Abstract. A fatal transfusion reaction due to contamination of platelet‐depleted whole blood with Pseudomonas fluorescens is reported. Routine sterility testing on blood products and environmental microbiological monitoring suggested no source for the contaminating organism, as has been the case for the majority of reported incidents of this type. The value of routine sterility testing in the prevention and investigation of such incidents is discussed.
The relation between quantities of blood ordered to cover obstetrical and gynaecological diagnoses and quantities actually used was studied over a period of 3 months in one Scottish hospital. It appeared that the amount of blood ordered as 'cover' for many operative procedures and for patients under observation was, in many instances, uneconomic. On the basis of this a 'maximum surgical blood-ordering schedule' has been proposed which would reduce the amount of blood cross-matched as 'cover' by 65%. Review of the circumstances of all transfusions given over the study period suggested that adoption of the proposed schedule would not be detrimental to patient study.
The number of nuclear power plants in the world rose exponentially to 420 by 1990 and peaked at 438 in 2002; but by 2014, as closed plants were not replaced, there were just 388. In spite of using more renewable energy, the world still relies on fossil fuels, but some countries plan to develop new nuclear programmes. Spent nuclear fuel, one of the most dangerous and toxic materials known, can be reprocessed into fresh fuel or into weapons-grade materials, and generates large amounts of highly active waste. This article reviews available literature on government and industry websites and from independent analysts on world energy production, the aspirations of the 'new nuclear build' programmes in China and the UK, and the difficulties in keeping the environment safe over an immense timescale while minimizing adverse health impacts and production of greenhouse gases, and preventing weaponization by non-nuclear-weapons states acquiring civil nuclear technology.
In a group of six normal male volunteers, infusion of DDAVP, venous occlusion and exercise were shown to increase plasma levels of factor VIII and plasminogen activator, activity and antigen, to different extents and at differing rates. Any mechanisms suggested to explain release of these proteins by various stimuli should account for such differences. All three stimuli could also increase plasma levels of prostacyclin metabolites, although this was only significant for high doses of DDAVP. Other potential endothelial markers, such as fibronectin and thrombospondin, showed no specific increase after any of the stimuli.
From clinical observation it would appear that hyperthyroid patients are particularly sensitive to the anticoagulant effects of warfarin. A study was made of clotting factors prothrombin (II), VII, procoagulant VIII (VIIIC), IX and X and of prothrombin ratio (PTR) and partial thromboplastin time with kaolin (PTT-K). These parameters and warfarin levels were measured before and following a single dose of warfarin given to five patients when hyperthyroid and again when euthyroid. Hyperthyroidism was associated with lower activity of factor II and a shorter PTT-K. Warfarin produced a greater fall in factors II and VII and a greater increase in PTR and PTT-K in the hyperthyroid state than in the euthyroid state. The enhanced response to warfarin in hyperthyroidism was, however, relatively greater for the PTR than for the PTT-K. In order to produce adequate protection against intravascular thrombosis by a suitable prolongation of the PTT-K, it may be necessary in hyperthyroid patients to extend the PTR beyond the normal therapeutic range.
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