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Impact of closed minimal extracorporeal circulation on microvascular tissue perfusion during surgical aortic valve replacement: intravital imaging in a prospective randomized study.

OBJECTIVES: Closed minimal extracorporeal circulation (MECC) systems currently do not represent the standard of surgical care for open-heart surgery. Yet, considering the beneficial results reported for coronary artery bypass graft (CABG) surgery, we used an MECC system in aortic valve replacement (AVR) and analysed the effects on intraoperative microvascular perfusion in comparison with conventional open extracorporeal circulation (CECC). METHODS: In the current study, we analysed alterations in microvascular perfusion at 4 predefined time points (T1-T4) during surgical AVR utilizing orthogo

Cholesterol metabolism in acute upper gastrointestinal bleeding, preliminary observations.

Hypocholesterolemia is commonly found in critically ill patients; however, the aetiology of this condition remains unclear. Several clinical studies refer to the possible negative impact of haemodilution on cholesterol (CH) metabolism in acute medical conditions. The aim of this study was to examine the serum CH profile (total CH, LDL and HDL CH) during acute gastrointestinal bleeding which is a life-threatening condition characterised by alterations in lipid metabolism. Serum non-CH sterols (lathosterol, squalene, sitosterol and campesterol) concentrations as markers of CH synthesis and CH ab

Society for the advancement of blood management administrative and clinical standards for patient blood management programs. 4th edition (pediatric version).

Patient Blood Management is the timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentra … rected therapy based on point of care and viscoelastic testing, antifibrinolytics, and avoidance of hemodilution and hypothermia as supported by evidence. For the full version, please go to https://www.sabm.org/publications.

The quest for quality blood banking program in the new millennium the American way.

For an industry to succeed and satisfy its customers, "QUALITY" must be a primary goal. Quality has been central to blood banking from its i … ion, maximum surgical blood order schedule, alternative transfusion such as autologous transfusion, hemodilution, and intra/post-operative blood salvage, surgical hemostasis, pharmacological hemostasis, and synthetic erythropoietin. Most importantly, implementation of the Quality Program should be something that we want to do rather than simply a burden that w …

Руководящие принципы и консенсус в отношении минимально адаптированной к остаточным болезням терапии в множестве миеломы, выработанные Рабочей группой по миеломе в Пантихоокеанском регионе.

Лечение множественной миеломы (ММ) вступило в эру терапии, ориентированной на глубокую ремиссию, где минимальные остаточные заболевания (МВД) стали ключевым показателем реакции на лечение и долгосрочного прогнозирования, превосходя обычные критерии полной ремиссии. Однако оптимальная интеграция МРТ в процесс принятия клинических решений еще не достигнута. Этот экспертный консенсус предлагает основанные на фактических данных руководящие указания относительно пересмотра целей лечения в эпоху лечения на основе CD38, включения статуса MRD в терапевтические решения, стандартизации обнаружения MRD и

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… However, NGS requires diagnostic material for sequencing and longer processing times, while NGF is feasible without baseline DNA and may be limited by sample quality or hemodilution. 30,67,76 The key differences between NGF and NGS are summarized in Table 3 . 341171 Table 3. … Impact of sample heterogeneity NGF is susceptible to hemodilution or sampling variability. NGS depends on initial clone identification to detect clonal hierarchical changes and clonal evolution. …

[Effect of sodium acetate Ringer injection on perioperative fluid therapy in children with cyanotic congenital heart disease].

OBJECTIVE: To evaluate the efficacy of volume therapy with sodium acetate Ringer solution during the perioperative period in children with c … in group C, all P < 0.01), indicating that all the children in the three groups achieved effective hemodilution. However, there was no significant difference in blood gas analysis before and after infusion among the three groups. The level of blood lactic acid (Lac) in all CHD children was decreased from (1.33±0.63) mmol/L to (0.98±0.36) mmol/L after infusion …

"Friends and foes" of multiple myeloma measurable/minimal residual disease evaluation by next generation flow.

Next Generation Flow (NGF) represents a gold standard for the evaluation of Minimal Residual Disease (MRD) in Multiple Myeloma (MM) patients at any stage of treatment. Although the assessment of MRD is still not universally employed in clinical practice, numerous studies have demonstrated the strength of MRD as a reliable predictor of long-term outcome, and its potential to supersede the prognostic value of CR. The possibility to acquire millions of events, in combination with the use of standard reagents and a good expertise in the analysis of rare populations, led to high chance of success a

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… Different methods have been recommended to accurately evaluate the degree of hemodilution. … Normalization of bone marrow aspirates for hemodilution in flow cytometric analyses. Cytom B Clin Cytom (2009) 76(1):27–36. doi: 10.1002/cyto.b.20429 62. Costa LJ, Derman BA, Bal S, Sidana S, Chhabra S, Silbermann R, et al. …

Long-term follow-up of hypothenar hammer syndrome: a series of 47 patients.

Hypothenar hammer syndrome (HHS) is an uncommon form of secondary Raynaud phenomenon, occurring mainly in subjects who use the hypothenar pa … telet aggregation inhibitors. Twenty-one patients with digital ischemia/necrosis were further given hemodilution therapy to reduce the hematocrit level to 35%. In 3 patients with HHS-related digital necrosis who exhibited partial improvement with vasodilators, prostacyclin analog therapy (a 5-day regimen of intravenous prostacyclin analog) was instituted, resu …

Triethylene glycol HO(CH2CH2O)3H.

TEG is a liquid higher glycol of very low vapor pressure with uses that are primarily industrial. It has a very low order of acute toxicity … moglobin concentration, decreased hematocrit and increased mean corpuscular volume, probably due to hemodilution following absorption of TEG. The NOAEL was 20 000 ppm TEG in diet. Short-term repeated aerosol exposure studies in the rat demonstrated that, by nose-only exposure, the threshold for effects by respiratory tract exposure was 1036 mg m(-3). Neither h …

A novel selective peroxisome proliferator-activator receptor-gamma modulator-SPPARgammaM5 improves insulin sensitivity with diminished adverse cardiovascular effects.

The use of the thiazolidinedione insulin sensitizers rosiglitazone and pioglitazone for the treatment of type 2 diabetes mellitus in recent years has proven to be effective in helping patients resume normal glycemic control. However, their use is often associated with undesirable side effects including peripheral edema, congestive heart failure and weight gain. Here, we report the identification and characterization of a novel selective PPARgamma modulator, SPPARgammaM5 ((2S)-2-(2-chloro-5-{[3-(4-chlorophenoxy)-2-methyl-6-(trifluoromethoxy)-1H-indol-1-yl]methyl} phenoxy)propionic acid), which

Minimal Residual Disease in Multiple Myeloma: Something Old, Something New.

The game-changing outcome effect, due to the generalized use of novel agents in MM, has cre-ated a paradigm shift. Achieving frequent deep responses has placed MM among those neoplasms where the rationale for assessing MRD is fulfilled. However, its implementation in MM has raised specific questions: how might we weight standard measures against deep MRD in the emerging CAR-T setting? Which high sensitivity method to choose? Are current response criteria still useful? In this work, we address lessons learned from the use of MRD in other neoplasms, the steps followed for the harmonization of cu

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… If this is not possible, they recommend the next pull to be extracted and sent with a repositioning of the needle to reduce the likelihood of hemodilution [ 110 ]. … Other strategies, such as functional imaging and liquid biopsy, which may be complementary and useful to resolve false-negative MRD evaluations due to BM sample hemodilution or spatial heterogeneity, are discussed below. High Throughput Sequencing. …

A phase 1 study of IO-202, an anti-LILRB4 antibody, in chronic myelomonocytic leukemia and acute myeloid leukemia.

IO-202 is a humanized immunoglobulin G1 monoclonal antibody with high affinity and specificity for leukocyte immunoglobulin-like receptor B4 (LILRB4; ILT3), which is predominantly expressed in monocytes and monocytic blasts. IO-202 induces antibody-dependent cellular cytotoxicity and antibody-dependent cellular phagocytosis in vitro and in patients with leukemia. Herein, we present the phase 1a dose escalation data of IO-202 as monotherapy and in combination with azacitidine (AZA) in patients with relapsed/refractory (R/R) acute myeloid leukemia (AML) and R/R chronic myelomonocytic leukemia (C

MRD в нескольких миеломах: клиническая перспектива.

Минимальное остаточное заболевание (МРД) стало ключевым прогнозным фактором в случае множественной миэломы (ММ), что позволяет более точно оценивать эффективность лечения после обычной полной ремиссии. Технологии высокой чувствительности, включая цитометрию потока следующего поколения (СПГ), последовательность следующего поколения (СПГ) и количественную PCR для олигонуклеотида аллеля, позволяют обнаруживать остаточные заболевания при уровнях 10-5-10-6. Достижение негатива MRD последовательно ассоциируется с продолжительным безподвижным выживанием (PFS) и общим выживанием (OS) в различных услов

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… NGF is widely applicable and standardized through EuroFlow protocols, although its accuracy may be influenced by hemodilution and sampling variability. …

Detection of MYD88L265P Mutation by Allele-Specific Polymerase Chain Reaction in Atypical Lymphoplasmacytic Lymphoma.

Herein, we report a case of lymphoplasmacytic lymphoma/Waldenström macroglobulinemia that presented with atypical bone marrow morphology and rapid clinical deterioration. Despite inconclusive flow cytometry findings and negative results for MYD88 L265P mutation via both next-generation and Sanger sequencing, allele-specific polymerase chain reaction ultimately detected the mutation and confirmed the diagnosis. This case emphasizes the role of highly sensitive molecular techniques when evaluating low-tumor-burden or morphologically atypical lymphoid neoplasms.

От статического риска до динамического мониторинга заболеваний: роль MRD и иммунного профилирования в множестве миелом.

Терапевтический ландшафт множественной миеломы (ММ) претерпел глубокие изменения, при этом высокоэффективные комбинированные режимы и иммунная терапия позволили обеспечить беспрецедентные темпы глубоких и устойчивых ответных мер. В результате этого одной традиционной стратификации базовых рисков становится все более недостаточно для объяснения неоднородности клинических результатов или для направления лечения на протяжении всего курса лечения. Эта эволюционирующая парадигма сместила внимание на динамическое, адаптированное к реакциям наблюдение за заболеваниями, сосредоточенное на поддающихся

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… Conversely, its accuracy depends on sample quality, adequate marrow representation, avoidance of hemodilution, and implementation of standardized analytical procedures. … Apparent MRD-negative relapse may result from insufficient sampling, hemodilution, inadequate cellular input, patchy marrow infiltration, or disease recurrence in unsampled anatomical compartments such as extramedullary sites. …

Delayed gastric emptying in critical illness: is enhanced enterogastric inhibition with cholecystokinin and peptide YY involved?

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… This should result in hemodilution to about 60% of normal plasma factor levels after the transfusion of about 10 units; this factor level can effect normal hemostasis. In reality, however, crystalloids may be given in excess of PRBCs, so after 10 units is transfused, less plasma protein may remain. … When combined with acute intraoperative hemodilution, this technology is also potentially cost saving. 149 Therapeutic Apheresis The word apheresis is derived from the Greek aphairein, “to take away”; thus, therapeutic hemapheresis is performed to remove unwanted plasma constituents (plasmapheresis …

FcRH5×CD3 bispecific antibody cevostamab in relapsed or refractory multiple myeloma: a phase 1 trial.

Fc receptor-homolog 5 (FcRH5) is a membrane protein that is ubiquitously expressed on myeloma cells. Cevostamab is a first-in-class, FcRH5×CD3 bispecific antibody. GO39775 is a phase 1 dose-escalation and dose-expansion study evaluating fixed-duration cevostamab in relapsed or refractory multiple myeloma. Cevostamab was initiated with step-up dosing and continued at the target dose (TD) once every 3 weeks for 17 cycles (~12 months) unless disease progression or unacceptable toxicity occurred. Primary objectives were to evaluate safety, including determination of the maximum tolerated dose (MTD

Acquired platelet disorders.

Platelets are essential to primary hemostasis, and defects in their number or function can lead to clinically significant bleeding or thrombosis. Acquired platelet disorders are far more common than the inherited forms and arise in a wide range of settings, including drug exposure, autoimmune, systemic, and critical illnesses. This review examines current understanding of the mechanisms driving acquired platelet dysfunction and outlines the diagnostic and therapeutic approaches that are shaping contemporary standards of care. Drug-related and immune-mediated platelet defects remain the most re

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… TP results mainly from hemodilution, direct mechanical destruction, and the huge inflammatory state. The requirement for systemic anticoagulation places these patients at additional risk for developing heparin-induced thrombocytopenia (HIT) that can complicate 3.7% of ECMO in adults ( 95 , 96 ). … microthrombosis Mechanical/shear stress | ECMO, CPB, prosthetic devices | Qualitative ↑/↓ Quantitative ↓ | Heparin use→ HIT→PLT activation/clearance, High-speed centrifuges: receptor shedding → impaired PLT function Artificial surface contact →PLT activation/aggregation/release of procoagulant microparticles Hemodilution …

Zoledronic Acid may reduce intraoperative bleeding in spinal tumors: a prospective cohort study.

Between June 2010 and June 2011, 176 patients were divided into 2 groups: a group with spinal metastasis of solid tumors (n = 157) and a group with multiple myeloma (n = 19). Both groups were further divided into 2 subgroups: a group receiving zoledronic acid before surgery and a control group. The zoledronic acid subgroup of the solid tumors group was group A (n = 81), the control subgroup of the solid tumors group was group B (n = 76), the zoledronic acid subgroup of the multiple myeloma group was group C (n = 10), and the control subgroup of the multiple myeloma group was group D (n = 9). T

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… In addition, we used measures during surgery to prevent bleeding and protect renal function, including hypervolemic hemodilution and controlled hypotension. During anesthesia administration, we began to dilute patients' blood to maintain a hypervolemic status. …

Результаты среди пациентов MM, получающих раннее вмешательство в процесс развития MRD после автономной трансплантации стволовых клеток.

Для оценки реакции нескольких пациентов, страдающих миеломой (ММ), на лечение необходимо проводить обследование на наличие минимальных остаточных заболеваний (МСД). Многие пациенты, прежде чем удовлетворять критериям клинического или биохимического прогресса (PD), сталкиваются с MRD (MRD-P), в связи с чем возникают вопросы о сроках лечения. В этом ретроспективном исследовании было исследовано воздействие раннего вмешательства (РВ) на прогнозы 42 вновь диагностированные пациенты MM, разработавшие MRD-P после первоначального лечения аутологической трансплантации стволовых клеток. В группе EI (n

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… Bone marrow aspirates (3–5 mL) were collected in EDTA anticoagulant tubes, and whenever feasible the first‐pull aspirate was preferentially used to minimize peripheral blood hemodilution. MRD was evaluated in BM samples (1.2 × 10 7 cells per sample). …