Treatment of platelet concentrates and plasma with riboflavin and UV light: Impact in bacterial reduction.

OBJECTIVES: Transfusion of hemocomponents is essential for clinical and surgical procedures and therefore their safety has increased. An option for pathogen reduction includes the combination of riboflavin and UV light. To our knowledge, there are no studies in Latin America that demonstrate the effectiveness of the pathogen reduction in hemocomponents. The objective of this work was to evaluate the efficiency of a pathogens reduction system in platelets concentrates (PC) and plasma. MATERIALS AND METHODS: PC and plasma were contaminated with Escherichia coli, Klebsiella pneumoniae, Streptococcus pyogenes and Staphylococcus epidermidis at 104 to 106 CFU and subjected to bacterial reduction. After bacterial reduction, hemocomponents were subjected to cultivation of surviving bacteria by automated method and classical colonies quantification. Additionally, quality control testing was performed in order to confirm the integrity of platelets and coagulation laboratory values in plasma before and after bacterial reduction. RESULTS: The bacterial death in PC/plasma was expressed by Logarithmic Reduction Value as follows: for both strains (E. coli and S. pyogenes) 4/4, 5/5 and 6/6; for K. pneumoniae 2.54/2.23, 2.94/2.22 and 3.44/2.98, for S. epidermidis 4/4, 3.11/5 and 3.23/4.19, for 104, 105 and 106 CFU, respectively. In PC and plasma, platelet count, pH (at 22°C), activated partial thromboplastin time (aPTT), prothrombin time (PT), fibrinogen, factor VIII and total proteins (TP) were slightly modified. CONCLUSIONS: UV light with riboflavin is able to reduce an important number of pathogens in hemocomponents; however, the bacterial reduction is influenced by the nature and quantity of the pathogen.

[Prevalence of human herpesvirus 7 in Mexican blood donors]. / Prevalencia del virus humano herpes 7 en donadores de sangre Mexicanos.

The human herpes virus 7 (HHV-7) has been recently isolated from CD4 cells of healthy persons. The present study describes the antibody prevalence of this virus in a healthy Mexican population. Two hundred blood samples from candidates for blood donation at the Hospital General de Mexico were studied with the indirect immunofluorescence test (IFA) in HHV-7 infected SupT1 cells. The testing was done in the University of Cologne, Germany; 167 were males and 33 female; the donors came from 12 of the 31 states in the Mexican republican, predominantly from Mexico City (60.5%) and the State of Mexico (28%). Their mean age was 29.2 years. All but three samples were positive to the HHV-7 (98.5% positivity). Nearly 85% had high titers (> or = 1:80). Other serology testing in the samples revealed 1% positive tests to hepatitis B, 2% to syphilis, and 0.5% to brucella. Hepatitis C and the HIV test were negative in all. The high prevalence of HHV-7 in our donor population should be further studied in order to determine titers indicative of an active infection and of their association with illnesses.

Prevalence of hepatitis C virus among candidates for blood donation at the Hospital General de Mexico.

Among the NonA-nonB hepatitis, only hepatitis C is exclusively of parenteral transmission. The reported seroprevalence among blood donors in the world ranges from 0.5 to 6.0%. In order to discover the seroprevalence of anti-HCV in candidates for blood donation at the General Hospital of Mexico, 330 individuals were studied. Determination of anti-HCV was performed by the UBI HCV EIA diagnostic test. Risk factors such as history of major surgery, transfusions, drug addiction, etc were also assessed. There were only 4 seropositive patients (1.2%), 95% CI = (0, 2.75%). Only major surgery was associated with seropositivity. It was not possible to exclude hemotransfusion during surgery as a risk factor.

Successful treatment of severe complicated measles with non-specific transfer factor.

Severe complicated measles has a high mortality rate and no specific treatment. Ten patients with complicated measles - 9 infants with respiratory failure and a 15 year old boy with encephalitis - received immunotherapy with Non-specific Transfer Factor (NTF). The patients had variable degrees of undernourishment and were severely ill when immunotherapy was started. 8/9 cases with respiratory failure were cured. One died of bronchoaspiration while recovering from the measles. The case with encephalitis showed no neurological sequelae two weeks after receiving the last dose of NTF. Treatment of complicated measles with NTF in these patients seemed very effective and deserves further trial.

[Agreement among observers in the classification of acute leukemias]. / Concordancia de observadores en la clasificación de las leucemias agudas.

This study was carried out to establish the level of concordance between two observers from two different health institutions in Mexico City, in the diagnosis of acute leukemias and their different varieties. We studied 73 consecutive cases of adults with these diseases. Each one of the two observers established their diagnosis on two occasions at least 15 days apart. They first made their diagnosis taking as a base the neoplastic cells morphology in bone marrow smears, and after that, with morphology plus specific cytochemistry. The outcomes of the two observers were also compared with the official diagnosis. Kappa test was performed to know interobserver and intraobserver concordance. The kappa values for the diagnosis myeloid/lymphoid were found among the highest (51 to 91). Weighted kappa was also applied to know the level of concordance in the diagnosis of the different varieties of acute leukemia, myeloid and lymphoid. In these cases the weighted kappa values were lower compared with the previous values (lymphoid, from 47 to 82; myeloid, from 30 to 66). Cytochemistry paradoxically was a confusing factor when it was used: in these cases the kappa values were lower (32 to 84) than morphology alone (39 to 91). The outcomes showed the subjective level in the diagnosis of the myeloid subtypes was more important in them than in the lymphoid subtypes.

[Hodgkin's disease in the Hospital General de México. Study of 309 cases]. / Enfermedad de Hodgkin en el Hospital General de México. Estudio de 309 casos.

In order to know the frequency and distribution of the histologic types of Hodgkin disease (HD) in the general Hospital of Mexico City and to compare the results with those of other countries; 96,909 surgical specimens were reviewed; 422 were of HD, from which only 309 (0.31%) could be reclassified according to the modified Rye classification, 214 (69%) were male and 95 (31%) female (M:F = 1:2.25). The mean age for the group was 26 years, for females was 30 and for males 24. The graphic for age and sex showed a unimodal curve in both sexes. The most frequent histologic type was mixed cellularity with 175 cases (56.6%), followed by the NE type with 83 (26.9%), the DL with 26 (8.4%) and finally the PL type with 25 (8.1%). In all the groups predominated the males as reported by other authors, but they reported a bimodal curve of age distribution and ours was unimodal as reported in Peru, Colombia, Uganda. The mean age is also one decade younger than in other countries, probably because almost 50% of the Mexican population are youngsters. The distribution of histologic types is similar to those of South Africa, Colombia, Uganda, Zambia and to the poor black population from USA, where the most frequent type is the mixed cellularity. The frequency of the other histologic types differs from the reports of Denmark Sweden, USA and England were the NE type predominates.(ABSTRACT TRUNCATED AT 250 WORDS)

Consideraciones sobre la esplecectomia en la leucemia de celulas peludas / Splenectomy in hairy cell leukemia

Durante el lapso comprendido entre 1972 y 1981 , se estudiaron 10 pacientes a quienes en base al cuadro clinico y hematologico se les establecio el diagnostico de "leucemia de celulas peludas", cifra que corresponde al 1.8% del total de leucemias estudiadas en la Clinica de la Universidad de Colonia en dicho periodo. En forma "tipica", el cuadro clinico comprendio franca esplenomegalia, adenomegalia variable (usualmente ausente) y discreta hepatomegalia. Desde el punto de vista hematologico se encontro anemia, trombocitopenia y leucopenia con neutropenia y linfocitosis. La observacion de los extendidos de sangre y de medula osea mostro porcentajes variables de "celulas peludas", las cuales se confirmaron como tales por medio de la tincion de fosfatasa acida resistente al tartrato (considerada como el medio mas preciso de diagnostico hasta la fecha). Asimismo se confirmo la fibrosis e infiltracion linfocitica en la medula osea. Al efectuarse la esplenectomia en estos pacientes, las imagens clinica y hematologica se normalizaron. Sin embargo, no se aprecio reduccion significativa de la susceptibilidad a contraer procesos infecciosos recidivantes en estos pacientes