Steps Forward to a Fair and Inclusive Blood Supply

Οι μεταγγίσεις αίματος αποτελούν δομικό στοιχείο του συστήματος περίθαλψης. Είναι υποχρέωση του κράτους να εξασφαλίζει την ασφάλεια και τη διαθεσιμότητα αίματος για τους ασθενείς που χρειάζονται μεταγγίσεις. Τα ιδανικά συστήματα συλλογής και διάθεσης αίματος βασίζονται στην εθελοντική και μη αμειβόμενη αιμοδοσία. Οι ανάγκες αίματος στην Ελλάδα είναι ιδιαίτερα αυξημένες λόγω του υψηλού αριθμού ατόμων που πάσχουν από αιμοσφαιρινοπάθειες και του μεγάλου αριθμού τροχαίων ατυχημάτων. Σκοπός της παρούσας μελέτης είναι η οργάνωση του συστήματος συλλογής και διάθεσης αίματος στην Ελλάδα ώστε να εξυπηρετεί τις ανάγκες των πασχόντων από συγγενείς αιμοσφαιρινοπάθειες, οι οποίοι χρειάζονται τακτικές μεταγγίσεις για όλη τους τη ζωή. Προκειμένου να είναι αποτελεσματικό το σύστημα αιμοδοσίας στην Ελλάδα, θα πρέπει οι παροχές αίματος να υπερκαλύπτουν τις ανάγκες. Για να επιτευχθεί αυτό, βάσει του προτεινόμενου στην παρούσα εργασία συστήματος αιμοδοσίας, οι αιμοδότες θα πρέπει να παραμείνουν εθελοντές και μη αμειβόμενοι, ενώ η ενημέρωση και ευαισθητοποίησή τους θα πρέπει να πραγματοποιείται ταυτόχρονα από πολλά διαφορετικά μέσα και με αυξημένη συχνότητα. Συγκεκριμένα, προτείνεται η παροχή μαζικών συμβουλών μέσω των μέσων μαζικής ενημέρωσης, ο ενεργός ρόλος των κλινικών και της εκκλησίας. Επίσης, ενδεικτικά, προτείνεται να γίνεται προσπάθεια αντιμετώπισης των κυριότερων φόβων των αιμοδοτών καθώς και να περιλαμβάνεται ένα «μάτι» σε προσωπικά email ή μηνύματα που θα αποστέλλονται στους πολίτες.

Optimal blood donation screening annotation.

Improving Patient Outcomes by Standardizing Care

The future of health professions education: Emerging trends in the United States.

Over the past decade, there has been an explosion in the use of molecular tests to diagnose and manage infectious diseases. HIV is a prime example of an infectious agent whose diagnosis at least in the acute stage, susceptibility testing, and management are all dependent on molecular diagnostics. The ability to accurately diagnose a plethora of respiratory pathogens quickly, simply, and relatively inexpensively compared to traditional methods is becoming a reality. Direct sequencing and microarray analysis holds great promise for directly detecting a wide variety of organisms from clinical specimens. The question is where this testing should be done in the clinical laboratory. There are at least four models that have emerged: Molecular infectious disease testing as an arm of the clinical microbiology laboratory. Molecular infectious disease testing done in a central molecular pathology laboratory under the leadership of a clinical microbiologist. Molecular infectious disease testing done in a central molecular pathology laboratory under the leadership of an individual whose primary interest is in another area of molecular pathology. Molecular infectious disease testing sent to a reference laboratory and not done on site or within the institution's health care system. We have asked three individuals who have thought about this very complex issue to share their rationale for supporting one of these models. Frederick Nolte is the Director of Clinical Laboratories and Director of Molecular Pathology at the Medical University of South Carolina, is active in and held several positions of responsibility in AMP (Association of Molecular Pathology) and is Chair of the CLSI's Area Committee for Molecular Methods, Alex McAdam is the Director of the Infectious Diseases Diagnostic Division at Children's Hospital Boston and an editor of this journal, and his colleague, Nima Mosammaparast, is the Assistant Director of the Infectious Diseases Diagnostic Laboratory at Children's Hospital Boston.

Health Systems Need to Transform Data Collection to Advance Health Equity.

Blood transfusion service is a health care effort that utilizes human blood as a basic ingredient with humanitarian purposes and not for commercial purposes. Blood transfusion services as one of the health efforts in order to cure disease and health recovery desperately require the availability of blood or adequate blood components, safe, accessible and affordable by the community. Each blood transfusion unit has a responsibility to meet the availability of blood in its working area. Blood availability is highly dependent on the willingness and awareness of people to donate their blood voluntarily and regularly. To achieve this, blood transfusion units need to conduct donor recruitment activities which include socialization efforts and campaign of voluntary blood donor, donor deployment and donor preservation. The need for blood is increasing in this world where 1 patient from 7 patients who are hospitalized requires a blood transfusion. Imbalance between blood supply and blood needs is increasing in the world. Currently only in 62 countries, blood supplies of 100% are derived from voluntary blood donors and 40 other countries still depend on family darai donors and paid blood donors. From the results of location analysis and info from blood transfusion Unit RS, Dr. Setomo, Surabaya PMI about the problems of lack of blood stocks at a certain moment, then make us perform a lack of public awareness about the blood Donor This, thereby giving our infiration to give intervention, counseling, convey that being a blood Donor can increase the stamina and occurrence of new erythrocytes, which can facilitate blood circulation and make the body healthier. Plan, create a community Web Site that is interested in becoming a voluntary blood Donor, so that the community is moved to become a voluntary blood Donor, of course not be separated must fulfill the requirements that the blood donation is worthy as Blood and healthy Donor, appropriate Perturan. Install Bener on a specific place, make a bag, T-shirt, key toy, a zipper box, and other knacks that can be used as the community Logo voluntary blood donor, in hopes of increasing the necessary blood stocks society. From the new results we perform to attract voluntary blood donors. Through the appeal to come to the counseling and to share Leaflet only at this early stage, there have been obtained result of increased blood stock from the results of voluntary blood donation after Community service. Obtained significant results, where there is an increase in the amount of blood in PMI, after the implementation of blood donation. There is an increase in blood stocks at that time as much as 40-50%, from the results of community devotion.

The period from the mid-1980s to the present has seen a virtual revolution in how blood collection, testing, and transfusion are carried out. Most of the changes that have occurred represent changes in organization, underlying paradigms of transfusion safety, and approaches to solutions to perceived problems, rather than technical or scientific advances. These changes were instituted with little or no data to support their safety and efficacy, much less their cost-effectiveness. Using data on changes in fees charged by regional blood centers during this period, an estimate was generated of the costs attending the purely administrative and organizational changes in the field of transfusion medicine. The additional expenditures, excluding inflation, are in the range of $226 million per year. This figure does not include changes in infectious disease testing on donated blood, the substantive scientific advance during this period. In addition to the questions of safety and efficacy, which are traditionally considered prior to clinical or procedural changes of this magnitude, the question remains whether these expenditures are a reasonable trade-off of cost versus benefit. Similar applications of federal regulatory standards intended for manufacturing (eg, good manufacturing practices) and industrial management theory (eg, total quality management) are now being implemented or proposed for hospitals, health care delivery systems, and individual physician's practices. Thus, the case of transfusion medicine may provide some cautionary lessons for future proposed changes in health care delivery and medical practices.

Background:Nowadays, one of the main challenges of the blood transfusion organization is the procurement, distribution, and monitoring of the appropriate use of blood and its products. Therefore, the aim of this study was to investigate the prevalence of Transfusion Transmitted Infections (TTIs) including human immunodeficiency virus (HIV+), hepatitis B virus (HBV+), and hepatitis C virus (HCV+), and also to determine the relationship between the prevalence of Transfusion Transmitted Infections and characteristics of Infected blood donors, which can be useful in the selection of blood donors. Methods: This retrospective study was conducted on all blood donors in Kerman Province during five years (from March 2014 to February 2019). Individuals whose initial test and supplementary test results were positive, were considered as definitely positive. Chi-square test was used to investigate the relationship between measured factor and outcome. Data were analyzed by SPSS version 20. Statistically significant value was considered at P≤0.05. Results: After confirmatory tests, it was revealed that 500 cases were infected with one of the three blood-borne viruses of HIV+, HBs+, and HCV+. Considering a 95% confidence interval, the prevalence of HIV+, HBs+, and HCV+ was, 0.0006%, 0.1%, and 0.04%, respectively. There was a significant relationship between the prevalence of infections and age, educational status (P=0.008), and donation status (P=0.007), but there was no significant relationship between the prevalence of infections and gender and marital status (P>0.05). Conclusion: The overall prevalence of TTIs among blood donors of Kerman province was 0.14%, indicating that the prevalence of TTIs is very low, it can be due to the appropriate screening of blood donors prior to the blood donation and performing advanced screening approved by the World Health Organization. According to the results, the healthiest blood donors are regular blood donors and those with a history of blood donation.

We studied the effect of blood transfusions (BT) from different H-2 donors on the induction of suppressor cells (SC) and of MLC inhibitory activity in serum in a drug-unmodified mouse model. Balb/c (H-2d) mice were transfused at weekly intervals with whole blood from donors of three strains using two transfusion protocols. In protocol I, blood was transfused first from C3H/HeJ (C3H) (H-2k), then C57Bl (H-2b), and then SJL (H-2s) strain mice, and in protocol II the order of blood donors was reversed. Spleen cells and serum samples were obtained from the transfused mice one and two weeks after the last BT. In both transfusion protocols, the kinetics of responses of cells from recipient transfused mice to cells from the blood donors in MLC were similar to those of cells from nontransfused mice. The peak responses of cells from transfused mice were consistently lower than those of cells from nontransfused mice. In cell-mixing experiments, radiosensitive SC capable of inhibiting responses of Balb/c mice to cells from all three blood donors in MLC could be demonstrated one week after the last transfusion in both protocols. Two weeks after the last BT, SC were demonstrable only against the first (C3H) blood donor in protocol I, and against all three blood donors in protocol II. Serum obtained one week after transfusion in protocol I inhibited responses of Balb/c mice to stimulator lymphocytes from all three blood donors in MLC. Serum obtained two weeks after BT, however, inhibited responses of recipient mice only to the first blood donor. In contrast, in protocol II, serum obtained both one and two weeks after BT did not cause inhibition of responses of cells from Balb/c mice to blood donor cells in MLC. Similar results were obtained when Balb/c mice were transfused at weekly intervals with whole blood from either C3H or from SJL mice. The data suggest that the induction of SC and/or MLC-inhibitory activity in the serum after BT is dependent on the H-2 type of the first blood donor.

To investigate the hepatitis C virus (HCV) infection rate among general population in Jiangsu province and to analyze the main risk factors for HCV infection. Subjects in 3 counties were surveyed by stratified cluster random sampling in the National Major Science and Technology Projects demonstration area in Jiangsu province. Interview was carried out with uniformly- designed questionnaires. Blood samples were collected and anti-HCV tested. Data were analysed under SPSS 13.0. Case-control study was conducted on two groups with subjects under 1:4 matching by sex, age, village of residence and status of HCV infection. Cox's proportional hazards regression analysis was then performed to analyze the risk factors for HCV infection. The positive rate of anti-HCV was higher in females (0.965%, 95%CI:0.899%-1.035%) than in males (0.572%, 95%CI:0.517%-0.632%). Significant differences were noticed among the positive rates of anti-HCV in the three counties (0.131%, 95%CI:0.103%-0.164%;0.316%, 95%CI: 0.268%-0.370%; 2.173% , 95% CI:2.039%-2.315% , respectively). Peak prevalence of anti-HCV (1.577%, 95%CI:1.425%-1.740%) was observed among persons at 50-59 years of age. Bottom rate (0.161%, 95%CI:0.125%-0.204%) was observed below 30 years of age. High anti-HCV positive rate was detected in people with lower education background or belonged to 'floating population'. Factors as having histories of hospitalization (OR = 3.049, 95% CI:1.322-7.036), blood transfusion (OR = 14.319, 95%CI:2.318-88.459) or sharing razor (OR = 3.604, 95%CI:1.096-11.851) were risk factors of HCV infection in the area with the lowest anti-HCV positive rate. In another county, factor as having histories of 'blood products transfusion' (OR = 7.202, 95% CI:1.170-44.310) appeared important while in the third county, having history of 'blood donation' (OR = 7.496, 95%CI:6.121- 9.180); 'blood transfusion' (OR = 2.305, 95%CI:1.578-3.369) and 'invasive physical examination' (OR = 1.258, 95% CI:1.021-1.549) appeared to be important. Age seemed a risk factor for HCV infection. "Sharing razor" was a specifically important risk factor among the 30- year-olds. "Having received acupuncture" was noticed a risk factor only among people at 50-59 years of age while "Having received invasive physical examination" was important in the 50-59 and 60-69 year-olds. High anti-HCV positive rate was observed in people at middle of aged population, as well as in those with poor education or under 'floating'. Unsafe blood donation or having received blood-product transfusion might be the risk factors in the last decades. Factors as sharing razor, having received acupuncture or invasive examination might be specifically risky in different populations.

Background: Blood transfusion is considered an important life-saving treatment in the medical field, saving millions of lives. In blood transfusion practice, blood donor selection is the first and most important step to safeguard the health of both donors and recipients. Donors may be deferred permanently or temporarily due to various reasons during the screening procedure. This study was carried out to understand the reasons for donor deferral and deferral rates at our blood center. Methods: A retrospective study was conducted at the Blood Center, GMERS Medical College and Hospital, Gotri, Vadodara, Gujarat, for the period of January 2022 to June 2023. Relevant data on total blood donations and donor deferrals were retrieved from the donor registration form and analyzed. Results: Out of a total of 6054 blood donors, 721 (11.9%) were deferred. Amongst them, 89.74% were temporarily deferred and 10.26% were permanently deferred. The most common cause for temporary deferral was anemia (Hemoglobin < 12.5 gm%), comprising 53.47%, and the most common cause for permanent deferral was RPR positive status, comprising 40.54%. Conclusion: Donor selection is a crucial step for safe and healthy blood transfusion. Understanding the reasons for donor deferral can greatly aid in blood donor recruitment efforts, especially targeting temporarily deferred young adult donors who can be returned to the donor pool.

Patient-Centered Outcomes Research: Early Evidence From A Burgeoning Field.

Seroprevalence of Kaposi's Sarcoma-Associated Herpesvirus Infection among Blood Donors from Texas

Background Transfusion-transmissible infections (TTIs) are life-threatening for patients requiring blood transfusion. The prevalence of these blood-borne infections among blood donors may reflect the burden of these diseases among populations in developing countries. Unsafe blood transfusion remains a major global health problem; therefore, TTIs are an important issue in transfusion medicine. Patients and methods A cross-sectional study was undertaken during March 2017 to June 2017 to focus on the magnitude of blood-borne infections among blood donors at Port Sudan Central Blood Bank and to assess the characteristics of reactive and nonreactive blood donors as well as association between coinfection and blood types. A total of 513 donors were encountered, and each blood donor was screened for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis immunologically. Results A total of 513 blood donors were enrolled in this study. Of these, 501 (97.7%) were males and 12 (2.3%) were females, with mean age of 32±9.7 years (range: 17–60 years); all of them are replacement blood donors. Overall, 103 (20.1%) blood donors were reactive, with 97 (18.9%) reactive for one blood-borne infection and six (1.1%) coinfected with two of the four TTIs. The prevalence of HBV, HCV, HIV, and syphilis accounts for 11.7, 0.4, 1.4, and 6.6%, respectively. Six (1.1%) of the study blood donors were coinfected: four (0.8%) with HBV–syphilis and two (0.4%) with HBV–HIV. Conclusion TTIs is outstretched among the blood donors and have increased significantly over time. Stringent selection of blood donors is highly recommended to emphasize the safety of blood to the recipient. However, switch to central blood transfusion service rather than replacement donation may help to reduce the dangerous effect of TTIs.