Archives of pathology & laboratory medicine
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Arch. Pathol. Lab. Med. · Jun 2007
Comparative StudyMethylation profiles of multiple CpG island loci in extrahepatic cholangiocarcinoma versus those of intrahepatic cholangiocarcinomas.
CpG island hypermethylation is attracting attention because of its importance as a tumor marker and its potential mechanism for the development of human cancers. Extrahepatic cholangiocarcinoma has been poorly investigated with respect to CpG island hypermethylation, and the number of genes known to be methylated in extrahepatic cholangiocarcinomas is fewer than 20. ⋯ A close relationship exists between CpG island hypermethylation and nodal metastasis of extrahepatic cholangiocarcinomas. Methylation profiles of extrahepatic cholangiocarcinomas are somewhat similar to but distinct from those of intrahepatic cholangiocarcinomas.
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We provide an overview of the principles of blood management: the appropriate use of blood and blood components, with a goal of minimizing their use. ⋯ Blood management is most successful when multidisciplinary, proactive programs are in place so that these strategies can be individualized to specific patients.
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Arch. Pathol. Lab. Med. · May 2007
ReviewOxygen therapeutics: pursuit of an alternative to the donor red blood cell.
There is no true substitute for the many functions of human red blood cells, and synthetic products will not replace the need for blood donation in the foreseeable future. Hemoglobin-based oxygen carriers have many characteristics that would serve as a useful adjunct to red cells in clinical settings. Over time, these technologies have the potential to dramatically reshape the practice of transfusion medicine. ⋯ Recognition of the true impact of red cell substitutes is still several years away. The most compelling products, hemoglobin-based oxygen carriers, have potential use in trauma, providing immediate oxygen-carrying support in the face of alloantibodies or autoantibodies, and in other clinical situations in which long-term survival of red cells is not essential. In the interim, efforts should be focused on enhancing the current blood supply system while supporting ongoing and planned blood substitute research efforts, including trials assessing novel clinical indications for these products.
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Arch. Pathol. Lab. Med. · Apr 2007
Ensuring timely completion of type and screen testing and the verification of ABO/Rh status for elective surgical patients.
A blood bank can provide compatible blood for an elective surgical procedure, provided a blood sample is received by the laboratory with sufficient time to allow pretransfusion testing and acquire enough compatible red blood cell units. With the push for same-day admission surgical procedures, a patient's pretransfusion blood sample is often collected the morning of surgery. However, if blood is needed, compatible units might not be immediately available. ⋯ Timely receipt of a presurgical specimen for type and screen testing and verification of a patient's ABO/Rh status can be ensured when clinical services collaborate and when the hospital blood utilization committee provides oversight to improve compliance.
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Arch. Pathol. Lab. Med. · Mar 2007
Comparative StudyThe impact of amino-terminal pro-brain natriuretic peptide testing on hospital length of stay and morbidity in patients with acute decompensated heart failure.
In clinical trials, N-terminal pro-brain natriuretic peptide (NT-proBNP) testing has been shown to be valuable for diagnosis and triage of patients with acute decompensated heart failure. It is not yet clear what benefits might be expected from the initiation of NT-proBNP testing in an everyday clinical setting. ⋯ Implementation of NT-proBNP testing may result in significant reductions in hospital length of stay as well as improvements in rates of morbidity and mortality in patients with acute decompensated heart failure.