...A Review Mark R. Looney, MD; Michael A. Gropper, MD, PhD, FCCP; and Michael A. Matthay, MD, FCCP Transfusion-related acute lung injury (TRALI) is an underreported complication of transfusion therapy, and it is the third most common cause of transfusion-associated death. TRALI is defined as noncardiogenic pulmonary edema temporally related to transfusion therapy. The diagnosis of TRALI relies on excluding other diagnoses such as sepsis, volume overload, and cardiogenic pulmonary edema. Supportive diagnostic evidence includes identifying neutrophil or human leukocyte antigen (HLA) antibodies in the donor or recipient plasma. All plasma-containing blood products have been implicated in TRALI, with the majority of cases linked to whole blood, packed RBCs, platelets, and fresh-frozen plasma. The pathogenesis of TRALI may be explained by a “two-hit” hypothesis, with the first “hit” being a predisposing inflammatory condition commonly present in the operating room or ICU. The second hit may involve the passive transfer of neutrophil or HLA antibodies from the donor or the transfusion of biologically active lipids from older, cellular blood products. Treatment is supportive, with a prognosis substantially better than most causes of clinical acute lung injury. (CHEST 2004; 126:249 –258) Key words: ARDS; lung injury; pulmonary edema; transfusion; transfusion-related acute lung injury Abbreviations: ALI acute lung injury; FDA Food and Drug Administration; Fio2 fraction of inspired oxygen;...
Words: 7507 - Pages: 31
...The Effect of Platelet Derived Growth Factors and Lipopolysaccharrides on KB cells Proliferation. Sobukonla Timothy and Karen Louis ABSTRACT Keratinocytes are stratified, squamous, epithelial cells that make up 95% of the cells in the epidermis. These cells are found in the basal layer of the stratified epithelium of the epidermis, and are to as basal cells, or basal keratinocytes. Keratinocytes play a vital role in the structural component of the skin, as well as a vital function in immune response. Platelet derived growth factor is a powerful mitogen for many cell types such with keratinocytes growth and motility. Lippolysaccharide (LPS) is found on the cell surface of gram-negative bacteria and assist in the stabilization of the overall cell wall structure. LPS along with CD14 and Toll-like receptor 4 expressed on the cell surface of keratinocytes, play a vital role in regulating the innate immune response system and influencing the adaptive immune response mechanism. INTRODUCTION Keratinocyte cells are stratified, squamous, epithelial cells that comprise of skin and mucosa, including oral, esophageal, and genital epithelia. 95% of the cells in the epidermis are keratinocytes. Keratinocytes are tightly bonded together to form a strong layer between the nerves of the skin and underlying tissues of the epidermis. These cells originate in basal layer of the stratified epithelium and are referred to as basal cells or basal keratinocytes. In addition to their structural...
Words: 2830 - Pages: 12
...Physiology of Blood Components, Characteristics, Functions of Blood Major Components of Blood 1. Formed elements - the actual cellular components of blood (special connective tissue) a.erythrocytes - red blood cells b.leukocytes - white blood cells c.platelets - cell fragments for clotting 2. Blood plasma - complex non-cellular fluid surrounding formed elements; protein & electrolytes. Separation of Components in a Centrifuge VOLUME LAYER clear/yellowish PLASMA 55% top thin/whitish buffy coat proerythroblast ->early (basophilic) erythroblast ->late (polychromatophilic) erythroblast ->(hemoglobin) normoblast -> (nucleus ejected when enough hemoglobin)reticulocyte -> (retaining some endoplasmic reticulum) ERYTHROCYTE life span: hemocytoblast -> reticulocyte 3-5 DAYS reticulocyte -> ERYTHROCYTE 2 DAYS (in blood) ERYTHROCYTE lifespan 100-120 DAYS (primarily destroyed by macrophages in the spleen) 3. Regulation of Erythropoiesis a. hormonal controls - erythropoietin is the hormone that stimulates RBC production DECREASED oxygen level in blood causes KIDNEYS to increase release of erythropoietin 1. Less RBCs from bleeding 2. Less RBCs from excess RBC destruction 3. Low oxygen levels (high altitude, illness) ...
Words: 9547 - Pages: 39
...Case Studies on Cardiac Function This is the first case study that is required for the class. Please submit a paper (doesn’t have to be long; you could even give me bullet-point answers to the questions listed below) that answers all of the questions posed after Case Study 1. I have included an easy second case study which, if you complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and responding to Case Study 1 is required work for the course. The extra credit, which is not required, will be worth a total of 10 points. Case 1 A.O. is an 89-year-old woman with a long history of systolic heart failure secondary to a large left ventricular infarct when she was in her 70s. She had poor activity tolerance and required assistance with activities of daily living. Even minimal activity was associated with moderately severe dyspnea and exertional chest pain, which was relieved by rest. A.O. also exhibited marked pedal edema bilaterally. She is being treated with digitalis, furosemide (Lasix), KCl, and sublingual nitroglycerin. Discussion Questions 1. Which type of heart failure (left or right sided) is usually associated with dyspnea? Left-sided heart failure is usually associated with dyspnea. What other clinical findings are likely to be present with left-sided heart failure? Other clinical findings that are likely to be present with left-sided heart failure include radiographic cardiomegaly, abnormal apical pulse and...
Words: 1080 - Pages: 5
...Chronic Obstructive Pulmonary Disease | INTRODUCTION We are doing a case study on medical, nursing, pharmacological management of COPD (Chronic Obstructive Pulmonary Disease). We took a COPD patient and assessed the patient for clinical manifestation, the medical, nursing, pharmacological care given to the patient. In our case study we will include the care Hawwa is receiving now and the care we can add to daily routine to help her recover faster. Hawwa Ismail is admitted to Medical ward with diagnosis of COPD. She is 145cm tall, slim, with dark complexion. She is 79 years old. She said that she has difficulty in breathing, she cannot sleep in night time ,she do not feel like eating food and she was having cough. Physical assessment revealed BP 138/47mmHg right arm in lying position, pulse 84 regular and strong, and breathing pattern was irregular labored, tachypnic at 40 breathes per minute,SpO2 99% in room air and temperature 360C (96.80F).Her facial color and lips are ruddy, but nails are clean ,pale and clubbed. She has a little barrel chest, uses accessory muscle to breathe. She has prolonged expiration. While auscultating lungs, diminished breath sound in most of the lower lobes and a small wheezing sound in right lower lobe was noted. PERSONAL DETAILS PATIENT NAME: Hawwa Ismail ADDRESS:Iruvaige/R.Inguraidhoo GUARDIAN: NAME: Abdul HameedHussain CONTACT NO: 7772099 AGE: 79yrs SEX: female NATIONALITY: Maldivian LANGUAGE: Dhivehi RACE: Asian ...
Words: 3574 - Pages: 15
...Thesis Statement Writing Tuesday, Jun. 8th 2010 Before you familiarize yourself with thesis statement writing, you need to know what the statement is in the first place. This sentence basically sums up your main objective for writing the term paper, creates a simple guide for the reader and provides the basis for your argument. All in all thesis statement writing is quite simple, as long as you keep some tips and techniques in mind. The first thing you need to do is put together one question which is only possible if you compress the entire thesis. A great way to do this is examine the main topic and create a question out of it. It will give you a basic idea of what the statement should look like and how you should answer that question. The first sentence should introduce the topic and the objective and the next few should spell out how you plan to support your argument. Thesis statement writing, therefore, is about asking yourself the fundamental question that forms the essence of your paper. When you are done writing the statement, step back and examine in from another point of view to determine whether it is strong or weak. A strong statement is one which sparkles with confidence and focuses on one and only one aspect of the issue. This means that you can’t be vague or off-hand about the topic. If you have selected a theme, you should be ready to stand up for it- now is not the time to be diplomatic or meek. In addition to that, it should also spell out the basis for...
Words: 4119 - Pages: 17
...I. Introduction - Shock (Chapter 11) A. Review of anatomy and physiology B. Pathophysiology Initiation | * Decreased tissue oxygenation * Decreased intravascular volume * Decreased Myocardial contractility (cardiogenic ) * Obstruction of blood flow (obstructive) * Decreased vascular tone (distributive) * Septic (mediator release) * Neurogenic (suppression of SNS) | No observable clinical indications Decreased CO may be noted with hemodynamic monitoring | Compensatory | * Neural compensation by SNS * Increased HR and Contractiliy * Vasoconstriction * Redistribution of blood flow from nonessential to essential organs * Bronchodilation * Endocrine Compensation (RAAS, ADH, glucocorticoid release) * Renal reabsorption of sodium, chloride, and water * Vasoconstriction * Glycogenolysis | * Increased HR (EXCEPT NEUROGENIC) * Narrowed pulse pressure * Rapid, deep respirations causing respiratory alkalosis * Thirst * Cool,moist skin * Oliguria * Diminished bowel sounds * Restlessness progressing to confsion * Hyperglycemia * Increased specific gravity and decreased creatinine clearance. | Progressive | * Progressive tissue hypoperfusion * Anaerobic metabolism wih lactic acidosis * Failure of sodium potassium pump * Cellular edema | * Dysrhythmias * Decreased BP with narrowed pulse pressure * Tachypnea * Cold, clammy skin * Anuria * Absent bowel sounds * Lethargy progressing...
Words: 12469 - Pages: 50
...* What Is a Blood Disorder? Bottom of Form Blood disorders are physical conditions that prevent the normal function of blood in the body. A disorder may involve factors that interfere with the production of the individual components found in the blood, such as hemoglobin or blood proteins. The nature of a blood disorder may also include situations where the blood does not coagulate properly, or the blood cells themselves are malformed or infected. There is a wide range of blood diseases known today. Anemia is one of the more common examples of a blood disorder. Sometimes referred to as tired blood, a person who is anemic is likely to have a lack of proteins and other elements in the blood. As a result, the blood cannot carry the needed nutrients to various parts of the body and the individual is likely to feel fatigued more often. Over time, anemia can also have a negative impact on the emotions, as the blood is unable to supply proper nutrition to the brain for the production of chemicals that help to maintain an even mood. Sickle cell anemia is one of the more serious types of anemic blood disorder. In addition to fatigue, a person suffering with this disorder is also likely to experience a great deal of pain. The pain may be localized in one part of the body or migrate to different areas throughout the course of the day. Ad Hemophilia is another relatively common blood disorder. Hemophiliacs suffer with a condition in which the blood lacks the normal ability to coagulate...
Words: 9331 - Pages: 38
...Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2013, Article ID 173184, 11 pages http://dx.doi.org/10.1155/2013/173184 Review Article Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction Andrea Ciavattini,1 Jacopo Di Giuseppe,1 Piergiorgio Stortoni,1 Nina Montik,1 Stefano R. Giannubilo,1 Pietro Litta,2 Md. Soriful Islam,3 Andrea L. Tranquilli,1 Fernando M. Reis,4 and Pasquapina Ciarmela3 1 Woman’s Health Sciences Department, Faculty of Medicine, Polytechnic University of Marche, Via Corridoni 11, 60123 Ancona, Italy Department of Gynaecological Sciences and Human Reproduction, University of Padova, Via Giustiniani 3, 35128 Padova, Italy 3 Department of Experimental and Clinical Medicine, Faculty of Medicine, Polytechnic University of Marche, Via Tronto 10/a, 60126 Ancona, Italy 4 Department of Obstetrics and Gynecology, Federal University of Minas Gerais and National Institute of Hormones and Women’s Health, 30130-100 Belo Horizonte, MG, Brazil 2 Correspondence should be addressed to Andrea Ciavattini; ciavattini.a@libero.it Received 28 February 2013; Revised 10 June 2013; Accepted 13 August 2013 Academic Editor: Hilary Critchley Copyright © 2013 Andrea Ciavattini et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Uterine leiomyomas (fibroids...
Words: 10389 - Pages: 42
...I. What is endocrinology? * The study of hormones chemical messangers * Nucleus collectiom of cell bodies of neurons of CNS * Ganglia collection of cell bodies of PNS II. Neurotransmitters vs. hormones * Neurotransmitters: * released into synapses (aka synaptic cleft) via exocytosis * secreted from the secreting cell to the target * affinity of neurotransmitter receptor binding lower because more neurotransmitter concentrated in synapses * Hormones: * released into circulation by exocytosis hormones diluted in blood * received by distant target cell (endocrine) * affinity of hormone receptor binding higher affinity for hormone because hormone in diluted in blood III. 3 types of hormone signals: * endocrine signalclassic hormone; stimulated far away via blood * paracrine signalstimulates adjacent target cell (para= beside) * autocrine signal stimulates itself (auto= self) IV. Chemical classes of hormones: * Proteins multiple peptides/ long polypeptide chain - ex: glucagon/ insulin * Steroids made of cholesterol * ex: testosterone/ estrogen * cholesterol: * 20-22 desmolase acts on cholesterol to make a 21 carbon molecule called pregnenolane (aka P450SCC- Side Chain clearing) * 20-22 desmolase is the 1st enzyme to modify cholesterol during steroidegenisis (synthesis of a seriod) * Peptides short chain of amino acids via peptide bonds * ex: TRH- tripepide/ Thyroxine Releasing...
Words: 4217 - Pages: 17
...Assignment topic: Liver Regeneration Submitted To : Dr.Samina By: Razia Saleem Quaid - e - Azam University Dept : Animal Sciences MSc 2nd Semester Index Page # 1. Introduction 3 2. Structure and functions of liver 3,4 3. Liver Regeneration 5 4. Two layers of defense against liver injury 5 5. Dynamics of liver regeneration 6 6. Stimuli of hepatic regeneration 7 7. Regeneration by hepatocytes (1st line of defense) 8 8. Signaling...
Words: 6087 - Pages: 25
...Tribodies: Fab-scFv fusion proteins as a platform to create multi-functional pharmaceuticals Nico Mertens Biotecnol SA, Lagoas Park, Edificio 7, 2741-901 Oeiras (Lisbon), Portugal/ Email: nm@biotecnol.com Abstract Tribodies are multifunctional recombinant antibody derivatives, which utilize the natural in vivo heterodimerization of the heavy chain (Fd fragment) and light chain (L) of a Fab fragment, to form a scaffold, upon which additional functions can be incorporated, such as additional binders - e.g. scFv binding domains. Each chain can be extended preferably at the C-terminus with an additional scFv binder. The chains are co-produced in mammalian cells, where the host-cell BiP chaperone drives the formation of the heavy chain-light chain heterodimer (Fd:L) - this reaction does not appear to be inhibited by the chain extensions, and leads to a very specific heterodimerization, using molecules abundantly present in serum (non-immunogenic) These heterodimers are stable, with each of the binders retaining their specific affinities, with the bivalent tribody having higher affinity, and higher activatation of T-cell proliferation and cytotoxicity in vivo. This design allows easy engineering of multispecificity in a single molecule, e.g. bispecific antibodies bivalent for the target and monovalent for effector activation (e.g. for T-cell activation), or trispecific antibodies pur sang. 1 Introduction ............................................................................
Words: 4895 - Pages: 20
...Essentials Ruth E. McCall, BS, MT (ASCP) Retired Program Director and Instructor Central New Mexico Community College Albuquerque, New Mexico President, NuHealth Educators, LLC Faculty, Emeritus Phoenix College Phoenix, Arizona Fifth Edition Cathee M. Tankersley, BS, MT (ASCP) Acquisitions Editor: Peter Sabatini Product Manager: Meredith L. Brittain Marketing Manager: Shauna Kelley Designer: Holly McLaughlin Production Services: Aptara, Inc. Fifth Edition Copyright © 2012, 2008 by Lippincott Williams & Wilkins, a Wolters Kluwer business. Two Commerce Square 2001 Market Street Philadelphia, PA 19103 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress...
Words: 129902 - Pages: 520
...Overview Hypercalcemia is the most common life-threatening metabolic disorder associated with neoplastic diseases, occurring in an estimated 10% to 20% of all adults with cancer. It also occurs in children with cancer, but with much less frequency (approximately 0.5%–1%).[1-3] Solid tumors (such as lung or breast cancer tumors) as well as certain hematologic malignancies (particularly multiple myeloma) are most frequently associated with hypercalcemia.[4] Although early diagnosis followed by hydration and treatment with agents that decrease serum calcium concentrations (hypocalcemic drugs) can produce symptomatic improvements within a few days, diagnosis may be complicated because symptoms may be insidious at onset and can be confused with those of many malignant and nonmalignant diseases. However, diagnosis and timely interventions not only are lifesaving in the short term but also may enhance the patient’s compliance with primary and supportive treatments and may improve quality of life.[5] When a patient has a refractory, widely disseminated malignancy for which specific therapy is no longer being pursued, the patient may want to consider withholding therapy for hypercalcemia. For patients or families who have expressed their wishes regarding end-of-life issues, this may represent a preferred timing and/or mode of death (as compared with a more prolonged death from advancing metastatic disease). This option is best considered long before the onset of severe hypercalcemia or...
Words: 10714 - Pages: 43
...The School Access to Emergency Epinephrine Act (S.1884 and H.R 3627) is a bill that will inspire states to enact laws that will permit schools to keep stock epinephrine (epipen) in the school medicine cabinet. The epinephrine will not be prescribed for any particular student and will be readily available for any student having anaphylaxis. The bill will also allow school staff to administer epinephrine without any liability. Moreover, any school that adopts this legislation will be given preferences when applying for asthma related government grants from health and human resources department (TheHill.com, 2012). Just recently, a first grader, Amarria Johnson of Virginia State died after experiencing an episode of anaphylaxis from eating peanut. Her death could have been prevented, but the school had no epinephrine on hand to save her life(TheHill.com,2012).According to the National Institute of Allergy and Infectious Disease (2011),the delay in using epinephrine is closely associated with death from anaphylaxis,expecially anaphylaxis resulting from peanuts allergy (niaid,2011).Symptoms of anaphylaxis include itching ,swelling of lips and tongue, tightness of throat, skin hives, vomiting, diarrhea ,cramps, shortness of breath, cough, wheezing, weak pulse, dizziness and passing out (niaid,2011). According to Gregory Nancy (July 2012), about eight percent of American children are affected by allergies. Six million children have food allergy and about forty percent of those...
Words: 4877 - Pages: 20
