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Laurén E, Vikatmaa L, Kerkelä E, Kivipuro T, Krusius T, Syrjälä M, Ihalainen J, Pettilä V. Red blood cell transfusion in southern Finland from 2011 to 2016: a quality audit. Transfus Med 2018; 29:41-47. [DOI: 10.1111/tme.12568] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/08/2018] [Accepted: 11/12/2018] [Indexed: 01/28/2023]
Affiliation(s)
- E. Laurén
- Finnish Red Cross Blood Service; Helsinki Finland
- Department of Anesthesiology, Intensive Care and Pain Medicine; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - L. Vikatmaa
- Department of Anesthesiology, Intensive Care and Pain Medicine; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - E. Kerkelä
- Finnish Red Cross Blood Service; Helsinki Finland
| | - T. Kivipuro
- Finnish Red Cross Blood Service; Helsinki Finland
| | - T. Krusius
- Finnish Red Cross Blood Service; Helsinki Finland
| | - M. Syrjälä
- Finnish Red Cross Blood Service; Helsinki Finland
| | - J. Ihalainen
- Finnish Red Cross Blood Service; Helsinki Finland
| | - V. Pettilä
- Department of Anesthesiology, Intensive Care and Pain Medicine; University of Helsinki and Helsinki University Hospital; Helsinki Finland
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Kuismanen K, Holopainen P, Vahtera E, Rasi V, Krusius T, Levo A, Partanen J. Single Founder Mutation (W380G) in Type II Protein C Deficiency in Finland. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1614039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe present study investigated the genetic basis for type II protein C deficiency in Finland, where this form has an unusually high incidence. We demonstrated that, first, a single novel mutation W380G in the protein C gene (PROC) explained 25/26 index patients, estimated to represent two thirds of all families with type II deficiency in Finland. Second, extended chromosomal conservation, i. e. a specific haplotype, around the W380G mutation was indicated in unrelated patients. Third, a local geographical origin for the W380G mutation was suggested by genealogical data. These results are in contrast to the heterogeneity in type II protein C deficiency elsewhere, but closely parallel disorders of the Finnish disease heritage. The high frequency of the type II disease can be explained by founder effect and subsequent enrichment of a single mutation in Finland. The present study also provided a simple means for genetic diagnosis of this disease and the genetic test can be included in the routine screenings in this population.
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Heinikari T, Huoponen O, Partanen J, Rasi V, Krusius T. Protein S gene polymorphisms Pro626 and nt2698 – no correlation to free protein S levels or protein S activities. Thromb Haemost 2017; 94:1340-1. [PMID: 16411419 DOI: 10.1160/th05-06-1340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kolho E, Naukkarinen R, Krusius T. Specificity and Sensitivity of Two Second-Generation ELISA Tests in Detecting Hepatitis C Antibodies in Blood Donors Known to Be Reactive with a Supplemental Assay. Vox Sang 2017. [DOI: 10.1159/000462252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Koljonen V, Tuimala J, Haglund C, Tukiainen E, Vuola J, Juvonen E, Lauronen J, Krusius T. The Use of Blood Products in Adult Patients with Burns. Scand J Surg 2016; 105:178-85. [DOI: 10.1177/1457496915622127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 11/11/2015] [Indexed: 11/15/2022]
Abstract
Introduction: Burn anemia represents a common complication following a burn injury. Burn anemia etiology carries distinct features occurring at each stage of the post-injury and treatment periods resulting from different causes. We aimed to analyze the use of blood components in Finnish burn victims and to identify patient- and injury-related factors influencing their use. Methods: To study the use of blood products in burn patients, we used data collected from the Optimal Use of Blood registry, developed through co-operation between 10 major hospital districts and the Finnish Red Cross Blood Service. Burn patients ⩾18 years treated at the Helsinki University Hospital between 2005 and 2011 with an in-hospital stay ⩾1 day who received at least one transfusion during their hospital stay were included in this study. Results: Among all 558 burn patients, 192 (34%) received blood products during their hospital stay. The transfused cohort comprised 192 burn patients. The study cohort received a total of 6087 units of blood components, 2422 units of leukoreduced red blood cells, 1728 units of leukoreduced platelets, and 420 units of single-donor fresh frozen plasma or, after 2007, 1517 units of Octaplas® frozen plasma. All three types of blood components were administered to 29% of patients, whereas 45% received only red blood cells and 6% received only Octaplas. Transfused patients were significantly older (p < 0.001), experienced fire-/flame-related accidents and burns to multiple locations (p < 0.001), and their in-hospital mortality exceeded that for non-transfused burn patients fivefold (p < 0.05). Discussion: We show that Finnish adult burn patients received ample transfusions. The number of blood components transfused varied according to the anatomical location of the injury and patient survival. Whether the additional mortality is related directly to transfusions or is merely a manifestation of the more severe burn injury remains unknown.
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Affiliation(s)
- V. Koljonen
- Department of Plastic Surgery, University of Helsinki and Töölö Hospital, Helsinki University Hospital, Helsinki, Finland
| | | | - C. Haglund
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland
| | - E. Tukiainen
- Department of Plastic Surgery, University of Helsinki and Töölö Hospital, Helsinki University Hospital, Helsinki, Finland
| | - J. Vuola
- Department of Plastic Surgery, University of Helsinki and Töölö Hospital, Helsinki University Hospital, Helsinki, Finland
| | - E. Juvonen
- Finnish Red Cross Blood Service, Helsinki, Finland
| | - J. Lauronen
- Clinical Consultations Unit, Finnish Red Cross Blood Service, Helsinki, Finland
| | - T. Krusius
- Finnish Red Cross Blood Service, Helsinki, Finland
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Kiminkinen LKM, Krusius T, Javela KM. Evaluation of soluble glycoprotein V as anin vitroquality marker for platelet concentrates: a correlation study betweenin vitroplatelet quality markers and the effect of storage medium. Vox Sang 2016; 111:120-6. [DOI: 10.1111/vox.12402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/21/2016] [Accepted: 03/03/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | - T. Krusius
- Finnish Red Cross Blood Service; Helsinki Finland
| | - K. M. Javela
- Finnish Red Cross Blood Service; Helsinki Finland
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Lieberman L, Devine DV, Reesink HW, Panzer S, Wong J, Raison T, Benson S, Pink J, Leitner GC, Horvath M, Compernolle V, Scuracchio PSP, Wendel S, Delage G, Nahirniak S, Dongfu X, Krusius T, Juvonen E, Sainio S, Cazenave JP, Guntz P, Kientz D, Andreu G, Morel P, Seifried E, Hourfar K, Lin CK, O'Riordan J, Raspollini E, Villa S, Rebulla P, Flanagan P, Teo D, Lam S, Ang AL, Lozano M, Sauleda S, Cid J, Pereira A, Ekermo B, Niederhauser C, Waldvogel S, Fontana S, Desborough MJ, Pawson R, Li M, Kamel H, Busch M, Qu L, Triulzi D. Prevention of transfusion-transmitted cytomegalovirus (CMV) infection: Standards of care. Vox Sang 2014; 107:276-311. [DOI: 10.1111/vox.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kaukonen KM, Vaara ST, Pettilä V, Bellomo R, Tuimala J, Cooper DJ, Krusius T, Kuitunen A, Reinikainen M, Koskenkari J, Uusaro A. Age of red blood cells and outcome in acute kidney injury. Crit Care 2013; 17:R222. [PMID: 24093554 PMCID: PMC4057274 DOI: 10.1186/cc13045] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 08/08/2013] [Indexed: 11/25/2022] Open
Abstract
Introduction Transfusion of red blood cells (RBCs) and, in particular, older RBCs has been associated with increased short-term mortality in critically ill patients. We evaluated the association between age of transfused RBCs and acute kidney injury (AKI), hospital, and 90-day mortality in critically ill patients. Methods We conducted a prospective, observational, predefined sub-study within the FINNish Acute Kidney Injury (FINNAKI) study. This study included all elective ICU admissions with expected ICU stay of more than 24 hours and all emergency admissions from September to November 2011. To study the age of RBCs, we classified transfused patients into quartiles according to the age of oldest transfused RBC unit in the ICU. AKI was defined according to KDIGO (Kidney Disease: Improving Global Outcomes) criteria. Results Out of 1798 patients, 652 received at least one RBC unit. The median [interquartile range] age of the oldest RBC unit transfused was 12 [11-13] days in the freshest quartile and 21 [17-27] days in the quartiles 2 to 4. On logistic regression, RBC age was not associated with the development of KDIGO stage 3 AKI. Patients in the quartile of freshest RBCs had lower crude hospital and 90-day mortality rates compared to those in the quartiles of older blood. After adjustments, older RBC age was associated with significantly increased risk for hospital mortality. Age, Simplified Acute Physiology Score II (SAPS II)-score without age points, maximum Sequental Organ Failure Assessment (SOFA) score and the total number of transfused RBC units were independently associated with 90-day mortality. Conclusions The age of transfused RBC units was independently associated with hospital mortality but not with 90-day mortality or KDIGO stage 3 AKI. The number of transfused RBC units was an independent risk factor for 90-day mortality.
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Coste J, Prowse C, Grabmer C, Schennach H, Santos Prado Scuracchio P, Wendel SN, Germain M, Delage G, Krusius T, Ekblom-Kullberg S, Tiberghien P, O’Riordan J, Murphy WG, Flesland Ø, Turner M, Williamson L, Gregori L, Epstein J, Asher D, Panzer S, Reesink HW. Prion reduction of red-blood-cells. Vox Sang 2012; 103:260-72. [DOI: 10.1111/j.1423-0410.2012.01597.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Reesink HW, Lee J, Keller A, Dennington P, Pink J, Holdsworth R, Schennach H, Goldman M, Petraszko T, Sun J, Meng Y, Qian K, Rehacek V, Turek P, Krusius T, Juvonen E, Tiberghien P, Legrand D, Semana G, Muller JY, Bux J, Reil A, Lin CK, Daly H, McSweeney E, Porretti L, Greppi N, Rebulla P, Okazaki H, Sánchez-Guerrero SA, Baptista-González HA, Martínez-Murillo C, Guerra-Márquez A, Rodriguez-Moyado H, Middelburg RA, Wiersum-Osselton JC, Brand A, van Tilburg C, Dinesh D, Dagger J, Dunn P, Brojer E, Letowska M, Maslanka K, Lachert E, Uhrynowska M, Zhiburt E, Palfi M, Berlin G, Frey BM, Puig Rovira L, Muñiz-Diaz E, Castro E, Chapman C, Green A, Massey E, Win N, Williamson L, Silliman CC, Chaffin DJ, Ambruso DR, Blumberg N, Tomasulo P, Land KJ, Norris PJ, Illoh OC, Davey RJ, Benjamin RJ, Eder AF, McLaughlin L, Kleinman S, Panzer S. Measures to prevent transfusion-related acute lung injury (TRALI). Vox Sang 2012; 103:231-59. [DOI: 10.1111/j.1423-0410.2012.01596.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Middelburg RA, Van Stein D, Zupanska B, Uhrynowska M, Gajic O, Muñiz-Diaz E, Galvez NN, Silliman CC, Krusius T, Wallis JP, Vandenbroucke JP, Briët E, Van Der Bom JG. Female donors and transfusion-related acute lung injury: A case-referent study from the International TRALI Unisex Research Group. Transfusion 2011; 50:2447-54. [PMID: 20529001 DOI: 10.1111/j.1537-2995.2010.02715.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although quantitative evidence is lacking, it is generally believed that the majority of cases of transfusion-related acute lung injury (TRALI) are caused by female blood donors. We aimed to examine the relation between female donors and the occurrence of TRALI. STUDY DESIGN AND METHODS We performed an international, multicenter case-referent study. TRALI patients who were diagnosed clinically, independent of serology or donor sex, and had received transfusions either only from male donors or only from female donors (unisex cases) were selected. The observed sex distribution among the donors of these TRALI patients was compared to the expected sex distribution, based on the relevant donor populations. RESULTS Eighty-three clinical TRALI cases were included; 67 cases received only red blood cells (RBCs), 13 only plasma-rich products, and three both. Among RBC recipients the relative risk (RR) of TRALI after a transfusion from a female donor was 1.2 (95% confidence interval [CI], 0.69-2.1) and among plasma-rich product recipients the RR was 19 (95% CI, 1.9-191). The p value for the difference between RBCs and plasma was 0.023. CONCLUSION Our data support the notion that plasma from female donors is associated with an increased risk of TRALI, while RBCs from female donors are not.
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Affiliation(s)
- Rutger A Middelburg
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Hiltunen LM, Laivuori H, Rautanen A, Kaaja R, Kere J, Krusius T, Rasi V, Paunio M. Factor V Leiden as a risk factor for preterm birth--a population-based nested case-control study. J Thromb Haemost 2011; 9:71-8. [PMID: 20946152 DOI: 10.1111/j.1538-7836.2010.04104.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Preterm birth is a major cause of neonatal morbidity and mortality, occurring in 5-13% of deliveries in developed countries. Genetic thrombophilia can theoretically contribute to the induction of preterm delivery, but the role of thrombophilia as risk factor is unclear. OBJECTIVES To assess factor V Leiden, FII G20210A and other selected inherited and acquired variables as risk factors for preterm birth. PATIENTS/METHODS We performed a population-based nested case-control study of 100,000 consecutive pregnancies in Finland. Cases and controls were identified by combining national registers. Clinical data were obtained from medical records and standardized questionnaires. We studied 324 cases with preterm delivery at or after 22 and before 37 completed weeks of gestation, and 752 controls. RESULTS FV Leiden was associated with a 2.4-fold risk (95% confidence interval [CI] 1.3-4.6) of preterm birth in all pregnancies, and a 2.6-fold risk (95% CI 1.4-5.1) in singleton pregnancies. FV Leiden was especially associated with late preterm birth at or after 32 weeks of pregnancy, with an odds ratio (OR) of 2.9 (95% CI 1.5-5.6) in all pregnancies and an OR of 3.1 (95% CI 1.6-6.2) in singleton pregnancies. FII G20210A was not associated with preterm birth. Twin pregnancy (OR 12.0, 95% CI 6.0-24.1) and a history of venous thrombosis (OR 3.8, 95% CI 1.4-9.8) were associated with increased risk. High educational level and modest overweight (body mass index 25-29.9 kg m(-2) ) had protective effects. CONCLUSIONS Maternal carriage of FV Leiden was associated with increased risk of late but not early preterm birth. FII G20120A was not associated with preterm birth.
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Affiliation(s)
- L M Hiltunen
- Department of Hemostasis, Finnish Red Cross Blood Service, Helsinki, Finland.
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Hiltunen LM, Laivuori H, Rautanen A, Kaaja R, Kere J, Krusius T, Paunio M, Rasi V. Factor V Leiden as risk factor for unexplained stillbirth – a population-based nested case-control study. Thromb Res 2010; 125:505-10. [DOI: 10.1016/j.thromres.2009.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 09/04/2009] [Accepted: 09/21/2009] [Indexed: 01/23/2023]
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Reesink HW, Panzer S, Dettke M, Gabriel C, Lambermont M, Deneys V, Sondag D, Dickmeiss E, Fischer-Nielsen A, Korhonen M, Krusius T, Ali A, Tiberghien P, Schrezenmeier H, Tonn T, Seifried E, Klüter H, Politis C, Stavropoulou-Gioka A, Parara M, Flesland Ø, Nascimento F, Balint B, Marin P, Bart T, Chen FE, Pamphilon DH. New cellular therapies: Is there a role for transfusion services? Vox Sang 2009; 97:77-90. [DOI: 10.1111/j.1423-0410.2009.01184.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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New HV, Stanworth SJ, Engelfriet CP, Reesink HW, McQuilten ZK, Savoia HF, Wood EM, Olyntho S, Trigo F, Wendel S, Lin Y, Hume H, Petäjä J, Krusius T, Villa S, Ghirardello S, von Lindern J, Brand A, Hendrickson JE, Josephson CD, Strauss RG, Luban NLC, Paul W. Neonatal transfusions. Vox Sang 2009; 96:62-85. [DOI: 10.1111/j.1423-0410.2008.01105.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hiltunen LM, Laivuori H, Rautanen A, Kaaja R, Kere J, Krusius T, Paunio M, Rasi V. Blood group AB and factor V Leiden as risk factors for pre-eclampsia: a population-based nested case-control study. Thromb Res 2008; 124:167-73. [PMID: 19110300 DOI: 10.1016/j.thromres.2008.11.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2008] [Revised: 10/29/2008] [Accepted: 11/23/2008] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Pre-eclampsia is an important cause of maternal morbidity and mortality. Its etiology is still unknown. Clinical symptoms correlate with activation of coagulation and inherited thrombophilia has been associated with pre-eclampsia. ABO blood group has been associated with thrombotic disorders and pre-eclampsia. We assessed ABO blood group, seven thrombophilia associated polymorphisms, and anti-beta2-glycoprotein I antibodies as risk factors for pre-eclampsia. MATERIALS AND METHODS We performed a population-based nested case-control study of 100,000 consecutive pregnancies in Finland. Cases and controls were identified by combining national registers and medical records were reviewed. We studied 248 cases fulfilling strict criteria for pre-eclampsia and 679 controls. Severe pre-eclampsia, early pre-eclampsia, and pre-eclampsia with intra-uterine growth restriction (IUGR) were analyzed separately. RESULTS Blood group AB increased the risk for pre-eclampsia as a whole (OR 2.1, 95% CI 1.3-3.5), and in the three subgroups (OR 2.3, 3.8, 3.4; 95% CI 1.3-3.9, 2.0-7.1, 1.6-7.1). FV Leiden increased the risk as a whole (OR 1.7, 95% CI 0.8-3.9), and in the three subgroups, although not statistically significantly. Anti-beta2-glycoprotein I antibodies were not associated with pre-eclampsia. High body mass index, diabetes, first pregnancy, and twin pregnancy increased the risk from 1.5-fold to 8.2-fold. CONCLUSIONS Our results confirm and extend the prior observation of blood group AB being a risk factor for pre-eclampsia. ABO blood group is known from all pregnant women. The value of blood group as risk factor for pre-eclampsia should be further assessed in prospective studies. In this study, FV Leiden was not statistically significant risk factor.
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Affiliation(s)
- Leena M Hiltunen
- Department of Hemostasis, Finnish Red Cross Blood Service, Helsinki, Finland.
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Reesink HW, Engelfriet CP, Henn G, Mayr WR, Delage G, Bernier F, Krusius T, Assal A, Gallian P, Corbi C, Morel P, David B, De Micco P, Murokawa H, Yugi H, Hino S, Tadokoro K, Flesland O, Brojer E, Letowska M, Olim G, Nascimento F, Gonçalves H, Castro L, Morais M, Stezinar SL, Alvarez M, Sauleda S, González R, Niederhauser C, Stolz M, Allain JP, Owusu-Ofori S, Eglin R, Stramer S, Busch M, Strong DM, Epstein J, Biswas R. Occult hepatitis B infection in blood donors. Vox Sang 2008; 94:153-66. [PMID: 18205672 DOI: 10.1111/j.1423-0410.2008.01017.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- H W Reesink
- Sanquin Consulting Services, Amsterdam, The Netherlands.
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Reesink HW, Engelfriet CP, Hyland CA, Coghlan P, Tait B, Wsolak M, Keller AJ, Henn G, Mayr WR, Thomas I, Osselaer JC, Lambermont M, Beaten M, Wendel S, Qiu Y, Georgsen J, Krusius T, Mäki T, Andreu G, Morel P, Lefrère JJ, Rebulla P, Giovanelli S, Butti B, Lecchi L, Mozzi F, Van Hilten JA, Zwaginga JJ, Flanagan P, Flesland Ø, Brojer E, Łętowska M, Åkerblom O, Norda R, Prowse C, Dow B, Jarvis L, Davidson F, Kleinman S, Bianco C, Stramer SL, Dodd RY, Busch MP. Biobanks of blood from donors and recipients of blood products. Vox Sang 2008; 94:242-260. [PMID: 18225990 DOI: 10.1111/j.1423-0410.2007.01020.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Recombinant DNA methods have been used to analyse core proteins of two different proteoglycans, one from a rat yolk sac tumour and the other from human fibroblasts and fetal membrane tissue. The processed core protein of the yolk sac tumour proteoglycan is a 104-amino acid polypeptide. This polypeptide contains a 49-amino acid serine-glycine repeat which clearly serves as the chondroitin sulphate attachment region. Genomic and mRNA blots suggest that this core protein is a member of a multigene family the members of which share the Ser-Gly repeat. The fibroblast/fetal membrane proteoglycan has a 329-amino acid core protein which is also processed from a larger precursor. This core protein contains three individual Ser-Gly dipeptides, one of which is known to be substituted with a chondroitin/dermatan sulphate side-chain. The availability of proteoglycan cDNA clones will facilitate gene transfer studies aimed at identifying the recognition sequences for the addition of the glycosaminoglycan. Gene transfer should also allow studies on the effects of proteoglycan expression on cellular properties such as adhesion and tumorigenicity.
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Hiltunen L, Laivuori H, Rautanen A, Kaaja R, Kere J, Krusius T, Paunio M, Rasi V. BLOOD GROUP AB AND FV LEIDEN AS RISK FACTORS FOR PRE-ECLAMPSIA. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb00880.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Palo R, Ahonen J, Salo H, Salmenperä M, Krusius T, Mäki T. Transfusion of red blood cells: no impact on length of hospital stay in moderately anaemic parturients. Acta Anaesthesiol Scand 2007; 51:565-9. [PMID: 17430317 DOI: 10.1111/j.1399-6576.2007.01265.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In a search for information to improve decision making on red blood cell (RBC) transfusion, we examined the impact of RBC transfusion on the length of hospital stay for delivery in moderately anaemic women (haemoglobin, 7-10 g/dl). METHODS This was a retrospective, observational study covering 2 years (2002 and 2003), and included major blood-transfusing hospitals from four university and five central hospital districts managing 67.5% of Finnish in-hospital deliveries. The impact of the transfusion of 1-2 RBC units vs. no transfusion on the length of hospital stay was evaluated for three different haemoglobin levels: 7-7.9, 8-8.9 and 9-10 g/dl. RESULTS Of the 1954 moderately anaemic mothers in hospital for delivery, 13.3% were transfused with RBC. The mean length of hospital stay was 5.2 days vs. the average Finnish hospital delivery stay of 3.5 days. No differences in stay were found between patients with comparable anaemia transfused with 1-2 RBC units or none (at the three haemoglobin levels: P= 0.50, P= 0.07 and P= 0.54, respectively). The final haemoglobin value was higher (P < 0.001) in transfused patients. CONCLUSION The duration of admission for delivery in moderately anaemic parturients was longer than the average length of hospital stay in Finnish parturients. However, 1-2 RBC units had no impact on the length of stay, suggesting that unnecessary RBCs are transfused after delivery. Thus, transfusion practices in obstetrics are not always optimal.
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Affiliation(s)
- R Palo
- Hospital District of Helsinki and Uusimaa, Department of Anaesthesia and Intensive Care, Helsinki University Hospital (Meilahti Hospital), Haartmaninkatu 4, FI 00029 HUS, Helsinki, Finland.
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Wendel S, Biagini S, Trigo F, Fontão-Wendel R, Taaning E, Jørgensen J, Riisom K, Krusius T, Koskinen S, Kretschmer V, Karger R, Lawlor E, Okazaki H, Charlewood R, Brand A, Solheim BG, Flesland O, Letowska M, Zupanska B, Muñiz-Diaz E, Nogués N, Senn M, Mansouri-Taleghani B, Chapman CE, Massey E, Navarrete C, Stainsby D, Win N, Williamson LM, Kleinman S, Kopko PM, Silva M, Shulman I, Holness L, Epstein JS. Measures to prevent TRALI. Vox Sang 2007; 92:258-77. [PMID: 17348877 DOI: 10.1111/j.1423-0410.2006.00870.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Wendel
- Hospital Sirio Libanês, Rua Adma Jafet 91, São Paulo, Brazil.
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Hiltunen L, Rautanen A, Rasi V, Kaaja R, Kere J, Krusius T, Vahtera E, Paunio M. An unfavorable combination of factor V Leiden with age, weight, and blood group causes high risk of pregnancy-associated venous thrombosis—a population-based nested case-control study. Thromb Res 2007; 119:423-32. [PMID: 16765424 DOI: 10.1016/j.thromres.2006.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2006] [Revised: 03/15/2006] [Accepted: 04/17/2006] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Hereditary and acquired risk factors increase the risk for thrombosis among pregnant women. Few risk estimates are, however, well established. The aim of the present study was to assess risk for pregnancy-associated venous thrombosis of factor V Leiden (FVL), FII G20210A, FV A4070G, MTHFR C677T, TFPI C536T, PROC T38853G, FXIII V34L, blood group, age, and body mass index (BMI), and their interactions and public health impact. MATERIALS AND METHODS Study design is a population-based nested case-control study of 100,000 consecutive pregnancies in Finland. Cases and controls were identified by combining national registers. Thirty four cases with objectively diagnosed venous thrombosis and 641 controls were studied. RESULTS FVL (OR 11.6, 95% CI 3.6-33.6), age >35 vs. <25 (OR 6.3, 95% CI 1.7-23.1), and BMI >30 vs. <25 (OR 5.6, 95% CI 2.3-13.9) were associated with thrombosis. Overall absolute risk of a FVL carrier was 1 in 314. FVL interacted with age, BMI, and blood group. Population attributable risk proportion was 19% for FVL, 23% for age >35, 33% for BMI >25, and 35% for non-O blood group. Unexpectedly, the prevalence of FVL increased with age in controls. CONCLUSIONS FVL appeared as a strong risk factor for pregnancy-associated venous thrombosis. Especially in elderly overweight mothers, FVL may cause a substantial thrombosis risk. Further studies are needed to confirm the increased prevalence of FVL in elderly mothers with normal pregnancies.
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Affiliation(s)
- Leena Hiltunen
- Department of Hemostasis, Finnish Red Cross Blood Service, Kivihaantie 7, FIN-00310 Helsinki, Finland
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Palo R, Capraro L, Hovilehto S, Koivuranta M, Krusius T, Loponen E, Mäntykoski R, Pentti J, Pitkänen O, Raitakari M, Rimpiläinen J, Salmenperä M, Salo H, Mäki T. Population-based audit of fresh-frozen plasma transfusion practices. Transfusion 2006; 46:1921-5. [PMID: 17076847 DOI: 10.1111/j.1537-2995.2006.00998.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In contrast to decreasing red blood cell (RBC) consumption in Finland, the use of fresh-frozen plasma (FFP) has been increasing since the 1990s, suggesting that FFP use may not always be optimal. To improve transfusion practices, knowledge of current FFP use and regional, national, and international comparison is necessary. STUDY DESIGN AND METHODS Nine (of 21) Finnish hospital districts participated. Data concerning FFP-transfused patients in the years 2002 and 2003 were collected from existing computerized medical records into a yearly updated database as part of a Finnish benchmarking project on blood component use. RESULTS Data included 11,590 FFP-transfused patients and 60,240 FFP units (71.2% of Finnish FFP use) delivered to Finnish hospitals during the study period. FFP was transfused most often to surgery patients (62.8% of FFP transfusion hospital visits) with blood circulatory system problems (32.3% of surgically treated and FFP-transfused patients). In only 65.9 percent of FFP-transfused patients were coagulation variables measured at any point in the hospital episode, and FFP was usually transfused in paired doses. Mean FFP use in Finland is comparable to other countries. CONCLUSION Although overall FFP use in Finland is similar to that of international figures, it does not ensure best practice. Perioperative staff, being the largest FFP user, should be encouraged to dose FFP based on coagulation variables and body weight. Improvement efforts should be directed to patient groups transfused with large amounts of FFP.
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Affiliation(s)
- Riikka Palo
- Finnish Red Cross Blood Service, Helsinki, Finland.
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25
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Palo R, Ali-Melkkilä T, Hanhela R, Jäntti V, Krusius T, Leppänen E, Mahlamäki EK, Perhoniemi V, Rajamäki A, Rautonen J, Salmenperä M, Salo H, Salonen I, Savolainen ER, Sjövall S, Suistomaa M, Syrjälä M, Tienhaara A, Vähämurto M, Mäki T. Development of permanent national register of blood component use utilizing electronic hospital information systems. Vox Sang 2006; 91:140-7. [PMID: 16907875 DOI: 10.1111/j.1423-0410.2006.00814.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES We wanted to establish a permanent national database system, which can be utilized to study transfusion recipients and blood use in Finland. MATERIALS AND METHODS A regularly updated register for permanent use was developed. To study the usability of the database, years 2002 and 2003 were further analysed. Database included all transfused patients in major blood-transfusing hospitals from four university and five central hospital districts managing altogether 63% of Finnish inpatient hospital episodes. RESULTS Audit of gathered data reveal 96.8% match in adult blood components with Finnish Red Cross, Blood Service sales figures. Model data set includes 59,535 transfused patients (44.3% men and 55.7% women) having received 529,104 blood components. Half of all blood units were transfused in connection with surgical operations. Most of the blood recipients were elderly (51.6% are over 64 years of age). Blood-component use and transfusion-related costs varied widely between hospitals. CONCLUSION Hospital data managing systems can be useful for creating a population-based database system to monitor and compare transfusion practices. This record provides information about transfusion epidemiology for transfusion professionals, hospital management, and hospital administration.
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Affiliation(s)
- R Palo
- Finnish Red Cross Blood Service, Helsinki, Finland.
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Kuismanen K, Levo A, Vahtera E, Rasi V, Labrouche S, Freyburger G, Krusius T, Partanen J. Genetic background of type I protein C deficiency in Finland. Thromb Res 2006; 118:603-9. [PMID: 16360797 DOI: 10.1016/j.thromres.2005.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2005] [Revised: 10/16/2005] [Accepted: 10/19/2005] [Indexed: 11/24/2022]
Abstract
In contrast to other populations the usually rare type II form of protein C deficiency is as common in Finland as type I deficiency. We recently reported that a single mutation explained virtually all cases of type II protein C deficiency in Finland, indicating strong founder effect. We now investigated in the same population the genetic background of type I protein C deficiency. Thirty-eight apparently unrelated families were studied. They represent the vast majority of all families with type I deficiency in Finland. A genetic defect was identified in 23 (61%) families who carried 13 different mutations. Only three of the 13 mutations have been reported in other populations. Unlike in type II deficiency, considerable heterogeneity in mutations was found in type I deficiency. Our results indicate interesting differences in mutational histories of these two different forms of protein C deficiency in Finland.
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Coste J, Reesink HW, Engelfriet CP, Laperche S, Brown S, Busch MP, Cuijpers HT, Elgin R, Ekermo B, Epstein JS, Flesland O, Heier HE, Henn G, Hernandez JM, Hewlett IK, Hyland C, Keller AJ, Krusius T, Levicnik-Stezina S, Levy G, Lin CK, Margaritis AR, Muylle L, Niederhauser C, Neiderhauser C, Pastila S, Pillonel J, Pineau J, van der Poel CL, Politis C, Roth WK, Sauleda S, Seed CR, Sondag-Thull D, Stramer SL, Strong M, Vamvakas EC, Velati C, Vesga MA, Zanetti A. Implementation of donor screening for infectious agents transmitted by blood by nucleic acid technology: update to 2003. Vox Sang 2005; 88:289-303. [PMID: 15877653 DOI: 10.1111/j.1423-0410.2005.00636_1.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- J Coste
- EFS Pyrénées-Méditerranée Laboratoire de R&D, F-34000 Montpellier, France.
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28
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Hannila-Handelberg T, Kontula K, Tikkanen I, Tikkanen T, Fyhrquist F, Helin K, Fodstad H, Piippo K, Miettinen HE, Virtamo J, Krusius T, Sarna S, Gautschi I, Schild L, Hiltunen TP. Common variants of the beta and gamma subunits of the epithelial sodium channel and their relation to plasma renin and aldosterone levels in essential hypertension. BMC Med Genet 2005; 6:4. [PMID: 15661075 PMCID: PMC547905 DOI: 10.1186/1471-2350-6-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2004] [Accepted: 01/20/2005] [Indexed: 11/25/2022]
Abstract
Background Rare mutations of the epithelial sodium channel (ENaC) result in the monogenic hypertension form of Liddle's syndrome. We decided to screen for common variants in the ENaC βand γ subunits in patients with essential hypertension and to relate their occurrence to the activity of circulating renin-angiotensin-aldosterone system. Methods Initially, DNA samples from 27 patients with low renin/low aldosterone hypertension were examined. The DNA variants were subsequently screened for in 347 patients with treatment-resistant hypertension, 175 male subjects with documented long-lasting normotension and 301 healthy
Plasma renin and aldosterone levels were measured under baseline conditions and during postural and captopril challenge tests. Results Two commonly occurring βENaC variants (G589S and a novel intronic i12-17CT substitution) and one novel γENaC variant (V546I) were detected. One of these variants occurred in a heterozygous form in 32 patients, a prevalence (9.2%) significantly higher than that in normotensive males (2.9%, p = 0.007) and blood donors (3.0%, p = 0.001). βENaC i12-17CT was significantly more prevalent in the hypertension group than in the two control groups combined (4.6% vs. 1.1%, p = 0.001). When expressed in Xenopus oocytes, neither of the two ENaC amino acid-changing variants showed a significant difference in activity compared with ENaC wild-type. No direct evidence for a mRNA splicing defect could be obtained for the βENaC intronic variant. The ratio of daily urinary potassium excretion to upright and mean (of supine and upright values) plasma renin activity was higher in variant allele carriers than in non-carriers (p = 0.034 and p = 0.048). Conclusions At least 9% of Finnish patients with hypertension admitted to a specialized center carry genetic variants of β and γENaC, a three times higher prevalence than in the normotensive individuals or in random healthy controls. Patients with the variant alleles showed an increased urinary potassium excretion rate in relation to their renin levels.
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Affiliation(s)
- Tuula Hannila-Handelberg
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Kimmo Kontula
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Ilkka Tikkanen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Tuula Tikkanen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Frej Fyhrquist
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Karri Helin
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Heidi Fodstad
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Kirsi Piippo
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Helena E Miettinen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
| | - Jarmo Virtamo
- Department of Epidemiology and Health Promotion, National Public Health Institute, 00300 Helsinki, Finland
| | - Tom Krusius
- The Finnish Red Cross Blood Service, 00310 Helsinki, Finland
| | - Seppo Sarna
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
| | - Ivan Gautschi
- Institute of Pharmacology and Toxicology, University of Lausanne, 1005 Lausanne, Switzerland
| | - Laurent Schild
- Institute of Pharmacology and Toxicology, University of Lausanne, 1005 Lausanne, Switzerland
| | - Timo P Hiltunen
- Department of Medicine, University of Helsinki, and Biomedicum Helsinki, University of Helsinki, 00290 Helsinki, Finland
- Helsinki University Central Hospital, Jorvi Hospital, 02740 Espoo, Finland
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Mäki T, Krusius T. [The microbial safety of transfusion products]. Duodecim 2004; 120:885-92. [PMID: 15154310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Tiina Mäki
- SPR Veripalvelu Kivihaantie 7 00310 Helsinki.
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30
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Krusius T, Porkka K. [Developments in blood transfusion]. Duodecim 2004; 120:857-9. [PMID: 15154306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Tom Krusius
- SPR Veripalvelu Kivihaantie 7 00310 Helsinki.
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31
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Reesink HW, Engelfriet CP, Muylle L, Wendel S, Dickmeiss E, Krusius T, Mäki T, Lin CK, O'Riordan J, Prati D, Rebulla P, Shirato T, Nakajima K, Dupuis HM, Flanagan P, Carasa MAV, Gallastegui RA, Turek P, Hewitt P, Bernat JL, Bianco C, Dodd RY, Klein HG. Future counselling of donors and recipients of blood products concerning prion-related diseases. Vox Sang 2003; 85:126-48. [PMID: 12925171 DOI: 10.1046/j.1423-0410.2003.00343.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- H W Reesink
- Sanquin Blood Bank Region North-West, Amsterdam, The Netherlands.
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Engelfriet CP, Reesink HW, Klein HG, AuBuchon JP, Strauss RG, Krusius T, Mäki T, Rebulla P, Högman CF, Knutson F, Letowska M, Dickmeiss E, Winter M, Henn G, Menichetti E, Mayr WR, Flanagan P, Martin-Vega C, Massuet L, Wendel S, Turek P, Lin CK, Shirato T. The future use of pathogen-inactivated platelet concentrates. Vox Sang 2003; 85:54-66. [PMID: 12823735 DOI: 10.1046/j.1423-0410.2003.00315.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Heliö T, Halme L, Lappalainen M, Fodstad H, Paavola-Sakki P, Turunen U, Färkkilä M, Krusius T, Kontula K. CARD15/NOD2 gene variants are associated with familially occurring and complicated forms of Crohn's disease. Gut 2003; 52:558-62. [PMID: 12631669 PMCID: PMC1773614 DOI: 10.1136/gut.52.4.558] [Citation(s) in RCA: 206] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Variants of the caspase activating recruitment domain 15/nucleotide oligomerisation domain 2 (CARD15/NOD2) gene have been associated with susceptibility to Crohn's disease (CD). AIM Our aim was to evaluate the allele frequencies of the CARD15 variants R702W, G908R, and 1007fs in Finnish inflammatory bowel disease (IBD) patients and to search for possible associations between CARD15 variants and occurrence of familial forms of IBD or complicated forms of CD. PATIENTS AND METHODS We investigated 198 sporadic CD patients, 46 probands with familial CD, 27 CD probands from mixed IBD families, 99 unrelated patients with ulcerative colitis (UC), and 300 control individuals for the occurrence of the CARD15 gene variants R702W, G908R, and 1007fs. RESULTS In CD patients, the allele frequencies for the rare variants of these polymorphisms were 3.3%, 0.6%, and 4.8% (total 8.7%), and the corresponding frequencies in healthy controls were 1.8%, 0%, and 1.7% (total 3.5%) (8.7% v 3.5%; p<0.01). In UC patients allele frequencies were comparable with those in controls. The frequency of the 1007fs polymorphism variant allele was significantly higher among all CD patients than in controls (4.8% v 1.7%; p<0.01) but there was no significant difference in allele frequencies between the CD and UC groups. The 1007fs allele frequency was higher in familial CD than in non-familial cases with CD (10.9% v 3.5%; p<0.01). There were no significant differences in the allele frequencies of the R702W and G908R polymorphisms between CD patients, UC patients, and controls. We found that 15.5% of CD patients, 9.1% of UC patients, and 6.7% of controls carried at least one of the CARD15 variants. In CD patients carrying at least one of the three NOD2 variants, the ileum was affected more often than in non-carrier CD patients (90% v 73%; p<0.05), they had stricturing or penetrating disease more often than non-carriers (88% v 56%; p<0.01), and they had an increased need for bowel surgery. CONCLUSIONS The frequency of NOD2 gene variants was lower in genetically homogenous Finns than in other populations. The 1007fs variant was associated with CD. The occurrence of CARD15 variants predicted ileal location as well as stricturing and penetrating forms of CD.
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Affiliation(s)
- T Heliö
- Department of Medicine, Helsinki University Hospital, Helsinki, Finland.
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34
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Schalin-Jäntti C, Valli-Jaakola K, Oksanen L, Martelin E, Laitinen K, Krusius T, Mustajoki P, Heikinheimo M, Kontula K. Melanocortin-3-receptor gene variants in morbid obesity. Int J Obes (Lond) 2003; 27:70-4. [PMID: 12532156 DOI: 10.1038/sj.ijo.0802184] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2002] [Revised: 06/10/2002] [Accepted: 07/22/2002] [Indexed: 11/09/2022]
Abstract
BACKGROUND Linkage and knock-out mice studies suggest that the melanocortin-3-receptor (MC3R) is a candidate gene for obesity. OBJECTIVE To evaluate whether MC3R mutations underlie morbid obesity. SUBJECTS AND METHODS MC3R coding and 5(')-flanking regions were sequenced in 48 subjects and the detected variants genotyped in 252 morbidly obese (BMI>/=40 kg/m(2)) Finns. Gel shifts were used to examine whether a mutation in the putative promoter alters GATA-factor binding. RESULTS Three common MC3R variants were found: a 17C>A variant, changing Thr6-->Lys in 16%, a 241G>A variant changing Val81-->Ile in 15%, and a -239A>G substitution in the GATA binding site in 21% of the subjects. Four other variants were detected in the 5(') flanking region. Frequencies of the three common variants did not differ between obese and contol subjects. Among the obese, the 17C>A and 241G>A variants were coinherited and associated with increased insulin-glucose ratios (P<0.05) and leptin levels (P<0.05). GATA-4 bound efficiently to wild type oligonucleotide, but only weakly to the oligonucleotide with the -239A>G mutation. CONCLUSIONS MC3R gene variants are common and do not explain human morbid obesity. These variants associated with subtle changes in onset of weight gain, hyperleptinemia and insulin-glucose ratios. The -239A>G mutation abolishes binding of GATA-4 to the MC3R promoter region.
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Affiliation(s)
- C Schalin-Jäntti
- Department of Medicine, University of Helsinki, Helsinki, Finland.
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Reesink HW, Engelfriet CP, Tegtmeier GE, O'Riordan J, Eglin R, Barbara JAJ, Flanagan P, Lin CK, Rawlinson W, Muylle L, Wendel S, Biagini S, Lazar AE, Krusius T, Alitupa E, Grillner L, Preiser W, Doerr HW, Brand A, Zupanska B, Brojer E, Degré M. Prevention of post-transfusion cytomegalovirus: leucoreduction or screening? Vox Sang 2002; 83:72-87. [PMID: 12100393 DOI: 10.1046/j.1423-0410.2002.t01-1-01851.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- H W Reesink
- Blood Bank North Holland (Sanquin) Plesmanlaan 125 NL - 1066 CX Amsterdam, The Netherlands
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Stengård JH, Salomaa V, Rasi V, Vahtera E, Ehnholm C, Krusius T, Perola M, Vartiainen E. Utility of the Arg/Gln polymorphism of the factor VII (FVII) gene, serum lipid levels and body mass index in the prediction of the FVII:C and FVII:Ag in North Karelia; a cross-sectional and prospective study. Blood Coagul Fibrinolysis 2001; 12:445-52. [PMID: 11555697 DOI: 10.1097/00001721-200109000-00004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The arginine/glutamine (Arg/Gln) polymorphism of the factor VII (FVII) gene is associated with variation in coagulation activity (FVII:C) and antigen concentration (FVII:Ag) of the FVII protein. We estimated frequency distributions of the Arg and Gln alleles and respective genotypes in North Karelia, and evaluated the utility of this polymorphism, serum lipids, and body mass index (BMI) in the prediction of the distributions of FVII:C and FVII:Ag in a cross-sectional study and in a prospective cohort study. The sample comprised 203 males and 262 females (aged 45-64 years) who were seen twice, in 1992 and 1995. The Arg/Arg genotype and the Arg allele frequencies were among the highest reported so far (86 and 93% respectively, in men; and 89 and 94% respectively, in women). Intragenotypic means of both FVII:C and FVII:Ag were significantly higher in the Arg/Arg genotype than in the Arg/Gln genotype in both genders. Also, intragenotypic variances were different in different genotypes in females. Regression relationships between the FVII:C and FVII:Ag and serum triglyceride, and total cholesterol levels and BMI were positive in both genotypes in both genders, which has not been found in other populations. In prospective analyses, average changes in the FVII:C and FVII:Ag were genotype specific in both genders, as were also regression relationships between these changes and changes in triglyceride level in females (P = 0.065 for FVII:C and P = 0.061 for FVII:Ag). A consequence of these complex genetic architectures is that predictive utility of the Arg/Gln genotypes depends on population, gender, serum lipid levels, and BMI, and changes in these factors over time.
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Affiliation(s)
- J H Stengård
- Department of Epidemiology and Health Promotion, KTL-National Public Health Institute, Helsinki, Finland.
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Halme L, Heliö T, Mäkinen J, Höckerstedt K, Färkkilä M, Piippo K, Krusius T, Kontula K. HFE haemochromatosis gene mutations in liver transplant patients. Scand J Gastroenterol 2001; 36:881-5. [PMID: 11495086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
BACKGROUND The majority of patients with inherited haemochromatosis carry two mutant alleles of the recently discovered HFE gene. Individuals heterozygous for the HFE mutation could be predisposed to end-stage liver disease due to other causes. METHODS The frequencies of the HFE gene mutations C282Y and H63D were determined in DNA samples obtained from 189 liver transplant patients and 225 healthy Finnish blood donors. RESULTS 5% of the 189 liver transplant recipients were heterozygotes and 0.5% homozygotes for the C282Y mutation, while 16% were heterozygotes and 0.5% homozygotes for the H63D mutation. These figures were not increased in comparison to controls, of whom 11% were C282Y heterozygotes, 16% H63D heterozygotes and 0.9% H63D homozygotes. Among recipients with acute non-A-E hepatitis (n = 31), the frequency of the H63D allele was higher than in controls (21% versus 9.1%, P < 0.01). Perls' stain for iron in explanted liver specimens was positive in 28% of recipients with alcoholic cirrhosis, 26% of patients with acute non-A-E hepatitis and 14% in the rest of the recipients. The HFE genotypes did not correlate with the iron status. CONCLUSION Individuals heterozygous for either the C282Y or H63D mutation of the HFE gene are not at increased risk of developing chronic end-stage liver disease. However, subjects heterozygous for the H63D mutation may have an increased risk to develop fulminant non-A-E hepatitis.
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Affiliation(s)
- L Halme
- Dept. of Surgery, University of Helsinki, Finland.
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Engelfreit CP, Reesink HW, Krusius T, Wendel S, Fontäo-Wendel R, Hoffer I, Medgyesi G, Tadokoro K, Pisacka M, Kühnl P, Schwartz DW, Mayr WR, Schönitzer D, Lin CK, James V, Castel A, Hazenberg CA, Letowska M, Solheim BG, Guerts M, Ghosh S, Flanagan P, Epstein J, Säfwenberg J, Riccardi D, Sirchia G. The use of the computer cross-match. Vox Sang 2001; 80:184-92. [PMID: 11449959 DOI: 10.1046/j.1423-0410.2001.00032.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- C P Engelfreit
- Central Laboratory of the Blood Transfusion Service (Sanquin) Plesmanlaan 125, NL-1066 CX Amsterdam, The Netherlands
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Rissanen P, Vahtera E, Krusius T, Uusitupa M, Rissanen A. Weight change and blood coagulability and fibrinolysis in healthy obese women. Int J Obes (Lond) 2001; 25:212-8. [PMID: 11410822 DOI: 10.1038/sj.ijo.0801540] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2000] [Revised: 08/09/2000] [Accepted: 09/19/2000] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To study the effect of weight loss and subsequent weight maintenance or weight regain on the activities of FVII and plasminogen activator inhibitor 1 (PAI-1) and the concentration of fibrinogen over 12 months in obese women consuming a hypoenergetic, low-fat diet with or without orlistat. In addition, the relation between the changes of the activities of PAI-1 and FVII with the changes of other cardiovascular risk factors were examined. METHODS AND PROCEDURES Design-a 12-month randomized double-blind weight reduction trial of placebo and orlistat. Subjects-51 healthy obese women (age 44+/-0.7 y, BMI 36.2+/-0.5 kg/m(2), mean+/-s.e.m.) Treatment-the participants were on a hypoenergetic diet (-600 kcal daily). The diet was adjusted for actual body weight (-300 kcal) at 6 months. Women were randomized to receive either orlistat 120 mg three times daily (n=25) or placebo three times daily (n=26) for 12 months according to a double-blind protocol after a 1 month run-in period. Measurements-changes of body weight, body composition, haemostatic and other cardiovascular risk factors were measured at 3-6 month intervals. The activity of plasma PAI-1 was measured by a chromogenic method, fibrinogen by the PT-derived method and the activity of FVII by the one-stage method. RESULTS The changes in body weight between orlistat and placebo groups were not statistically significantly different. Orlistat did not influence haemostatic factors beyond its effect on weight loss. Therefore, the results of the orlistat and placebo groups were pooled. The average weight loss at 3, 6 and 12 months was 7.6, 9.5 and 10.0 kg, respectively (P<0.001). Between 6 and 12 months, 35% of women regained weight, 24% had stable weight and 41% continued to lose weight. No changes in the mean plasma fibrinogen concentration were observed at any time point during the trial. During the first 3 months the activities of PAI-1 and FVII decreased. The decline depended on the magnitude of weight loss. Between months 6 and 12 the changes of PAI-1 and FVII activities paralleled the changes of body weight. The activities rose with weight rebound but remained below the 6-month values if weight loss was sustained or continued. The changes of serum insulin were significantly correlated with the changes of both PAI-1 and FVII at 6 months and with PAI-1 at 12 months. CONCLUSIONS The maintenance of modest weight loss is associated with long-term benefits in PAI-1 and FVII in obese women. The change of serum insulin is associated with the changes of PAI-1 activities. Fibrinogen is not affected by modest weight loss.
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Affiliation(s)
- P Rissanen
- Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland, and Obesity Research Unit, Helsinki University Central Hospital, Helsinki, Finland.
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Kanerva J, Tiirikainen MI, Mäkipernaa A, Riikonen P, Möttönen M, Salmi TT, Krusius T, Saarinen-Pihkala UM. Initial P-glycoprotein expression in childhood acute lymphoblastic leukemia: no evidence of prognostic impact in follow-up. Pediatr Hematol Oncol 2001; 18:27-36. [PMID: 11205837 DOI: 10.1080/088800101750059837] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Treatment results in childhood acute lymphoblastic leukemia (ALL) have improved remarkably during the past 20 years, but still 25% of children cannot be permanently cured. Drug resistance is a major cause of poor outcome. One of the most investigated resistance mechanisms is the P-glycoprotein (P-gp)-mediated multiple-drug resistance (MDR). The authors prospectively analyzed P-gp using flow cytometry with monoclonal antibody JSB1 in a population-based series of 103 children with ALL treated according to intensive Nordic ALL protocols. Increased P-gp expression was detected in 55 patients (53%). With a cutoff value of 1% P-gp-positive blasts in bone marrow, no difference was found in event-free survival (EFS) or overall survival between children with low vs. increased P-gp expression. The 4-year EFS in the whole series was 77%. Patients with T-ALL had higher P-gp levels than the others, 3.6% vs. 1.0% (p = .002). P-gp expression did not correlate with the white blood cell count, age, sex, or cytogenetics. The authors conclude that the level of P-gp expression cannot be used as a tool for treatment stratification in childhood ALL.
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Affiliation(s)
- J Kanerva
- Hospital for Children and Adolescents, Helsinki University Central Hospital, P.O.B. 281, FIN-00290 Helsinki, Finland.
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Abstract
In the seventh national voluntary cross-sectional survey (in 1999) of Finnish patients with haemophilia A or B, type 3 von Willebrand disease or factor XIII deficiency, a plasma sample was received from 193 patients (67%). The samples were tested for hepatitis B and C, human immunodeficiency virus (HIV) and human T-cell leukaemia virus (HTLV) antibodies. Fifty-one percent of the patients were hepatitis C antibody positive and 34% hepatitis B core antibody positive. None of the patients had antibodies against HIV or HTLV. Eighteen percent of the patients had an elevated alanine aminotransferase activity. Abnormal alanine aminotransferase was significantly associated with hepatitis C seropositivity. No new seroconversions were detected among the haemophiliacs or patients with type 3 von Willebrand disease when compared with the last two surveys in 1993 and 1996, and there was no seroconversion in sole users of solvent/detergent-treated factor products. Currently, 32% of the patients use prophylactic factor treatment as their principal mode of therapy, particularly the younger patients with severe forms of the bleeding diseases.
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Affiliation(s)
- F Ebeling
- Finnish Red Cross Blood Transfusion Service, Helsinki, Finland
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Reesink HW, Engelfriet CP, Vrielink H, Krusius T, Lankinen M, Flanagan P, Barbara J, Gill P, Dodd RY, Busch MP, Prati D, Mozzi F, Sirchia G, Diekamp U, Epstein JS, Tabor E, Martin-Vega C, Hernândez JM. Consequences of nucleic acid amplification testing for blood transfusion centres. Vox Sang 2000; 74:263-70. [PMID: 9691411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Engelfriet CP, Reesink HW, Brand B, Lévy G, Williamson LM, Menitove JE, Heier HE, Jørgensen J, Politis C, Seyfried H, Smit Sibinga CT, Faber JC, Vesga MA, Selivanov E, Danilova T, Tadokoro K, Krusius T, Hafner V, Snopek I, Reali G, d'Almeida Gonçalves J. Haemovigilance systems. Vox Sang 2000; 77:110-20. [PMID: 10577259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- C P Engelfriet
- Central Laboratory of The Netherlands, Red Cross Blood Transfusion Service, Amsterdam
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Engelfriet CP, Reesink HW, Strauss RG, Luban NL, Letsky E, Modi N, Zupańska B, van Leeuwen EF, Martín-Vega C, Krusius T. Blood transfusion in premature or young infants with polyagglutination and activation of the T antigen. Vox Sang 2000; 76:128-32. [PMID: 10232999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Levo A, Kuismanen K, Holopainen P, Vahtera E, Rasi V, Holopainen P, Rasi V, Krusius T, Partanen J. Single founder mutation (W380G) in type II protein C deficiency in Finland. Thromb Haemost 2000; 84:424-8. [PMID: 11019966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The present study investigated the genetic basis for type II protein C deficiency in Finland, where this form has an unusually high incidence. We demonstrated that, first, a single novel mutation W380G in the protein C gene (PROC) explained 25/26 index patients, estimated to represent two thirds of all families with type II deficiency in Finland. Second, extended chromosomal conservation, i.e. a specific haplotype, around the W380G mutation was indicated in unrelated patients. Third, a local geographical origin for the W380G mutation was suggested by genealogical data. These results are in contrast to the heterogeneity in type II protein C deficiency elsewhere, but closely parallel disorders of the Finnish disease heritage. The high frequency of the type II disease can be explained by founder effect and subsequent enrichment of a single mutation in Finland. The present study also provided a simple means for genetic diagnosis of this disease and the genetic test can be included in the routine screenings in this population.
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Affiliation(s)
- A Levo
- Finnish Red Cross Blood Transfusion Service, Helsinki
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Krusius T. Blood Transfusion in Premature or Young Infants with Polyagglutination and Activation of the T Antigen. Vox Sang 1999. [DOI: 10.1046/j.1423-0410.1999.76201288.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Virtanen MA, Viinikka LU, Virtanen MK, Svahn JC, Anttila RM, Krusius T, Cook JD, Axelsson IE, Räihä NC, Siimes MA. Higher concentrations of serum transferrin receptor in children than in adults. Am J Clin Nutr 1999; 69:256-60. [PMID: 9989689 DOI: 10.1093/ajcn/69.2.256] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The serum transferrin receptor (TfR) concentration in adults is suggested to provide a sensitive measure of iron depletion and together with the serum ferritin concentration to indicate the entire range of iron status, from iron deficiency to iron overload. However, little is known about TfR concentrations in children. OBJECTIVE Our objective was to compare serum TfR and ferritin concentrations and their ratios in children and adults and look for correlations between TfR concentrations and other measures of iron status. DESIGN Our study groups were healthy 1-y-old infants (n = 36), 11-12-y-old prepubertal boys (n = 35), and 20-39-y-old men (n = 40). RESULTS TfR concentrations were higher in infants (x; 95% reference interval: 7.8 mg/L; 4.5, 11.1) than in prepubertal boys (7.0 mg/L; 4.7, 9.2) and higher in prepubertal boys than in men (5.8 mg/L; 3.1, 8.5). Geometric mean TfR-ferritin ratios were higher in infants (316; 95% reference interval: 94, 1059) than in prepubertal boys (219; 78, 614) and higher in prepubertal boys than in men (72; 23, 223). By multiple linear regression analysis, the best predictors of TfR concentration were serum iron (P = 0.004) and log serum ferritin (P < 0.0001), both being inverse correlations (R2 = 0.32). Mean corpuscular volume, blood hemoglobin, transferrin iron saturation, transferrin, and even age seemed to not have an influence on the TfR concentration and erythropoiesis was not a determinant of TfR concentration. CONCLUSIONS Low serum ferritin and iron concentrations, even within the normal physiologic range, result in high TfR concentrations. The lower the iron stores, the stronger the influence of ferritin on TfR. A high TfR concentration in children, especially in infants, is a response to physiologically low iron stores. Age-specific reference concentrations for TfR are needed.
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Affiliation(s)
- M A Virtanen
- Department of Clinical Chemistry and Hospital for Children and Adolescents, University of Helsinki, Finland.
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