Showing papers by "German Red Cross published in 1990"

Efficiency and cost-effectiveness of advanced EMS in West Germany

Abstract: A model study was performed by an economist in Lower Frankonia (a mostly rural area of West Germany with several urban centers) to examine the efficiency and cost-effectiveness of the emergency medical service that included prehospital physician presence. ‡ ‡"Modellver-such Notfallretung Untenfranken, Dokumentation Band II", 1985, edited by the German Traffic Safety Council. To perform this examination about $3.5 million were spent to improve organization and communication within the local emergency medical service, to purchase additional equipment and further emergency vehicles, and to install pre-hospital emergency physician service. The median response time was lowered to 6 minutes. This report surveys whether these reforms and extra fundings were beneficial and cost-efficient.

The Role of Regional Anesthesia under Field Conditions

Abstract: The authors, who served as anesthesiologists for 15 months at an International Committee of the Red Cross (ICRC) surgical field hospital in a Cambodian refugee camp, report their anesthesiologic experience with 2,906 patients. In spite of preferential use of regional anesthetic techniques, general anesthesia was required in 68% of the cases. Local infiltration anesthesia was applied in 21% of the cases, conduction anesthesia in 3%, and spinal anesthesia in 8%.

HIV prevalence in blood donors in urban and in rural areas of the Federal Republic of Germany.

Abstract: HIV infection rates in blood donors from the FRG were compared with the prevalence in donors from Berlin to obtain information on the HIV infections in donors of rural versus urban origin. The HIV prevalences decrease similarly in the first years of testing, although on different levels. They are lower in rural areas by a factor of 15 in the first year and of 10 thereafter. The modes of infectivity in both groups are similar although drug abuse seems to be more frequent amongst infected donors of urban areas. Ninety percent of the infected donors are either persons at risk or sexual partners of risk persons. During the observed time period there seems to be a trend from homo-/bisexuality and i.v. drug abuse to heterosexual contacts with persons at risk as the mode of infection. In conjunction with the stabile low and constant rates of infection for the last two years, these data indicate that the risk of HIV infection by blood transfusion is reduced to an acceptable minimum even in urban areas.

A Silent Allele in the Orosomucoid (ORM) System

Abstract: Orosomucoid 1 (ORM1) — or alpha-i-acid glycoprotein assigned as a genetic polymorphism to human chromosome 9 — with its common three codominant autosomal alleles ORM1*F1, ORM1*F2 and ORM1*S is a very useful system in paternity testing. In 1986 the existence of a second structual locus ORM2 was discovered and has been confirmed in the meantime. This study seems to present evidence for a silent allele ORM1*Q0.

Is screening of blood donors for anti-HBc useful?

Abstract: Blood donor screening for antibodies to hepatitis B core antigen (anti-HBc) was introduced in the USA because the retrospective evaluation of two studies performed between 1973 and 1980 on posttransfusion hepatitis (PTH) showed a weak correlation between anti-HBc in the donor blood and non-A, non-B P T H in the blood recipient [6, 11]. In a German study performed in 1980/81, a similar correlation was suggested [12]. Since that time the epidemiological association may have been fundamentally changed by measures to prevent persons at risk for HIVinfection from donating blood, and in recent studies the correlation could not be confirmed [1,4, 8, 9]. A crucial prerequisite for such a correlation is a reliable assay for anti-HBc. It is, however, a common experience that current enzyme immunoassays (EIAs) generate up to 30°7o more positive results than radioimmunoassays for anti-HBc [3, 10, 14, 16] and that there are important discrepancies between the currently available EIAs [16]. The latter could recently be confirmed in a large cooperative study of the German Red Cross [2], in which six test kits were applied in parallel to 4,080 blood donor sera. Of 1,838 sera evaluable in all six assays, only 62 produced consistently positive results while 228 gave divergent results. Reference testing by two additional tests and a recently developed direct binding assay identified up to 50°70 false positives in the initial screening and a significant number of false negatives [2]. The estimated efficacy of excluding anti-HBc positive blood units was already low in the first two studies considering that some non-A, non-B PTH infections also occured after transfusions of only anti-HBc negative blood. Only 1 out of 6 1 6 donations discarded for anti-HBc could be assumed infectious. Yet 57°70 to 78°7o of non-A, non-B P T H cases could not be prevented [6, 11].