The importance of risk behaviour of blood donors in the system of safe blood transfusion

The availability of sufficient quantities of safe blood is the main goal of transfusion services as well as medical institutions that use blood and blood components in treatment of patients. In order to minimize the risk of transmission of transfusion transmitted infections (TTI) during transfusion therapy, WHO has promoted and recommended collection of blood from volunteer blood donor (VBD) from population groups with low-risk behavior who give blood for altruistic motives. The study was aimed to examine knowledge about TTI, type and prevalence of specific forms of risky behavior (RB) and the approach and opinion on the safety of transfusion therapy of VBD in Vojvodina. Material and methods: A prospective multicenter cross-sectional study was conducted in Blood Transfusion Institute of Vojvodina and Transfusion services at nine general hospitals in Vojvodina during the period October 1, 2012 through April 30, 2013. 1191 VBD who voluntarily and anonymously fulfilled specially created and validated "Questionnaire for voluntary blood donors" were included in this study. Acquired data were analyzed using appropriate statistical nonparametric tests. Results: 90 percents of VBD have answered to be informed about the conditions for blood donation. The most frequent sources of information were brochures (32 percents), general practitioner (25 percents), family member or friend (23 percents) and lectures (22 percents). All offered statements regarding TTI have been answered correctly by 75 percents of VBD. Established forms of RB have been reported as follows: often and very often usage of alcohol in 0.25 - 4 percents V D; "h r " "l ht" drug usage in 1 percents and 8 percents, respectively. Sexual relationship with a person known to be drug addicted, with a person known to changing partners frequently, with an unknown person following last blood donation, have been reported in 1 percents , 9 percents and 2 percents, respectively. 8 percents of VBD has changed sexual partner during the last six months; 6 percents have had 2 or more sexual partners simultaneously; 1 percents have paid for intercourse and 1 percents have had sexually transmitted disease. 0.44 percents VBD has received money for sexual favors. A positive attitude and thinking regarding their impact on the safety of transfusion therapy has not been reported by 1 percents to 7 percents of VBD. Conclusion: VBD in Vojvodina are mostly well informed about conditions for blood donation and TTI. However, significant proportion of VBD in this study has not been aware of their impact on the safety of transfusion therapy. VBD with risky behavior, who have not been detected during the standard recruitment procedure, represents potential risk for safe blood transfusion. Therefore, there is a continuous need for promotion and improvement of active participation of VBD in the selection process

The importance of risk behaviour of blood donors in the system of safe blood transfusion

The availability of sufficient quantities of safe blood is the main goal of transfusion services as well as medical institutions that use blood and blood components in treatment of patients. In order to minimize the risk of transmission of transfusion transmitted infections (TTI) during transfusion therapy, WHO has promoted and recommended collection of blood from volunteer blood donor (VBD) from population groups with low-risk behavior who give blood for altruistic motives. The study was aimed to examine knowledge about TTI, type and prevalence of specific forms of risky behavior (RB) and the approach and opinion on the safety of transfusion therapy of VBD in Vojvodina. Material and methods: A prospective multicenter cross-sectional study was conducted in Blood Transfusion Institute of Vojvodina and Transfusion services at nine general hospitals in Vojvodina during the period October 1, 2012 through April 30, 2013. 1191 VBD who voluntarily and anonymously fulfilled specially created and validated "Questionnaire for voluntary blood donors" were included in this study. Acquired data were analyzed using appropriate statistical nonparametric tests. Results: 90 percents of VBD have answered to be informed about the conditions for blood donation. The most frequent sources of information were brochures (32 percents), general practitioner (25 percents), family member or friend (23 percents) and lectures (22 percents). All offered statements regarding TTI have been answered correctly by 75 percents of VBD. Established forms of RB have been reported as follows: often and very often usage of alcohol in 0.25 - 4 percents V D; "h r " "l ht" drug usage in 1 percents and 8 percents, respectively. Sexual relationship with a person known to be drug addicted, with a person known to changing partners frequently, with an unknown person following last blood donation, have been reported in 1 percents , 9 percents and 2 percents, respectively. 8 percents of VBD has changed sexual partner during the last six months; 6 percents have had 2 or more sexual partners simultaneously; 1 percents have paid for intercourse and 1 percents have had sexually transmitted disease. 0.44 percents VBD has received money for sexual favors. A positive attitude and thinking regarding their impact on the safety of transfusion therapy has not been reported by 1 percents to 7 percents of VBD. Conclusion: VBD in Vojvodina are mostly well informed about conditions for blood donation and TTI. However, significant proportion of VBD in this study has not been aware of their impact on the safety of transfusion therapy. VBD with risky behavior, who have not been detected during the standard recruitment procedure, represents potential risk for safe blood transfusion. Therefore, there is a continuous need for promotion and improvement of active participation of VBD in the selection process

Spine injections: the rationale for CT guidance

Back pain is one of the most common medical problems and is associated with high socioeconomic costs. Imaging-guided spinal injections are a minimally invasive method to evaluate where the back pain is originating from, and to treat patients with radicular pain or spinal stenosis with infiltration of corticosteroids. CT-guided spine injections are a safe procedure, characterized by precise needle placement, excellent visualization of the relevant anatomical structures, and low radiation exposure for the patient and the interventional radiologist. In this review article, the variety of applications of CT-guided injections (focused on nerve roots and epidural injections) and the optimal injection procedure as well as risks and side effects are discussed. Keywords: CT-guided spine injections; Epidural injection; Nerve root block; Steroid injection

Assessment of hepatic fibrosis and inflammation with look-locker T1 mapping and magnetic resonance elastography with histopathology as reference standard

Purpose: To compare the diagnostic performance of T1 mapping and MR elastography (MRE) for staging of hepatic fibrosis and grading inflammation with histopathology as standard of reference. Methods: 68 patients with various liver diseases undergoing liver biopsy for suspected fibrosis or with an established diagnosis of cirrhosis prospectively underwent look-locker inversion recovery T1 mapping and MRE. T1 relaxation time and liver stiffness (LS) were measured by two readers. Hepatic fibrosis and inflammation were histopathologically staged according to a standardized fibrosis (F0-F4) and inflammation (A0-A2) score. For statistical analysis, independent t test, and Mann-Whitney U test and ROC analysis were performed, the latter to determine the performance of T1 mapping and MRE for fibrosis staging and inflammation grading, as compared to histopathology. Results: Histopathological analysis diagnosed 9 patients with F0 (13.2%), 21 with F1 (30.9%), 11 with F2 (16.2%), 10 with F3 (14.7%), and 17 with F4 (25.0%). Both T1 mapping and MRE showed significantly higher values for patients with significant fibrosis (F0-1 vs. F2-4; T1 mapping p < 0.0001, MRE p < 0.0001) as well as for patients with severe fibrosis or cirrhosis (F0-2 vs. F3-4; T1 mapping p < 0.0001, MRE p < 0.0001). T1 values and MRE LS were significantly higher in patients with inflammation (A0 vs. A1-2, both p = 0.01). T1 mapping showed a tendency toward lower diagnostic performance without statistical significance for significant fibrosis (F2-4) (AUC 0.79 vs. 0.91, p = 0.06) and with a significant difference compared to MRE for severe fibrosis (F3-4) (AUC 0.79 vs. 0.94, p = 0.03). For both T1 mapping and MRE, diagnostic performance for diagnosing hepatic inflammation (A1-2) was low (AUC 0.72 vs. 0.71, respectively). Conclusion: T1 mapping is able to diagnose hepatic fibrosis, however, with a tendency toward lower diagnostic performance compared to MRE and thus may be used as an alternative to MRE for diagnosing hepatic fibrosis, whenever MRE is not available or likely to fail due to intrinsic factors of the patient. Both T1 mapping and MRE are probably not sufficient as standalone methods to diagnose hepatic inflammation with relatively low diagnostic accuracy. Keywords: Biopsy; Fibrosis; Liver; MR elastography; T1 mappin

Assessment of hepatic fibrosis and inflammation with look-locker T1 mapping and magnetic resonance elastography with histopathology as reference standard.

PURPOSE To compare the diagnostic performance of T1 mapping and MR elastography (MRE) for staging of hepatic fibrosis and grading inflammation with histopathology as standard of reference. METHODS 68 patients with various liver diseases undergoing liver biopsy for suspected fibrosis or with an established diagnosis of cirrhosis prospectively underwent look-locker inversion recovery T1 mapping and MRE. T1 relaxation time and liver stiffness (LS) were measured by two readers. Hepatic fibrosis and inflammation were histopathologically staged according to a standardized fibrosis (F0-F4) and inflammation (A0-A2) score. For statistical analysis, independent t test, and Mann-Whitney U test and ROC analysis were performed, the latter to determine the performance of T1 mapping and MRE for fibrosis staging and inflammation grading, as compared to histopathology. RESULTS Histopathological analysis diagnosed 9 patients with F0 (13.2%), 21 with F1 (30.9%), 11 with F2 (16.2%), 10 with F3 (14.7%), and 17 with F4 (25.0%). Both T1 mapping and MRE showed significantly higher values for patients with significant fibrosis (F0-1 vs. F2-4; T1 mapping p < 0.0001, MRE p < 0.0001) as well as for patients with severe fibrosis or cirrhosis (F0-2 vs. F3-4; T1 mapping p < 0.0001, MRE p < 0.0001). T1 values and MRE LS were significantly higher in patients with inflammation (A0 vs. A1-2, both p = 0.01). T1 mapping showed a tendency toward lower diagnostic performance without statistical significance for significant fibrosis (F2-4) (AUC 0.79 vs. 0.91, p = 0.06) and with a significant difference compared to MRE for severe fibrosis (F3-4) (AUC 0.79 vs. 0.94, p = 0.03). For both T1 mapping and MRE, diagnostic performance for diagnosing hepatic inflammation (A1-2) was low (AUC 0.72 vs. 0.71, respectively). CONCLUSION T1 mapping is able to diagnose hepatic fibrosis, however, with a tendency toward lower diagnostic performance compared to MRE and thus may be used as an alternative to MRE for diagnosing hepatic fibrosis, whenever MRE is not available or likely to fail due to intrinsic factors of the patient. Both T1 mapping and MRE are probably not sufficient as standalone methods to diagnose hepatic inflammation with relatively low diagnostic accuracy

ESB-Based Sensor Web Integration for the Prediction of Electric Power Supply System Vulnerability

Electric power supply companies increasingly rely on enterprise IT systems to provide them with a comprehensive view of the state of the distribution network. Within a utility-wide network, enterprise IT systems collect data from various metering devices. Such data can be effectively used for the prediction of power supply network vulnerability. The purpose of this paper is to present the Enterprise Service Bus (ESB)-based Sensor Web integration solution that we have developed with the purpose of enabling prediction of power supply network vulnerability, in terms of a prediction of defect probability for a particular network element. We will give an example of its usage and demonstrate our vulnerability prediction model on data collected from two different power supply companies. The proposed solution is an extension of the GinisSense Sensor Web-based architecture for collecting, processing, analyzing, decision making and alerting based on the data received from heterogeneous data sources. In this case, GinisSense has been upgraded to be capable of operating in an ESB environment and combine Sensor Web and GIS technologies to enable prediction of electric power supply system vulnerability. Aside from electrical values, the proposed solution gathers ambient values from additional sensors installed in the existing power supply network infrastructure. GinisSense aggregates gathered data according to an adapted Omnibus data fusion model and applies decision-making logic on the aggregated data. Detected vulnerabilities are visualized to end-users through means of a specialized Web GIS application