The blood-donation experience: perceived physical, psychological and social impact of blood donation on the donor.

BACKGROUND AND OBJECTIVES: This study aimed to investigate the impact and effects of blood donation on blood donors as perceived and reported by donors themselves. MATERIALS AND METHODS: A self-administered questionnaire was distributed to 600 consecutive whole-blood donors (who had a history of at least one previous donation) consisting of an open-ended question asking whether the blood donation had any impact on the donor. The answers to this question were considered as descriptions of effects perceived by the donors to be evoked by whole-blood donation. RESULTS: In all, 528 subjects completed the questionnaire (88%; 319 males and 209 females) and answered the question about the effects of blood donation. Altogether, 54% (287 out of 528) of the blood donors reported one or several effects. Exclusively positive effects were described by 29% (151) of blood donors, while exclusively negative effects and mixed effects (i.e. concomitant positive and negative effects in the same subject) were described by 19% (103) and 6% (33), respectively, while no effect was reported by 46% (241) of the donors. A majority of the effects commenced within 1 h of blood donation. The positive effects lasted significantly longer (often for weeks, P < 0.0001) than negative effects (min/h/days). Among positive effects a feeling of satisfaction, of being more alert, and feeling generally better than before the blood donation predominated for both female and male donors. Among negative effects, vertigo/dizziness was reported more frequently by female donors (P < 0.0001). Logistic regression analysis revealed that the negative effects were less likely to occur with increasing age (P < 0.001) and that they were more likely to occur in female donors (P < 0.001) in comparison to male donors, irrespective of age. CONCLUSIONS: The majority of effects elicited by blood donation on blood donors were positive (i.e. feelings of satisfaction, greater alertness, increased wellbeing, etc.). The positive effects did not differ from the negative regarding time of onset, yet their duration was reported to be significantly longer. There was no association between frequency of occurrence of positive effects and the number of blood donations, indicating that there is no 'addictive' relationship between donors and blood donations. The findings in this study of high frequency of occurrence of positive long-lasting effects elicited in blood donors by blood donation may be of great importance for the recruitment of new blood donors as it may make blood donation less frightening and perhaps even attractive.

Predictors of radiological progression and changes in hand bone density in early rheumatoid arthritis.

OBJECTIVE: To identify predictors for radiological and functional outcome and bone loss in the hands in early rheumatoid arthritis (RA) during the first 2 yr of disease and to study the relationship between these variables. METHODS: An inception cohort of consecutively recruited patients was examined at baseline and after 12 and 24 months using X-rays of hands and feet, clinical [28-joint count, Health Assessment Questionnaire (HAQ), global visual analogue scale (VAS), grip strength] and laboratory (erythrocyte sedimentation rate, C-reactive protein, markers of bone formation and resorption) measurements and dual-energy X-ray absorptiometry measurements of the hands. RESULTS: Joint destruction increased significantly during the study, with the Larsen score at baseline as the strongest predictor. Radiological progression and bone loss over 24 months were significantly retarded in patients responding to therapy. The effects of the shared epitope and initial high inflammatory activity on radiological progression were overridden by the therapeutic response. Radiological progression correlated significantly with bone loss. Global VAS, Larsen score and HAQ at inclusion significantly predicted change in HAQ over time. CONCLUSIONS: Radiological progression and bone loss were retarded by early therapeutic response. Bone loss was related to radiological progression.

Localization of the gene for congenital dyserythropoietic anemia type III, CDAN3, to chromosome 15q21-q25.

Congenital dyserythropoietic anemia, type III (CDA III) is a rare autosomal dominant disorder characterized by macrocytic anemia, bone marrow erythroid hyperplasia and giant multinucleate erythroblasts. We have genetically characterized a large Swedish family in which the concurrence of CDA III and myeloma or benign monoclonal gammopathy is significantly higher than expected and have found that the causative genetic defect for CDA III maps to an 11 cM interval within 15q21-q25.

Cloning and expression of the histo-blood group Pk UDP-galactose: Ga1beta-4G1cbeta1-cer alpha1, 4-galactosyltransferase. Molecular genetic basis of the p phenotype.

The molecular genetic basis of the P histo-blood group system has eluded characterization despite extensive studies of the biosynthesis of the P(1), P, and P(k) glycolipids. The main controversy has been whether a single or two distinct UDP-Gal:Galbeta1-R 4-alpha-galactosyltransferases catalyze the syntheses of the structurally related P(1) and P(k) antigens. The P(1) polymorphism is linked to 22q11.3-ter. Data base searches with the coding region of an alpha4GlcNAc-transferase identified a novel homologous gene at 22q13.2 designated alpha4Gal-T1. Expression of full coding constructs of alpha4Gal-T1 in insect cells revealed it encoded P(k) but not P(1) synthase activity. Northern analysis showed expression of the transcript correlating with P(k) synthase activity and antigen expression in human B cell lines. Transfection of P(k)-negative Namalwa cells with alpha4Gal-T1 resulted in strong P(k) expression. A single homozygous missense mutation, M183K, was found in six Swedish individuals of the rare p phenotype, confirming that alpha4Gal-T1 represented the P(k) gene. Sequence analysis of the coding region of alpha4Gal-T1 in P(1)+/- individuals did not reveal polymorphisms correlating with P(1)P(2) typing.