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https://www.readbyqxmd.com/read/29908901/neonatal-rbc-transfusions-do-benefits-outweigh-risks
#1
REVIEW
Iman F Iskander, Khaled M Salama, Rasha M Gamaleldin, Jerard Seghatchian
Preterm neonates represent one of the most transfused categories of patients. Their target hematocrits, however, are mainly based on expert opinion. The risk of transfusions are very high in the smallest preterm baby with a weak immune response, immature antioxidant ability, fragile germinal matrix and impaired cerebral autoregulation, yet red cell transfusions remain the only life saving measure in the baby with symptomatic anemia. Minimizing phlebotomy losses, following a restrictive transfusion policy and using screened, leukocyte depleted, irradiated, single donor blood remain the best means of avoiding the possible risks while maximizing the benefits of red cell transfusions in the preterm newborn...
May 9, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29900772/randomized-controlled-trial-comparing-the-effects-of-alfaxalone-and-ketamine-hydrochloride-in-the-haitian-giant-galliwasp-celestus-warreni
#2
Laura M Kleinschmidt, Christopher S Hanley, John M Sahrmann, Luis R Padilla
  The immobilization properties and cardiopulmonary effects following intramuscular administration of one of two chemical immobilization agents were compared in the Haitian giant galliwasp ( Celestus warreni) in a prospective, blinded, randomized controlled trial. Adult, clinically healthy galliwasps ( n = 30) were given a randomly assigned single intramuscular injection of either 15 mg/kg alfaxalone ( n = 15) or 40 mg/kg ketamine hydrochloride ( n = 15). Heart rate, respiratory rate, and depth classification stage were recorded every 5 min; cloacal temperature was recorded every 15 min to ensure maintenance within this species' preferred optimal temperature range (75-85°F, 24-29°C)...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29897731/small-molecule-inhibitors-of-nfkb-reverse-iron-overload-and-hepcidin-deregulation-in-a-zebrafish-model-for-hereditary-hemochromatosis-type-3
#3
Sandeep Basu, Kanika Jalodia, Shashi Ranjan, Jing-Ruey J Yeh, Randall T Peterson, Chetana Sachidanandan
Hereditary hemochromatosis (HH) is one of the most common genetic disorders in Caucasian populations, with no viable therapeutic options except phlebotomy. We describe a zebrafish model of human HH (HH) created by targeted mutagenesis of the gene encoding Transferrin receptor 2 (tfr2). TFR2 mutations in humans lead to HH Type 3, a rare but severe form of the disease. The tfr2 mutant model in zebrafish recapitulates the defining features of HH3; iron overload and suppression of hepcidin, the iron regulatory hormone...
June 13, 2018: ACS Chemical Biology
https://www.readbyqxmd.com/read/29886220/removal-of-non-infected-arteriovenous-fistulae-following-kidney-transplantation-is-a-safe-and-beneficial-management-strategy-for-unused-dialysis-access
#4
Charles D Fraser, Joshua C Grimm, Rui Han Liu, Russell N Wesson, Faris Azar, Robert J Beaulieu, Thomas Reifsnyder
INTRODUCTION: Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This study evaluates the indications for, and safety of, arteriovenous fistula (AVF) removal in patients following successful renal transplantation. METHODS: All patients that underwent AVF excision at a single institution from 2006-2016 were retrospectively reviewed...
June 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29881576/congenital-erythrocytosis-discover-of-a-new-mutation-in-the-egln1-gene
#5
João Barradas, Catarina Dantas Rodrigues, Gisela Ferreira, Paula Rocha, Conceição Constanço, Maria Reis Andrade, Celeste Bento, Helena Matos Silva
Congenital erythrocytosis is a hereditary disorder due to an increase in red cell mass that can be caused by mutations in proteins involved in HIF-α pathway, as PHD2. Hereby, we describe a new familial mutation in PHD2 gene. Considering an increased thrombotic potential, patients began antiplatelet aggregation therapy and phlebotomies.
June 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29863679/evaluating-the-role-of-mitochondrial-function-in-cancer-related-fatigue
#6
Li Rebekah Feng, Quang Nguyen, Alexander Ross, Leorey N Saligan
Fatigue is a common and debilitating condition that affects most cancer patients. To date, fatigue remains poorly characterized with no diagnostic test to objectively measure the severity of this condition. Here we describe an optimized method for assessing mitochondrial function of PBMCs collected from fatigued cancer patients. Using a compact extracellular flux system and sequential injection of respiratory inhibitors, we examined PBMC mitochondrial functional status by measuring basal mitochondrial respiration, spare respiratory capacity, and energy phenotype, which describes the preferred energy pathway to respond to stress...
May 17, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29851238/implementation-and-preliminary-results-of-an-emergency-department-nontargeted-opt-out-hepatitis-c-virus-screening-program
#7
Elissa M Schechter-Perkins, Nancy S Miller, Jon Hall, Joshua J Hartman, David Dorfman, Chris Andry, Benjamin Linas
BACKGROUND: Emergency Department (ED) visits provide an opportunity for hepatitis C virus (HCV) screening for patients who otherwise might be tested. We report on a novel nontargeted, opt-out HCV screening and linkage-to-care program implemented in an urban ED. METHODS: This is a descriptive analysis from 3 months (November 2016-January 2017) of a nontargeted, opt-out ED HCV screening and linkage-to-care program among patients at least 13 years old undergoing phlebotomy for clinical purposes...
May 31, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29790786/the-impact-of-disruption-of-the-care-delivery-system-by-commercial-laboratory-testing-in-a-children-s-health-care-system
#8
Beverly B Rogers, James L Adams, Alexis B Carter, Francine Uwindatwa, Cynthia B Brawley, Charles G Cochran, Leah N Bryan, Elizabeth P Weinzierl, Sampath Prahalad
CONTEXT: - Disruption of outpatient laboratory services by routing the samples to commercial reference laboratories may seem like a cost-saving measure by the payers, but results in hidden costs in quality and resources to support this paradigm. OBJECTIVE: - To identify differences when outpatient tests are performed at a Children's Hospital lab compared to a commercial reference lab, and the financial costs to support the reference laboratory testing. DESIGN: - Outpatient testing was sent to 3 different laboratories, specified by the payer...
May 23, 2018: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29783085/indoor-black-carbon-and-biomarkers-of-systemic-inflammation-and-endothelial-activation-in-copd-patients
#9
Eric Garshick, Stephanie T Grady, Jaime E Hart, Brent A Coull, Joel D Schwartz, Francine Laden, Marilyn L Moy, Petros Koutrakis
RATIONALE: Evidence linking traffic-related particle exposure to systemic effects in chronic obstructive lung disease (COPD) patients is limited. OBJECTIVES: Assess relationships between indoor black carbon (BC), a tracer of traffic-related particles, and plasma biomarkers of systemic inflammation and endothelial activation. METHODS: BC was measured by reflectance in fine particle samples over a mean of 7.6 days in homes of 85 COPD patients up to 4 times seasonally over a year...
May 18, 2018: Environmental Research
https://www.readbyqxmd.com/read/29771953/mitochondrial-disease-patient-motivations-and-barriers-to-participate-in-clinical-trials
#10
Zarazuela Zolkipli-Cunningham, Rui Xiao, Amy Stoddart, Elizabeth M McCormick, Amy Holberts, Natalie Burrill, Shana McCormack, Lauren Williams, Xiaoyan Wang, John L P Thompson, Marni J Falk
BACKGROUND: Clinical treatment trials are increasingly being designed in primary mitochondrial disease (PMD), a phenotypically and genetically heterogeneous collection of inherited multi- system energy deficiency disorders that lack effective therapy. We sought to identify motivating factors and barriers to clinical trial participation in PMD. METHODS: A survey study was conducted in two independent mitochondrial disease subject cohorts. A discovery cohort invited subjects with well-defined biochemical or molecularly- confirmed PMD followed at a single medical center (CHOP, n = 30/67 (45%) respondents)...
2018: PloS One
https://www.readbyqxmd.com/read/29765443/management-of-cardiac-hemochromatosis
#11
Wilbert S Aronow
Iron-overload syndromes may be hereditary or acquired. Patients may be asymptomatic early in the disease. Once heart failure develops, there is rapid deterioration. Cardiac hemochromatosis is characterized by a dilated cardiomyopathy with dilated ventricles, reduced ejection fraction, and reduced fractional shortening. Deposition of iron may occur in the entire cardiac conduction system, especially the atrioventricular node. Cardiac hemochromatosis should be considered in any patient with unexplained heart failure...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29754478/methicillin-resistant-staphylococcus-aureus-contamination-of-phlebotomy-tourniquets-and-faucets
#12
T Abeywickrama, K Amarasinghe, S Wijerathne, C Dharmaratne, D Fernando, B C Senaratna, H A K M Gunasekera
Introduction: Methicillin resistant Staphylococcus aureus (MRSA) is transmitted through direct contact or fomites. The most important means of nosocomial spread is by hospital personnel. However, fomites are being increasingly recognized as sources of nosocomial infection. Objectives: Our aim was to describe the MRSA contamination rate of phlebotomy tourniquets and faucets in a tertiary care hospital and to compare the contamination of plastic tourniquets with that of fabric tourniquets...
March 31, 2018: Ceylon Medical Journal
https://www.readbyqxmd.com/read/29750336/relapse-of-porphyria-cutanea-tarda-after-treatment-with-phlebotomy-or-4-aminoquinoline-antimalarial-a-meta-analysis
#13
H Salameh, H Sarairah, M Rizwan, Y-F Kuo, K E Anderson, A K Singal
INTRODUCTION: Porphyria cutanea tarda (PCT), the most common human porphyria, due to hepatic deficiency of uroporphyrinogen decarboxylase (UROD) activity, which is acquired in the presence of multiple susceptibility factors. PCT presents clinically with cutaneous blistering photosensitivity and is readily treatable with either repeated phlebotomy or 4-aminoquinoline antimalarial. We performed a systematic review and meta-analysis to compare the effectiveness of these quite different treatment approaches, especially on relapse rates after achieving remission...
May 11, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29743399/-successful-treatment-of-x-linked-sideroblastic-anemia-with-alas2-r452h-mutation-using-vitamin-b-6
#14
Toru Kawakami, Hideyuki Nakazawa, Fumihiro Kawakami, Shuji Matsuzawa, Yuriko Sudo, Hitoshi Sakai, Sayaka Nishina, Noriko Senoo, Yasushi Senoo, Michiharu Komatsu, Takeji Umemura, Tomomi Yamaguchi, Tomoki Kosho, Tohru Fujiwara, Hideo Harigae, Fumihiro Ishida
A 45-year-old man presented with fatigue and pain in the finger joints. Despite having a history of suspected sideroblastic anemia since the age of 18 years, he had not been followed up for years. Upon presentation, laboratory data revealed microcytic anemia and elevated serum ferritin levels. In addition, ringed sideroblasts were increased in the bone marrow. A liver biopsy revealed hemochromatosis and cirrhosis. Furthermore, genetic analysis revealed that he harbored the ALAS2 R452H mutation, leading to the diagnosis of X-linked sideroblastic anemia (XLSA)...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/29729240/reducing-hospital-toxicity-impact-on-patient-outcomes
#15
Richard V Milani, Robert M Bober, Carl J Lavie, Jonathan K Wilt, Alexander R Milani, Christopher J White
BACKGROUND: Circadian rhythms are endogenous 24-hour oscillations in biologic processes that drive nearly all physiologic and behavioral functions. Disruption in circadian rhythms can adversely impact short and long-term health outcomes. Routine hospital care often causes significant disruption in sleep-wake patterns that is further compounded by loss of personal control of health information and health decisions. We wished to evaluate measures directed at improving circadian rhythm and access to daily health information on hospital outcomes...
May 2, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29728199/errors-of-classification-with-potassium-blood-testing-the-variability-and-repeatability-of-critical-clinical-tests
#16
Paul A Friedman, Christopher G Scott, Kent Bailey, Nikola A Baumann, David Albert, Zachi I Attia, Dorothy J Ladewig, Omar Yasin, John J Dillon, Bhupinder Singh
OBJECTIVE: To understand the performance of a currently used clinical blood test with regard to the frequency and size of variation of the results. PATIENTS AND METHODS: From November 29, 2012, through November 29, 2013, patients were recruited at 65 sites as part of a previously reported clinical trial (ClinicalTrials.gov Identifier: NCT01737697). Eligible outpatients who had been fasting for at least 8 hours underwent venous phlebotomy at baseline, 30 minutes, and 60 minutes to measure plasma potassium levels in whole blood using a point-of-care device (i-STAT, Abbott Laboratories)...
May 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29728092/cytoreductive-treatment-patterns-among-us-veterans-with-polycythemia-vera
#17
Shreekant Parasuraman, Jingbo Yu, Dilan Paranagama, Sulena Shrestha, Li Wang, Onur Baser, Robyn Scherber
BACKGROUND: Polycythemia vera (PV) is a myeloproliferative neoplasm associated with increased thrombotic and cardiovascular risk, which are key contributors to patient morbidity and mortality. The Veterans Health Administration (VHA) is the largest integrative health network in the United States. Available data concerning patients with PV in this population are limited. METHODS: This retrospective observational study evaluated the characteristics, management, and outcomes of patients with PV in the VHA Medical SAS® Dataset (October 1, 2005, to September 30, 2012)...
May 4, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29722188/haemochromatosis-a-clinical-update-for-the-practising-physician
#18
Daniel E Radford-Smith, Elizabeth E Powell, Lawrie W Powell
Haemochromatosis is most commonly due to the autosomal recessive inheritance of a C282Y substitution in the HFE protein, whereby both alleles of the corresponding gene are affected. The disease is characterised by an inappropriate increase in intestinal iron absorption due to reduced expression of the iron regulatory protein, hepcidin. Progressive iron deposition in parenchymal tissues may ultimately lead to liver and other organ toxicity. The characteristic biochemical abnormalities are raised serum ferritin and transferrin saturation, which can be used in conjunction with genetic tests and emerging magnetic resonance imaging-based techniques to diagnose patients with the disorder...
May 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29721337/influence-of-seasonality-and-circulating-cytokines-on-serial-quantiferon-discordances
#19
Marsha L Griffin, Saroochi Agarwal, Melissa Zhu Murphy, Larry D Teeter, Edward A Graviss
Objectives. An 18-month prospective study serially tested healthcare workers (HCWs) for tuberculosis infection (TBI) and reported discordant QuantiFERON Gold In-Tube® (QFT) results in some participants. The purpose of the current study was to investigate whether the interferon-gamma (IFN- γ ) measured by QFT in discordant individuals could be influenced by other circulating cytokines that vary seasonally at the time of phlebotomy. Methods. The CDC funded TBESC Task Order 18 (TO18) project to assess the use of Interferon Gamma Release Assays (IGRAs), T-SPOT...
2018: Tuberculosis Research and Treatment
https://www.readbyqxmd.com/read/29719291/evaluating-otherwise-discarded-umbilical-cord-blood-as-a-source-for-a-neonate-s-complete-blood-cell-count-at-various-time-points
#20
Patrick D Carroll, Eva Livingston, Vickie L Baer, Kerby Karkula, Robert D Christensen
BACKGROUND: Previous studies have reported the use of cord blood for admission laboratory complete blood counts (CBCs). However, no studies have investigated its stability for the first 30 min after delivery. OBJECTIVES: We quantified blood cells drawn from the umbilical vein to determine the effect of (1) the time after placental delivery, and (2) the site of blood sampling (umbilical vein on an isolated cord segment vs. umbilical vein on the placental surface)...
2018: Neonatology
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