine the impact of the COVID-19 pandemic on local blood supply management in the Davao Region, Philippines from 2019 to 2021 through the analysis of trends in blood supply in Davao Region, Philippines.@*Methodology@#Secondary data from two blood centers in the Davao Region for the years 2019 to 2021 were used to determine the trends on blood donation supply. To evaluate trends, the overall number of blood donors and the quantities of various types of blood components in whole blood, packed red blood cells (PRBCs), fresh frozen plasma (FFPs) and platelet concentrate have been compared between pre-pandemic, pandemic periods and as restrictions eased.@*Results@#A substantial decrease of 51.6% in the number of blood donors was seen during 2021 in comparison with 2019. The trend in collection by blood components also showed a significant trend from 2019 to 2021, whole blood (200.8%), packed RBCs (37.1%), fresh frozen plasma (113.6%). While the platelet concentrate supply declined by 34.9% from 2019 to 2020, an increase of 10.7% was noted onwards to 2021.@*Conclusion@#The results demonstrate that during the COVID-19 pandemic, there was a major reduction in donation and supply of blood. The challenges faced by blood banks in ensuring a stable and sufficient blood supply are highlighted by the decrease in the number of donors and by the different trends in the supply of blood components. The targeted efforts to promote blood donation and enhance the resilience of the blood supply during and after the pandemic is important.

Does leukocyte-platelet-rich fibrin (L-PRF) cause long term acceleration in the rate of canine retraction? A split-mouth, two-arm parallel group, randomized control trial

ABSTRACT Objective: The present study was conducted to investigate the effects of leukocyte-platelet-rich fibrin (L-PRF) on the rate of maxillary canine retraction for a period of 5 months. Methods: A split-mouth study was conducted on 16 subjects (9 males and 7 females; age range 17-25 years; mean age, 21.85±2.45 years) who required therapeutic extraction of bilateral maxillary first premolars. After the initial leveling and alignment, L-PRF plugs were placed in a randomly selected extraction socket (Experimental Group), and the other side served as a control (Control Group). Canine retraction was carried out by the activation of nickel-titanium (NiTi) closed-coil springs delivering 150 g of force. The rates of canine movement, canine rotation, tipping, root resorption, and molar movement were assessed at monthly intervals for five months (T0-T5). Pain, swelling and discomfort accompanying the procedure were assessed using a Likert scale. Results: The study revealed a significant increase in the rate of canine movement on the experimental side in the first two months, and significant molar anchorage loss was observed only in the first month for control side. There were no statistically significant differences between the groups regarding canine rotation, tipping, probing depth, root resorption, and pain perception. Conclusions: The use of L-PRF plugs in extraction sockets considerably enhanced the rate of canine movement only in the first two months, and long-term efficacy was not observed in this study.

RESUMO Objetivo: O presente estudo foi realizado para investigar os efeitos da fibrina rica em leucócitos e plaquetas (L-PRF) na taxa de retração do canino superior, durante um período de cinco meses. Métodos: Um estudo de boca dividida foi realizado em 16 indivíduos (9 homens e 7 mulheres; faixa etária de 17 a 25 anos; idade média de 21,85 ± 2,45 anos) que precisavam de extração terapêutica dos primeiros pré-molares superiores de ambos os lados. Após o nivelamento e o alinhamento iniciais, os plugs de L-PRF foram colocados em um alvéolo pós-extração, selecionado aleatoriamente (Grupo Experimental), e o outro lado serviu como controle (Grupo Controle). A retração do canino foi realizada pela ativação de molas fechadas de níquel-titânio (NiTi) com 150 g de força. As taxas de movimentação do canino, rotação, inclinação e reabsorção radicular do canino e movimentação do molar foram avaliadas em intervalos mensais durante cinco meses (T0-T5). A dor, o inchaço e o desconforto após o procedimento foram avaliados por meio de uma escala de Likert. Resultados: O estudo revelou um aumento significativo na taxa de movimentação do canino no lado experimental nos dois primeiros meses, e uma perda significativa de ancoragem do molar foi observada apenas no primeiro mês no lado controle. Não houve diferenças estatisticamente significativas entre os grupos, com relação à percepção da dor e rotação, inclinação, profundidade de sondagem e reabsorção radicular do canino. Conclusões: O uso de plugs de L-PRF em alvéolos pós-extração aumentou consideravelmente a taxa de movimentação do canino apenas nos dois primeiros meses, não sendo observada uma eficácia em longo prazo.

FUNCTIONAL OUTCOME OF EARLY STAGES OF OSTEOARTHRITIS KNEE TREATED WITH BONE MARROW ASPIRATE CONCENTRATE AND INTRAARTICULAR STEROID

Objectives: The objective is to observe the functional outcome of early stages of osteoarthritis knee treated with Bone marrow aspirate concentrate (BMAC) and Intraarticular steroid A total of 60 Methods: patients of both genders aged 45–60 years were included in the study. 5ml - 10ml of Bone marrow was aspirated under local anaesthesia from iliac crest, ipsilateral / contralateral to the knee, with a bone marrow aspiration needle and was centrifuged and processed. 40 mg of Triamcinolone was mixed with BMAC and was administered in the knee joint. This procedure was done under Day Care. At 6-month follow-up, BMAC injection with 40 mg triamcinolone signi?cantly improved knee pain and Results: function. BMAC injection with 40 mg triamcinolone signi?cantly improved knee pain and function in early stages of Conclusion: osteoarthritis knee

Analysis of different platelet-rich fibrin processing / Análise de diferentes processamentos da fibrina rica em plaquetas

Introduction: Platelet-rich fibrin (PRF) is formed by an autologous blood concentrate, with properties that promote cell proliferation and regenerationof bone, gingival and epithelial tissue. Objective: To compare four different procedures for processing as well as obtaining PRF, and analyzing their formation through laboratory techniques. The purpose of the study is to validate a method that produces higher quality PRF for oral surgery use in different branches of dentistry. Material and method: The experiment consisted of collecting blood from 12 volunteers, and processing each patient's sample in 4 different ways. In the following two-stage process analysis, the first, quantitative, step was to analyze the samples' platelet-poor plasma (PPP),with a Neubauer Hemocytometer to count blood components. In the second, qualitative step, the sample's PRF were analyzed under microscopy using histological slides. Result: The statistical analysis of the leukocyte, red blood cell and platelet count did not show any significant distinction when comparing different processes. Histological analysis of the PRF showed fibrin network with platelet aggregation, several leukocytes and presence of red blood cells, with double centrifuged samples presenting more white blood cells than the others. Conclusion: Among the analyzed procedures, the sample centrifuged once at 3000 RPM (1900 G) for 10 min showed the best quality PRF.

Introdução: A fibrina rica em plaquetas (FRP) é formada por um concentrado sanguíneo autólogo, com propriedades de promover a proliferação celular, regeneração de tecido, dentre eles tecido ósseo, gengival e epitelial. Objetivo: Comparar quatro tipos diferentes de processamento e obtenção de FRP, analisando a sua formação através de técnicas laboratoriais. A finalidade do estudo é validar um método que obtenha maior qualidade para o uso em cirurgias nas diversas áreas da odontologia. Material e método: O experimento foi constituído de uma coleta de sangue de 12 voluntários, onde a amostra de cada paciente foi processada de 4 formas. A análise dos processamentos se deu em duas etapas, onde na primeira, quantitativa, foi analisado o plasma pobre em plaquetas (PPP), através de contagem de constituintes sanguíneos em câmara de Neubauer. Na segunda etapa, qualitativa, foram analisadas as FRP em microscopia através de lâminas histológicas. Resultado: A análise estatística da contagem de leucócitos, hemácias e plaquetas não mostraram diferença significativa entre os distintos processamentos. As análises histológicas do FRP mostraram redes de fibrina com agregação plaquetária, inúmeros leucócitos e presença de hemácias, sendo que as amostras de dupla centrifugação apresentaram mais leucócitos que nas demais. Conclusão: Dos procedimentos analisados, a amostra centrifugada a 1 única vez a 3000 RPM (1900 G) por 10 min mostrou-se a melhor qualidade de FRP.

A multicenter phase Ⅲ clinical study of human prothrombin complex concentrate in treatment of hemophilia B / 中国输血杂志

【Objective】 To evaluate the clinical efficacy and safety of one kind of human prothrombin complex concentrate in treatment of patients with hemophilia B. 【Methods】 The clinical data of 36 patients with hemophilia B treated with human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. from May 2018 to April 2019 were retrospectively analyzed, and its clinical efficacy and safety were analyzed. 【Results】 A total of 35 subjects entered the full analysis set (FAS)and safety set (SS), 33 subjects entered the per protocol Set (PPS). Thirty minutes after the first infusion of FAS subjects, the activity of coagulation factor Ⅸ increased from (3.93±0.975) IU/dL to (25.61±9.337) IU/dL, and the infusion efficiency was (96.43±22.007)%. The increased value of coagulation factor Ⅱ activity was (73.25±14.874) IU/dL. The activity of coagulation factor Ⅶ was (42.79±16.847) IU/dL. The increased value of coagulation factor Ⅹ activity was (65.29±17.042) IU/dL. The increased value of coagulation factor Ⅸ activity was (21.68±9.434%) IU/dL. Twenty-four hours after the first infusion of FAS subjects, the improvement of bleeding symptoms and signs was excellent in 21 cases (60%), improved in 14 cases (40.0%), and the effective rate was 100%. The incidence of adverse reactions was 2.9%(1/35), and there was no antibody to human coagulation factor Ⅸ and new virus infection. 【Conclusion】 Infusion of human prothrombin complex concentrate produced by Shenzhen Weiguang Biological Products Co. Ltd. in the treatment of hemophilia B has significant clinical efficacy and good safety.

High Titer Inhibitor-Acquired Hemophilia A Treated With Human FVIII Concentrate in Limited Resource: A Case Report

@#Acquired hemophilia A (AHA) is a rare condition that affects one in a million people each year, and there are not many diagnostics or therapeutic agents available for treatment due to its rarity. This is a case report of a 61-year-old woman who presented with a spontaneous subcutaneous hematoma and multiple extensive bruises in her extremities. There was no prior history of bleeding disorders, and the laboratory results showed an isolated aPTT prolongation with no correction after mixing studies, and a reduction in FVIII activity level along with a high FVIII inhibitor titer (928BU). Furthermore, the diagnosis of idiopathic AHA was made after other secondary causes had been ruled out, and the patient received human FVIII concentrate instead of bypassing agents due to its availability. The patient still experienced clinical improvement despite using this alternative. AHA is currently managed using both hemostasis agents and inhibitor eradication, and they come with several limitations. Human FVIII concentrate therapy is still an option in situations with limited resources, even though it is not recommended in patients with high inhibitor titer levels.

Uso de concentrados de fibrinógeno para el tratamiento de la hipofibrinogenemia adquirida / Use of Fibrinogen Concentrates for the Treatment of Acquired Hypofibrinogenemia

Resumen Introducción: Un adecuado manejo del sangrado debe incluir la correcta valoración y eventual reposición de fibrinógeno. Las fuentes tradicionales de este elemento hemostático incluyen el plasma fresco congelado y los crioprecipitados. Los concentrados liofilizados de fibrinógeno humano (CFH) son una alternativa terapéutica novedosa en el mercado chileno. Objetivo: Este estudio describe el curso clínico de los primeros pacientes en nuestra institución requirentes de CFH, dentro de un algoritmo de reposición hemostática por metas. Materiales y Método: Serie de pacientes con hipofibrinogenemia secundaria a sangrado perioperatorio severo, en los que se utilizó CFH como método de reposición de fibrinógeno. Se utilizó tromboelastometría para definir dosis. Se registraron variables demográficas, operatorias, complicaciones y seguimiento hasta los 3 meses. Resultados: Se utilizaron CFH en 18 pacientes. La mediana de edad fue 40,7 (56,5-63) años y dos tercios de los pacientes fueron de sexo masculino. Fallecieron 5 pacientes de la serie. Todos los pacientes requirieron manejo posoperatorio en una unidad de cuidados intensivos. Ocho pacientes fueron sometidos a cirugía cardiaca. El uso de hemocomponentes y concentrados liofilizados fue heterogéneo, pero en todos los casos su uso fue determinado por tromboelastometría. Ningún paciente fue reintervenido a causa de sangrado posoperatorio. Conclusión: El uso de concentrados de fibrinógeno humano dentro de un algoritmo de manejo de sangrado guiado por tromboelastometría, es un recurso hemostático factible en la realidad nacional. El impacto clínico de esta intervención requiere una subsiguiente evaluación basada en la evidencia.

Introduction: An adequate bleeding management should include a proper assessment of fibrinogen values and consequent replacement. Traditional sources for this hemostatic element include fresh frozen plasma and cryoprecipitates. Lyophilized human fibrinogen concentrates are a novel therapeutic alternative for the chilean market. Aim: This study aims to describe the clinical course of the first patients in our institution receiving fibrinogen concentrates, included in a goal directed hemostatic management algorithm. Materials and Method: Case series of patients with hypofibrinogenemia secondary to severe perioperative bleeding, in which fibrinogen concentrate was used for fibrinogen replacement. Thromboelastometry was used to define dose regimens. Demographic and surgical variables, complications and follow-up up to 3 months were registered. Results: Fibrinogen concentrate was used in 18 patients. Median age was 40.7 (56.5-63) years, and two thirds of the patients were male. Five patients died. All of the cases required postoperative intensive care. Eight patients underwent cardiac surgery. There was a heterogenic use of blood derived products and lyophilized concentrates, but in all cases its use was guided by thromboelastometry. No patients needed a secondary exploration due to bleeding. Conclusion: The use of human fibrinogen concentrate included in a bleeding management algorithm is a feasible hemostatic resource in the chilean current situation. The clinical impact of this intervention requires further evidence-based evaluation.

Em busca do melhor aproveitamento de bolsas de concentrado de hemácia de baixo volume / In search of the best use of bags low-volume red blood cells concentrate

RESUMO: Introdução: A produção de bolsas de sangue total com volume inferior ao esperado é prevista na Portaria de Consolidação no 05/2017, porém, a sua dispensação hoje leva em consideração apenas o teor de hemoglobinas e hematócrito da bolsa. Objetivo: Determinar, a partir dos parâmetros técnicos brasileiros existentes, os critérios para o melhor aproveitamento para bolsas de concentrados de hemácias de baixo volume (CHBV) produzidas na Fundação HEMOPA. Material e métodos: Foram analisados volume, teor de hemoglobina e hematócrito de 525 bolsas de CHBV provenientes de bolsas duplas sem adição de conservante; triplas convencional com adição de SAG-M (soro fisiológico, adenina, glicose e manitol); triplas top and bottom (TAB) com adição de SAG-M; e quádruplas TAB com filtro "in line" e adição de SAG-M. Resultados: Foi observado que 71,43% (375/525) das bolsas de CHBV, independente do tipo da bolsa, apresentavam-se em conformidade para hematócrito e teor de hemoglobina em relação à legislação. As bolsas duplas e triplas convencionais apresentaram os maiores valores de teor de hemoglobina. Observou-se ainda que as bolsas de sangue total coletadas com volumes entre 350 e 404 ml geraram bolsas de CHBV com os menores índices de descarte. O maior descarte das bolsas de CHBV ocorreu quando o volume final ≤250 mL e hemoglobina ≤ 16 g/dL. Conclusão: Observou-se que o melhor aproveitamento das bolsas de CHBV ocorreu quando as bolsas de sangue total se encontravam com volumes entre 350 e 404 mL e as bolsas de CHBV apresentavam volume final ≥ 250 mL e hemoglobina ≥ 16g/dL.(AU)

ABSTRACT: Introduction: The production of whole blood bags with a lower volume than expected is approved in the Consolidation Ordinance number 05/2017; however, its dispensation today takes into account only the hemoglobin and hematocrit content of the bag. Objective: From the existing Brazilian technical parameters, determine the criteria for the best clinical use for low-volume red cell concentrate (LVRCC) bags produced at the HEMOPA Foundation. Material and methods: We analyzed volume, hemoglobin content, and hematocrit of 525 LVRCC bags from double bags without addition of preservative; conventional triple bags with the addition of SAG-M (saline, adenine, glucose, and mannitol); triples bags top and bottom (TAB) with the addition of SAG-M, and quadruple bags TAB with "in line" filter and the addition of SAG-M. Results: It was observed that 71.43% (375/525) of bags of LVRCC, regardless of bag type, were in conformance with hematocrit and hemoglobin content concerning Brazilian legislation. With the double and conventional triple bags, they had the highest values of hemoglobin content. It was also observed that the bags of whole blood collected with volumes between 350 and 404 mL generated LVRCC bags with the lowest rate of discard. The greatest discard of LVRCC bags occurred when the final volume ≤ 250 mL and hemoglobin ≤ 16 g/dL. Conclusion: It was observed that the best use of LVRCC bags occurred when the whole blood bags were between 350 and 404 mL and the LVRCC bags had a final volume ≥ 250 mL and hemoglobin ≥ 16 g/dL. (AU)

Determinación de la viabilidad de los concentrados plaquetarios obtenidos de capa leucocitaria (buffy coat) durante siete días de almacenamiento / Monitoring of the Viability of Platelet Concentrates Obtained from Buffy Coat during Seven Days of Storage / Determinação da viabilidade de concentrados de plaquetas obtidos de camada leucocitária (buffy coat) durante sete dias de armazenamento

Introducción: los concentrados plaquetarios (CPG) son hemocomponentes lábiles afectados por varios factores, desde el método de obtención hasta las condiciones de almacenamiento, que provocan una paulatina pérdida de funcionalidad, por lo que es necesario evaluar parámetros de calidad que garanticen la viabilidad de las plaquetas durante los días de almacenamiento, con el propósito de monitorear el mantenimiento de las características funcionales de las plaquetas. Materiales y métodos: estudio descriptivo transversal, con un tamaño muestral de 64 cpq, evaluados a los 3, 5 y 7 días de almacenamiento. Los parámetros monitoreados fueron físicos, de almacenamiento y porcentaje de la activación plaquetaria mediante la medición de P-selectina (cd62) por citometría de flujo. Se aplicó el estadístico de chi cuadrado, Anova de un factor, Kruskall-Wallis y correlación de Pearson. Resultados: existen diferencias significativas al séptimo día con relación al tercer y quinto día de almacenamiento, especialmente en el parámetro de formación de remolino plaquetario o swirling (p < 0.005) y agregados plaquetarios (p = 0.001). La activación plaquetaria aumentó significativamente (p = 0.001) desde el quinto día. Conclusiones: la viabilidad de los cpq difiere con los días de almacenamiento, por lo que es necesario evaluar pH, formación de remo-linos y agregados a todos los cpq antes de ser transfundidos como indicativos de activación plaquetaria y disminución de su funcionalidad

Introduction: Platelet concentrates (cpq) are labile blood components affected by several factors from the method of production to storage conditions that cause a gradual loss of functionality. For this reason, it is necessary to evaluate the platelet quality parameters that guarantee the viability during the storage days, with the purpose of monitoring the maintenance of the functional characteristics of the platelets. Materials and methods: This cross-sectional descriptive study had a sample size of 64 platelet concen-trates, evaluated at 3, 5, and 7 days of storage. The monitored parameters were the physical storage parameters and percentage of platelet activation by measuring P-selectin (cd62) via flow cytometry. The chi-square statistic, one-way Anova, Kruskal­Wallis test, and Pearson correlation were applied. Results: Significant differences were observed on the 7th day in relation to the 3rd and 5th day of storage, espe-cially in the swirling parameter (p < 0.005) and platelet aggregates (p = 0.001). The platelet activation increased significantly (p = 0.001) on the 5th day. Conclusions: Based on the findings of this study, the viability of the platelet concentrates differs with the days of storage. For this reason, it is necessary to evaluate the swirling, pH, and aggregates to all platelet concentrates before being transfused as an indication of platelet activation and decreased functionality

Introdução: os concentrados de plaquetas (cpq) são hemocomponentes lábeis afetados por diversos fato-res, desde o método de obtenção até as condições de armazenamento que ocasionam uma perda grada-tiva de funcionalidade, sendo necessário avaliar os parâmetros de qualidade que garantem a viabilidade das plaquetas ao longo dos dias de armazenamento, a fim de monitorar a manutenção das características funcionais das plaquetas. Materiais e métodos: estudo descritivo transversal, com tamanho de amostra de 64 cpq, avaliados aos três, cinco e sete dias de armazenamento. Os parâmetros monitorados foram físicos, de armazenamento e porcentagem de ativação plaquetária pela dosagem de P-selectin (cd62) por citometria de fluxo. Os testes estatísticos aplicados incluíram o teste qui-quadrado, anovade um fator, teste de Kruskall-Wallis e correlação de Pearson. Resultados: há diferenças significativas no sétimo dia em relação ao terceiro e quinto dia de armazenamento, principalmente no parâmetro formação de rede-moinhos ou swirling de plaquetas (p < 0.005) e agregados plaquetários (p = 0.001). A ativação plaquetária aumentou significativamente (p = 0.001) a partir do quinto dia. Conclusões: a viabilidade dos concentra-dos de plaquetas difere com os dias de armazenamento, por isso é necessário avaliar o pH, a formação de redemoinhos e agregados a todos os concentrados de plaquetas antes de serem transfundidos como indicativo de ativação plaquetária e diminuição de sua funcionalidade

Meta-analysis of the effect of platelet-rich fibrin in alveolar ridge preservation / 口腔疾病防治

Objective @#To evaluate the effect of platelet-rich fibrin (PRF) on alveolar ridge preservation after tooth extraction.@*Methods@#Randomized controlled trials (RCTs) published before August 25, 2020 about the use of PRF after tooth extraction were searched through the PubMed, Embase, Cochrane Library, HowNet, Wanfang, CBM databases and clinical trial registration centers in China and the United States. Outcome indicators included in the studies included dry socket occurrence, alveolar bone resorption in the horizontal and vertical directions, and the percentage of new bone. Meta-analysis was conducted with Review Manager Version 5.3 software.@*Results@# A total of 706 studies were retrieved. After screening, 8 studies were analyzed quantitatively. Meta-analysis results showed that PRF could reduce the absorption of alveolar bone after tooth extraction, which reduced the horizontal bone mass (WMD=-0.71, 95% CI=-1.11 to -0.32, P < 0.05) and buccal (WMD=-1.38, 95% CI =-1.87 to -0.88, P < 0.05) and lingual sides (WMD=-0.49, 95% CI=-0.92 to -0.06, P < 0.05) and increased the percentage of new bone (SMD=1.24, 95% CI =0.25 to 2.23, P < 0.05). However, there was no significant difference in preventing the occurrence of dry socket (RD < 0.01, 95% CI=-0.05 to 0.04, P=0.95) and reducing bone absorption in the vertical direction of mesial (WMD=-0.11, 95% CI=-1.17 to 0.95, P=0.84) and distal (WMD=-0.66, 95% CI=-1.93 to 0.60, P=0.30) alveolar ridge after tooth extraction. @*Conclusion @# Using PRF alone after tooth extraction can effectively preserve bone mass in the horizontal direction of the alveolar ridge and the vertical direction of the buccal and lingual sides.

Application of gel adsorption tank in large-scale production of human prothrombin complex / 中国输血杂志

【Objective】 To study the application effect of gel adsorbent tank in the production of human prothrombin complex concentrate(PCC). 【Methods】 Six batches of PCC were produced from 1000 L cryoprecipitated plasma, using the same gel twice for adsorption within the tank.The number of gel repeated application was examined by retrospective confirmation, and the adsorption rate, specific activity and residue of finished virus inactivation reagent were determined before and after adsorption. 【Results】 All 6 batches of PPC, produced by the same gel, satisfied quality criteria. Both PPC solution and the gel presented good color. The average activities of coagulation Factors Ⅱ, Ⅶ, Ⅸ and Ⅹ of six batches of PCC were 118.2%, 157.0%, 140.5% and 176.8%, respectively. The The adsorption capacity of coagulation factor Ⅱ, Ⅸ and Ⅹ were both 100% in the first and second adsorption, while coagulation factor Ⅶ were 75% and 81%, respectively. The average specific activity of coagulation factor Ⅸ was 0.7 IU/mg. The average residues of polysorbate 80 and tributyl phosphate products were 0 μg/mL and 33 μg/mL, respectively. The same batch of gel can be repeatedly used up to 6 times during the PCC process. 【Conclusion】 The gel adsorption tank presents good application value in the production of PCC, which can realize process amplification and automatic control.

Residual efficacy of deltamethrin applied to foliage against Malaysian Aedes aegypti (L.) and Aedes albopictus (Skuse)

@#The spraying of insecticide on foliage to provide an insecticidal barrier may serve as part of the vector control measures to combat the increasing threat of Aedes-borne diseases. The effectiveness of insecticide barrier spraying was evaluated by assessing the residual efficacy of deltamethrin sprayed on foliage against Malaysian Ae. aegypti (L.) and Ae. albopictus (Skuse). In this semi-field study, landscape plants grown within the vicinity of the Institute for Medical Research (IMR), Malaysia, were treated with deltamethrin suspension concentrate (SC) with the dosage of 30 mg/m2 and 50 mg/m2 in three rounds of spraying. Deltamethrin residual activity on treated and untreated leaves was investigated using standard WHO cone bioassays. Wild Aedes populations at both deltamethrin-treated and untreated plant clusters were monitored by ovitrap surveillance. Ovitrap monitoring revealed that the mean number of Ae. albopictus larvae at deltamethrin-treated were significantly lower than the mean number of larvae of the same species at the untreated plant cluster. Cone bioassay results showed that the insecticide remained effective for up to 4 weeks (> 80% mortality), but the insecticide residual activity was affected by rainfall. These results suggest that insecticide barrier spraying is a promising tool and may be used along with other mosquito control tools such as indoor residual spray and space spraying to reduce the dengue burden.

Effectiveness and cost analysis of two chemical molluscicides in hilly schistosomiasis-endemic regions / 中国血吸虫病防治杂志

Objective To investigate the effectiveness and cost of 50% and 80% wettable powder of niclosamide ethanolamine salt (NESWP) and 26% metaldehyde and niclosamide suspension concentrate (MNSC) in hilly schistosomiasis-endemic regions, so as to provide insights into the selection of chemical molluscicides in hilly regions. Methods In September 2020, a wasteland in Guanshanqiao Village, Yanrui Township, Yushan County of Jiangxi Province was selected as the experimental region, which was sectioned into five blocks and defined as four experimental groups (A1, A2, B, C) and a blank control group (D). 80% NESWP were given at doses of 1 g/m2 and 1.5 g/m2 in groups A1 and A2 using the spraying method, 50% NESWP was given at a dose of 2 g/m2 in Group B using the spraying method, and 26% MNSC was at a dose of 4 g/m2 in Group C using the spraying method, while no chemical treatment was given in Group D. Snail survey was performed using a systematic sampling method before chemical treatment and 1, 3, 7 d and 15 d post-treatment to examine the molluscicidal effect, and all molluscicidal costs were estimated to calculate the cost of chemical treatment per 1 m2 and the cost of the reduction in the mean density of living snails per 1%. Results The highest mortality of snails was 78.95% and the lowest density of living snails was 0.2388 snails/0.1 m2 in the experimental groups within 7 d of chemical treatment, and the highest mortality of snails was 94.74% and the lowest density of living snails was 0.058 0 snails/0.1 m2 7 d post-treatment. There were no significant differences in the snail mortality among the A1, A2, B and C groups 1 (χ2 = 2.250, P > 0.05), 3 (χ2 = 1.779, P > 0.05) or 15 d post-treatment (χ2 = 2.286, P > 0.05), while a significant difference was detected in the snail mortality among the four groups 7 d post-treatment (χ2 = 7.990, P = 0.046). In addition, there were no significant differences in the snail mortality between A1 and A2 groups 1 (χ2 = 0.724, P > 0.05), 3 (χ2 = 0.584, P > 0.05), 7 (χ2 = 0.400, P > 0.05) or 15 d post-treatment (χ2 = 0.251, P > 0.05). The costs of chemical treatment per 1 m2 were 0.58, 0.60, 0.64 Yuan and 0.73 Yuan in groups A1, A2, B and C, and the costs of the mean density of living snail per 1% reduction were 19.29, 20.44, 21.68 Yuan and 23.53 Yuan in groups A1, A2, B and C, respectively. Conclusion 80% NESWP shows a high molluscicidal efficacy and low cost in hilly schistosomiasis-endemic regions.

Avaliação morfológica do concentrado autólogo de plaquetas em cães sob refrigeração e criopreservação em DMSO 6% / [Morphological evaluation of the autologous platelet concentrate in dogs under refrigeration and criopreservation in 6% DMSO]

The morphological characteristics of the autologous platelet concentrate (APC) of 31 dogs were evaluated after cooling and freezing in 6% DMSO. Blood from the jugular vein of each patient was collected and centrifuged at 191g for six minutes to obtain APC. In the fresh sample, the platelet count, MPV, PDW and cell morphology were evaluated. Four samples of each animal were sent for storage, one refrigerated at 4°C for seven days, another for 30 days and two more stored in a freezer at -80°C in the same time interval, using 6% DMSO as cryoprotectant. The conserved samples were submitted to the same laboratory analysis as the fresh sample. There was a difference between fresh and preserved samples for platelet count, cell concentration, MPV and PDW (P<0.05), except in the 30-day refrigerated group, which showed severe morphological changes. In the frozen group for seven days, no difference was observed in the percentage of activation (P>0.05). The results obtained lead to the conclusion that cryopreservation with 6% DMSO at -80°C for seven days is a favorable option for the maintenance of platelet concentrations and the morphological characteristics of APC in dogs.(AU)

Carcass Traits and Leather Quality Characteristics of Blackhead Ogaden Sheep Fed Different

An experiment was conducted to assess the effect of varying level of roughage to concentrate ratios on carcass traits and leather quality characteristics of Blackhead Ogaden sheep aged 2 years (20.8±1.8 initial body weight). Twenty four lambs were blocked into 6 groups of four lambs based on initial body weight and randomly assigned within group to 4 diets. Roughage composed of natural grass hay and haricot bean hauls (50:50 ratio) and concentrate mixture composed of wheat bran (69%) and 31% of oil seed meal (noug seed cake and cottonseed meal in the ratio of 1.1:1) were offered at roughage (R) to concentrate (C) ratios of 60R:40C, 50R:50C, 40R:60C, and 30R:70C. Roughage and supplement were offered separately and percentages of the two feeds were determined based on ad libitum consumption of individual animal on dry matter (DM) basis. After the completion of stall feeding, animals were slaughtered for carcass parameters and leather quality evaluation. Slaughter body weight, hot carcass weight, dressing percentage as a proportion of slaughter body weight, empty body weight, and total usable products are greater in group consumed 30R:70C than 60R:40C ration (P<0.05). Fat content and elongation percentage of leather produced from sheep consumed 60R:40C was higher (p<0.05) than 30R:70C. However, the other chemical and physico-mechanical quality of leather were not affect by the treatment diet (P>0.05). Thus, we conclude that feeding of roughage and concentrate at the ratio of 30R:70C could be recommended as better feeding strategy for better performances of finishing sheep

Aplicación de la terapia regenerativa en la enfermedad arterial periférica y el pie diabético isquémico / Use of regenerative therapy in the peripheral arterial disease and the ischemic diabetic foot

Introducción: El pie diabético isquémico y la enfermedad arterial periférica, son dos enfermedades que ocasionan dolor por isquemia crítica y ponen en peligro la viabilidad de las extremidades inferiores. Objetivo: Demostrar la efectividad de la terapia regenerativa con plasma rico en plaquetas en pacientes con las enfermedades citadas. Métodos: Estudio longitudinal, prospectivo y aleatorizado realizado en el Servicio de Angiología del Hospital: Julio Trigo López, entre enero 2016-diciembre 2017. Se incluyeron 26 pacientes en dos grupos de estudios, 10 pacientes no diabéticos con claudicación intermitente y 16 pacientes con lesiones isquémicas en el pie del diabético. Se aplicó plasma rico en plaquetas por vía intramuscular en la pierna afectada, en el primer grupo y de forma intra- y perilesional en el pie del diabético isquémico. Resultados: Se obtuvo alivio del dolor y mejoría en más del 70 por ciento de los pacientes en la distancia de claudicación por encima o cerca de los 200 metros. En los pacientes con pie diabético isquémico, alivio del dolor y cierre de las lesiones isquémicas en el 81,3 por ciento, solo 3 pacientes requirieron amputaciones mayores de los miembros inferiores. Conclusiones: La terapia regenerativa resulta efectiva en el salvataje de las extremidades inferiores en los pacientes estudiados, asociada a los procedimientos convencionales empleados en la cirugía revascularizadora; disminuye la amputación mayor de miembros inferiores y es una posibilidad terapéutica más en manos de especialistas entrenados, por su impacto social y en la calidad de vida de pacientes y familiares(AU)

Introduction: Ischemic diabetic foot and peripheral arterial disease are two conditions that cause pain and put in danger the functionality of lower limbs. Objective: To demonstrate the effectiveness of regenerative therapy with platelet-rich plasma in patients with the above mentioned diseases. Methods: Longitudinal, prospective and randomized study that was conducted in the Angiology Service of Julio Trigo López Hospital, from January 2016 to December 2017. There were 26 patients included in 2 groups: 10 non-diabetic patients with intermittent claudication and 16 patients with ischemic lesions in the diabetic foot. Platelet-rich plasma was used instramuscularly in an affected legs of the first group, and intraperilesional and perilesional in the diabetic foot. Results: There was pain relief and improvement in more than 70 percent of patients in the claudication distance higher or near to 200 meters. In the patients presenting ischemic diabetic foot, pain relief and closing of ischemic lesions in the 81,3 percent , just 3 patients required major amputations of lower limbs. Conclusions: Regenerative therapy results effective in the rescue of lower limbs in patients presenting peripheral arterial disease and ischemic diabetic foot. It also reduces major amputations of lower limbs and it is another therapeutic option in the hands of trained specialists due to its social impact and in the life quality of patients and their families(AU)

Extraction of protein concentrate from red bean (Phaseolus vulgaris L.): antioxidant activity and inhibition of lipid peroxidation

Red Bean Protein Concentrate (RBPC) and their hydrolysates were used to evaluate the antioxidant capacity. TheRBPC protein content was in the range of 57.38%–72.68% of the total sample content. RBPC protein profile showeda range of 15–100 kDa. Phaseolin protein was identified with bands of 45 and 50 kDa. Phaseolin protein was foundin all the RBPC samples at the different pHs assayed. In the gastric digestion phase, bands from 60 to 100 kDa weretotally hydrolyzed with pepsin. Phaseolin protein (45 and 50 kDa) presented resistance to gastric hydrolysis. All theRBPCs and gastrointestinal digest presented antioxidant activity using ferric-reducing antioxidant power (FRAP),2,2-azinobis (3-ethyl-benzothiazoline-6-sulfonic acid) (ABTS), oxygen radical absorbance capacity (ORAC), andthiobarbituric acid reactive substances using the in vitro and in vivo methods. RBPC at pH 7.0 presented a value of95.80 µmoL TE/g of RBPC (FRAP); 257.12 µmoL TE/g of RBPC (ABTS), and 1960 µmoL TE/g of RBPC (ORAC).Duodenal digest of RBPC presented high antioxidant activity with 225.77 µmoL TE/g of digest (FRAP); 345.21 µmoLTE/g of digest (ABTS); and 3256 µmoL TE/g of digest (ORAC). Gastric and duodenal digest of RBPC were usedto inhibit lipid peroxidation using the in vitro method presenting a value of 87.95% and 93.0%, respectively. Whenthe in vivo method in zebrafish larvae was used, values were 79.03% and 86.76%, respectively. RBPCs showed noreactive oxygen species (ROS) inhibition. However, RBPCs with gastric and gastrointestinal digests, presented ROSinhibition, 75.30% for gastric digests and 66.40% for gastrointestinal digests.

Milk Production Function and Resource use Efficiency in Rajasthan

The study was undertaken in Rajasthan with the objective to examine the input-output relationships and assess the resource use efficiency in milk production. The study covered 60 dairy households. The results of Cobb-Douglas production function revealed that concentrate had positive and significant influence on returns from buffalo, crossbred cow and local cow milk. Green fodder and labour were also significantly influenced the returns from buffalo, crossbred and local cow. The results of resource use efficiency and marginal value productivity of inputs indicated that inputs were not optimally utilized by dairy households. The green fodder, dry fodder, concentrate and labour in buffalo, concentrate and labour crossbred cow milk production and green fodder in local cow milk production were found to be over utilized in study area resulting higher per litre cost of milk production on these species.