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2.
Andrologia ; 44 Suppl 1: 287-94, 2012 May.
Article in English | MEDLINE | ID: mdl-21729138

ABSTRACT

The biodiversity in South Africa provides more than 30,000 higher plants, of which more than 3000 are used by traditional healers to treat diseases. Typha capensis (bulrush) is one of the medicinal plants used in South Africa to treat male fertility problems. Considering that South African traditional healers have been recognised by Law and the health benefits of T. capensis have not been scientifically investigated yet, this study aimed at investigating the in vitro effects of aqueous extracts from this plant on male reproductive functions. Both leaves and rhizomes of T. capensis were dried, infused with distilled water and freeze-dried. Motile sperm from 50 men were isolated by swim-up and incubated with 1 µg ml(-1) aqueous extract of Typha rhizome for 1 h at 37 °C. Vitality, motility, sperm production of reactive oxygen species and mitochondrial membrane potential were analysed in the test sample, a control and in the pellet from the swim-up. Results showed that the rhizome extract had significant (P < 0.0001) negative effects on all parameters. The extracts from the leaves and rhizomes revealed dose-dependent inhibitory activity for collagenase and free radical formation. No inhibitory activity for elastase was found. The inhibitory activity for collagenase might indicate possible anti-cancer effects.


Subject(s)
Enzyme Inhibitors/pharmacology , Free Radical Scavengers/pharmacology , Matrix Metalloproteinase Inhibitors , Membrane Potentials/drug effects , Mitochondria/drug effects , Plant Extracts/pharmacology , Sperm Motility/drug effects , Typhaceae/chemistry , Humans , Male , Pilot Projects
3.
Vox Sang ; 99(2): 142-8, 2010 Aug 01.
Article in English | MEDLINE | ID: mdl-20202183

ABSTRACT

BACKGROUND AND OBJECTIVES: On May 12, 2008, a severe earthquake hit Sichuan province in China. A post-earthquake survey was conducted to study the earthquake's effect on blood donor behaviour and stress at three blood centres at varying distances from the epicentre. MATERIALS AND METHODS: A questionnaire was developed to assess donor post-traumatic stress disorders (PTSD) and attitudes toward giving blood. Responses were compared by centre and donor characteristics using multivariate logistic regression techniques. RESULTS: Of all 17 456 donors, the overall prevalence of PTSD was 13.2%. Donors who knew someone killed or injured by the earthquake were 2.1 times more likely to have PTSD than others (95% CI: 1.8-2.4). 85.2% of donors cited the earthquake as their reason for donating. 16.1% of donors felt it acceptable to be less honest about one's health history in an emergency. After adjusting for PTSD, geographic and demographic characteristics, the donors knowing someone killed or injured by the earthquake were 1.4 times (95% CI: 1.2-1.7) more likely to cite the earthquake as reason for donating, and 1.8 times (95% CI: 1.5-2.1) more likely to accept being less honest about one's health history in case of national emergency. CONCLUSIONS: The psychological and behavioural impacts of the earthquake on blood donors extended far from the epicentre. After a disaster, it is important to emphasize that donors must be truthful on the donor questionnaire as some donors appear willing to be less than honest when they perceive an increased need for blood products.


Subject(s)
Blood Donors/psychology , Disasters , Earthquakes , Stress Disorders, Post-Traumatic/psychology , Adolescent , Adult , Behavior , Blood Donors/statistics & numerical data , China/epidemiology , Female , Humans , Male , Middle Aged , Risk Factors , Stress Disorders, Post-Traumatic/epidemiology , Surveys and Questionnaires , Young Adult
4.
Transfusion ; 50(6): 1240-8, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20088834

ABSTRACT

BACKGROUND: In the United States, African Americans donate at approximately half the rate of whites and therefore are underrepresented in the volunteer blood donor pool. The goal of this study was to identify motivators and barriers to African Americans donating blood. STUDY DESIGN AND METHODS: A consortium of 15 predominantly African American churches of varying denominations in metropolitan Atlanta, Georgia, participated in an 81-item self-administered survey. The questionnaire was designed to assess participant's demographic background, blood donation frequency, motivators and barriers to donation, knowledge and beliefs regarding donation, and overall health status. RESULTS: A total of 930 participants completed the survey: 72% female, 55% age 40 or older, 99% African American, and 58% college-educated. The most frequent reported motivators were donating to help save a life (96%) and donating because blood is needed (95%), while the most frequent barriers were that they rarely think about it and they were afraid, nervous, or anxious to give blood (35%). The association of barriers with donation status, age, gender, and education level was stronger than for motivators. Fear was more common in nondonors than lapsed and current donors, youngest compared to older adults, and women than men and less in those with higher income. CONCLUSION: Motivators and barriers to blood donation in African American church attendees differ depending on the respondents' demographics. To increase the effectiveness of church drives, donor recruitment should focus on addressing these barriers and motivators.


Subject(s)
Attitude to Health , Black or African American , Blood Donors/psychology , Motivation , Religion and Medicine , Surveys and Questionnaires , Adult , Fear/psychology , Female , Georgia , Humans , Male
5.
Transfusion ; 50(4): 881-7, 2010 Apr.
Article in English | MEDLINE | ID: mdl-19951315

ABSTRACT

BACKGROUND: Presenting blood donors are screened to ensure both their safety and that of the recipients of blood products. Donors with identified risks are deferred from donating blood either temporarily or permanently. Minorities are underrepresented as donors in the United States and this may in part be a result of increased donor deferral rates in minorities compared to white individuals. STUDY DESIGN AND METHODS: Data consisted of deferred and successful blood donor presentations to the American Red Cross Southern Region in the metropolitan Atlanta area in 2004 to 2008. Bivariate and multivariate analyses were conducted by race/ethnicity, age group, and sex. RESULTS: A total of 586,159 voluntary donor presentations occurred in 2004 to 2008, of which 79,214 (15.6%) resulted in deferral. In the age 16 to 69 years subset (98.3% of the presentations), deferred presentations were mostly women (78.2%). The most common reason for donor deferral was low hemoglobin (62.6%). The donor deferral rate varied by race/ethnicity, age, and sex: whites (11.1%), Hispanics (14.1%), and African Americans (17.9%); 16- to 19-year-olds (17.0%) and 50- to 59-year-olds (11.7%); and females (20.0%) and males (6.2%). Compared to whites and Hispanics, African American females had the highest deferral rate in each age group. CONCLUSIONS: Minorities are disproportionately impacted by blood donor deferrals. Methods to decrease blood donor deferral rates among African Americans are needed.


Subject(s)
Blood Donors/statistics & numerical data , Adolescent , Adult , Aged , Black People/statistics & numerical data , Demography , Ethnicity , Female , Georgia , Hispanic or Latino/statistics & numerical data , Humans , Male , Middle Aged , Racial Groups , Urban Population/statistics & numerical data , White People/statistics & numerical data , Young Adult
6.
Clin Exp Dermatol ; 34(5): e72-4, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19438525

ABSTRACT

Legionnaires' disease is an acute bacterial infection, generally caused by Legionella pneumophila, which primarily involves the lower respiratory tract, although it is often associated with multisystemic extrapulmonary features. Cutaneous features are very uncommon and may include erythematous or petechial, macular or maculopapular lesions. We report a male patient who expressed all features of a severe lobular pneumonia. Over the course of the disease the patient developed a livid erythematous, maculopapular exanthem rapidly extending over the entire body. Given the rapid development and target-like appearance of the skin lesions with extensive skin involvement and blister formation, the initial diagnosis was that of a severe cutaneous drug reaction. However, histological examination of biopsy did not confirm this diagnosis, but instead was suspicious for a viral exanthem or a more aggressive inflammatory response due to sensitization to bacterial antigens. L. pneumophila infection was verified during the course of the disease.


Subject(s)
Drug Eruptions/diagnosis , Exanthema/diagnosis , Legionnaires' Disease/diagnosis , Skin Diseases, Bacterial/diagnosis , Diagnosis, Differential , Fatal Outcome , Humans , Male , Middle Aged
8.
J Mol Biol ; 384(1): 109-19, 2008 Dec 05.
Article in English | MEDLINE | ID: mdl-18804117

ABSTRACT

A new method is presented for the redesign of protein-protein interfaces, resulting in specificity of the designed pair while maintaining high affinity. The design is based on modular interface architecture and was carried out on the interaction between TEM1 beta-lactamase and its inhibitor protein, beta-lactamase inhibitor protein. The interface between these two proteins is composed of several mostly independent modules. We previously showed that it is possible to delete a complete module without affecting the overall structure of the interface. Here, we replace a complete module with structure fragments taken from nonrelated proteins. Nature-optimized fragments were chosen from 10(7) starting templates found in the Protein Data Bank. A procedure was then developed to identify sets of interacting template residues with a backbone arrangement mimicking the original module. This generated a final list of 361 putative replacement modules that were ranked using a novel scoring function based on grouped atom-atom contact surface areas. The top-ranked designed complex exhibited an affinity of at least the wild-type level and a mode of binding that was remarkably specific despite the absence of negative design in the procedure. In retrospect, the combined application of three factors led to the success of the design approach: utilizing the modular construction of the interface, capitalizing on native rather than artificial templates, and ranking with an accurate atom-atom contact surface scoring function.


Subject(s)
Computational Biology , Peptide Fragments/chemistry , Peptide Fragments/metabolism , Proteins/chemistry , Proteins/metabolism , Templates, Genetic , Bacterial Proteins/chemistry , Bacterial Proteins/metabolism , Databases, Protein , Models, Molecular , Mutation , Protein Binding , Reproducibility of Results , Software , Surface Plasmon Resonance , Thermodynamics , beta-Lactamases/chemistry , beta-Lactamases/metabolism
9.
Hum Mutat ; 29(6): 809-22, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18366090

ABSTRACT

Mutations in the genes encoding collagen VI (COL6A1, COL6A2, and COL6A3) cause Bethlem myopathy (BM) and Ullrich congenital muscular dystrophy (UCMD), two related conditions of differing severity. BM is a relatively mild dominantly inherited disorder characterized by proximal weakness and distal joint contractures. UCMD was originally regarded as an exclusively autosomal recessive condition causing severe muscle weakness with proximal joint contractures and distal hyperlaxity. We and others have subsequently modified this model when we described UCMD patients with heterozygous in-frame deletions acting in a dominant-negative way. Here we report 10 unrelated patients with a UCMD clinical phenotype and de novo dominant negative heterozygous splice mutations in COL6A1, COL6A2, and COL6A3 and contrast our findings with four UCMD patients with recessively acting splice mutations and two BM patients with heterozygous splice mutations. We find that the location of the skipped exon relative to the molecular structure of the collagen chain strongly correlates with the clinical phenotype. Analysis by immunohistochemical staining of muscle biopsies and dermal fibroblast cultures, as well as immunoprecipitation to study protein biosynthesis and assembly, suggests different mechanisms each for exon skipping mutations underlying dominant UCMD, dominant BM, and recessive UCMD. We provide further evidence that de novo dominant mutations in severe UCMD occur relatively frequently in all three collagen VI chains and offer biochemical insight into genotype-phenotype correlations within the collagen VI-related disorders by showing that severity of the phenotype depends on the ability of mutant chains to be incorporated in the multimeric structure of collagen VI.


Subject(s)
Collagen Type VI/genetics , Muscular Dystrophies/genetics , Mutation , RNA Splicing , Cells, Cultured , Collagen Type VI/metabolism , DNA Mutational Analysis , Exons , Fibroblasts/metabolism , Gene Deletion , Humans , Muscle, Skeletal/metabolism , Severity of Illness Index , Skin/cytology
10.
Acta Myol ; 27: 54-8, 2008 Oct.
Article in English | MEDLINE | ID: mdl-19364062

ABSTRACT

Calpainopathy is an autosomal-recessive limb girdle muscular dystrophy (LGMD2A) characterized by selective atrophy and weakness of proximal limb girdle muscles. The clinical phenotype of the disease is highly variable inter-familial, but little is known about intra-familial variability. This study reports the phenotypic variability in eight sibling pairs with genetically proven LGMD2A. Although siblings with identical mutations were often similarly affected, in some families the age of onset and the clinical course varied considerably.


Subject(s)
Muscular Dystrophies, Limb-Girdle/genetics , Phenotype , Adolescent , Adult , Calpain/genetics , Child , Female , Humans , Male , Muscle Proteins/genetics , Retrospective Studies , Siblings , Young Adult
11.
Int J Obes (Lond) ; 32(1): 23-9, 2008 Jan.
Article in English | MEDLINE | ID: mdl-17563764

ABSTRACT

OBJECTIVE: To document meal frequency and its relationship to body mass index (BMI) in a longitudinal sample of black and white girls from ages 9-19 years. DESIGN: Ten-year longitudinal observational study. SUBJECTS: At baseline, 1209 Black girls (539 age nine years, 670 age 10 years) and 1,166 White girls (616 age nine years, 550 age 10 years) were enrolled in the National Heart, Lung and Blood Institute Growth and Health Study (NGHS). MEASUREMENTS: Three-day food diaries, measured height and weight and self-reported physical activity and television viewing were obtained at annual in-person visits. RESULTS: Over the course of the study, the percentage of girls eating 3+ meals on all 3 days was reduced by over half (15 vs 6%). Participants who ate 3+ meals on more days had lower BMI-for-age z-scores. Black girls, but not white girls, who ate 3+ meals on more days were less likely to meet criteria for overweight. CONCLUSION: Meal frequency was related to BMI and should be considered when developing guidelines to prevent childhood overweight.


Subject(s)
Black People , Body Composition/genetics , Body Mass Index , Feeding Behavior/ethnology , White People , Adolescent , Adult , Child , Diet Records , Eating , Female , Humans , Longitudinal Studies
12.
Article in English | MEDLINE | ID: mdl-17994172

ABSTRACT

UNLABELLED: There is an increasing interest, including androgenic and anabolic substances (AAS). The uncritical use may be associated with severe adverse effects. We observed five patients with different patterns of adverse reaction to AAS: two females and three males, they were identified when seeking medical help and advice. The following adverse effects from of AAS have been observed: deepening of the voice due to topical use of AAS in an anti-cellulite cream; circumscribed hypertrichosis and late onset acneiform eruptions due to testosterone replacement therapy after ovariectomy; homolateral gynecomastia and infertility, acne and striae distensae in males using injectable AAS. CONCLUSIONS: ASS can trigger significant adverse effects. An interdisciplinary approach may be necessary for evaluation. The dermatologists should be familiar with the adverse effects.


Subject(s)
Anabolic Agents/adverse effects , Androgens/adverse effects , Androstenols/adverse effects , Gynecomastia/chemically induced , Infertility/chemically induced , Skin Diseases/chemically induced , Virilism/chemically induced , Administration, Topical , Adult , Anabolic Agents/administration & dosage , Androgens/administration & dosage , Androstenols/administration & dosage , Doping in Sports , Female , Gynecomastia/diagnostic imaging , Humans , Male , Middle Aged , Ultrasonography
13.
Curr Top Microbiol Immunol ; 316: 71-95, 2007.
Article in English | MEDLINE | ID: mdl-17969444

ABSTRACT

All type I IFNs act through a single cell surface receptor composed of the IFNAR1 and IFNAR2 subunits and two associated cytoplasmic tyrosine kinases of the Janus family, Tyk2 and Jak1. A central issue in type I IFN biology is to understand how a multitude of subtypes can generate similar signaling outputs but also govern specific cellular responses. This review summarizes results from the last decade that contributed to our current state of knowledge of IFN-receptor complex structure and assembly.


Subject(s)
Receptor, Interferon alpha-beta/physiology , Amino Acid Sequence , Humans , Models, Molecular , Molecular Sequence Data , Receptor, Interferon alpha-beta/chemistry , Receptor, Interferon alpha-beta/genetics , Receptor, Interferon alpha-beta/metabolism
14.
J Mol Biol ; 365(3): 663-79, 2007 Jan 19.
Article in English | MEDLINE | ID: mdl-17070843

ABSTRACT

Proteins bind one another in aqua's solution to form tight and specific complexes. Previously we have shown that this is achieved through the modular architecture of the interaction network formed by the interface residues, where tight cooperative interactions are found within modules but not between them. Here we extend this study to cover the entire interface of TEM1 beta-lactamase and its protein inhibitor BLIP using an improved method for deriving interaction maps based on REDUCE to add hydrogen atoms and then by evaluating the interactions using modifications of the programs PROBE, NCI and PARE. An extensive mutagenesis study of the interface residues indeed showed that each module is energetically independent on other modules, and that cooperativity is found only within a module. By solving the X-ray structure of two interface mutations affecting two different modules, we demonstrated that protein-protein binding occur via the structural reorganization of the binding modules, either by a "lock and key" or an induced fit mechanism. To explain the cooperativity within a module, we performed multiple-mutant cycle analysis of cluster 2 resulting in a high-resolution energy map of this module. Mutant studies are usually done in reference to alanine, which can be regarded as a deletion of a side-chain. However, from a biological perspective, there is a major interest to understand non-Ala substitutions, as they are most common. Using X-ray crystallography and multiple-mutant cycle analysis we demonstrated the added complexity in understanding non-Ala mutations. Here, a double mutation replacing the wild-type Glu,Tyr to Tyr,Asn on TEM1 (res id 104,105) caused a major backbone structural rearrangement of BLIP, changing the composition of two modules but not of other modules within the interface. This shows the robustness of the modular approach, yet demonstrates the complexity of in silico protein design.


Subject(s)
Bacterial Proteins/chemistry , Bacterial Proteins/metabolism , Monomeric GTP-Binding Proteins/chemistry , Monomeric GTP-Binding Proteins/metabolism , Protein Interaction Mapping , Alanine/genetics , Amino Acid Sequence , Binding Sites , Cluster Analysis , Models, Molecular , Molecular Sequence Data , Mutant Proteins/chemistry , Mutant Proteins/metabolism , Mutation/genetics , Protein Binding , Protein Structure, Secondary , Thermodynamics
15.
Article in English | MEDLINE | ID: mdl-16998607

ABSTRACT

Adult cutaneous Langerhans cell histiocytosis (LCH) is a rare disease. We report two cases illustrating the variability of the clinical presentation and the response to treatment. In both cases a remission was achieved: in one case a partial remission with psoralen plus UVA irradiation (PUVA) and methotrexate plus topical corticosteroid ointment; in the other case by treatment with thalidomide. Despite a therapeutic response, both patients later developed haematological malignancies: a chronic myelo-monocytic leukaemia and an acute lymphatic leukaemia. In conclusion, patients with adult cutaneous LCH should be monitored carefully so that a secondary malignancy is not overlooked.


Subject(s)
Hematologic Neoplasms/complications , Histiocytosis, Langerhans-Cell/complications , Adult , Aged , Humans , Male
16.
Andrologia ; 38(4): 152-7, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16872467

ABSTRACT

Phospholipid hydroperoxide glutathione peroxidase (PHGPx) is a selenoprotein belonging to the family of glutathione peroxidases. PHGPx has long been considered a major antioxidant that, in cooperation with vitamin E, protects biomembranes. To determine the expression pattern of PHGPx mRNA in human, quantitative RT-polymerase chain reaction (PCR) analyses using RNA from different embryonal and adult tissues were performed. A predominant expression was found in testes. In spermatozoa, PHGPx was found to be localized in the mid-piece of spermatozoa. We studied the relationship between spermatozoa PHGPx expression, mutations in PHGPx gene and human oligoasthenozoospermia, a defect in which both the number and the motility of spermatozoa are significantly below normal. Spermatozoa specimens from 45 infertile males were analysed for fertility-related parameters according to World Health Organisation and were classified as suffering from oligoasthenozoospermia. Two patients (4.44%) showed no expression of PHGPx and in nine patients (20.00%), a reduced expression of the enzyme was observed. DNA sequences of various regions of the PHGPx gene (coding, 5'flanking region and intron 1) from these patients and 58 fertile volunteers were analysed for mutations by PCR amplification and direct sequencing. Sequence data revealed no cause/effect relationship for any of the variants. From these data it can be concluded that oligoasthenozoospermia is associated with a decrease in the level of expression of PHGPx in the spermatozoa of some infertile men (24.44%), but is not linked to mutations in PHGPx gene.


Subject(s)
Gene Expression Regulation, Enzymologic , Glutathione Peroxidase/genetics , Oligospermia/enzymology , Oligospermia/genetics , Female , Humans , Infertility, Male/enzymology , Infertility, Male/genetics , Male , Mutation , Phospholipid Hydroperoxide Glutathione Peroxidase , RNA/genetics , RNA/isolation & purification , Reverse Transcriptase Polymerase Chain Reaction , Sperm Motility
17.
J Affect Disord ; 88(3): 307-12, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16182374

ABSTRACT

BACKGROUND: Beta-arrestins interfere in G protein-receptor interaction leading to desensitization of G protein-mediated receptor signaling. G protein-receptor signaling and its desensitization were previously implicated in the pathophysiology, diagnosis and treatment of mood disorders. The present study aims at evaluating alterations in beta-arrestin1 protein and mRNA levels in mononuclear leukocytes of untreated patients with major depression and the effects and time course of antidepressant treatments on these alterations. METHODS: Repeated beta-arrestin1 protein and mRNA measurements, through immunoblot analyses using monoclonal antibodies against beta-arrestin1 and reverse transcriptase polymerase chain reaction, respectively, were carried in mononuclear leukocytes of 18 patients with major depression and compared with 18 healthy subjects. Each patient was examined while untreated and after 1, 2, and 4 weeks of antidepressant treatment. RESULTS: Beta-arrestin1 protein and mRNA levels in mononuclear leukocytes of untreated patients with major depression were significantly lower than those of healthy subjects. The low beta-arrestin1 protein and mRNA levels were alleviated by antidepressant treatment. Normalization of beta-arrestin1 measures preceded, and thus predicted clinical improvement. CONCLUSIONS: These findings support the implication of beta-arrestin1 in the pathophysiology of major depression and in the mechanism underlying antidepressant-induced receptor down-regulation and therapeutic effects. Beta-arrestin1 measurements in patients with depression may potentially serve for biochemical diagnostic purposes and for monitoring and predicting response to antidepressants.


Subject(s)
Arrestins/biosynthesis , Depressive Disorder/drug therapy , Depressive Disorder/physiopathology , Adult , Arrestins/analysis , Female , Humans , Leukocytes/physiology , Male , Middle Aged , RNA, Messenger/analysis , RNA, Messenger/biosynthesis , Reverse Transcriptase Polymerase Chain Reaction , beta-Arrestins
18.
Cytogenet Genome Res ; 111(2): 179-81, 2005.
Article in English | MEDLINE | ID: mdl-16103662

ABSTRACT

Small supernumerary marker chromosomes (sSMC) are small additional chromosomes characterizable for their origin only by molecular cytogenetic approaches. sSMC have been reported previously in four types of syndromes associated with chromosomal imbalances: in approximately 150 cases with Turner syndrome, 26 cases with Down syndrome and only one case each with Klinefelter syndrome and "Triple-X"-syndrome. Here we report the second case with an sSMC detected in addition to a Klinefelter karyotype. Molecular cytogenetics applying centromere-specific multicolor FISH (cenM-FISH) and a specific subcentromere-specific (subcenM-FISH) probe set characterized the sSMC as a dic(9)(:p12-->q11.1::q11.1--> p11.1:). The reported patient was described with hypogonadism, gynaecomastia plus a bronchial carcinoma. The patient's clinical features are discussed in connection with other Klinefelter cases and possible consequences of presence of the sSMC(9). Furthermore, a suggestion is made for the mode of sSMC-formation in this case.


Subject(s)
Chromosomes, Human, Pair 9 , Klinefelter Syndrome/genetics , Adenocarcinoma/surgery , Adult , Chromosome Mapping , Gene Duplication , Genetic Markers , Humans , In Situ Hybridization, Fluorescence , Karyotyping , Lung Neoplasms/surgery , Male , Oligospermia/genetics
19.
Transfusion ; 45(7): 1073-83, 2005 Jul.
Article in English | MEDLINE | ID: mdl-15987350

ABSTRACT

BACKGROUND: An ongoing issue in transfusion medicine is whether newly identified or emerging pathogens can be transmitted by transfusion. One method to study this question is through the use of a contemporary linked donor-recipient repository. STUDY DESIGN AND METHODS: The Retrovirus Epidemiology Donor Study Allogeneic Donor and Recipient (RADAR) repository was established between 2000 and 2003 by seven blood centers and eight collaborating hospitals. Specimens from consented donors were collected, components from their donations were routed to participating hospitals, and recipients of these units gave enrollment and follow-up specimens for long-term storage. The repository was designed to show that zero transmissions to enrolled recipients would indicate with 95 percent confidence that the transfusion transmission rate of an agent with prevalence of 0.05 to 1 percent was lower than 25 percent. RESULTS: The repository contains pre- and posttransfusion specimens from 3,575 cardiac, vascular, and orthopedic surgery patients, linked to 13,201 donation specimens. The mean number of RADAR donation exposures per recipient is 3.85. The distribution of components transfused is 77 percent red cells, 13 percent whole blood-derived platelet concentrates, and 10 percent fresh frozen plasma. A supplementary unlinked donation repository containing 99,906 specimens from 84,339 donors was also established and can be used to evaluate the prevalence of an agent and validate assay(s) performance before accessing the donor-recipient-linked repository. Recipient testing conducted during the establishment of RADAR revealed no transmissions of human immunodeficiency virus, hepatitis C virus, or human T-lymphotropic virus. CONCLUSIONS: RADAR is a contemporary donor-recipient repository that can be accessed to study the transfusion transmissibility of emerging agents.


Subject(s)
Blood Banks , Blood Donors , Hospitals , Transfusion Reaction , Virus Diseases/blood , Virus Diseases/transmission , Acquired Immunodeficiency Syndrome/blood , Acquired Immunodeficiency Syndrome/transmission , HTLV-I Infections/blood , HTLV-I Infections/transmission , HTLV-II Infections/blood , HTLV-II Infections/transmission , Hepatitis, Viral, Human/blood , Hepatitis, Viral, Human/transmission , Humans , Prevalence , Transplantation, Homologous , United States , Virus Diseases/epidemiology
20.
Transfusion ; 45(7): 1089-96, 2005 Jul.
Article in English | MEDLINE | ID: mdl-15987352

ABSTRACT

BACKGROUND: Calculation of viral residual risk is dependent on estimating incidence, which is not easily obtainable by most blood centers. Prevalence, however, is readily available. Understanding whether prevalence reflects corresponding incidence may help blood centers monitor disease risks. STUDY DESIGN AND METHODS: With data on 12 million allogeneic donations, prevalence and incidence of transfusion-transmitted viral infections (TTVIs) were calculated. Relationships between prevalence (in total, first-time, and repeat donations) and incidence were analyzed for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) relative to temporal and donor demographic stratifications, respectively. RESULTS: Overall prevalence of HIV, HBV, and HCV did not consistently reflect corresponding incidence. The relationship between prevalence and incidence varied with time and donors' age and was virus-specific. CONCLUSION: Incidence of TTVIs cannot be easily predicted from overall prevalence. Accurate assessment of TTVI risk necessitates knowledge about donation histories and person-years at risk. Establishing comprehensive frameworks for monitoring blood donations and infectious disease markers remains a key to monitoring blood safety.


Subject(s)
Blood Donors , Blood Transfusion , Virus Diseases/epidemiology , Virus Diseases/transmission , Blood Banks/standards , Blood Donors/statistics & numerical data , Cross-Sectional Studies , Deltaretrovirus Infections/epidemiology , Deltaretrovirus Infections/transmission , Demography , HIV Infections/epidemiology , HIV Infections/transmission , Hepatitis B/epidemiology , Hepatitis B/transmission , Hepatitis C/epidemiology , Hepatitis C/transmission , Humans , Incidence , Prevalence , Risk , United States/epidemiology
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