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APPLICAZIONE DI LINEE GUIDA AZIENDALI PER L'IMPIEGO DELL'ALBUMINA UMANA: IMPATTO SUI CONSUMI
No full textXXXVIII CONVEGNO NAZIONALE DI STUDI DI MEDICINA TRASFUSIONALE 8.02 ALTRI – EVIDENCE BASED MEDICINE E DIFINIZIONE DI LINEE GUIDA
ABS396 APPLICAZIONE DI LINEE GUIDA AZIENDALI PER L’IMPIEGO DELL’ALBUMINA UMANA: IMPATTO SUI CONSUMI
De Nicolò M.C.(1), Coluzzi S.(1), Tomei G.(1), Carmini D.(1), Pasqualetti D.(1), Screnci M.(1), Merli M.(2), Girelli G.(1)
(1) SIMT, Az.Pol.Umberto I Univ. “La Sapienza”, Roma; (2) Gastroenterologia, Az.Pol.Umberto I, Univ.”La Sapienza”, Roma
Introduzione
In Italia, come in Europa, non è stata raggiunta l’autosufficienza del plasma per la produzione di plasmaderivati tra cui l’albumina; è pertanto necessario un uso razionale e appropriato per evitare di depauperare scorte già insufficienti. L’uso appropriato di emocomponenti e di emoderivati è uno dei compiti istituzionali dei Servizi di Medicina Trasfusionale.
Metodi
Nel 2006 presso la nostra Azienda abbiamo richiesto l’istituzione di una commissione, da noi coordinata, per la messa a punto di Linee Guida (LG) per migliorare l’appropriatezza d’uso dell’albumina. I componenti del gruppo di lavoro sono stati nominati dalla Direzione Sanitaria con il coinvolgimento dei reparti maggiori utilizzatori di albumina. Per la stesura delle LG si è tenuto conto della revisione della letteratura, delle LG internazionali e di quelle SIMTI. Le LG elaborate e validate e la nuova modulistica per la richiesta sono state diffuse da Dicembre 2006 in ambito aziendale per via cartacea e attraverso la rete intranet. Le richieste vengono evase dalla Farmacia previa autorizzazione del SIMT. Al fine di verificare il corretto impiego delle LG e l’impatto sul consumo aziendale, abbiamo confrontato i consumi di albumina prima e dopo l’applicazione delle LG.
Risultati
Vedi Tabella.
Conclusioni
L’applicazione delle LG ha comportato nel 2007 una riduzione del consumo di albumina del 27%, pari a 5779 flaconi. Considerando il costo unitario di 35.64 € per flacone, il risparmio per la nostra Azienda è stato di 205.963 €. 6.027 flaconi, pari al 38.6% dei consumi totali del 2007, è coperto da soli 5 Reparti (Rianimazione, Trapianti d’Organo, Cardiochirurgia, Gastroenterologia e Chirurgia d’Urgenza) su una parte dei quali è sicuramente possibile un intervento di miglioramento dell’impiego. Da una prima analisi dei consumi è emerso che la riduzione nel 2007 è senza dubbio dovuta ad un migliore utilizzo legato all’introduzione delle LG; tuttavia dall’analisi delle singole richieste emerge che è possibile un ulteriore ottimizzazione dell’impiego attraverso un audit con i reparti coinvolti
Collection of umbilical cord blood for banking: collection rate and factors influencing collection.
No full textDear Sir,
Umbilical cord blood (UCB) is a very rich source
of transplantable stem cells, which are thought to be a
useful treatment for a number of genetic diseases, blood
malignancies and immune deficiencies in paediatric and
adult patients lacking a suitable related or unrelated
donor1. Banking UCB is a way of preserving potentially
life-saving cells that are usually discarded after the
interruption of the blood supply from the umbilical cord
to the newborn infant2,3.
UCB harvesting after vaginal delivery or Caesarean
section is a simple, risk-free and quick procedure that
does not change the normal course of the birth4. Since
UCB is a graft source and UCB transplantation provides
good results5, the UCB collection rate for banking should
be optimised.
The aims of this retrospective, preliminary, singlecentre
study were to assess the collection rate of UCB
from selected suitable donors and to investigate the
factors influencing this rate.
Between January 2014 and June 2016, during
the phase of antenatal selection of UCB donors, 365
pregnant women were consecutively recruited for
donation and entered the study. Enrolment took place, a
few days before each woman's delivery, in the obstetric
department of "Policlinico Umberto I" hospital in Rome.
In accordance with local regulations, eligibility for
donation was assessed by the staff of the Cord Blood
Bank from detailed clinical and family information and
written informed consent was obtained from the donor
parents. All documentation was kept in a safe place in
the delivery room. As a reminder, a certified statement of
suitability for UCB donation was issued to the pregnant
women to be given to health care personnel at the time
of admission to hospital.
Among the 365 families investigated, the majority
(87.4%) resulted suitable for UCB donation while
the remaining 12.6% were ineligible. Table I gives
an overview of the causes of ineligibility: the most
common reason was a documented maternal infection
(32.6%) followed by autoimmune diseases and systemic
immunological diseases present in the parents of the
unborn child (30.5%).
Despite the 319 potential planned donations, after
delivery only 121 UCB samples (about 38%) were
collected. Table II shows the reasons why UCB was not
collected. In most cases this was because of dystocial
childbirth and urgent Caesarean section (16.6%).
Unfortunately, although the suggested operating procedure
requires the reason for non-collection to be recorded, in
our experience this was not done in the majority of cases
(almost 60%) and the causes, therefore, remain unknown.
This finding may be related to the standard of the
department involved in the study and probably also to
the shortage of staff; indeed, because of the advanced
level of care for obstetrics and neonatology, the staff
were probably taking care of complicated pregnancies.
Furthermore, in about 5% of the deliveries UCB was
not harvested because the delivery room staff were not
informed about the potential, suitable donation; this
could be attributed to the study population of pregnant
women who, obviously, lose interest in donation during
their hospitalisation and labou
Does the volume reduction manipulation before cryopreservation influence cord blood cell recovery pretransplant?
No full text
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Donating umbilical cord blood to a public bank or storing it in a private bank: knowledge and preference of blood donors and of pregnant women.
No full textBackground. Umbilical cord blood (UCB) is a source of stem cells for allogeneic haematopoietic transplantation in paediatric and adult patients with haematological malignancies and other indications. Voluntary donation is the basis for the success of unrelated UCB transplantation programmes. In the last few years a growing number of private banks offer their services to expectant parents, to store UCB for future use. The debate concerning UCB donation and private preservation has been ongoing for several years. The aims of this single centre study were to explore knowledge about UCB stem cells and attitudes towards voluntary UCB donation or private UCB preservation among both blood donors and pregnant women. Materials and methods. This study was conducted at the "Sapienza" University of Rome. Two types of anonymous questionnaires were prepared: one type was administered to 1,000 blood donors while the other type was distributed to 300 pregnant women. Results. Most blood donors as well as the majority of pregnant women had some general knowledge about UCB (89% and 93%, respectively) and were aware of the possibility of donating it (82% and 95%). However, the level of knowledge regarding current therapeutic use resulted generally low, only 91 (10%) among informed blood donors and 69 (31%) among informed pregnant women gave a correct answer. The survey revealed a preference for voluntary donation both among blood donors (76%) and among pregnant woman (55%). Indeed, a minority of blood donors (6.5%) and of pregnant women (9%) would opt to store UCB for private use. Discussion. The study raises the following considerations: (i) the large support for UCB donation expressed by blood donors and by pregnant women suggests that UCB preservation does not represent an obstacle to the expansion of UCB donation and to development of unrelated transplantation programmes; (ii) information about UCB donation and preservation should be carefully given by professionals and institutions. © SIMTI Servizi Srl
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Appropriateness in the clinical use of albumin solutions and effects on the hospital cost reports
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