Anger over HIV questions cancels blood clinic at Ottawa university

Ottawa''s Carleton University cancelled a February blood-donor clinic after the Red Cross failed to hold sensitivity-training sessions for its volunteers. The sessions were requested after students complained that the organization''s screening procedures are insensitive and offend gay students. The Red Cross maintains that rigorous screening, including questions about high-risk sexual behaviour, is essential if the blood supply is to be protected. In March a compromise was announced: the Red Cross will begin sensitivity training for its volunteer workers in April and blood-donor clinics will return to Carleton in the fall.     

Registry of unrelated bone marrow donors.

Reports of successful transplantation of bone marrow obtained from unrelated donors who were histocompatibility leukocyte antigen (HLA) identical prompted the Canadian Red Cross Blood Transfusion Service in Ottawa to assess the possibility of developing a bone marrow donor registry in Canada. We sent a pamphlet that explained the program to 1568 people who had undergone apheresis and asked them to reply, stating their interest. At the same time the pamphlets and a poster were placed in the blood donor clinic. We received 1232 replies (78.6%) from the apheresis donors, 838 (68.0%) of which indicated a willingness to attend information sessions. Of the 7158 people who gave blood during the 3-month study period, 225 (3.1%) were interested. At the time this paper was written 47 information sessions had been held, and 721 people had attended, 624 (86.5%) of whom had signed a consent form. This indicates a clear interest in a bone marrow donation program. We believe that the ethical issues are overcome by requesting the donation before identification of any patient. From our experience a national registry of unrelated donors seems feasible, and steps are being taken to implement such a program.     

HIV-specific antibody among voluntary blood donors in Lower Saxony (FRG)

Anti-HIV test results of the Red Cross Blood Transfusion Service of Lower Saxony from 1 June 1985 to 31 July 1986 inclusive were analysed retrospectively. Nine out of 70,936 donors who had not donated blood before 1 June 1985 (first-time donors) and 9 out of 261,231 donors who had donated blood before this date (repeating donors) were found anti-HIV confirmed positive at the time of the first blood donation during the study period. The prevalence of HIV antibody in first-time donors was significantly higher than in repeating donors (p less than 0.01). It was concluded that some members of risk groups used blood donation to obtain an anti-HIV test result. One out of 30,300 blood donations was confirmed anti-HIV positive. The results of this study justify the transfusion of blood donations that are reactive only in the initial ELISA test.     

Frequency of anemia in Rostock students]

For the purpose of determining the frequency of anaemia a check-up was made in 735 students (498 females, 237 males) at an age of at least 19 years at the beginning of their university studies. 9.4% of them had subnormal haemoglobin values. 91.3% of them were female students. A comparison between the test persons with a decrease of haemoglobin values and those without it on the one hand and data gathered from the students' health certificate on the other hand, revealed no ensured aetiologic connection. Analyzing the state of health of that group with lowered Hb-values showed that more than half of them suffered from diseases (mostly infections) at the time, when the blood examination was made. A check-up made one year later resulted in a high percentage of normalized values. Comparisons taken from medical literature clearly indicate that the frequency of anaemia of this student population examined here is relatively low in total. From an organizational point of view, complete check-up examinations shoudl be carried out or induced for female students by the outpatient departments working at the institutions of higher learning because they provide better possibilities of covering them.     

Seroepidemiology of hepatitis C virus infection in Japan and HCV infection in haemodialysis patients

Abstract: Since January 1990, Japanese Red Cross Blood Centres have introduced hepatitis C virus screening with a first-generation ELISA. From April to December 1992, approximately 0.98% among 10905 489 blood donations screened by a second-generation assay were anti-HCV-positive in all Japan. Seropositivity of anti-HCV increased with the age and serum transminase value in both sexes. In blood donors having a history of transfusion, the anti-HCV reactive rate was 7.4%. The results of the study made by the Japanese Red Cross Non-A, Non-B Hepatitis Research Group show the effectiveness of implementation of HCV screening to prevent posttransfusion hepatitis. Consecutive haemodialysis patients with chronic renal failure are at risk for inflection by a variety of blood-borne agents transmitted within dialysis units. Because of their immunocompromised state, they frequently also have an unusual susceptibility to a variety of nosocomial infections, such as HBV, and HTLV-I. We tested the prevalence of anti-HCV in 1423 (848 males and 575 females) haemodialiysis patients from 18 hospitals in Kumamoto Prefecture, Japan using the Orhto first generation anti- HCV screening assay. There were 316 patients (22.2%) positive for HCV antibodies. The second-generation test was positive in most haemodialysis patients who were eractive to the firs-generation assay. The prevalence of HCV infection increased with the duration of haemodialysis, yet there was a high frequency of HCV seropositivity even wihtout blood transfusion. Acquisition of HCV in dialysis patients could be explained by HCV seropositivity even without blood (all haemodialysis are done with disposable kits, and needles), by secondary HCV infection after the immunodeficiency of haemodialysis, or by HCV infection of the kidney or glomerular deposition of immune HCV/anti-HCV complexes leading to chronic renal failure (as with HBV infection of the liver and kidney).     

Retroviral infections transmitted by blood transfusion

Modifications in donor screening and the introduction of laboratory testing of donated blood for anti-HIV-1 and anti-HTLV-I have resulted in a significant reduction in the risks of retroviral infections from blood transfusion. Presently, the American Red Cross detects an average of eight carriers of human immunodeficiency virus, type 1 (HIV-1) per 100,000 otherwise acceptable blood donors (0.008 percent), compared with an average of 35 per 100,000 (0.035 percent) when testing for HIV-1 antibodies began in 1985. Surveillance studies in the United States indicate a small likelihood that HIV-2 carriers will pass current screening procedures and be accepted as blood donors. Even if an HIV-2-infected person were to be accepted as a blood donor, there is a 42-92 percent likelihood that this person's blood would be detected as infective for HIV-2 and excluded because of serological cross-reactions that occur in the EIA for HIV-1 antibodies. During 1989, which was the first year that donated blood was routinely tested for antibodies to human T-lymphotropic virus, type I (HTLV-I) in the United States, approximately nine in 100,000 donors (0.009 percent) were confirmed positive for antibodies to HTLV-I, and their donated blood was excluded. Subsequent testing has revealed that a significant number of these persons whose sera was reactive by the HTLV-I EIA were, in fact, infected by HTLV-II. Epidemiological studies of human retroviral infections (HIV-1, HIV-2, HTLV-I, and HTLV-II) continue to provide important data and direction for improving criteria for qualifying blood donors.     

Concern mounts as transfusion medicine loses its lustre

Transfusion medicine is in trouble. Several factors, ranging from the tainted-blood scandal to changes in the way the system operates, mean that young physicians are avoiding the specialty. Dr. Antonio Giulivi of the Red Cross says the issue is serious because these specialists act as the system''s overseers, and this fact won''t change when the Red Cross gets out of the blood business in September.     

Frequency of hepatitis B antigen in blood donors

Routine testing of all blood donations for hepatitis B antigen by counter-immunoelectrophoresis was started in April 1971. The frequency of HBAg carriers among apparently healthy volunteer blood donors in the Toronto Centre of the Canadian Red Cross Blood Transfusion Service was 15 in 10,000 with a male:female ratio of 6:1. Excluding penitentiary inmates, the highest incidence was among young, male, non-Anglo-Saxon city dwellers.A system of notification of HBAg-positive donors was developed, through which a carrier is referred to a special clinic for clinical and pathological evaluation.A survey of hospital patients indicated an incidence of HB antigen 3.5 times that of our healthy donor population. A comparison of the number of post-transfusion hepatitis cases occurring before and after the commencement of routine testing for HBAg showed a marked reduction in reported cases in 1971.     

Donor issues in Indonesia: A developing country in South East Asia

In most developing countries in South East Asia blood services have not been treated properly as an important service to support health program. Indonesia as a large archipelago country in South East Asia has specific obstacles in managing a blood service. To position the country blood service profile especially in term of donor issues, we compared our blood service with that in other South East Asia countries.Indonesia has 17 thousand islands with 220 million inhabitants. Blood services have been mostly run by the Indonesian Red Cross as a government assignment since 1950. Donor recruitment programs have been directed toward 100% of Voluntary Non Remunerated Blood Donor (VNRD), which now have reached 81.3%. Dissemination of information on VNRD, donor recruiter's training and VNRD appreciation programs are strategies to increase and maintain the VNRD.Limited female donors and insufficient blood supply during the fasting month and holidays constitute major challenges. Low hemoglobin level, low body weight and fear are reasons for low number of female donors. Poor management of blood stock during fasting month, long holidays and also poor networking of blood supply are reasons for insufficient blood supply during the year.Considering the great size of Indonesia with different ethnic groups and cultures, worsened by lack of infrastructure, decisive and effective strategies in donor recruitment and retention programs are needed.     

Effect of a Preparative Technique on the Viability of Concentrated Red Cells

In a study of the technique employed by the Canadian Red Cross Blood Transfusion Service in Montreal, the authors found that the packed red blood cells from 10 healthy donors had a mean hematocrit of 83 ± 1.45 with a 24-hour red cell survival after three weeks'' storage of 79.4 ± 2%. The technique used a centrifugal force of 6975 G, the practical maximum of present-day equipment. In addition to finding excellent survival of packed cells subjected to extreme plasma deprivation and extreme forces of centrifugation they also report excellent survival of stored, highly concentrated red cells infused under pressure.     

A Hemodilution Technique for Open-Heart Surgery: A Preliminary Clinical Report

With the extension of open-heart procedures and the increasing success of open-heart surgery, a great strain has been placed on many hospital laboratories and on the Red Cross for the maintenance of equipment and the supply of blood. In order to decrease both of these needs, hemodilution techniques combined with disposable oxygenators have been introduced. The authors have used a disposable oxygenator with low molecular weight dextran prime, along with moderate hypothermia, in a consecutive series of 15 patients operated upon for congenital and acquired heart lesions. In this consecutive series there has been one death and this could not be attributed to the perfusion technique but to the surgical procedure carried out. It is felt that this combination not only broadens the horizons of open-heart surgery but makes the procedure more readily available and safer, as well as being economical of blood donors and time.     

Exogenous bacterial contamination of donor blood.

The Canadian Red Cross blood transfusion service has followed a set protocol for phlebotomy and collection of a unit of blood. Recent requirements for automated testing have necessitated that a second tube of blood be obtained from the blood line following collection of the unit. Evaluation of the techniques used, however, has indicated the possibility of bacterial contamination from the skin of donors, from insertion of the needle through an unsterile rubber stopper, and through backflow from a nonsterile vacuum tube. To test these possibilities swabs were taken from skin and stoppers of vacuum tubes. Further, vacuum tubes were deliberately contaminated with Escherichia coli. The normal sampling procedure, which involves stripping the donor line to refill and mix the blood, was then followed. This resulted in contamination of the segments and even the blood bag. These findings led to modification of the standard bleeding technique, whereby stripping was eliminated and sterile vacuum tubes were to be used at all times.     

Risk Estimation of HNA-3 Incompatibility and Alloimmunization in Thai Populations

Severe transfusion-related acute lung injury (TRALI) is often due to antibodies in blood components directed against human neutrophil antigen (HNA)-3a. This study aimed to report the genotype frequencies of the HNA-3 system and to estimate the potential risk of HNA-3 incompatibility and alloimmunization in two Thai populations. Eight hundred DNA samples obtained from 500 unrelated healthy blood donors at the National Blood Centre, Thai Red Cross Society, Bangkok and 300 samples from the Blood Bank, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand were included. HNA-3 genotyping was performed using an in-house polymerase chain reaction with sequence-specific primer (PCR-SSP) technique. The observed frequencies of the HNA-3a/3a, HNA-3a/3b, and HNA-3b/3b genotypes were 0.528, 0.380, and 0.092 in central Thais and 0.600, 0.350, and 0.050 in northern Thais, respectively. The frequencies were used to estimate HNA-3 incompatibility and risk of HNA-3a alloimmunization. The HNA-3 incompatibility in central Thais (33.28%) was higher than northern Thais (28.75%), corresponding to a significantly higher probability of HNA-3a alloimmunization (P<0.05) similar to Japanese and Chinese populations. This study showed the high risk of HNA-3 incompatibility and alloimmunization, especially in central Thai blood donors. A molecular-based identification of the HNA-3 genotype of female donors is suggested to reduce the risk of TRALI following plasma and whole blood allogeneic transfusion.     

Recruiting unrelated donors for the National Marrow Donor Program

Medical advances have made bone marrow transplantation the treatment of choice for certain hematologic diseases. For those patients eligible for a marrow transplant only about 30 percent find an HLA-compatible match within their families. Studies indicate that unrelated volunteers are willing to donate their marrow. The National Marrow Donor Program was formed in 1986 as a result of a federal contract. This group is a network of donor centers, transplant centers, and collection centers. The Connecticut Red Cross Blood Services is one of approximately 70 donor centers. Recruitment methods vary with each donor center, depending on the resources available. The Connecticut Red Cross Blood Services has recruited more than 1,000 volunteers for entry into the National Marrow Donor Program.     

“岗课赛证”四位一体“动物微生物”课程教学改革探索与实践

为适应当前职业教育政策,积极推进高水平职业院校“岗课赛证”综合育人课程建设,“动物微生物”课程教学团队进行“岗课赛证”四位一体课程教学改革,以岗位能力培养为核心,以职业标准和技能大赛为引导制定课程标准,编写特色教材,通过任务驱动法、项目式教学法和引“赛场”入课堂教学方法提高课堂教学效果,打造优质教育教学资源,加强课程师资力量建设,实现岗位、课程、大赛、证书的互为融通,把学生培养为企业需要的高素质技能型人才,全面提升教学质量。     

The pharyngeal beta-hemolytic streptococcal carrier state among blood donors

459 blood donors aged 18-50 years were examined in 1987-1988 in Moscow. Among them, carrier state with respect to beta-hemolytic streptococci was detected in 107 donors (23.3%). The number of carriers gradually decreased with the increase of age of the examined donors. Group C streptococci occurred least of all (6.9%). Group A beta-hemolytic streptococci were isolated in 16.7% of the carriers. The isolation rate of streptococci from blood achieved its maximum in autumn and winter months and did not depend on preceding diseases, unhealthy working conditions, the rhesus factor and, with the exception of group A streptococci, the blood group. Among tonsillectomized donors carrier state with respect to beta-hemolytic streptococci occurred 2.2 times less frequently than among donors who had not undergone tonsillectomy. Carrier state with respect to beta-hemolytic streptococci was accompanied by higher levels of salivary sIgA antibodies to polysaccharide A, serum antibodies to polysaccharide A and circulating polysaccharide A. All beta-hemolytic streptococci were sensitive to erythromycin. All groups of streptococci showed the highest percentage of cultures resistant to gentamicin and tetracycline. In 100% of cases group A streptococci were sensitive to benzylpenicillin, methicillin, ampicillin, erythromycin and lincomycin.     

Hepatitis B antigen in Montréal blood donors: childhood institutionalization as an epidemiologic factor.

In 1971 the Canadian Red Cross blood tranfusion service instituted routine screening for HBAg of all blood donors, using nationwide a standardized counterimmunoelectrophoretic technique. The prevalence of carriers in the Province of Québec is unusually high (0.51%), being 3 to 12 times higher than in the other nine provinces. Among the carriers found in the Montréal area 289 volunteered to be seen by our group for an extensive interview and a series of laboratory tests. There were 243 men and 46 women; their ages ranged from 18 to 55, 90% being less than 40. Twenty-nine were of foreign origin and 260 were born in Canada. The epidemiologic data revealed that the reservoir of HBAg carriers among the blood donors of the Montréal area was found predominantly in the autochthonous population of French origin. Moreover, it appeared that 149 (52%) had lived in institution when they were infants or children: 127 were orphans and had been placed in institutions as newborns or babies, and 22 others had lived in institutions for at least 1 year between the ages of 5 and 10. This was by far the most important single epidemiologic factor that could contribute to the explanation of the abnormally high prevalence of HBAg carriers in the population studied.     

Life or Death Decisions: Framing the Call for Help

Background

Chronic blood shortages in the U.S. would be alleviated by small increases, in percentage terms, of people donating blood. The current research investigated the effects of subtle changes in charity-seeking messages on the likelihood of people responses to a call for help. We predicted that “avoid losses” messages would lead to more helping behavior than “promote gains” messages would.

Method

Two studies investigated the effects of message framing on helping intentions and behaviors. With the help and collaboration of the Red Cross, Study 1, a field experiment, directly assessed the effectiveness of a call for blood donations that was presented as either death-preventing (losses) or life-saving (gains), and as being of either more or less urgent need. With the help and collaboration of a local charity, Study 2, a lab experiment, assessed the effects of the gain-versus-loss framing of a donation-soliciting flyer on individuals’ expectations of others’ monetary donations as well their own volunteering behavior. Study 2 also assessed the effects of three emotional motivators - feelings of empathy, positive affect, and relational closeness.

Result

Study 1 indicated that, on a college campus, describing blood donations as a way to “prevent a death” rather than “save a life” boosted the donation rate. Study 2 showed that framing a charity’s appeals as helping people to avoid a loss led to larger expected donations, increased intentions to volunteer, and more helping behavior, independent of other emotional motivators.

Conclusion

This research identifies and demonstrates a reliable and effective method for increasing important helping behaviors by providing charities with concrete ideas that can effectively increase helping behavior generally and potentially death-preventing behavior in particular.     

Hepatitis B surface antigen: regional variation in sub-type ratio in the Canadian Red Cross donor population.

A total of 344 sera positive for hepatitis B surface antigen from volunteer blood donors at several Canadian Red Cross centres were subtyped for ad and ay specificity by counterelectrophoresis. Of the 50 sera from Toronto 21 (42%) were ad and 29 (58%) were ay; of the 95 from Montreal 82 (86%) were ad and 13 (14%) were ay; of the 199 from Quebec 179 (90%) were ad and only 20 (10%) were ay. The w and r specificities were also determined in 125 of the samples: 123 were w; the 2 samples of r specificity were from Toronto. On the other hand, among 45 sera from patients with acute hepatitis type B in Quebec 13 (29%) were ad and 33 (71%) ay.     

Endogenous lithium and boron red cell-plasma ratios: normal subjects versus bipolar patients not on lithium therapy

This study was undertaken to compare endogenous lithium concentrations in human blood and its components from normal donors versus bipolar patients. The patients were not on lithium therapy at the time that the blood samples were donated and had not received any lithium therapy for at least 2 yr. Blood components were separated by centrifugation. The analytical method for lithium as developed in this laboratory consists of thermal-neutron activation of freeze-dried samples. 3H is produced via the reaction 6Li + n = 3H + 4He, and high-sensitivity rare gas mass spectrometry is used to measure 3He formed from beta-decay of 3H. Boron measurements are made concurrently using 4He from the reaction 10B + n = 4He + 7Li. Seven normal donors and seven patients with a diagnosis of bipolar disorder participated in this study. Measurements of lithium and boron were made in whole blood, plasma, and red cells. Red cell-plasma ratios R(Li) and R(B) were calculated after corrections were made for trapped plasma in the red cells. The results show that bipolar patients may have higher concentrations of lithium in blood, plasma, and red cells (p = 0.08, 0.02, and 0.02, respectively) and may have higher R(Li) values than normal donors (p = 0.01). No evidence was found for bipolar-normal differences in these four parameters for boron. Although our sample size is admittedly very small, the results clearly show that the endogenous red cell ratio R(Li) and plasma or red cell lithium concentrations may become useful diagnostic indicators for bipolar illness if the analytical methods are further developed.