RESUMO
The author offers information on the training of security officers, legal powers and limitations of officers, general duties of security officers, and special problems to be dealt with.
Assuntos
Capacitação em Serviço/métodos , Recursos Humanos em Hospital/educação , Medidas de Segurança/normas , Direito Penal , Incêndios/prevenção & controle , Humanos , Transtornos Mentais , Greve , Estados UnidosAssuntos
Transplante de Células-Tronco Hematopoéticas , Síndrome de Job/terapia , Linfoma de Células B/terapia , Linfoma Difuso de Grandes Células B/terapia , Terapia Combinada , Evolução Fatal , Humanos , Síndrome de Job/complicações , Síndrome de Job/imunologia , Linfoma de Células B/complicações , Linfoma Difuso de Grandes Células B/complicações , Masculino , Pessoa de Meia-Idade , Fibrose Pulmonar/etiologiaRESUMO
BACKGROUND: Accurately predicting the outcomes of peripheral blood stem cell harvests is important because unproductive collections are expensive and subject the donor to unnecessary toxicity. STUDY DESIGN AND METHODS: Predictive factors for stem cell mobilization and collection by a retrospective review of 104 consecutive donors were evaluated. RESULTS: Of several previously suggested measures, the peripheral CD34+ cell concentration on the day of harvest (pCD34DH) correlated best with total numbers of CD34+ collected (r = 0.88). This was followed by the pCD34 on the day before harvest (pCD34Day -1) (r = 0.74). The peripheral WBC count on the day of harvest (pWBC) was inferior (r = 0.39). When ratios of potential predictive factors divided by the previous day's value were examined, pWBC ratio was found to be a significant independent predictive factor for cells collected (r = 0.45). Furthermore, the predictive value of both the pCD34Day -1 and the pWBC can be improved by combining with the pWBC ratio. To examine whether the chosen collection starting days were optimal, serial pCD34 obtained daily during the harvest procedures was examined. Poorly mobilizing donors, who required several days of collection, did not reach maximal harvest yields until the fourth collection day. CONCLUSIONS: pCD34DH is the optimal predictive factor for harvest yields. If pCD34DH is not available, pCD34Day -1 or pWBC combined with the pWBC ratio may offer the best prediction of harvest outcomes. The best harvest yields on poorly mobilizing donors occur 3 to 4 days after the usual collection starting times.
Assuntos
Antígenos CD34/metabolismo , Doadores de Sangue , Mobilização de Células-Tronco Hematopoéticas , Células-Tronco Hematopoéticas/metabolismo , Adulto , Idoso , Contagem de Células Sanguíneas , Tratamento Farmacológico , Feminino , Fator Estimulador de Colônias de Granulócitos/farmacologia , Células-Tronco Hematopoéticas/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Proteínas Recombinantes/farmacologia , Estudos RetrospectivosRESUMO
The combination of multiple surgical procedures is attractive and convenient to the patient. Increased awareness of wound healing difficulties and pulmonary complications, however, suggest caution with this approach, particularly when combining abdominal lipectomy with intraabdominal procedures. This study confirms the high risk of pulmonary emboli in patients with combined abdominal lipectomy and intraabdominal gynecological procedures. The use of perioperative warfarin may reduce the incidence of pulmonary embolism in patients who have combined abdominal lipectomy and gynecological surgical procedures, and it is not associated with increased bleeding or other postoperative complications.