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"Jacques, Annie"
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Pressure Infusion Cuff and Blood Warmer during Massive Transfusion: An Experimental Study About Hemolysis and Hypothermia
Blood warmers were developed to reduce the risk of hypothermia associated with the infusion of cold blood products. During massive transfusion, these devices are used with compression sleeve, which induce a major stress to red blood cells. In this setting, the combination of blood warmer and compression sleeve could generate hemolysis and harm the patient. We conducted this study to compare the impact of different pressure rates on the hemolysis of packed red blood cells and on the outlet temperature when a blood warmer set at 41.5°C is used.
Pressure rates tested were 150 and 300 mmHg. Ten packed red blood cells units were provided by Héma-Québec and each unit was sequentially tested.
We found no increase in hemolysis either at 150 or 300 mmHg. By cons, we found that the blood warmer was not effective at warming the red blood cells at the specified temperature. At 150 mmHg, the outlet temperature reached 37.1°C and at 300 mmHg, the temperature was 33.7°C.
To use a blood warmer set at 41.5°C in conjunction with a compression sleeve at 150 or 300 mmHg does not generate hemolysis. At 300 mmHg a blood warmer set at 41.5°C does not totally avoid a risk of hypothermia.
Journal Article
The Graduate Virtual Classroom Webinar: A Collaborative and Constructivist Online Teaching Strategy
Based on research findings derived from interviews and questionnaires collected between 2009 and 2012, this concept paper proposes blended online learning design (BOLD) as a solution to some widespread online learning challenges in higher education. More specifically, it defines the pedagogical underpinnings of the blended online learning design (or BOLD) webinar, a hybrid instructional design and delivery model which maintains quality of instruction while increasing accessibility to higher education and cost- effectiveness in graduate-level courses, all elements that contribute to sustainability in online learning. Set against a backdrop of the graduate seminar, learning activity sequencing, based on a combination of individual, team and group work, is presented, design and delivery solutions are described and student, faculty and administration satisfaction levels reported. Preliminary results point favorably to the BOLD webinar model as increasing sustainability in online graduate studies.
Journal Article
Heart valve allograft decontamination with antibiotics: impact of the temperature of incubation on efficacy
Heart valve allografts are typically processed at 4°C in North America, including the step of antibiotic decontamination. In our own experience with heart valve banking, we often observe persistent positive cultures following decontamination at wet ice temperature. We hypothesized that warmer temperatures of incubation might increase the efficacy of the decontamination procedure. In a first series of experiments, 12 different bacterial species were grown overnight, frozen in standardized aliquots and used directly to inoculate antibiotic cocktail aliquots at 10
5
colony-forming units (CFU)/ml. The antibiotic cocktail contains vancomycin (50 μg/ml), gentamicin (80 μg/ml) and cefoxitin (240 μg/ml) in Dulbecco’s Modified Eagle’s Medium. Inoculated aliquots were incubated at 4, 22 and 37°C and CFUs were determined at regular intervals up to 24 h post-inoculation. In a second set of experiments, 10 heart valves were spiked with 5000 CFU/ml and incubated with antibiotics at 4 and 37°C for 24 h. The final rinse solutions of these heart valves were filtered and tested for bacterial growth. After 24 h of incubation, CFUs of all 12 bacterial species were reduced by a factor of only one to two logs at 4°C whereas log reductions of 3.7 and 5.0 or higher were obtained at 22 and 37°C, respectively. Most microorganisms, including
Staphylococcus
epidermidis
,
Lactococcus
lactis
lactis
and
Propionibacterium
acnes
survived well the 24-h antibiotic treatment at 4°C (<1 Log reduction). All 10 heart valves that were spiked with microorganisms had positive final rinse solutions after antibiotic soaking at 4°C, whereas 8 out of 10 cultures were negative when antibiotic decontamination was done at 37°C. These experiments show that a wet ice temperature greatly reduces the efficacy of the allograft decontamination process as microorganisms survived well to a 24-h 4°C antibiotic treatment. This could explain the high rate of positive post-processing cultures obtained with our routine tissue decontamination procedure. Increasing the decontamination temperature from 4 to 37°C may significantly reduce the incidence of post-disinfection bacterial contamination of heart valves.
Journal Article
CD40-activated B cells from patients with systemic lupus erythematosus can be modulated by therapeutic immunoglobulins in vitro
Introduction Aberrant signaling within and between B and T cells, considered to be central in systemic lupus erythematosus (SLE), could depend on enhanced CD40-CD154 activation. As a result, autoreactive B cells, normally anergic, differentiate and secrete antibodies attacking several normal tissues. Thus restorating B cell homeostasis might help control this disease. In this study, two facets of SLE B cells were investigated, namely their in vitro response to CD40-CD154 and the effect of treatment with human immunoglobulins for intravenous use (IVIg). Materials and Methods Blood samples from SLE patients and healthy volunteers were obtained and used to isolate B cells, which were activated through CD40 in the presence or absence of IVIg. The phenotype, proliferation, and differentiation of the SLE B cells were determined and compared with those of control B cells using flow cytometry and standard ELISA. Results In this model, CD40-activated SLE B cells, as control B cells, proliferated and differentiated and were characterized by the emergence of CD19loCD38⁺⁺CD138⁺CD27⁺⁺ cells. IVIg treatment of the CD40-activated SLE B cells resulted in higher differentiation, characterized by increased secretion rates of IgG and IgM, as reported previously for control B cells. Conclusions Taken as a whole, such accelerated differentiation of CD40-activated B cells suggests that IVIg may participate in re-equilibration of the antibody repertoire by replacing pathological antibodies by de novo harmless antibodies.
Journal Article
ROME ANTIQUE: FORUM - PALATIN - COLISEE
Cent quatre-vingt dessins d'architectes font revivre à l'Ecole Nationale des Beaux-Arts à Paris, trois sites prestigieux de la Rome antique: le Forum, le Palatin et le Colisée.
Magazine Article
Les carnets de croquis des architectes français à Pompéi
Des centaines de dessins sur Pompéi témoignent de la passion des architectes pour la cité antique dans la fraîcheur des découvertes des années 1820.
Magazine Article