Erythrocytes stored for 3 weeks are as efficacious as are erythrocytes stored for 3.5 h in reversing the neurocognitive deficit of acute anemia. Requiring fresh rather than stored erythrocytes for augmentation of oxygen delivery does not seem warranted.

No abstract

Bilateral infusions of d-amphetamine into the rat ventral-lateral striatum (VLS) were previously shown to cause a robust behavioral activation that was correlated temporally with a net increase in firing of substantia nigra pars reticulata (SNpr) neurons, a response opposite predictions of the basal ganglia model. The current studies assessed the individual and cooperative contributions of striatal D 1 and D 2 dopamine receptors to these responses. Bilateral infusions into VLS of the D 1 /D 2 agonist apomorphine (10 g/l/side) caused intense oral movements and sniffing, and an overall increase in SNpr cell firing to 133% of basal rates, similar to effects of d-amphetamine. However, when striatal D 2 receptors were stimulated selectively by infusions of quinpirole (30 g/l/side) ϩ the D 1 antagonist R-(ϩ) -7-chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepine (SCH 23390; 10 g/l/ side), no behavioral response and only modest and variable changes in SNpr cell firing were observed. Selective stimulation of striatal D 1 receptors by (Ϯ) 6-chloro-APB hydrobromide (SKF 82958; 10 g/l/side) ϩ the D 2 antagonist cis-N-(1-benzyl-2-methyl-pyrrolidin-3-yl)-5-chloro-2-methoxy-4-methyl-aminobenzamide (YM 09151-2; 2 g/l/side) caused a weak but sustained increase in oral movements and modestly increased SNpr cell firing, but neither response was of the magnitude observed with apomorphine. When the two agonists were infused concurrently, however, robust oral movements and sniffing again occurred over the same time period that a majority of SNpr cells exhibited marked, sometimes extreme and fluctuating, changes in firing (net increase, 117% of basal rates). These data confirm that concurrent striatal D 1 /D 2 receptor stimulation elicits a strong motor activation that is correlated temporally with a net excitation rather than inhibition of SNpr firing, and reveal that D 1 and D 2 receptors interact synergistically within the striatum to stimulate both forms of output.The basal ganglia functional model predicts that dopamine, by stimulating the striatonigral pathway via D 1 receptors and inhibiting the striatopallidal pathway via D 2 receptors, should inhibit output from the substantia nigra pars reticulata and internal pallidal segment (SNpr/GPi). Inhibition of output from the SNr/GPi should in turn disinhibit the thalamus to facilitate movement (for review, see Alexander and Crutcher, 1990). Many of the predictions of the model have been supported by electrophysiological studies in humans with Parkinson's disease and animal models of this disorder (Filion and Tremblay, 1991;Bergman et al., 1994;Papa et al., 1999;Levy et al., 2001). However, the question of whether these predictions are valid and supported in normal animals without dopaminergic lesions has been less rigorously addressed.A definitive test of this hypothesis has been made difficult by the complexity of the circuitry, in particular by the fact that D 1 and D 2 receptors are expressed not only within the striatum but also in other nuclei of th...

Computer-based systems can detect underreported adverse events. We hypothesized that a system could be designed to detect potential or unreported cases of transfusion-related acute lung injury (TRALI). We developed and tested a computer screening system using retrospective computer blood gas data after transfusions during a 45-day period at a tertiary care academic hospital. The program identified cases of posttransfusion hypoxemia. Medical records of identified cases were reviewed to diagnose TRALI. During the 45-day period, 820 patients received 6,888 blood products. Seven cases of TRALI were diagnosed, whereas only 2 had been reported. The system had 99% accuracy and 26% positive predictive value for detecting potential TRALI. Computer screening finds more cases of TRALI than are reported voluntarily, and a prospective study using this system is feasible and needed to validate this method of detecting this important adverse transfusion reaction.

Computer-based systems can detect underreported adverse events. We hypothesized that a system could be designed to detect potential or unreported cases of transfusion-related acute lung injury (TRALI). We developed and tested a computer screening system using retrospective computer blood gas data after transfusions during a 45-day period at a tertiary care academic hospital. The program identified cases of posttransfusion hypoxemia. Medical records of identified cases were reviewed to diagnose TRALI. During the 45-day period, 820 patients received 6,888 blood products. Seven cases of TRALI were diagnosed, whereas only 2 had been reported. The system had 99% accuracy and 26% positive predictive value for detecting potential TRALI. Computer screening finds more cases of TRALI than are reported voluntarily, and a prospective study using this system is feasible and needed to validate this method of detecting this important adverse transfusion reaction.