Abstract:
INTRODUCTION:Canadian Armed Forces adopted fibrinogen concentrate (RiaSTAP) for hemostatic resuscitation in the far-forward combat setting, given its potential benefits of reducing blood loss, blood transfusion and mortality, and its long storage stability and high portability. The current guidance recommends that RiaSTAP should be administered within 8 hours after reconstitution when stored at room temperature. However, little information about its stability is available. There is also a need to investigate the stability and efficacy of RiaSTAP after reconstitution and exposure to extreme temperatures in which our forces may operate. MATERIALS AND METHODS:RiaSTAP was reconstituted as per manufacturer's instruction and stored at specific temperatures (-20°C, 4°C, 22°C, 35°C, 42°C, or 50°C) for up to 6 months. Reconstituted RiaSTAP was also oscillated on a rocker at 18 rpm under 22°C and 50°C. Its hemostatic function was measured using rotational thromboelastometry performed with RiaSTAP-spiked whole blood. Fibrinogen concentrations were measured by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Gel electrophoresis was also conducted for initial and stored samples. RESULTS:We found no change to the hemostatic function of reconstituted RiaSTAP after storage at -20°C for 6 months. At 4°C, no obvious changes to the hemostatic effect of reconstituted RiaSTAP relative to 0 hours were seen until 1,680 hours. At 22°C, a remarkable decrease began after storage for 168 hours. Storage at 35°C significantly decreased the hemostatic effect after 144 hours, while the storage at 42°C resulted in decreased hemostatic function after 72 hours. Finally, storage at 50°C for 8 hours resulted in complete loss of hemostatic function. Compared to the hemostatic activity, the fibrinogen concentration for reconstituted RiaSTAP showed less change over time. No apparent decline in fibrinogen concentration was seen after storage at -20°C for 6 months and at 4°C for 1,680 hours. At 22°C, there were no clear alterations until 792 hours. There was a decline in fibrinogen concentration at 35°C and 42°C after 672 and 600 hours of storage, respectively. At 50°C, little amount of fibrinogen was detected by ELISA at 8 hours. Similar changes in the hemostatic effect and fibrinogen concentration over time were observed under the rocking condition in comparison with the static condition at the same temperature. The gel electrophoresis confirmed fibrinogen degradation which increased with storage temperature and time. CONCLUSIONS:The stability of reconstituted RiaSTAP decreases with increasing storage temperature. The hemostatic function deteriorated before fibrinogen concentration and integrity were significantly altered at all temperatures for the study period except at 50°C where there was a rapid decline in both hemostatic function and fibrinogen concentration. Sample oscillation did not significantly affect its stability. The shelf life of reconstituted RiaSTAP may, therefore, be recommended accordingly when stored at different temperatures and extended to 6 days at room temperature provided that sterility is maintained.
journal_name
Mil Medjournal_title
Military medicineauthors
Peng HT,Beckett Adoi
10.1093/milmed/usaa409subject
Has Abstractpub_date
2020-11-16 00:00:00eissn
0026-4075issn
1930-613Xpii
5983609pub_type
杂志文章abstract::To help preserve in-theater strength within deployed military units, commercially available, rapid, user-friendly ABO-Rh blood typing kits were evaluated to determine their stability in storage conditions commonly encountered by the warfighter. Methods for environmental exposure testing were based on MIL-STD-810F. Whe...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-00-0909
更新日期:2009-10-01 00:00:00
abstract::A young man evaluated for a testis tumor was found to have Burkitt's lymphoma. The presentation of Burkitt's lymphoma in the United States as a testis mass is unusual. The rapid proliferation and metastatic potential of the tumor mandates prompt evaluation and the early initiation of systemic chemotherapy. ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:Background:Return to play and risk factors for functional limitations have been widely reported among athletes following anterior cruciate ligament reconstruction (ACLR) but has not been well studied in the military population. Methods:We conducted a retrospective review of all active duty service members who underwen...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx007
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:Many studies have shown that community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) is a very prevalent organism. However, no data have been published to date with regard to CAMRSA prevalence in patients presenting to the emergency department (ED) of a military medical facility. Our obj...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.173.10.945
更新日期:2008-10-01 00:00:00
abstract::This study examined the infleunce of three types of boot-sock systems on incidence and severity of foot blisters. Participants were 357 men undergoing U.S. Marine recruit training at Parris Island, South Carolina. Each participant was assigned to one of three treatment groups. The first group wore the standard militar...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
abstract:INTRODUCTION:The aims of this study were as follows: first to quantify and review the types of surgical procedures performed by military surgeons assigned to a Forward Surgical Team (FST) providing medical support to the population (MSP) in the Ivory Coast (IC), and second to analyze how this MSP was achieved. METHODS...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-14-00688
更新日期:2015-10-01 00:00:00
abstract::A retrospective study reviewed medical records of military personnel who had participated in a vision readiness study the previous year. The review evaluated (1) the number of personnel who returned for an eye examination (as recommended), (2) the number of dilated eye examinations, (3) the number of optical devices o...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract::This study examined predictors of smoking relapse in the year after the mandatory smoking ban during basic military training (BMT) in the U.S. Air Force. Participants were all smokers who completed BMT from August 1995 to August 1996 and relapsed to smoking in the subsequent year (N = 4,303). Results demonstrated that...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract::This case study describes the rehabilitation of 10 active duty U.S. soldiers with exertional rhabdomyolysis. The pathophysiology of rhabdomyolysis is discussed. The initial management is concerned with accurate diagnosis and monitoring of laboratory values to prevent complications. Active and passive range of motion, ...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1996-09-01 00:00:00
abstract::The Navy Reserve Nurse Corps faces a nursing shortage that reflects the national picture and holds major implications for the military patient care readiness of this nation. This account of the changing climate of nursing practice in the Navy Reserves offers observations on recruitment and retention strategies for the...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1989-10-01 00:00:00
abstract::In December 1913, a board of medical officers was appointed to adapt new U.S. Army equipment to the needs of the Hospital Corps. One of the improvements concerned substitution of the satchel-like Hospital Corps pouch used to carry first aid equipment. A waist belt with 10 pockets, known as the medical belt, was devise...
journal_title:Military medicine
pub_type: 历史文章,杂志文章
doi:10.7205/MILMED-D-15-00390
更新日期:2016-10-01 00:00:00
abstract::A duplication cyst of the ileum was initially observed in a fetus at 26 weeks gestation on prenatal ultrasonography. Repeated spontaneous resolution of the cyst by decompression into the adjacent bowel lumen delayed diagnosis and management until the child was 9 months of age. The child experienced two episodes of hem...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Addition of an oxygen concentrator into a control loop furthers previous work in autonomous control of oxygenation. Software integrates concentrator and ventilator function from a single control point, ensuring maximum efficiency by placing a pulse of oxygen at the beginning of the breath. We sought to verif...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-15-00150
更新日期:2016-05-01 00:00:00
abstract::Arterial thromboembolic events are not common after chemotherapy. We present a case of a cerebrovascular accident, which developed after chemotherapy in a patient with a germ cell tumor. A 34-year-old man with a testicular germ cell tumor who did not have any comorbid disease was admitted to hospital. After a radical ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed-d-01-3508
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:To investigate the delivery of health services to different ethnic groups in the war and postwar periods in the area of Livno, Bosnia and Herzegovina. METHODS:The total population, percentages by nationality, and numbers of persons medically or surgically treated at the War and General Hospital of Livno betw...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.170.9.810
更新日期:2005-09-01 00:00:00
abstract::Symptoms of vaginitis and urinary tract infections are miserable, distracting, and significantly affect women's quality of life. Among civilian women, these symptoms account for 10.5 million office visits per year. To examine the scope of the problem for military women during deployment situations, surveys were sent t...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract::The objective of this study was to compare military suicide rates with civilian suicide rates, adjusting for age and sex differences that exist between the two populations. The number of active component (AC) service members whose manner of death was certified as suicide was determined for specific age and sex groups ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx209
更新日期:2018-03-01 00:00:00
abstract:Introduction:To develop a short form (SF) of the 45-item multidimensional Moral Injury Symptom Scale - Military Version (MISS-M) to use when screening for moral injury and monitoring treatment response in veterans and active duty military with PTSD. Methods:A total of 427 veterans and active duty military with PTSD sy...
journal_title:Military medicine
pub_type: 杂志文章,随机对照试验
doi:10.1093/milmed/usy017
更新日期:2018-11-01 00:00:00
abstract::In 1991-1992, a pelvic stress fracture incidence of 11.2% was recorded in a cohort of 143 female Australian Army recruits. An incidence of 0.1% was recorded in a cohort of male recruits trained in the 1992-1993 year using a nearly identical program. A number of preventive strategies were instituted in an attempt to re...
journal_title:Military medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1999-05-01 00:00:00
abstract::The purpose of this study was to explore the nature of information in after-action reports in terms of nursing practice and the utility of using after-action reports in a feedback loop to improve nursing training. This was a three-phase, mixed-method, qualitative study, using focus groups, phone surveys, and e-mail su...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.173.2.210
更新日期:2008-02-01 00:00:00
abstract::The purpose of this work was to determine the concentration and ratio of uranium isotopes in allied forces Gulf War veterans. The 27 patients had their 24-hour urine samples analyzed for 234U, 235U, 236U, and 238U by mass spectrometry. The urine samples were evaporated and separated into isotopic dilution and concentr...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2002-08-01 00:00:00
abstract:INTRODUCTION:The most common cause of preventable death on the battlefield is significant blood loss, eventually causing decrease in tissue oxygen delivery. Pulse oximeters (POs) are widely used by the Israeli Defense Forces to obtain fast and noninvasive information about peripheral oxygen saturation (SpO2). However, ...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usaa314
更新日期:2021-01-25 00:00:00
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journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-16-00022
更新日期:2017-03-01 00:00:00
abstract::A 23-year-old active duty United States Air Force air crew male presented to the flight medicine clinic in Germany after experiencing sudden onset penile pain while flying as part of a long-range operational mission. He was admitted to the German hospital and empirically treated for infection with antibiotics, which d...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-14-00506
更新日期:2015-05-01 00:00:00
abstract::The rules governing armed conflict are numerous and in many respects complex. In areas that are very complex, experts such as lawyers may be called in to assist, especially in the planning of military action. But the nature and tempo of warfare rarely allows a person in the field to enjoy such a luxury. Therefore, eve...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:2002-08-01 00:00:00
abstract::Semmes-Weinstein monofilament (SWM) evaluation for protective sensation in diabetic feet is a widely used tool to guide patient care. Little evidence is available for alternative testing modalities for use when monofilament is not available or is deformed. Multiple varieties of intravenous angiocatheter tubing were su...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-13-00423
更新日期:2014-04-01 00:00:00
abstract:Introduction:Mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) are common military service-related conditions diagnosed both singly and together in veterans returning from recent military conflicts overseas. The impact of these disorders in real-world Veterans Health Administration practice h...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.1093/milmed/usx050
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:The Beck Depression Inventory-II (BDI-II) is widely used as a screening instrument for depressive symptomatology in clinical settings. The factor structure has been researched in a variety of settings with results ranging from a single factor to a five-factor structure. The purpose of this study was to examin...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/MILMED-D-14-00048
更新日期:2014-08-01 00:00:00
abstract::During Operation Assured Response in Liberia and Sierra Leone, between May and July 1996, five confirmed cases of falciparum malaria occurred in U.S. Navy personnel. The threat of malaria in west central Africa was recognized from the outset, and preventive medicine guidance was given to all the units participating in...
journal_title:Military medicine
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract::This study describes injury and illness rates and some risk factors among soldiers from an armor division during a rotation at the National Training Center (Fort Irwin, California). Soldiers from a brigade of the 1st Cavalry Division were involved in a 5-week training exercise at the National Training Center. Health c...
journal_title:Military medicine
pub_type: 杂志文章
doi:10.7205/milmed.171.11.1051
更新日期:2006-11-01 00:00:00