Search Results (12)

Background: The aim of this study was to analyse the results of the mastoid obliteration technique with sticky bone (SB) and compare them with those obtained using bioactive glass S53P4 (BAG). Methods: This prospective preliminary study comprised 28 adults who underwent canal wall down (CWD) surgery using two mastoid obliterative techniques: SB (n = 21) or BAG (n = 7). The SB group was treated with the patients’ own bone dust and injectable platelet rich fibrin (IPRF) (n = 13%) or bone dust, IPRF, and additionally allogenic lyophilised demineralised bone (n = 9%). Results: Nine months after the surgery, in the SB group, retroauricular depression was observed in three (14%) patients, temporary retroauricular fistula in one (5%), and a conical and smooth external auditory canal (EAC) was achieved in 15 (71%). Mean EAC capacity was 0.6 mL higher than in the contralateral ear. In the SB group, the tympanic membrane (TM) of nineteen (91%) patients was fully healed, one (5%) had TM perforation, and one (5%) developed a retraction pocket. In the BAG group, retroauricular depression was observed in four (57%) patients, temporary retroauricular fistula was present in one (14%), and a conical and smooth EAC was achieved in five (71%). Mean EAC capacity was 0.3 mL higher than on the opposite side. In the BAG group, we stated six (86%) patients with fully healed TM and one (14%) with a retraction pocket. One cholesteatoma was found in the BAG group and two in SB, (14% vs. 10%). After 9 months, all patients in both groups achieved a dry and self-cleaning cavity. Conclusions: Mastoid obliteration in CWD surgery using SB or BAG allows for reconstruction of the conical shape of the EAC with a volume similar to that of a healthy ear. Both techniques seem to have a minimal risk of complications and result in a dry, self-cleaning cavity. Further studies concerning a larger series of cases are necessary to confirm the findings of this preliminary analysis. Full article

Persistent-breeding-induced endometritis (PBIE) is the leading cause of subfertility and poor reproductive efficiency in mares. Platelet-rich plasma (PRP) treatment has been shown to mitigate PBIE, reduce uterine infections, and improve fertility in mares. However, the proteome of PRP in mares, particularly those susceptible to PBIE, remains unknown. This study aimed to fill this knowledge gap by comparing the most abundant proteins present in PRP prepared from mares with histories of being susceptible or resistant to PBIE. The study involved twelve light-breed mares: seven susceptible and five resistant to PBIE. A complete blood count and physical examination were performed on each mare before blood drawing to ensure good health. The PRP was prepared following collection in a blood transfusion bag and double centrifugation. Platelet counts in the PRP were compared across the groups. The PRP was cryopreserved in liquid nitrogen until proteomics could be completed. Physical parameters and complete blood cell counts were within normal ranges. The platelet counts for resistant (561 ± 152 × 10³) and susceptible mares (768 ± 395 × 10³) differed (p < 0.05). One hundred and five proteins were detected in all mares, and four proteins were more abundant in resistant mares (p < 0.05). The proteins were apolipoprotein C-II, serpin family G member 1, protection of telomeres protein 1, and non-specific serine/threonine protein kinase. All these proteins are linked to the immune response. These results suggest that PRP prepared from mares resistant to PBIE may be more beneficial in mitigating PBIE in mares, offering a promising avenue for improving equine reproductive health. However, this remains to be determined with in vivo studies. Full article

Transfusion-transmitted bacterial infection (TTBI) is the leading cause of transfusion-transmitted infections. Platelet components are more likely to be associated with bacterial contamination due to their storage requirements. Australian Red Cross Lifeblood introduced the bacterial contamination screening (BCS) of all platelet components in 2008. The process was recently updated with the use of BACT/ALERT^® VIRTUO^®, a large-volume delayed sampling (LVDS) protocol and extending platelet shelf-life to seven days. This article describes the results from the routine BCS of platelet components in Australia. Use of VIRTUO has resulted in lower false-positive rates, reducing wastage and improving platelet inventory. Our findings show that the combination of LVDS and VIRTUO improves the safety of platelet transfusions through earlier time to detection, especially for pathogenic bacterial species. Pathogenic bacteria grew within 24 h of incubation with a clear delineation between pathogenic and non-pathogenic species. The data show this protocol is very safe, with no TTBI cases during this time. There were no TTBI reports in recipients of platelet components that subsequently had a positive culture with Cutibacterium species, probably due to the low pathogenic potential of these organisms and slow replication in aerobic platelet bags. We conclude there is no advantage in incubating culture bottles beyond five days. Full article

Dimethyl sulfoxide (DMSO) is regularly used as a cryoprotectant agent for the cryopreservation of platelets. However, DMSO is considered toxic. We therefore hypothesized that saline could be used as a non-toxic medium for the cryopreservation of platelets. Double-dose buffy coat platelets (n = 10) were divided and cryopreserved at −80 °C using 5–6% dimethyl sulfoxide (DMSO) or in NaCl (9 mg/mL). Paired testing was conducted pre-freeze, post-thaw (PT 1 h). Upon analysis, each bag was thawed and reconstituted in fresh plasma. Analyses included cell counts and the metabolic, phenotypic, and functional properties of the platelets together with thromboelastometry. The cryopreserved platelets showed several biochemical and ultrastructural changes compared to pre-freezing. Platelet recovery was approximately 17% higher in DMSO-free units (p < 0.001), but the platelet viability was reduced (p < 0.001). However, using controlled freezing (n = 6), the platelet viability was improved. The clot formation time (CFT) was comparable, but DMSO-free platelets showed slightly decreased maximum clot firmness (MCF) (p = 0.034). By reducing the reconstituted plasma volume, a reduced CFT and increased MCF were obtained (p < 0.001). This study demonstrates that platelets can be cryopreserved in saline without the addition of DMSO, with high recovery and maintained hemostatic function. However, controlled freezing is required to optimize platelet quality. Full article

Lead (Pb), mercury (Hg), and cadmium (Cd) are identified as potent developmental neurotoxicants. Neonates are the main group receiving multiple blood transfusions. The exposure of neonates to these heavy metals (HMs) can occur through blood transfusions. This study aimed to determine the concentrations of lead (Pb), mercury (Hg), and cadmium (Cd) in various blood products (plasma, platelets, packed red blood cells (pRBCs), and whole blood (WB)) to explore the probability of concurrent exposure of these HMs and to identify the metal load per transfusion with risk assessment. Residual bloods from blood bank bags were collected after neonatal transfusion. Pb, Hg, and Cd concentrations were determined in 120 samples of blood products by inductively coupled plasma mass spectrometry (ICP-MS). Pb and Cd levels were over the normal levels in 19.2 and 5.9% of all blood units, respectively. In 35 and 0.8% of blood units, the Pb and Cd concentrations, respectively, were higher than that recommended for transfusions in premature neonates. The anticipated safe value was surpassed by 2.5% for Cd of all transfusions, primarily because of WB. However, Hg was detected only in 5.8% of all samples and their concentrations were within the normal range. The concurrent neonatal exposure to Pb, Hg, and Cd was statistically significant. Hazard quotients of Hg and Cr were >1 and Pb cancer risk was 2.41 × 10⁻⁴. To the best of our knowledge, this study is the first report examining Pb, Hg, and Cd in blood products other than WB and pRBCs using ICP-MS. This study demonstrated the exposure of neonates to Pb, Hg, and Cd during transfusion with a considerable amount of Pb. It confirms the significant concurrent exposure to the three HMs, which maximize their potential developmental neurotoxicity with a high probability of developing non-carcinogenic and carcinogenic health effects. Full article

Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity worldwide. This study aimed to develop and validate a predictive model for PPH after vaginal deliveries, based on routinely available clinical and biological data. The derivation monocentric cohort included pregnant women with vaginal delivery at Brest University Hospital (France) between April 2013 and May 2015. Immediate PPH was defined as a blood loss of ≥500 mL in the first 24 h after delivery and measured with a graduated collector bag. A logistic model, using a combination of multiple imputation and variable selection with bootstrap, was used to construct a predictive model and a score for PPH. An external validation was performed on a prospective cohort of women who delivered between 2015 and 2019 at Brest University Hospital. Among 2742 deliveries, PPH occurred in 141 (5.1%) women. Eight factors were independently associated with PPH: pre-eclampsia (aOR 6.25, 95% CI 2.35–16.65), antepartum bleeding (aOR 2.36, 95% CI 1.43–3.91), multiple pregnancy (aOR 3.24, 95% CI 1.52–6.92), labor duration ≥ 8 h (aOR 1.81, 95% CI 1.20–2.73), macrosomia (aOR 2.33, 95% CI 1.36–4.00), episiotomy (aOR 2.02, 95% CI 1.40–2.93), platelet count < 150 Giga/L (aOR 2.59, 95% CI 1.47–4.55) and aPTT ratio ≥ 1.1 (aOR 2.01, 95% CI 1.25–3.23). The derived predictive score, ranging from 0 to 10 (woman at risk if score ≥ 1), demonstrated a good discriminant power (AUROC 0.69; 95% CI 0.65–0.74) and calibration. The external validation cohort was composed of 3061 vaginal deliveries. The predictive score on this independent cohort showed an acceptable ability to discriminate (AUROC 0.66; 95% CI 0.62–0.70). We derived and validated a robust predictive model identifying women at risk for PPH using in-depth statistical methodology. This score has the potential to improve the care of pregnant women and to take preventive actions on them. Full article

Transfusion-associated bacterial infections continue to occur which may be due to the formation of bacterial biofilms on the inner surface of the blood bag. Plasticized poly (vinyl chloride) (p-PVC) platelet storage bags in three surface roughness states (rough, smooth and flattened) were used to determine the effect that a conditioning film (CF) of human plasma had on surface properties and its interaction with Staphylococcus epidermidis and Serratia marcescens. SEM and optical profilometry determined changes in surface roughness, whilst EDX and ATR-FTIR determined surface chemistry. The physicochemistry of the surfaces and bacteria was assessed using contact angle measurements and MATH assays respectively. When applied to a rougher surface, the CF reduced the surface topography, masked certain surface chemistry features and made the surfaces more hydrophilic. The CF reduced the adhesion of the bacteria to most of the hydrocarbons. When human plasma was combined with bacteria, most of the physicochemical properties changed similarly to those of human plasma alone, with the most significant changes observed after 24 h especially with Ser. marcescens. The results demonstrated that the presence of human plasma had a significant effect on the surface properties of the platelet bags and also on microbial interactions with the bag surface. Full article

Cardiovascular diseases have been identified as one of the top three causes of death worldwide, with onset and deaths mostly due to heart failure (HF). In ICU, where patients with HF are at increased risk of death and consume significant medical resources, early and accurate prediction of the time of death for patients at high risk of death would enable them to receive appropriate and timely medical care. The data for this study were obtained from the MIMIC-III database, where we collected vital signs and tests for 6699 HF patient during the first 24 h of their first ICU admission. In order to predict the mortality of HF patients in ICUs more precisely, an integrated stacking model is proposed and applied in this paper. In the first stage of dataset classification, the datasets were subjected to first-level classifiers using RF, SVC, KNN, LGBM, Bagging, and Adaboost. Then, the fusion of these six classifier decisions was used to construct and optimize the stacked set of second-level classifiers. The results indicate that our model obtained an accuracy of 95.25% and AUROC of 82.55% in predicting the mortality rate of HF patients, which demonstrates the outstanding capability and efficiency of our method. In addition, the results of this study also revealed that platelets, glucose, and blood urea nitrogen were the clinical features that had the greatest impact on model prediction. The results of this analysis not only improve the understanding of patients’ conditions by healthcare professionals but allow for a more optimal use of healthcare resources. Full article

Our research group, through the analysis of miRNomes in platelet concentrates (PCs) stored in blood banks, identified and validated the miR-127 and miR-320a miRNAs as biomarkers of platelet storage lesions (PSLs) in PCs. In order to validate the miRNAs 127 and 320a methodologically, as PSL biomarkers in a large number of PC bags, we also evaluated important immunological markers involved in the platelet activation/aggregation process—the CD62P receptor (P-selectin), the surface glycoproteins (GP) IIb/IIIa, and the purinergic P2Y12 receptor—via flow cytometry. The miRNAs miR-127 and miR-320a were quantified by real-time quantitative PCR (RT-qPCR). To carry out this study, 500 collection tubes were used at the upper edge of the PC bags containing platelets. Each tube was divided into seven equal parts (totaling 3500 samples) for platelet analysis from 7 different storage days, where the 1st day represents the high-quality control, and the 7th day corresponds to the low-quality control of the platelets. After analyzing all parameters during storage days, it was concluded that the relative quantification of miR-320a below 0.50 and the CD62P receptor below 27.92% are reliable indicators of the absence of storage lesions in blood banks. We believe that the values found in the expression of the CD62P receptor legitimize the use of the miR-320a and miR-127 miRNAs to build a kit capable of accurately measuring whether the stored platelets are suitable for transfusion. Full article

Potentially toxic plasticizers are commonly added to polyvinyl chloride medical devices for transfusion in order to improve their flexibility and workability. As the plasticizers are not chemically bonded to the PVC, they can be released into labile blood products (LBPs) during storage. Ideally, LBPs would be used in laboratory studies of plasticizer migration from the medical device. However, short supply (i.e., limited stocks of human blood in collection centres) has prompted the development of specific simulants for each type of LBP in the evaluation of new transfusion devices. We performed a Delphi study with a multidisciplinary panel of 24 experts. In the first (qualitative) phase, the panel developed consensus definitions of the specification criteria to be met by each migration simulant. Next, we reviewed the literature on techniques for simulating the migration of plasticizers into LBPs. A questionnaire was elaborated and sent out to the experts, and the replies were synthesized in order to obtain a consensus. The qualitative study established specifications for each biological matrix (whole blood, red blood cell concentrate, plasma, and platelet concentrate) and defined the criteria required for a suitable LBP simulant. Ten criteria were suggested: physical and chemical characteristics, opacity, form, stability, composition, ability to mimic a particular clinical situation, ease and safety of use, a simulant–plastic interaction correlated with blood, and compatibility with analytical methods. The questionnaire data revealed a consensus on the use of natural products (such as pig’s blood) to mimic the four LBPs. Opinions diverged with regard to synthetic products. However, an isotonic solution and a rheological property modifier were considered to be of value in the design of synthetic simulants. Consensus reached by the Delphi group could be used as a database for the development of simulants used to assess the migration of plasticizers from PVC bags into LBPs. Full article

In light of PRP’s increasing popularity in veterinary practice, this study aimed to compare three manual methods to prepare and cool equine PRP. The blood of 18 clinically healthy mares was collected via venipuncture in a blood transfusion bag (method 1), blood tubes (method 2), and a syringe (method 3). In method 1, samples were double centrifuged; method 2 involved one centrifugation, and in method 3 the syringe was kept in an upright position to sediment for 4 h. After processing with three methods, PRP and platelet-poor plasma (PPP) were extracted and assessed for red (RBC) and white blood cell counts (WBC), platelet counts, and viability. In a subset of mares (n = 6), samples were processed with the three methods, and PRP was evaluated at 6 and 24 h postcooling at 5 °C. Method 1 resulted in the highest and method 3 in the lowest platelet concentration (p < 0.05), and the latter also had greater contamination with WBC than the others (p < 0.001). Platelet viability was similar across treatments (p > 0.05). Cooling for 24 h did not affect platelet counts in all methods (p > 0.05); however, platelet viability was reduced after cooling PRP produced by method 3 (p = 0.04), and agglutination increased over time in all methods (p < 0.001). The three methods increased (1.8–5.6-fold) platelet concentration in PRP compared to whole blood without compromising platelet viability. In conclusion, all three methods concentrated platelets and while cooling affected their viability. It remains unknown whether the different methods and cooling would affect PRP’s clinical efficacy. Full article

Background: Platelet concentrate (PC) is one of the main products used in a therapeutic transfusion. This blood component requires special storage at blood banks, however, even under good storage conditions, modifications or degradations may occur and are known as platelet storage lesions. Methods: This research was performed on scientific citation databases PubMed/Medline, ScienceDirect, and Web of Science, for publications containing platelet storage lesions. The results obtained mainly reveal the clinical applicability of miRNAs as biomarkers of storage injury and as useful tools for a problem affecting public and private health, the lack of PC bags in countries with few blood donors. The major studies listed in this review identified miRNAs associated with important platelet functions that are relevant in clinical practice as quality biomarkers of PC, such as miR-223, miR-126, miR-10a, miR-150, miR-16, miR-21, miR-326, miR-495, let-7b, let-7c, let-7e, miR-107, miR-10b, miR-145, miR-155, miR-17, miR-191, miR-197, miR-200b, miR-24, miR-331, miR-376. These miRNAs can be used in blood banks to identify platelet injury in PC bags. Conclusion: The studies described in this review relate the functions of miRNAs with molecular mechanisms that result in functional platelet differences, such as apoptosis. Thus, miRNA profiles can be used to measure the quality of storage PC for more than 5 days, identify bags with platelet injury, and distinguish those with functional platelets. Full article