ABSTRACT
The use of automated blood processors in combination with bottom and top blood containers has been found to improve the standardization and quality of blood components. A study was performed to validate a new type of processor (Optipress II) and compare its performance with a first generation processor (Optipress I). Primary separation on the Optipress II was investigated on 570 mL (+/- 10%) of anticoagulated blood in a nonpaired study. In addition, the quality of the products in routine production was compared between the results of the Optipress I and Optipress II. The whole blood units were kept overnight at room temperature (20 +/- 2 degrees C). Separation was performed under conditions to obtain 55 mL buffy coats with a 50% haematocrit (ht). Platelet concentrate preparation was investigated in a paired study and compared to the routine manual method using PAS II additive solution. Parameters studied were volume, red cell, white cell and platelet counts, ht, haemoglobin (hb, total and free). Primary separation was more efficient in the Optipress II because the platelet count was lower in the erythrocyte concentrates (P < 0.0001), platelets were lower in plasma (P < 0.0001) and platelet counts were higher in buffy coats (P < 0.0001). Buffy coat volume showed less variation (Optipress II VC = 4%, Optipress I VC = 7.4%). Secondary separation did not show differences between the Optipress II and manual method but was advantageous because of the automatic termination of the procedure. Further improvement of standardization in blood component preparation is possible with an automated blood processor, leading to improvement of the quality of blood products for patient care.
Subject(s)
Blood Component Removal/instrumentation , Blood Component Removal/standards , Blood Component Removal/methods , Blood Platelets/cytology , Cell Separation/instrumentation , Cell Separation/methods , Equipment Failure , Humans , Quality Control , Time FactorsABSTRACT
Double-blind study comparing efficacy and safety of alprazolam and bromazepam in 119 ambulatory anxious patients receiving flexible dosage. 119 ambulatory anxious patients (global score on the Hamilton anxiety rating scale between 18 and 35) have been included in this double-blind trial (duration 4 weeks) comparing alprazolam and bromazepam given at flexible dosage. The global score on the Hamilton anxiety rating scale improved by 57.8% and 55.3% for alprazolam and bromazepam respectively. The percentage of therapeutic success according to the psychiatrist and the patient were respectively 82.7% and 79.3% for alprazolam compared to 74.1% and 71.9% for bromazepam. Fewer side-effects were recorded in the alprazolam group (97) than in the bromazepam group (120) and global safety of alprazolam seemed superior (p = 0.07). At trial-end, mean dosage reached 1.70 mg/day for alprazolam and 10.35 mg for bromazepam, but no correlation was found between anxiety intensity and optimal daily dosage used; however, a correlation has been found between the improvement of the overall Hamilton rating scale score and the dosage given (p = 0.02). The overall results suggest that the efficacy/safety ratio is better for alprazolam.
Subject(s)
Alprazolam/therapeutic use , Anti-Anxiety Agents/therapeutic use , Anxiety Disorders/drug therapy , Bromazepam/therapeutic use , Adolescent , Adult , Aged , Alprazolam/administration & dosage , Alprazolam/adverse effects , Ambulatory Care , Bromazepam/administration & dosage , Bromazepam/adverse effects , Double-Blind Method , Humans , Middle Aged , Random AllocationSubject(s)
Hospitals, Psychiatric/history , Female , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , Hospitals, Psychiatric/economics , Hospitals, Psychiatric/organization & administration , Hospitals, Public/history , Hospitals, Voluntary/history , Humans , Mental Disorders/therapy , MexicoABSTRACT
Resumen A finales del siglo XVII se creó en Nueva España el primer hospital destinado a dar asilo a las mujeres que tenlan perturbadas sus facultades mentales. Su fundador fue un carpintero. llamado José Sayago. quien sin ninguna ayuda económica del virreinato y en condiciones bastante precarias, inició esta labor hospitalaria con sus propios medios. Esta institución se llamó Hospital de Mujeres Dementes. La demanda de asilo fue creciendo tanto q ue en el año 1700 rebasó su capacidad y las mujeres asiladas fueron transladadas a otro local. que se encontraba en la calle de La Canoa. En este lugar el hospital fue puesto bajo el cuidado de una congregación jesuita llamada del Divino Salvador. quien se hizo cargo de administrarlo hasta 1767, en que la compañía de Jesús fue expulsada del pais. Durante todo este tiempo. el tratamiento médico que las pacientes recibían iba de acuerdo a los conocimientos de la época y procurando seguir al paso de la evolución de la medicina. Al estallar la Guerra de Independencia y. posteriormente Otras luchas internas la labor del hospital nose alteró grandemente. a excepción de su organización administrativa que pasó por esos tiempos a diferentes corporaciones de beneficencia que se habían creado en el México republicano. La benéfica labor de este viejo hospital. que se conoció también con el nombre de Hospital de La Canoa por su ubicación. terminó en 1910 al ser transladadas todas las pacientes al nuevo Manicomio General de la Castañeda. fundado por Don Porfirio Díaz. La importante labor desarrollada por el Hospitaldel Divino Salvador durante más de 200 años de servicios ininterrumpidos. no puede desligarse de la vida histórica de México y de la evolución de la asistencia médica
Subject(s)
Medical Assistance , Hospitals, Psychiatric , MexicoABSTRACT
We have found that an institutional psychothérapy for neurosis could benefit by using elements of the work of Winnicott as well as of the bioenergetic and existential movements. This corresponds to a more and more explicit request from depressed patients who are expecting more from their stay in the hospital than simply to recharge their energy. We thought that our department, because of its size, type of patients, staff and its own orientation would be well adapted to an experience of this kind. In our hospital we try to facilitate in the patient: --regressive experiences; --the perception of "being"; --the symbolic and emotional feeling of the reality of time and place and particularity of the body; --the capacity to repair himself; --playing in the sense of Winnicott: playing with the in and the out (of onesself), the positions of the body, verbal play, play of alternation. --Centering on desire on the interior space, with the capacity to be "alone in the presence on another"; --the discovery of "responsability" and "compassion", also in the sense of Winnicott. We must take into consideration that in order to benefit from this type of therapy, there must be a good enough integration and a pain that is authentically experienced, that is, not acted out, not sutured, and without too many defenses. The results can be appreciated only very subjectively, since improvement is of a qualitative order, in the area of development of being serious existentially. We can perhaps envisage another future for the depressed patient than the interminable repetition of relapses or of beign treated indefinitely. This consists of discovering another way of being, more global, more serious, more authentic (real-self), considering the difficulties involved in the engagement of the realself in an already structured existence.
