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https://www.readbyqxmd.com/read/27926661/the-effect-of-intraoperative-and-6-h-postoperative-intravenous-administration-of-low-dose-prostacyclin-on-the-endothelium-hemostasis-and-hemodynamics-in-patients-undergoing-a-pancreaticoduodenoctemy-a-randomized-controlled-pilot-study
#1
Pär I Johansson, Christian R Mortensen, Tatiana Nielsen, Carsten Tollund, Jakob Stensballe, Carsten P Hansen, Hans J Frederiksen, Sisse R Ostrowski
BACKGROUND: Capillary leakage, secondary to endothelial breakdown, is common in patients undergoing major surgical procedures with extensive tissue injury and this is associated with increased morbidity and mortality. Prostacyclin has been ascribed cytoprotective properties together with its vasodilatory and antiplatelet effects. The present pilot study investigated the safety and endothelial protective effects of low-dose prostacyclin infusion. PATIENTS AND METHODS: A randomized placebo-controlled pilot study evaluating the effect of prostacyclin (iloprost) infusion (1...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27923273/decision-points-in-the-treatment-of-transfusional-iron-overload-in-patients-with-myelodysplastic-syndromes-why-when-and-how-to-chelate
#2
Farhan Imran, Pradyumna Phatak
Patients with myelodysplastic syndromes (MDS) differ from those with other transfusion-dependent conditions (eg, thalassemia) as they are typically older, have comorbid conditions, and a generally shorter life expectancy. The underlying disease process in MDS and frequent use of red blood cell transfusions lead to iron accumulation and ultimately organ damage. Whether iron-reducing interventions such as chelation therapy can improve outcomes in this population is currently under investigation. Areas Covered: We reviewed published English-language articles from PubMed on the topic of iron overload (IO) in MDS, and the use of iron chelation therapies (ICTs) to alleviate iron burden...
December 7, 2016: Expert Review of Hematology
https://www.readbyqxmd.com/read/27917465/warm-reactive-immunoglobulin-g-autoantibodies-and-laboratory-testing-best-practices-review-of-the-literature-and-survey-of-current-practice
#3
REVIEW
Alyssa Ziman, Claudia Cohn, Patricia M Carey, Nancy M Dunbar, Mark K Fung, Andreas Greinacher, Simon Stanworth, Nancy M Heddle, Meghan Delaney
BACKGROUND: Warm-reactive autoantibodies (WAAs) are the most common cause of autoimmune hemolytic anemia (AIHA) and can also be present without clinically significant hemolysis. WAAs complicate immunohematological testing, yet there is no commonly accepted approach to laboratory evaluation and red blood cell (RBC) selection. STUDY DESIGN AND METHODS: We searched PubMed/Cochrane Central for articles that described testing methodology and blood selection for patients with WAAs...
December 4, 2016: Transfusion
https://www.readbyqxmd.com/read/27917462/iron-overload-across-the-spectrum-of-non-transfusion-dependent-thalassaemias-role-of-erythropoiesis-splenectomy-and-transfusions
#4
John B Porter, Maria Domenica Cappellini, Antonis Kattamis, Vip Viprakasit, Khaled M Musallam, Zewen Zhu, Ali T Taher
Non-transfusion-dependent thalassaemias (NTDT) encompass a spectrum of anaemias rarely requiring blood transfusions. Increased iron absorption, driven by hepcidin suppression secondary to erythron expansion, initially causes intrahepatic iron overload. We examined iron metabolism biomarkers in 166 NTDT patients with β thalassaemia intermedia (n = 95), haemoglobin (Hb) E/β thalassaemia (n = 49) and Hb H syndromes (n = 22). Liver iron concentration (LIC), serum ferritin (SF), transferrin saturation (TfSat) and non-transferrin-bound iron (NTBI) were elevated and correlated across diagnostic subgroups...
December 5, 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/27915456/use-of-iron-sucrose-and-red-blood-cell-transfusions-in-anaemic-cancer-patients-in-france-oncofer-study
#5
Elisabeth Luporsi, Alain Toledano, Dominique Spaeth, Florian Scotté, Marc Espié, Stéphanie Perot, Ladan Duvillié, Isabelle Pithois Merli, Roland Bugat
PURPOSE: This report describes the results of an observational, retrospective cohort study, evaluating the use of iron sucrose (IS) and red blood cell (RBC) transfusions in patients with cancer in routine clinical practice in France. A parallel investigated cohort treated with ferric carboxymaltose (FCM) has been reported earlier. METHODS: Data of patients with a solid tumour or haematological malignancy who have received IS or an RBC transfusion during 2010 from 3 months prior (M-3) to 3 months post first treatment (M+3) were analysed...
December 3, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27913516/immunoregulatory-networks-in-sickle-cell-alloimmunization
#6
Karina Yazdanbakhsh
Red blood cell (RBC) transfusions are critical for treatment and prevention of complications of sickle cell disease (SCD), and most SCD patients will receive 1 or more transfusions by age 20. However, SCD alloimmunization remains a serious complication of transfusions that can lead to life-threatening acute and delayed transfusion reactions. Alloimmunization rates are higher in SCD patients most likely due to RBC antigenic differences between largely white donors vs mainly African-American recipients and frequency of transfusions...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913515/cellular-immune-responses-in-red-blood-cell-alloimmunization
#7
James C Zimring, Krystalyn E Hudson
In excess of 340 blood group antigens have now been described that vary between individuals. Thus, any unit of blood that is nonautologous represents a significant dose of alloantigen. Most blood group antigens are proteins, which differ by a single amino acid between donors and recipients. Approximately 1 out of every 70 individuals are transfused each year (in the United States alone), which leads to antibody responses to red blood cell (RBC) alloantigens in some transfusion recipients. When alloantibodies are formed, in many cases, RBCs expressing the antigen in question can no longer be safely transfused...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913514/understanding-red-blood-cell-alloimmunization-triggers
#8
Jeanne E Hendrickson, Christopher A Tormey
Blood group alloimmunization is "triggered" when a person lacking a particular antigen is exposed to this antigen during transfusion or pregnancy. Although exposure to an antigen is necessary for alloimmunization to occur, it is not alone sufficient. Blood group antigens are diverse in structure, function, and immunogenicity. In addition to red blood cells (RBCs), a recipient of an RBC transfusion is exposed to donor plasma, white blood cells, and platelets; the potential contribution of these elements to RBC alloimmunization remains unclear...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911975/transfusion-requirements-in-esrd-patients-admitted-with-gi-hemorrhage-undergoing-inpatient-endoscopy
#9
Conor McCartney, Shrihari Santosh, Setu Patolia, Sadashiv Santosh
OBJECTIVES: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding requiring inpatient endoscopy. METHODS: A retrospective chart review was performed on all patients with ESRD who underwent inpatient endoscopy for suspected GI bleeding between 2009 and 2015...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27911694/seroprevalence-of-babesia-microti-in-individuals-with-lyme-disease
#10
Sabino R Curcio, Laurel P Tria, Azad L Gucwa
INTRODUCTION: Babesiosis is an emerging tick-borne disease (TBD) caused by Babesia microti, an intracellular parasite of red blood cells. Currently, it is the highest ranked pathogen transmitted by blood transfusion. Most healthy individuals infected with B. microti are asymptomatic, but may be at risk for chronic infection. Similar to Lyme disease transmitted by Borrelia burgdorferi, B. microti is spread by Ixodes scapularis ticks. The rate of coinfection with these TBDs in humans is unclear as most studies have focused their prevalence in ticks or rodent reservoirs...
December 2016: Vector Borne and Zoonotic Diseases
https://www.readbyqxmd.com/read/27909630/comparison-between-closed-suction-drainage-and-no-drainage-following-total-knee-arthroplasty-in-a-tertiary-care-setting-in-pakistan
#11
Avais Raja, Hana Manzoor, Waqar M Jan, Salman Assad
BACKGROUND: Total knee arthroplasty is associated with hematoma formation and extensive blood loss up to 1.5 liters. The placement of a closed suction drain to control this complication is controversial. The purpose of this study is to determine the efficacy between total knee arthroplasty without a drain and with a closed suction drain.  Methods: A retrospective cohort study was conducted between January 2014 and December 2015 on 100 patients to assess the hemoglobin and hematocrit levels, the rate of allogeneic blood transfusion, and the length of hospital stay in patients with a closed suction drain versus no suction post-total knee arthroplasty...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27909219/superior-survival-of-ex-vivo-cultured-human-reticulocytes-following-transfusion-into-mice
#12
Sabine Kupzig, Stephen F Parsons, Elinor Curnow, David J Anstee, Allison Blair
The generation of cultured red blood cells from stem cell sources may fill an unmet clinical need for transfusion dependent patients, particularly in countries that lack a sufficient and safe blood supply. Cultured red blood cells were generated from human CD34+ cells from adult peripheral blood or cord blood by ex vivo expansion and a comprehensive in vivo survival comparison with standard red cell concentrates was undertaken. Significant amplification (>105 fold) was achieved using CD34+ cells from both cord blood and peripheral blood, generating high yields of enucleated cultured red blood cells...
December 1, 2016: Haematologica
https://www.readbyqxmd.com/read/27908905/mortality-hospitalization-and-quality-of-life-among-patients-with-hepatitis-c-infection-on-hemodialysis
#13
David A Goodkin, Brian Bieber, Michel Jadoul, Paul Martin, Eiichiro Kanda, Ronald L Pisoni
BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is widely prevalent among patients on hemodialysis (HD), but very rarely treated. The aim of our study is to evaluate the burdens of HCV suffered by patients on HD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The Dialysis Outcomes and Practice Patterns Study is an international, prospective, cohort study of patients on HD. We reviewed the HCV status of 76,689 adults enrolled between 1996 and 2015. We compared HCV-positive (HCV+) with HCV-negative (HCV-) patients for risk of mortality, hospitalization, decline in hemoglobin concentration <8...
December 1, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27908184/irradiation-with-x-rays-of-the-energy-18-mv-induces-radioactivity-in-transfusion-blood-proposal-of-a-safe-method-using-6-mv
#14
Katharina Frentzel, Harun Badakhshi
PURPOSE: To prevent a fatal transfusion-associated graft-versus-host disease, it is recommended to irradiate transfusion blood and blood components with ionizing radiation. Using x-rays from a linear accelerator of the radiotherapy department is an accepted alternative to gamma irradiation devices of the blood bank and to the orthovoltage units that are replacing the gamma irradiators today. However, the use of high energy x-rays may carry a potential risk of induced radioactivity. The objective of this study was to investigate the effect of two different energy levels, 6 and 18 MV, which are executed in routine clinical settings...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27904903/prediction-of-severe-bleeding-after-coronary-surgery-the-will-bleed-risk-score
#15
Fausto Biancari, Debora Brascia, Francesco Onorati, Daniel Reichart, Andrea Perrotti, Vito G Ruggieri, Giuseppe Santarpino, Daniele Maselli, Giovanni Mariscalco, Riccardo Gherli, Antonino S Rubino, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Magnus Dalén, Matteo Saccocci, Eeva-Maija Kinnunen, Juhani K E Airaksinen, Paola D'Errigo, Stefano Rosato, Francesco Nicolini
Severe perioperative bleeding after coronary artery bypass grafting (CABG) is associated with poor outcome. An additive score for prediction of severe bleeding was derived (n=2494) and validated (n=1250) in patients from the E-CABG registry. Severe bleeding was defined as E-CABG bleeding grades 2-3 (transfusion of >4 units of red blood cells or reoperation for bleeding). The overall incidence of severe bleeding was 6.4 %. Preoperative anaemia (3 points), female gender (2 points), eGFR <45 ml/min/1.73 m(2) (3 points), potent antiplatelet drugs discontinued less than five days (2 points), critical preoperative state (5 points), acute coronary syndrome (2 points), use of low-molecular-weight heparin/fondaparinux/unfractionated heparin (1 point) were independent predictors of severe bleeding...
December 1, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27904454/red-blood-cell-transfusion-and-skeletal-muscle-tissue-oxygenation-in-anaemic-haematologic-outpatients
#16
Matej Podbregar, Ana Ursula Gavric, Eva Podbregar, Hugon Mozina, Sebastian Stefanovic
BACKGROUND: Stored red blood cells (RBCs) accumulate biochemical and biophysical changes, known as storage lesion. The aim of this study was to re-challenge current data that anaemia in chronically anaemic haematology patients is not associated with low skeletal muscle tissue oxygen (StO2), and that RBC storage age does not influence the tissue response after ischaemic provocation, using near-infrared spectroscopy. PATIENTS AND METHODS: Twenty-four chronic anaemic haematology patients were included...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27900772/hematopoietic-stem-cell-transplantation-for-people-with-%C3%A3-thalassaemia-major
#17
REVIEW
Vanitha A Jagannath, Zbys Fedorowicz, Amani Al Hajeri, Akshay Sharma
BACKGROUND: Thalassemia is an inherited autosomal recessive blood disorder, caused by mutations in globin genes or their regulatory regions. This results in a reduced rate of synthesis of one of the globin chains that make up haemoglobin. In ß-thalassaemia major there is an underproduction of ß-globin chains combined with excess of free α-globin chains. The excess free α-globin chains precipitate in red blood cells, leading to their destruction (haemolysis) and ineffective erythropoiesis...
November 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27899173/procoagulant-role-of-microparticles-in-routine-storage-of-packed-red-blood-cells-potential-risk-for-prothrombotic-post-transfusion-complications
#18
Htet Htet Aung, John-Paul Tung, Melinda M Dean, Robert L Flower, Natalie M Pecheniuk
During routine storage, packed red blood cells (PRBC) undergo biochemical and morphological changes including loss of red blood cell (RBC) membrane asymmetry and release of microparticles (MPs) bearing phosphatidylserine (PS), a procoagulant phospholipid. This study investigated the association between PRBC storage duration, MP profile and procoagulant activity. Leukodepleted PRBC-supernatant (PRBC-SN; n=13) was prepared at weekly intervals throughout storage. Phospholipid-dependent procoagulant activity, assessed using a factor X-activated clotting time (XACT) assay, decreased throughout storage (p<0...
November 26, 2016: Pathology
https://www.readbyqxmd.com/read/27898431/improving-outcome-of-trauma-patients-by-implementing-patient-blood-management
#19
Christoph Füllenbach, Kai Zacharowski, Patrick Meybohm
PURPOSE OF REVIEW: Patient blood management aims to improve patient outcome and safety by reducing the number of unnecessary red blood cell transfusions and vitalizing patient-specific anemia reserves. While this is increasingly recognized as best clinical practice in elective surgery, the implementation in the setting of trauma is restrained because of typically nonelective (emergency) surgery and, in specific circumstances, allogeneic blood transfusions as life-saving therapy. RECENT FINDINGS: Viscoelastic diagnostics allow a precise identification of trauma-induced coagulopathy...
November 24, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27895370/lower-red-cell-transfusion-rates-with-use-of-tranexamic-acid-in-single-stage-bilateral-total-knee-arthroplasty-a-retrospective-audit
#20
Muhammad Aziz, Salman Bin Mahmood, Riaz Hussain Lakdawala, Tashfeen Ahmad
Bilateral total knee arthroplasty (BTKA) patients may require blood transfusion which has its risks. Anti-fibrinolytic drugs such as aprotinin, aminocaproic acid and tranexamic acid (TXA) have reduced transfusion requirements in major surgery. This retrospective audit was performed to assess effectiveness of TXA in reducing blood transfusion rate in single-stage sequential BTKA cases operated by a single surgeon. Records of 91 patients given TXA and 80 controls who were operated before 2012 and not given TXA were reviewed...
October 2016: JPMA. the Journal of the Pakistan Medical Association
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