First-time whole blood donation: A critical step for donor safety and retention on first three donations.

AIM OF THE STUDY: Whole blood donation is generally safe although vasovagal reactions can occur (approximately 1%). Risk factors are well known and prevention measures are shown as efficient. This study evaluates the impact of the donor's retention in relation to the occurrence of vasovagal reaction for the first three blood donations. MATERIAL AND METHODS: Our study of data collected over three years evaluated the impact of classical risk factors and provided a model including the best combination of covariates predicting VVR. The impact of a reaction at first donation on return rate and complication until the third donation was evaluated. RESULTS: Our data (523,471 donations) confirmed the classical risk factors (gender, age, donor status and relative blood volume). After stepwise variable selection, donor status, relative blood volume and their interaction were the only remaining covariates in the model. Of 33,279 first-time donors monitored over a period of at least 15 months, the first three donations were followed. Data emphasised the impact of complication at first donation. The return rate for a second donation was reduced and the risk of vasovagal reaction was increased at least until the third donation. CONCLUSION: First-time donation is a crucial step in the donors' career. Donors who experienced a reaction at their first donation have a lower return rate for a second donation and a higher risk of vasovagal reaction at least until the third donation. Prevention measures have to be processed to improve donor retention and provide blood banks with adequate blood supply.

Comparison of continuous versus intermittent administration of zolpidem in chronic insomniacs: a double-blind, randomized pilot study.

The subjective efficacy and safety of intermittent administration of a hypnotic for insomnia was assessed, since such a regime may provide a potential means of reducing the risk of habituation and dependence. A total of 160 adult patients (mean 45 years) with chronic insomnia were treated for 2 weeks with zolpidem, 10 mg, either continuously or intermittently (five nights zolpidem, two consecutive nights placebo per week) in this multicentre, out-patient, pilot study. At the end of the 2-week treatment, patients subjectively estimated their nightly total sleep time as 6.96 +/- 1.19 h (from 6.07 +/- 1.25 h at baseline) and 6.94 +/- 1.30 h (from 5.72 +/- 1.46 h) after the continuous and intermittent treatments, respectively. Patients' reports did not indicate any differences between the two groups in global evaluation of impairment, sleep quality, or the incidence of adverse events. These results suggest that the efficacy and safety of zolpidem, 10 mg, are comparable whether the drug is administered every night or intermittently. Further studies with a broader well-defined patient base, are needed to confirm these data.