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Gerald McGwin

Publications and source records attributed to Gerald McGwin.

At least 19 recordsLinked to original sources
PubMed2006

Consumer product-related eye injury in the United States, 1998-2002.

PROBLEM: Eye injury is currently a leading cause of visual impairment and monocular blindness in the United States. Information regarding consumer products associated with eye injuries can have important implications for the prevention of these injuries. METHODS: The National Electronic Injury Surveillance System (NEISS) was used to describe the types of consumer products associated with emergency department treated eye injuries in the United States from 1998 through 2002. RESULTS: The leading product type associated with eye injuries was welding equipment followed by household cleaners, basketball equipment, workshop equipment, and adhesives. Eye injuries attributed to hardware, tools, construction, sports, toys, and lawn equipment were more common among males. In females, eye injuries attributable to chemicals, housewares, storage and organization, and bed and bath items were more common. Differences were also apparent across the age spectrum. CONCLUSION: This study identified specific products and categories of products frequently associated with eye injury and prevention initiatives should focus on these items. IMPACT ON INDUSTRY: This study has identified consumer products associated with eye injuries requiring medical treatment in the United States. Manufacturers of these products could be encouraged to add or strengthen safety messages regarding the potential for eye injury.

Adolescent↗
PubMed2006

African-American and Hispanic ethnicities, renal involvement and obesity predispose to hypertension in systemic lupus erythematosus: results from LUMINA, a multiethnic cohort (LUMINAXLV).

OBJECTIVE: To examine the predictors of the occurrence of hypertension in a large multiethnic US cohort. PATIENTS AND METHODS: There were 614 patients with systemic lupus erythematoses (SLE; > or = 4 American College of Rheumatology revised criteria) with < or = 5 years of disease duration at entry into the cohort (T0) and of Hispanic (Texan or Puerto Rican), African-American or Caucasian ethnicity. T0 variables were compared between patients who did and did not develop hypertension (blood pressure > or = 140/90 mm Hg on at least two occasions and/or the use of antihypertensive drugs) after T0. Significant and clinically relevant variables were then examined by a stepwise logistic regression model. RESULTS: A total of 379 patients without hypertension at T0 were included (patients who developed hypertension prior to SLE diagnosis (n = 126) or before T0 (n = 109) were excluded). Predictors of hypertension were African-American and Texan-Hispanic ethnicities, renal involvement and a higher body mass index. CONCLUSIONS: Traditional cardiovascular risk factors, disease-related factors and ethnicity play a role in the occurrence of hypertension in patients with SLE. Controlling renal involvement and optimising body weight may prevent the occurrence of hypertension.

Adult↗
PubMed2006

Systemic lupus erythematosus in a multiethnic US cohort, XXXVII: association of lymphopenia with clinical manifestations, serologic abnormalities, disease activity, and damage accrual.

OBJECTIVE: To determine if lymphopenia is associated with clinical/immunologic manifestations, disease activity, and disease damage in systemic lupus erythematosus (SLE). METHODS: The study group comprised 591 patients with SLE participating in a multiethnic, longitudinal outcome study. Cumulative clinical/immunologic (per American College of Rheumatology criteria) and pharmacologic treatment variables were obtained at enrollment (T0) and last visit (TL). Lymphopenia (<1,500/mm3) was scored only when clinically attributable to SLE and not to medications or other causes. Lymphocyte counts were expressed in 4 categories per the Systemic Lupus Activity Measure (SLAM): normal (> or =1,500/mm3), mild (1,000-1,499/mm3), moderate (500-999/mm3), and marked (<500/mm3). Disease activity was assessed with the SLAM and the Physician's Global Assessment (PGA). Disease damage was determined with the Systemic Lupus International Collaborating Clinics Damage Index (SLICC-DI). The relationship of lymphopenia with cumulative clinical/immunologic and pharmacologic treatment variables was first examined, then the association between the SLAM, PGA, and SLICC-DI scores with different categories of lymphopenia was examined by generalized estimating equation (GEE) regression analyses. Ethnicity, age, and sex were entered into all regression models. RESULTS: At T0 and TL, lymphopenia was found to be positively associated with renal involvement, leukopenia, anti-double-stranded DNA antibodies, anti-Ro antibodies, and the use of glucocorticoids, azathioprine, and methotrexate, but was negatively associated with photosensitivity. On GEE analyses, marked lymphopenia at T0 and moderate and marked lymphopenia for all visits were independently associated with higher SLAM, PGA, and SLICC-DI scores. CONCLUSION: Lymphopenia is associated with several clinical/immunologic manifestations in SLE. Moderate and marked lymphopenia are associated with higher disease activity and damage accrual.

Adult↗
PubMed2006

Comparison of the Moorfields classification using confocal scanning laser ophthalmoscopy and subjective optic disc classification in detecting glaucoma in blacks and whites.

OBJECTIVE: To compare the diagnostic accuracy of the Moorfields regression classification (MRC) and subjective optic disc evaluation in discriminating early to moderate glaucomatous from nonglaucomatous eyes. DESIGN: Cross-sectional observational study. PARTICIPANTS: Two hundred thirty-three patients with glaucoma and 216 normal subjects were included in the analysis. Racial groups were defined by self-description. METHODS: All subjects underwent confocal scanning laser ophthalmoscopy, stereophotography, and standard perimetry. Glaucoma was defined by visual field defect alone and confirmed with a second visual field test. Stereo photographs were graded as either normal or glaucomatous appearing in a masked fashion by 2 independent graders and adjudicated by a third grader in cases of disagreement. Mean disc area was compared between patients correctly and incorrectly diagnosed with either technique. MAIN OUTCOME MEASURES: Sensitivity and specificity of MRC and subjective evaluation of stereophotographs in the detection of glaucomatous visual field loss. RESULTS: With the MRC, the sensitivity and specificity were higher using the 95% cutoff than using the 99.9% cutoff. Classification based on subjective photo assessment had a greater agreement with the diagnosis of glaucoma than the MRC for blacks (MRC, sensitivity = 62.5%, specificity = 93.2%; Photo, sensitivity = 76.5%, specificity = 91.5%) and whites (MRC, sensitivity = 67.0%, specificity = 92.2%; photo, sensitivity = 78.4%, specificity = 91.9%). Disc area was significantly larger in patients incorrectly diagnosed with the MRC (P = 0.0289). CONCLUSIONS: Subjective optic disc grading by glaucoma specialists outperformed the MRC with the HRT II in both black and white subjects. Both subjective and objective diagnostic methods were associated with similar sensitivity and specificity between racial groups. The MRC was more likely to provide an incorrect diagnosis in subjects with larger optic discs.

Black or African American↗
PubMed2006

Health-related quality of life and psychosocial characteristics of patients with benign essential blepharospasm.

OBJECTIVE: To examine vision-targeted health-related quality of life and psychosocial characteristics in patients with benign essential blepharospasm (BEB) compared with patients with hemifacial spasm (HFS). METHODS: Persons with BEB (n = 159) or HFS (n = 91) were identified based on International Classification of Diseases, Ninth Revision, Clinical Modifications codes with subsequent verification by record abstraction. Information regarding demographics, health characteristics, disease characteristics, and vision-targeted health-related quality of life was obtained through a telephone interview. RESULTS: For patients with BEB and HFS, the composite scores and subscale scores on the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) were low. Compared with patients with HFS, patients with BEB reported more depressive symptoms (P = .03), met the criteria for generalized anxiety disorder (P = .007), had lower NEI-VFQ-25 composite scores (P<.001), and had lower NEI-VFQ-25 subscale scores regarding general vision (P = .03), ocular pain (P<.001), distance activities (P = .001), driving (P<.001), and all of the vision-specific subscales addressing psychosocial issues. CONCLUSIONS: Compared with patients with HFS, those with BEB experience a greater reduction in vision-targeted health-related quality of life and are more prone to symptoms of depression and anxiety. This underscores the inadequacy of current treatment options for BEB in light of the fact that these patients had been undergoing standard-of-care treatments for some time.

Aged↗
PubMed2006

3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitors and the presence of age-related macular degeneration in the Cardiovascular Health Study.

OBJECTIVE: To evaluate both the use of cholesterol-lowering medications as a group and the use of statins specifically with regard to the risk of age-related macular degeneration (AMD). METHODS: A case-control study was conducted using data from the Cardiovascular Health Study, a population-based prospective study of adults enrolled from 4 communities in the United States in 1989 and 1990. Individuals with AMD (cases) and those without AMD (controls) were compared with regard to their use of cholesterol-lowering medications and statins. RESULTS: Nearly equal proportions of cases and controls used cholesterol-lowering medications, both before adjustment (odds ratio, 0.92; 95% confidence interval, 0.70-1.21) and after adjustment for selected confounding variables (age, sex, and race) (odds ratio, 1.35; 95% confidence interval, 0.98-1.87). Statin use was also found to be similar among cases and controls (odds ratio, 0.98; 95% confidence interval, 0.73-1.30). After controlling for the aforementioned 3 confounders (odds ratio, 1.40; 95% confidence interval, 0.99-1.98), we noted a modest trend for statin users to have an increased risk of AMD. CONCLUSION: The results suggest that no association exists between having used cholesterol-lowering medications and AMD. However, there was a suggestion that statin use might increase the risk of AMD.

Aged↗
PubMed2006

Systemic lupus erythematosus in a multiethnic US cohort: XXXIV. Deficient mannose-binding lectin exon 1 polymorphisms are associated with cerebrovascular but not with other arterial thrombotic events.

OBJECTIVE: To study the association between deficient mannose-binding lectin (MBL) genotypes and arterial thrombotic events in systemic lupus erythematosus (SLE). METHODS: Patients with SLE of Hispanic, African American, and Caucasian ethnicity from LUMINA (LUpus in MInorities, NAture versus nurture), a multiethnic, longitudinal study of outcome, were studied. Arterial thrombotic events (myocardial infarction, angina, coronary artery bypass graft surgery, stroke, claudication, gangrene, or tissue loss and/or peripheral arterial thrombosis) that occurred after diagnosis were recorded. Genotyping for MBL gene polymorphisms was performed and their distribution was compared between patients who did and did not have thrombotic events. RESULTS: There were 58 events (21 cardiovascular, 27 cerebrovascular, and 10 peripheral vascular) in 48 patients. Patients who had thrombotic events were older and were more likely to be smokers, to have more severe disease, and to have accrued more damage overall. Also, a larger proportion of these patients had C-reactive protein values in the highest quintile of distribution. No significant difference in arterial thrombotic events was found in patients homozygous for MBL-deficient alleles compared with others. Similar results were seen within ethnic groups. Caucasians who developed potential thrombotic events exhibited a higher frequency of MBL-deficient alleles, but the difference was not statistically significant for all events together or for cardiovascular and cerebrovascular events combined. However, when only the cerebrovascular events were considered, the difference became statistically significant. CONCLUSION: Age, smoking, and measures of activity and damage were associated with arterial thrombotic events in patients with SLE, but MBL-deficient genotypes were not, with cerebrovascular events in Caucasians being the exception. The relationship between MBL-variant alleles and arterial thrombotic events may exist only within select ethnic groups and event types.

Adult↗
PubMed2006

The contribution of opiate analgesics to the development of infectious complications in burn patients.

BACKGROUND: Immune and infectious complications are associated with burn injury. Opiate analgesics also can induce similar complications, however, their impact on postburn infectious complications is unknown. METHODS: A retrospective survey of records from 1997 to 2002 from an academic burn center was conducted. Information on all opiate analgesic use was obtained and expressed as opiate equivalents (OEs). Total OEs were summed for each patient and then compared between cases and controls. RESULTS: Patients who developed infections were more likely to be in the high OE group. This association was modified by burn severity. Patients with small burns and infection were more likely to be in the high OE group, whereas patients with moderate to large burns and infections were not associated significantly with opiate use. CONCLUSIONS: The results of this preliminary study suggest that opiate analgesics can contribute to the development of postburn infectious complications when the burn injury is of a less severe nature.

Analgesics, Opioid↗
PubMed2006

Gun-related eye injury in the United States, 1993-2002.

OBJECTIVE: To present the descriptive epidemiology of gun-related eye injury in the United States from 1993 through 2002. METHODS: Data from the National Electronic Injury Surveillance System was used to estimate the number of patients treated in the United States for gun-related eye injury (GEI) (air guns and firearms), air gun-related eye injury (AEI) (BB/pellet guns and rifles) and firearm-related eye injury (FEI) (all powder discharge guns) during the time period 1993 through 2002. Rates were calculated according to age, gender, race, weapon type and circumstances surrounding the injury event (e.g., locale and intent). RESULTS: The rate of gun-related eye injury in the United States declined to 7.5 per 1,000,000 in 2002 from 14.8 per 1,000,000 in 1993, representing a decline of approximately 5.4% per year (p = 0.0002), due primarily to a decline in the rate of FEI (6.7% per year, p = 0.029). The rate of AEI was relatively constant. GEI rates were highest among those aged 10-19 years, males, and Blacks. The overall rate of AEI was higher than the rate of FEI (6.0 per 1,000,000 and 5.1 per 1,000,000, respectively). According to race, the rate of FEI was higher than the rate of AEI in Blacks whereas the rate of AEI was higher than the rate of FEI in Whites and Hispanics. The majority of GEIs occurred at home and were unintentional. CONCLUSION: The rate of gun-related eye injury in the United States declined from 1993 through 2002 primarily due to a reduction in firearm-related eye injury, whereas the rate of air gun-related eye injury remained constant. Persons who were young, Black, and male were at highest risk for gun-related eye injury.

Adolescent↗
PubMed2006

Motor vehicle restraint system use and risk of spine injury.

OBJECTIVE: Motor vehicle collision (MVC)-related spinal injury is a severe and often permanently disabling injury. In addition, strain injuries have been reported as a common outcome of MVCs. Although advances in automobile crashworthiness have reduced both fatalities and severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on thoracolumbar spine injuries is unknown. This study examined the relationship between the occurrence of mild to severe cervical and thoracolumbar spine injury and occupant restraint systems among front seat occupants involved in frontal MVCs. METHODS: A retrospective cohort study was conducted among subjects obtained from the 1995-2004 National Automotive Sampling System. Cases were identified based on having sustained a spine injury of >/=1 on the Abbreviated Injury Scale (AIS), 1990 Revision. Risk risks (RRs) and 95% confidence intervals (CIs) were computed comparing occupant restraint systems with unrestrained occupants. RESULTS: We found an overall incidence of AIS1 cervical (11.8%) and thoracolumbar (3.7%) spinal injury. Seatbelt only restraints were associated with increased cervical AIS1 injury (RR = 1.40, 95% CI 1.04-1.88). However, seatbelt only restraints showed the greatest risk reduction for AIS2 spinal injuries. Airbag only restraints reduced thoracolumbar AIS1 injuries (RR = 0.29, 95% CI 0.08-1.04). Seatbelt combined with airbag use was protective for cervical AIS3+ injury overall (RR = 0.29, 95% CI 0.14-0.58), cervical neurological injury (RR = 0.19, 95% CI 0.05-0.81), and thoracolumbar AIS3+ injury overall (RR = 0.20, 95% CI 0.05-0.70). CONCLUSIONS: The results of this study suggest that seatbelts alone or in combination with an airbag increased the incidence of AIS1 spinal injuries, but provide protection against more severe injury to all regions of the spine. Airbag deployment without seatbelt use did not show increased protection relative to unrestrained occupants.

Abbreviated Injury Scale↗
PubMed2006

Bovine polymerized hemoglobin (hemoglobin-based oxygen carrier-201) resuscitation in three swine models of hemorrhagic shock with militarily relevant delayed evacuation--effects on histopathology and organ function.

OBJECTIVE: To test our hypothesis that hemoglobin-based oxygen carrier (HBOC)-201 resuscitation in hemorrhagic shock (HS) will not lead to increased organ injury and dysfunction. DESIGN: Three swine HS models simulating military-relevant delayed evacuation: a) moderate controlled HS, b) severe controlled HS, and c) severe uncontrolled HS. SETTING: Military research laboratory. SUBJECTS: Swine. INTERVENTIONS: Swine were anesthetized/intubated and instrumented. To induce HS, in two controlled hemorrhage experiments, 40% (moderate controlled HS) or 55% (severe controlled HS) of blood volume was withdrawn; in an uncontrolled HS experiment, the liver was crushed/lacerated. During a 4-hr "prehospital phase," pigs were resuscitated with HBOC-201 (HBOC) or Hextend (HEX) or were nonresuscitated (NON). Upon "hospital arrival," liver injury was repaired (severe uncontrolled HS), blood or saline was infused, hemodynamics were monitored, and blood was collected. Upon animal death and/or 72 hrs, necropsy was followed by histopathologic evaluation of organ injury (hematoxylin and eosin, electron microscopy) and immunohistochemistry of oxidative potential (3-nitrotyrosine). Significance (p < .05) was assessed by Kruskal-Wallis, analysis of variance/Bonferroni, and mixed procedure tests. MEASUREMENTS AND MAIN RESULTS: Survival was significantly higher with HBOC than HEX only with severe uncontrolled HS (p = .002). Myocardial necrosis/fibroplasia, fluid requirements, cardiac output, and cardiac enzymes were generally similar or lower in HBOC than HEX pigs, but creatine kinase-MB (but not creatine kinase-MB/creatine kinase ratio) was higher with HBOC in moderate controlled HS. Alveolar/interstitial pulmonary edema was similar with HBOC and HEX, but Po2 was higher with HBOC in severe uncontrolled HS. Jejunal villar epithelial and hepatocellular necrosis were similarly minimal to moderate in all groups. Minimal biliary changes occurred exclusively with HBOC. Aspartate aminotransferase, lactate dehydrogenase, and alkaline phosphatase were generally higher with HBOC than HEX. Mild renal papillary injury occurred more frequently with HBOC, but consistent patterns for urine output, blood urea nitrogen, and creatinine, were not seen. The 3-nitrotyrosine staining intensity was not different. CONCLUSIONS: In comparison with hetastarch, HBOC-201 resuscitation of swine with HS increased survival (with severe HS), did not increase evidence of oxidative potential, and had histopathologic and/or functional effects on organs that were clinically equivocal (myocardium, lungs, hepatic parenchyma, jejunum, and renal cortex/medulla) and potentially adverse (hepatobiliary and renal papilla). The effects of HBOC-201-resuscitation in HS should be corroborated in controlled clinical trials.

Analysis of Variance↗
PubMed2006

Agreement in assessing cup-to-disc ratio measurement among stereoscopic optic nerve head photographs, HRT II, and Stratus OCT.

PURPOSE: To compare the level of agreement between subjective and objective methods in estimating horizontal and vertical cup-to-disc ratios (HCDR and VCDR, respectively) to determine if objective techniques may be used as surrogates for subjective cup-to-disc (CDR) estimation. METHODS: Fifty-one glaucoma patients and 49 control subjects underwent full ophthalmic examination, stereoscopic optic nerve head photographs (ONHPs), confocal scanning laser ophthalmoscopy (Heidelberg Retina Tomography II [HRT II]), and optical coherence tomography (Stratus OCT). The intraclass correlation coefficient (ICC) and Bland Altman plots were used to assess the agreement across the three methods. Repeated measures analysis of variance (ANOVA), Tukey adjustment, and pairwise P values were used to compare the HCDR and VCDR estimates between three clinicians who reviewed photos, Stratus OCT, and HRT II. RESULTS: For the clinicians, the agreement in subjectively assessed HCDR and VCDR was substantial (ICC=0.84 and 0.85, respectively), and for all three methods, overall agreement was good (ICC=0.75 and 0.77 for the HCDR and VCDR, respectively). Stratus OCT provided the largest overall mean+/-SD HCDR (0.68+/-0.14) and VCDR (0.62+/-0.13). The smallest overall mean+/-SD HCDR was provided by ONHP (0.32+/-0.16), and the smallest overall mean+/-SD VCDR was provided by HRT II (0.26+/-0.20). Repeated measures ANOVA test demonstrated significant differences across the three methods for glaucomatous (P=0.0017 and 0.0016, HCDR and VCDR, respectively) and normal (P=0.0001 for both HCDR and VCDR) eyes. Tukey adjustment demonstrated specific statistical differences between pairs of methods. CONCLUSIONS: Although the overall agreement between various methods was good, the mean estimates were statistically different. Additional studies are needed to evaluate the sources of variability, their level of significance, and longitudinal agreement between various methods of the CDR estimation.

Adult↗
PubMed2006

Visual field defects and vision-specific health-related quality of life in African Americans and whites with glaucoma.

PURPOSE: To examine the relationship of visual field impairment to vision-specific health-related quality of life and symptoms in a large cohort (N=345) of African Americans and Whites of non-Hispanic origin diagnosed with glaucoma. MATERIALS AND METHODS: Participants consisted of persons > or =55 years of age recruited from university-affiliated ophthalmology and optometry practices in Birmingham, AL who had been diagnosed with glaucoma. Medical records were abstracted to collect information on demographics, visual acuity, and visual fields. A telephone survey was conducted to obtain information on vision-specific health-related quality of life [National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25)], glaucoma symptoms [Glaucoma Symptom Scale (GSS)], and cognitive status (Short Portable Mental Status Questionnaire). Visual fields were used to compute a visual field defect score for each eye based on the Advanced Glaucoma Intervention Study (AGIS) scoring system. RESULTS: Mean NEI VFQ-25 subscale scores ranged from the 50s to 80s. Scores for African Americans and Whites did not differ except for the general health and ocular pain subscales for which African Americans had slightly higher scores. For both African Americans and Whites, as the AGIS score became worse in the better and/or worse eye, there was a decrease in VFQ subscale score for most VFQ subscales including general vision, distance vision, near vision, social functioning, color vision, and peripheral vision (P<0.05). AGIS scores were unrelated to the GSS subscales in African Americans; for Whites, the visual but not the nonvisual subscale was related to AGIS score. CONCLUSIONS: Scores on most subscales of the NEI VFQ-25 and the 2 subscales of the GSS are highly similar in African Americans and Whites of non-Hispanic origin who have been diagnosed with glaucoma. In addition, for both African Americans and Whites, the VFQ subscales for the most part demonstrated good construct validity with respect to the extent of visual field impairment. Results imply that the NEI VFQ-25 and the GSS are appropriate instruments for studying the personal burden of glaucoma in studies whose samples involve both African American and White adults.

Black or African American↗
PubMed2006

The relationship among race, iris color, central corneal thickness, and intraocular pressure.

PURPOSE: Central corneal thickness (CCT) influences applanation intraocular pressure (IOP) measurement. The present study sought to determine whether iris color might represent a qualitative surrogate for CCT or race, and therefore differential risk for elevated IOP and, consequently, developing glaucoma. METHODS: Eligible patients included those with best-corrected visual acuity (BCVA) better than 20/40 and who had not worn contact lenses within 24 hours. Exclusion criteria were prior ophthalmic surgery, topical ocular or systemic medication that would influence IOP, previous ocular inflammatory conditions, or current treatment for ophthalmic treatment. Data collection included demographic (name, date of birth, race), BCVA, and iris color. Iris color was judged according to a purpose-developed chart (white: blue, green, brown or black: brown) and patients were assigned to one of four groups. Goldmann applanation tonometry and pachymetry measurements were performed consecutively. To attain a power of 90% to find a difference of 40 microm with alpha < 0.05, we examined at least 14 subjects (28 eyes) for each group. RESULTS: Comparing pachymetry measurements among iris colors revealed no statistically significant difference among the three groups of whites: blue (552 microm), green (552 microm), and brown (562 microm). The same held true when comparing IOP and CCT-adjusted IOP with iris color: blue-15.2, 15.1, green-15.4, 15.2, and brown-14.7, 14.0. When comparing CCT between whites and blacks, CCT was significantly thinner in blacks (533 microm), whether evaluating all whites (555 microm, p = 0.03) or comparing only the brown-iris white group with the black group (562 microm vs. 533 microm, p = 0.03). Mean CCT-adjusted IOP was barely significantly different between whites (14.8) and blacks (16.7) (p = 0.04). CONCLUSION: These results suggest that iris color is not associated with CCT and apparently iris color does not influence measured IOP. We were able to establish a relationship between race and IOP when adjusting IOP for CCT. Our data show a significantly higher CCT-adjusted IOP for blacks than whites demonstrating a racial difference in CCT-corrected IOP.

Adolescent↗
PubMed2006

Immune effects of resuscitation with HBOC-201, a hemoglobin-based oxygen carrier, in swine with moderately severe hemorrhagic shock from controlled hemorrhage.

HBOC-201, a hemoglobin-based oxygen carrier, improved physiologic parameters and survival in hemorrhagic shock (HS) animal models. However, resuscitation from HS and the properties of different fluids influence immune responses. The aim of this study was to determine if HBOC-201 significantly alters immune function in traumatic HS. Anesthetized pigs underwent soft tissue injury, controlled hemorrhage of 40% of blood volume, and resuscitation with HBOC-201 or Hextend, or no resuscitation. Sequential whole-blood samples were collected for analyses of leukocyte differential (hematology analyzer), T-lymphocyte subsets (CD3, CD4, and CD8) (FACS), lymphocyte adhesion marker CD49d (alpha4-integrin) expression (FACS), plasma cytokines-tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-10-(ELISA), and lymphocyte apoptosis (annexin-V/propidium iodide staining) (FACS). Statistical analyses were performed by the mixed procedure. Total WBC counts decreased posthemorrhage in both resuscitation groups. Lymphocyte percentages decreased and PMN percentages increased around 4 h posthemorrhage in all groups. CD3 cells decreased in all groups, but CD4 and CD8 cells decreased only in the resuscitation groups. TNF-alpha levels were not detectable in any groups. IL-6 levels were similar across treatment groups (P > 0.05); however, IL-10 levels were higher in the HBOC group, as early as 1 h posthemorrhage (P = 0.04). Increases in lymphocytic CD49d expression levels and apoptosis occurred only in nonresuscitation and Hextend groups, respectively (P < or = 0.01). In comparison with Hextend, HBOC-201 had no significant adverse or beneficial effects on immune function in this model of moderately severe HS in swine, suggesting that it may be safe as a resuscitation fluid in HS patients.

Animals↗