Recenti progressi in medicina
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Review Clinical Trial
[Clinical use of virally inactived plasma. The experience of Blood Transfusion Unit in Mantova, Italy].
Fresh Frozen Plasma (FFP) is a blood component whose clinical use is widespread worldwide. Transfusion safety of this product is ensured by legally obligatory tests. Although these tests are carried out on each plasma donation, safety levels can be further improved by using some technical procedures, such as, among others, methylene blue (MB) and solvent-detergent (SD) viral inactivation methods. The DMTE (Blood Transfusion Unit) in Mantova has used the pharmaceutical-like SD virally inactivated plasma since 2007 (Plasmasafe, Kedrion) as replacement of the PFC by each single donor. Guidelines for the usage of both products are the same. ⋯ The results of our study clearly document that Plasmasafe, a virally inactivated pharmaceutical-like product with a standardized content of coagulation factors, is a safe and cost-effective treatment, able to rapidly correct hemostatic abnormalities, for critical patients.
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Head trauma is one of the most frequent disabling diseases, with annual incidence of approximately 250-600 patients per 100,000, and mortality of 17 cases per 100,000. The mild head injury is nearly 15 times more frequent than the moderate, and more than 20 times than the severe. Although there are still contradictions regarding the clinical significance of the term "head injury", it can not be considered synonymous with traumatic brain injury. ⋯ Patients with GCS <14 are subjected to CT, those with values GCS14-15 without risk factors are discharged, whereas protein S100B is assessed stat in those with GCS 14-15 and the presence of risk factors. According to the value of the marker, patients with a concentration below the diagnostic cut-offs are discharged, whereas CT is performed in those with higher concentrations. By combining the percentage of positive CT scans in patients with mild head trauma and the negative predictive value of protein S100B, this protocol would safely abate unnecessary CT by 30-50% and costs by 28%.