ABSTRACT
Amotosalen-HCl-UVA (AI) is a process to inactivate pathogens in therapeutic plasma (FFP). Tolerance is the main residual issue in FFP transfusion, and only large series observations are powered enough to identify significantly elevated levels of hazards. We report here on 15,133 new transfusions of AI-FFP, over the previously published 36,035, which in all represents one of the largest series observed by means of a highly standardized surveillance (51.168 observations). There is no noticeable difference in terms of tolerance of AI-FFP compared to 5875 transfusions of Quarantine (Q)-FFP. There was no significant difference in terms of advance events, between the two types of FFP (P = 0.98); further, no difference was recorded either when the total number of AI-FFP (51,168) was compared to the corresponding number of Q-FFP (5875; P = 0.62).
Subject(s)
Blood Preservation/methods , Furocoumarins/adverse effects , Hypersensitivity/epidemiology , Transfusion Reaction , Ultraviolet Rays/adverse effects , Blood Preservation/adverse effects , Blood Transfusion/statistics & numerical data , France , Humans , Hypersensitivity/etiologyABSTRACT
OBJECTIVES: This study aimed to describe the professional practices in pediatric transfusion to assess the accuracy of transfusion guidelines in children. METHODS: The study retrospectively analyzed the characteristics of all the pediatric transfusions prescribed in the Clermont-Ferrand (France) university hospital center over 1 year and determined whether they conformed to the national guidelines. RESULTS: One thousand six hundred and seven blood products were delivered to 233 children (806 red cell units, 670 platelet units, and 131 plasma units), accounting for 5.3% of the center's whole blood products. Transfusions were mainly prescribed by the oncohematology unit (68.2%), the intensive care unit (15.4%), and for surgery (10.2%). Ten adverse events were reported in eight patients (0.6% of transfusions). The prescription conformed to the national guidelines in 35.9%, 41.6%, and 80.9% of the red blood cell, platelet, and plasma unit transfusions, respectively. Nonconformity was mainly due to abusive irradiation and "cytomegalovirus seronegative" specifications. CONCLUSION: Malignancies, intensive care, and surgery are the main indications for transfusion in children. Substantial discrepancy between recommendations and actual practices was observed. This illustrates the variability of risk evaluation. This should be made simpler by the use of photochemical pathogen inactivation techniques.
Subject(s)
Blood Transfusion/standards , Guideline Adherence/statistics & numerical data , Practice Patterns, Physicians' , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Retrospective Studies , Young AdultABSTRACT
PURPOSE OF THE STUDY: Like every actor in transfusion, staff members practising within blood banks of healthcare establishments have to follow a specific initial training and must frequently update their knowledge in blood transfusion. METHODS: To address this need from these professionals, the Établissement français du sang Auvergne-Loire set up training sessions which content regularly evolved according to regulation recommendations. Every cycle consists in a total of 35hours of training, divided in five one-day modules. The comparison of the evaluation questionnaires offered at the beginning and at the end of each day allowed to measure the benefits provided by every module and to compare progress according to the number of modules previously followed. The analysis of satisfaction surveys contributed to improving the education towards a high level of satisfaction of every participant. RESULTS CONCLUSION: At the end of its third year of existence, the 35hours education programme permitted to achieve a better level of training for all the staffs and the evolution towards an on-site continuing education format seems to better correspond to the personnel's expectations.
Subject(s)
Blood Banks , Education, Continuing , Blood Transfusion , Curriculum , Educational Measurement , France , Humans , Inservice Training , Job Satisfaction , Professional Practice , Program Evaluation , Surveys and QuestionnairesABSTRACT
Activators are functional jaw orthopedic appliances which provide various mandibular position, but always different from habitual positions. Mechanisms and modus operandi of activators explain therapeutic objectives of clinicians. When we analyse different determinants of modus operandi of activators (skeletal, muscular and articular), it is possible to classify these appliances in rigid monobloc appliances, composite or elastic activators and thrusting activators. Many prospective or retrospective clinical studies analyse dentoalveolar or skeletal effects of the activators.
Subject(s)
Activator Appliances , Malocclusion, Angle Class II/therapy , Maxillofacial Development , Orthodontics, Interceptive/instrumentation , Dental Stress Analysis , Extraoral Traction Appliances , Humans , Mandibular Advancement/instrumentationABSTRACT
Tooth agenesis and clef palate are associated to the mutation of the Msx1 homeobox genes, highlighting the pivotal role of homeobox genes during the initial development of the craniofacial skeleton. Msx1 also controls the terminal differentiation of mineralised tissues forming cells. Recently, a Msx1 antisense RNA has been identified which inhibits Msx1 protein expression in odontoblastic cells. In order to investigate the role of Msx1 gene and its antisense RNAs during the late developmental stages of the craniofacial bone formation, the expression pattern of Msx1 protein, sense and antisense transcripts and the aspects of bone growth have been studied in post-natal normal and Msx1 knock-in mutant mice. Msx1 protein was strongly expressed in preosteoblasts of specific bone sites such as the basal mandible. At the same bone sites, bone growth was impaired or markedly decreased in knock-in mice. The comparison between the various expression patterns of Msx1 protein, sense and antisense RNAs suggests that the site-specific action of Msx1 protein on bone growth and craniofacial morphogenesis and that Msx1 protein level could be controlled by the local ratio of Msx1 sense and antisense RNAs. Regarding our experimental data and hypothesis, a clinical study of patients with MSX1 mutation will be performed in order to better characterize the abnormalities of the craniofacial skeleton growth.
Subject(s)
Craniofacial Abnormalities/genetics , Homeodomain Proteins/genetics , Maxillofacial Development/genetics , Transcription Factors/genetics , Animals , Gene Expression Regulation, Developmental , Genes, Homeobox , Humans , MSX1 Transcription Factor , Mice , Mice, Transgenic , Mutation , RNA, Antisense , Reverse Transcriptase Polymerase Chain ReactionSubject(s)
Dentition, Mixed , Facial Muscles/physiopathology , Malocclusion/therapy , Maxillofacial Development , Orthodontics, Corrective/methods , Adolescent , Child , Female , Humans , Male , Myofunctional Therapy/instrumentation , Myofunctional Therapy/methods , Orthodontic Appliances, Functional , Orthodontics, Corrective/instrumentationSubject(s)
Activator Appliances , Extraoral Traction Appliances , Malocclusion, Angle Class II/therapy , Cephalometry , Child , Female , Humans , Male , Vertical DimensionABSTRACT
The aim of this work is the study of effects on vertical dimension of a functional appliance: combination of headgear and activator. We have pointed out in this study: a good control of occlusal and palatal plans; vertical stability of ANS; no change of facial axis; intrusion of maxilla incisors; correction of anterior deep-bite. We concluded that this combination headgear activator, in addition to the sagittal correction of Class II, permitted a good control of vertical skeletal and dental dimensions.