RÉSUMÉ
OBJECTIVES: This study aimed to analyse motivational factors for blood donation in different donor groups. BACKGROUND: As the demographic change will result in a decrease of the population in age groups of blood donors, the risk of blood product shortage increases. METHODS: During a 12-month period, every sixth blood donor presenting at the blood donation centre of the University Hospital was asked to complete a self-administered questionnaire assessing motivational factors for blood donation. Despite the formalised enrolment protocol, frequent donors were over-represented in the study cohort, which was adjusted by weighting donors with different numbers of donations per year in such a way that the distribution of numbers of donations per year was the same in the sample as in the donor population. RESULTS: Of 2443 participants, 14·3% were first-time and 85·3% repeat donors. To "help other people" (>90%) and receiving "medical assessment of my blood values" (63-69%) were the strongest motivational factors in all donor groups. Receiving remuneration (49·2% vs 38·1%) was more important for repeat donors than for first-time donors, whereas it was the opposite for "being taken by a friend to the donor clinic" (47·0% vs 15·5%). A potentially important observation is that 33·9% of frequent donors reported feeling physically better after blood donation compared to infrequent donors (29·5%). CONCLUSION: Identification of motivational factors can lead to the design of targeted motivation campaigns for blood donation. The underlying cause of the perceived well-being after blood donation requires further studies.
Sujet(s)
Donneurs de sang , Motivation , Enquêtes et questionnaires , Adolescent , Adulte , Sujet âgé , Études transversales , Femelle , Allemagne , Humains , Mâle , Adulte d'âge moyenRÉSUMÉ
BACKGROUND: Heparin, the standard perioperative anticoagulant for the prevention of graft vessel thrombosis in patients undergoing liver transplantation (LT), binds to the chemokine platelet factor 4 (PF4). Antibodies that are formed against the resulting PF4/heparin complexes can induce heparin-induced thrombocytopenia. LT is a clinical situation that allows the study of T-cell dependency of immune responses because T-cell function is largely suppressed pharmacologically in these patients to prevent graft rejection. OBJECTIVES: To investigate the immune response against PF4/heparin complexes in patients undergoing LT. PATIENTS AND METHODS: In this prospective cohort study, 38 consecutive patients undergoing LT were systematically screened for anti-PF4/heparin antibodies (enzyme immunoassay and heparin-induced platelet aggregation assay), platelet count, liver function, and engraftment. RESULTS: At baseline, 5 (13%) of 38 patients tested positive for anti-PF4/heparin IgG (non-platelet-activating) antibodies. By day 20, an additional 5 (15%) of 33 patients seroconverted for immunoglobulin G (two platelet-activating) antibodies. No patient developed clinical heparin-induced thrombocytopenia. Two of six patients with graft function failure had anti-PF4/heparin IgG antibodies at the time of graft function failure. Graft liver biopsy samples from these patients showed thrombotic occlusions of the microcirculation. CONCLUSIONS: Anti-PF4/heparin IgG antibodies are generated despite strong pharmacologic suppression of T cells, indicating that T cells likely have a limited role in the immune response to PF4/heparin complexes in humans.
Sujet(s)
Anticoagulants/effets indésirables , Occlusion du greffon vasculaire/induit chimiquement , Héparine/effets indésirables , Immunoglobuline G/sang , Transplantation hépatique/effets indésirables , Facteur-4 plaquettaire/immunologie , Thrombopénie/induit chimiquement , Thrombose/induit chimiquement , Adulte , Sujet âgé , Anticoagulants/immunologie , Biopsie , Femelle , Occlusion du greffon vasculaire/diagnostic , Occlusion du greffon vasculaire/immunologie , Héparine/immunologie , Humains , Immunosuppresseurs/usage thérapeutique , Tests de la fonction hépatique , Mâle , Adulte d'âge moyen , Numération des plaquettes , Études prospectives , Lymphocytes T/immunologie , Thrombopénie/diagnostic , Thrombopénie/immunologie , Thrombose/diagnostic , Thrombose/immunologie , Facteurs temps , Résultat thérapeutiqueSujet(s)
Plaquettes/effets des médicaments et des substances chimiques , Hématologie/normes , Hémostase/effets des médicaments et des substances chimiques , Antiagrégants plaquettaires/composition chimique , Collecte de données , Hématologie/méthodes , Hémorragie/prévention et contrôle , Humains , Coopération internationale , Guides de bonnes pratiques cliniques comme sujet , Risque , Sociétés médicales , Thromboembolie/prévention et contrôle , Thrombose/prévention et contrôle , Résultat thérapeutiqueSujet(s)
Acide acétylsalicylique/pharmacocinétique , Perte sanguine peropératoire/prévention et contrôle , Services des urgences médicales , Antiagrégants plaquettaires/pharmacocinétique , Transfusion de plaquettes , Hémorragie postopératoire/prévention et contrôle , Ticlopidine/analogues et dérivés , Sujet âgé , Sujet âgé de 80 ans ou plus , Acide acétylsalicylique/administration et posologie , Acide acétylsalicylique/effets indésirables , Acide acétylsalicylique/sang , Clopidogrel , Calendrier d'administration des médicaments , Association de médicaments , Urgences , Femelle , Allemagne , Humains , Mâle , Adulte d'âge moyen , Projets pilotes , Antiagrégants plaquettaires/administration et posologie , Antiagrégants plaquettaires/effets indésirables , Antiagrégants plaquettaires/sang , Transfusion de plaquettes/effets indésirables , Hémorragie postopératoire/étiologie , Soins préopératoires , Appréciation des risques , Facteurs de risque , Ticlopidine/administration et posologie , Ticlopidine/effets indésirables , Ticlopidine/sang , Ticlopidine/pharmacocinétique , Résultat thérapeutiqueRÉSUMÉ
BACKGROUND: Venous thromboembolism (VTE) is a multi-factorial disease. Extensive thrombophilia screening is costly and often inconclusive. Simple laboratory methods are required to predict the risk of recurrence. OBJECTIVE: To assess if measurement of activated partial thromboplastin time (APTT) allows stratification of patients with VTE into high- and low-risk categories with regard to recurrence. PATIENTS AND METHODS: We prospectively followed 918 patients with a first unprovoked VTE and studied the relationship between recurrence and an APTT after discontinuation of anticoagulation. APTT was expressed as a ratio of test to reference coagulation times. Study endpoint was symptomatic recurrent VTE. RESULTS: Venous thromboembolism recurred in 101 (11%) patients. Patients without recurrence had a greater APTT ratio than those with recurrence (0.97 +/- 0.09 vs. 0.93 +/- 0.09, P = 0.001). After 4 years, probability of recurrent VTE was 8.5% (95% CI: 5.5-11.5%) among patients with a ratio equal to or > 0.95 and 15.6% (95% CI: 11.4-19.9%) among patients with a lower ratio (P = 0.005). Compared with patients with an APTT ratio < 0.95, the relative risk (RR) of recurrence among patients with a ratio equal to or > 0.95 was 0.56 (95% CI: 0.38-0.84, P = 0.005) before and 0.58 (95% CI: 0.39-0.87, P = 0.009) after adjustment for sex, age, factor V Leiden, and factor II G20210A. CONCLUSIONS: Measurement of APTT allows stratification of patients with VTE into high- and low-risk categories with regard to recurrence.