Background Platelet transfusions are used in modern clinical practice to prevent and treat bleeding in people who are thrombocytopenic due to bone marrow failure. Although considerable advances have been made in platelet transfusion therapy in the last 40 years, some areas continue to provoke debate, especially concerning the use of prophylactic platelet transfusions for the prevention of thrombocytopenic bleeding. This is an update of a Cochrane review first published in 2004, and previously updated in 2012 that addressed four separate questions: prophylactic versus therapeutic-only platelet transfusion policy; prophylactic platelet transfusion threshold; prophylactic platelet transfusion dose; and platelet transfusions compared to alternative treatments. This review has now been split into four smaller reviews looking at these questions individually; this review compares prophylactic platelet transfusion thresholds. Objectives To determine whether different platelet transfusion thresholds for

TY - JOUR. T1 - Effects of neonatal polycythemia and partial exchange transfusion on cardiac function. T2 - An echocardiographic study. AU - Murphy, D. J.. AU - Reller, M. D.. AU - Meyer, R. A.. AU - Kaplan, S.. PY - 1985. Y1 - 1985. N2 - Although infants with neonatal polycythemia and hyperviscosity often present with cardiorespiratory distress, little information is available regarding the cardiac function of such babies before or after partial exchange transfusion. To assess cardiac function, we performed M-mode echocardiograms in 19 asymptomatic newborn infants (4 to 12 hours of age) who had venous hematocrits greater than 65%. The echocardiograms were performed immediately prior to and following partial exchange transfusion and were repeated at 48 hours of age. Eighteen matched newborn controls also underwent echocardiography within the first 12 hours of life and again at 48 hours. Polycythemic newborns had elevated right ventricular preejection period to right ventricular ejection time ...

UNLABELLED The erythropoietic capacity for preoperative autologous blood donation (ECPABD) shows marked inter individual variability. This study was performed to evaluate factors useful to predict individual ECPABD from data available before the first donation. The subjects consisted of 74 adult patients who received autologous blood donation, with a mean of 61 +/- 12.8 yr (SD). We classified the patients into four groups using our criteria for evaluating the ECPABD and investigated the relationships among age, disease, pre-platelet count, and the rate of platelet increase. RESULTS (1) Advanced age and the status of disease were not distinctly correlated with low ECPABD. (2) Patients with a high pre-platelet levels had a low ECPABD regardless of the haemoglobin. (3) Patients in which the platelet count increased in accordance with the level of collection exhibited low pre-platelet counts and high ECPABD. CONCLUSION In patients with high pre-platelet levels, we reduced the amount collected,

TY - JOUR. T1 - Early autologous fresh whole blood transfusion leads to less allogeneic transfusions and is safe. AU - Rhee, Peter. AU - Inaba, Kenji. AU - Pandit, Viraj. AU - Khalil, Mazhar. AU - Siboni, Stefano. AU - Vercruysse, Gary. AU - Kulvatunyou, Narong. AU - Tang, Andrew. AU - Asif, Anum. AU - OKeeffe, Terence. AU - Joseph, Bellal. PY - 2015/4/4. Y1 - 2015/4/4. N2 - BACKGROUND: The practice of transfusing ones' own shed whole blood has obvious benefits such as reducing the need for allogeneic transfusions and decreasing the need for other fluids that are typically used for resuscitation in trauma. It is not widely adopted in the trauma setting because of the concern of worsening coagulopathy and the inflammatory process. The aim of this study was to assess outcomes in trauma patients receiving whole blood autotransfusion (AT) from hemothorax. METHODS: This is a multi-institutional retrospective study of all trauma patients who received autologous whole blood transfusion from hemothorax ...

Recipient factors,ref,Vlaar AP, et al. Risk factors and outcome of transfusion-related acute lung injury in the critically ill: a nested case-control study. Crit Care Med. 2007;176:886,/ref,,ref,Gajic O, et al. Transfusion-related acute lung injury in the critically ill: prospective nested case-control study. Am J Respir Crit Care Med. 2007;176:886,/ref,,ref name='fifteen',Toy P, et al. Transfusion-related acute lung injury: incidence and risk factors. Blood. 2012;119:1757,/ref,,ref,Benson AB, et al. Transfusion-related acute lung injury in ICU patients admitted with gastrointestinal bleeding. Intensive Care Med. 2010;36:1710,/ref ...

Hemoglobin (Hb) transfusion thresholds are established in intensive care units. A restrictive transfusion threshold (Hb 70-75 g/l) is recommended in septic patients, and a liberal transfusion threshold (Hb 90 g/l) for cardiogenic shock. It is unclear whether these historically adopted transfusion thresholds meet the challenges of individual patients. We evaluated microvascular flow index (MFI) and proportion of perfused vessels (PPV) in the sublingual microcirculation with CytoCam-IDF microscopy and near-infrared spectroscopy (NIRS). A study team-independent, treating intensivist assigned a total of 64 patients to 1 of 2 two transfusion thresholds, 43 patients to the Hb 75 g/l threshold and 21 patients to the Hb 90 g/l threshold, at a surgical intensive care unit. We performed microcirculatory measurements 1 h before and 1 h after transfusion of 1 unit of red blood cells. Microcirculatory flow variables correlated negatively with pre-transfusion flow variables (ΔMFI: ρ = − 0.821, p | 0.001; ΔPPV:

TY - JOUR. T1 - Transfusion-related acute lung injury following random donor platelet transfusion. T2 - A report of two cases. AU - Ramanathan, Ramesh K.. AU - Triulzi, Darrell J.. AU - Logan, Theodore F.. PY - 1997/1/1. Y1 - 1997/1/1. N2 - Objectives: Transfusion-related acute lung injury (TRALI) following random donor platelet (RDP) transfusion is a rare complication of transfusion without any well-documented case reported in the English language literature. We describe 2 patients in whom TRALI occurred following RDP transfusion. Methods: Conventional clinical and laboratory methods. Results: Both patients developed acute shortness of breath 30-60 min after completion of RDP transfusion and required mechanical ventilatory support. Chest X-ray (CXR) in both cases revealed bilateral pulmonary infiltrates. Patient 1 required vasopressors for hypotension. Right heart catheterization ruled out fluid overload. Patient 2 remained hemodynamically stable. Both patients improved rapidly with continued ...

Many people diagnosed with haematological malignancies experience anaemia, and red blood cell (RBC) transfusion plays an essential supportive role in their management. Different strategies have been developed for RBC transfusions. A restrictive transfusion strategy seeks to maintain a lower haemoglobin level (usually between 70 g/L to 90 g/L) with a trigger for transfusion when the haemoglobin drops below 70 g/L), whereas a liberal transfusion strategy aims to maintain a higher haemoglobin (usually between 100 g/L to 120 g/L, with a threshold for transfusion when haemoglobin drops below 100 g/L). In people undergoing surgery or who have been admitted to intensive care a restrictive transfusion strategy has been shown to be safe and in some cases safer than a liberal transfusion strategy. However, it is not known whether it is safe in people with haematological malignancies.To determine the efficacy and safety of restrictive versus liberal RBC transfusion strategies for people diagnosed with

Severe bacterial infections are associated with mortality of about 30%. Patients with moderate to severe bacterial infections given early and appropriate empirical antibiotic treatment are at a lesser risk for a fatal outcome, with odds ratios ranging from 1.6 to 6.9. However only about 2/3 of patients worldwide are given early and appropriate empirical antibiotic treatment. About 40% of patients treated with antibiotics are given superfluous treatment.. TREAT is a computerized decision support system for antibiotic treatment in inpatients with common bacterial infections. TREAT is based on a state of the art stochastic model of the domain (a causal probabilistic network) and uses a cost benefit model for antibiotic treatment, including costs assigned to future resistance. It was tested in a randomized controlled trial in 3 countries and shown to improve the percentage of appropriate empirical antibiotic treatment while at the same time reduce hospital stay and the use of broad-spectrum ...

TY - JOUR. T1 - Exchange transfusion and cytarabine for transient abnormal myelopoiesis in hydrops fetalis. AU - Okamura, Tomoka. AU - Washio, Yousuke. AU - Yoshimoto, Junko. AU - Tani, Kazumasa. AU - Tsukahara, Hirokazu. AU - Shimada, Akira. PY - 2019. Y1 - 2019. N2 - Most cases of transient abnormal myelopoiesis (TAM) in neonates with Down syndrome (DS) resolve spontaneously; however, DS-TAM neonates with hydrops fetalis (HF) show poor clinical outcomes. We report three infants with DS-TAM and HF who were treated with exchange transfusion (ET) followed by low-dose cytarabine (LD-CA). All of them survived without developing liver failure, acute leukemia, or other serious adverse events. Our results suggest that this combination treatment with ET and LD-CA would be safe, tolerable and effective as an novel approach for DS-TAM patients with HF.. AB - Most cases of transient abnormal myelopoiesis (TAM) in neonates with Down syndrome (DS) resolve spontaneously; however, DS-TAM neonates with hydrops ...

Autologous Blood Injection (ABI) and Platelet Rich Plasma (PRP) injections involve injecting a patient s blood into damaged part of body for the treatment of tendinitis at Melbourne Radiology Clinic.

Risk of Sensorineural Hearing Loss and Bilirubin Exchange Transfusion Thresholds. Pediatrics. 2015; 136(3):505-12 (ISSN: 1098-4275). Wickremasinghe AC; Risley RJ; Kuzniewicz MW; Wu YW; Walsh EM; Wi S; McCulloch CE; Newman TB ABSTRACT Risk of Sensorineural Hearing Loss and Bilirubin Exchange Transfusion Thresholds. Pediatrics. 2015; 136(3):505-12 (ISSN: 1098-4275). Wickremasinghe AC; Risley RJ; Kuzniewicz MW; Wu YW; Walsh EM; Wi S; McCulloch CE; Newman TB BACKGROUND AND OBJECTIVES: High bilirubin levels are associated with sensorineural…

Chronic bacterial prostatitis is a bacterial infection of the prostate gland. It should be distinguished from other forms of prostatitis such as acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS). Chronic bacterial prostatitis is a relatively rare condition that usually presents with an intermittent UTI-type picture. It is defined as recurrent urinary tract infections in men originating from a chronic infection in the prostate. Symptoms may be completely absent until there is also bladder infection, and the most troublesome problem is usually recurrent cystitis. Chronic bacterial prostatitis occurs in less than 5% of patients with prostate-related non-BPH lower urinary tract symptoms (LUTS). Dr. Weidner, Professor of Medicine, Department of Urology, University of Gießen, has stated: "In studies of 656 men, we seldom found chronic bacterial prostatitis. It is truly a rare disease. Most of those were E-coli." In chronic bacterial prostatitis there are bacteria in the prostate, ...

Ten and a half years ago, when our 21-month-old daughter was diagnosed with Acute Lymphoblastic Leukemia, Scott and I were told to be thankful it was ALL and not some other kind of cancer. We were thankful, strange as it was to feel glad about anything related to a cancer diagnosis. We knew that the prognosis was better for kids with ALL than with other types of cancer.. But we were a full week into treatment before we found out how very good the prognosis actually was. Jane had started the week with two complete blood exchanges, purging her body of all the cancerous white blood cells that had escaped her bone marrow and were coursing through her tiny veins. She had made it through the first terrible week of chemotherapy-the fevers, the vomiting, the countless needle sticks. One week down, years to go. The head of the hem/onc department came in to meet us, and he asked us, rather professorially, what our goal was with Jane's treatment.. 'Remission?' I asked. He smiled in obvious amusement. 'Yes, ...

Background: Intra-operative blood salvage is a scientific technique known to reduce the need for an allogenic transfusion and associated risks of infectious and non-infectious complications and time required to acquire blood in situations of emergency surgeries like acute ruptured ectopic pregnancies. Despite the known benefits of intra-operative blood salvage, the techniques is not utilized or taught in Mulago National referral hospital. Detailed insight into the issues leading to failure of intra-operative blood transfusion (IBS) utilization was lacking in Mulago. To encourage the initiation and utilization of IBS, tailored recommendations aimed at barriers that hinder its practice were made. Main objective: The study was aimed at exploring relevant barriers and facilitators that influence the implementation of intra-operative blood salvage in the management of acute ruptureda qu ectopic pregnancies. Methods: This was alitative descriptive study carried in Mulago National Referral Hospital. ...

Review question We evaluated the evidence about whether giving antifibrinolytics (tranexamic acid or epsilon-aminocaproic acid) to people with a low platelet count prevents bleeding and whether these antifibrinolytics are associated with side effects. Our target population was people with haematological disorders who have a low platelet count and would usually be treated with platelet transfusions. We did not include people with immune thrombocytopenia because they are not usually treated with platelet transfusions.. Background People with haematological (blood) cancers and other blood disorders (for example, aplastic anaemia) are frequently at risk of severe or life-threatening bleeding from having low platelet counts (thrombocytopenia). This may be from bone marrow failure due to an underlying blood disorder but also from the toxic effect of treatment (chemotherapy) on the bone marrow. These people can be given prophylactic platelet transfusions (from donations) to prevent bleeding if their ...

TY - JOUR. T1 - Electrothermal bipolar coagulation decreases the rate of red blood cell transfusions for pelvic exenterations. AU - Bansal, Nisha. AU - Roberts, William S.. AU - Apte, Sachin M.. AU - Lancaster, Johnathan M.. AU - Wenham, Robert M.. PY - 2009/11/1. Y1 - 2009/11/1. N2 - Background: We evaluated whether electrothermal bipolar coagulation (Ligasure) for pelvic exenterations decreases operative morbidity. Methods: All cases of pelvic exenterations, for all malignancies, performed at Moffitt Cancer Center from 1999 to 2008, were identified through retrospective review of medical records. Estimated blood loss (EBL), transfusion, operative time, hospital stay, and complications were compared between Ligasure cases and non-Ligasure cases. Results: Seventy-five patients underwent identified. Ligasure was used in 29/75 (39%) cases and standard techniques in 46/75 (61%) cases. Primary malignancy was gynecologic in 31/75(40%) cases (18/29, 62% Ligasure cases, 13/46, 26% non-Ligasure cases). ...

Abstract 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. TXA was given 15mg/kg intravenously (IV) before tourniquet deflation and 3 hours postoperatively.Blood transfusion was done in 9(10%) patients in the TXA group compared to 20(25%)in the control group (p|0.01). One (1.25%) patient in the control group had non-fatal pulmonary embolism.TXA appeared to be effective in decreasing post-operative blood loss and requirement for blood transfusion after single-stage BTKA.

The NIBTS exists to fully supply the needs of all hospitals and clinical units in the province with safe and effective blood and blood products and other related services. The discharge of this function includes a commitment to the care and welfare of our voluntary donors.. The Northern Ireland Blood Transfusion Service, established in 1946, is an independent, Special Agency of the DHSSPS. It is responsible for the collection, testing and distribution of over 64,000 blood donations each year. The Service operates three mobile units at around 250 locations throughout the province. Including headquarters, located on the site of the Belfast City Hospital, a total of almost 1,000 donation sessions are held each year.. ...

Background and objectives: Platelet storage lesions (PSL) are the sum of deleterious changes that platelets undergo during storage, affecting platelet concentrate viability for transfusion. In veterinary medicine, transfusion medicine has gained popularity and recent advances have been made. There is a continuous effort to prolong the shelf life and improve the quality of platelet concentrates. Removal of leukocytes has been proven to reduce febrile post-transfusion reactions and decrease platelet premature activation and apoptosis in humans. The present study objectives were to determine if leukoreduced canine platelet concentrates have fewer and delayed onset of in vitro storage lesions compared with non-leukoreduced concentrates and to determine which variable best predicts in vitro platelet viability. Methods: Platelet concentrates from twelve dogs were stored between 22°C - 24°C under continuous agitation for 7 days. Each sample was equally divided into leukoreduced (LR), leukoreduced ...

TY - JOUR. T1 - Systematic review of the use of fibrin sealant to minimize perioperative allogeneic blood transfusion. AU - Carless, Paul A.. AU - Anthony, Danielle M.. AU - Henry, D. A.. PY - 2002. Y1 - 2002. N2 - Background: Fibrin sealants have become popular in improving perioperative haemostasis and reducing the need for allogeneic red cell transfusion. Methods: A systematic review of randomized controlled trials was conducted to examine the efficacy of fibrin sealants in reducing perioperative blood loss and allogeneic red blood cell transfusion. Studies were identified by computer searches of Medline, Embase, Current Contents, the Cochrane Library, manufacturer websites (to January 2001), and bibliographic searches of published articles. Trials were eligible for inclusion if they involved adult elective surgery and reported quantitative data on blood loss, the proportion of patients exposed to allogeneic red cell transfusion and/or the volume of blood transfused. Results: Twelve trials ...

This study is an ancillary (add-on) study to the clinical trial entitled Red Cell Storage Duration Study (RECESS), which has clinicaltrials.gov identifier NCT00991341. The RECESS study randomizes cardiac surgery patients to receive either red blood cell units stored for no more than 10 days, or red blood cell units stored for at least 21 days, if they need any red blood cell transfusions during their hospital stay for the surgery.. This ancillary study is entitled Impact of Blood Storage Duration on Physiologic Measures: RECESS Ancillary Physiologic Study (RECAP). The hypothesis of the RECAP study is that there will be differences between the two randomized treatment groups in how much the following measurements change, from shortly before a red blood cell transfusion to shortly after a red blood cell transfusion, and from before surgery to 24 hours after surgery:. ...

A delayed hemolytic transfusion reaction (DHTR) is a type of transfusion reaction. It is defined as fever and other symptoms/ signs of hemolysis more than 24 hours after transfusion; confirmed by one or more of the following: a fall in haemoglobin (Hb) level or failure of Hb level to rise after transfusion rise in bilirubin (jaundice) incompatible crossmatch not detectable pre-transfusion. This can occur up to four weeks after the transfusion. Delayed blood transfusion reaction occurs more frequently (1 in 20,569 blood components transfused in the USA in 2011) when compared to acute haemolytic transfusion reaction. One way this can occur is if a person without a Kidd blood antigen receives a Kidd antigen in a transfusion. Other common blood groups with this reaction are Duffy and Kell. Noizat-Pirenne F, Bachir D, Chadebech P, et al. (December 2007). "Rituximab for prevention of delayed hemolytic transfusion reaction in sickle cell disease". Haematologica. 92 (12): e132-5. ...

TY - JOUR. T1 - Neonatal hyperbilirubinemia in Japanese neonates. T2 - Analysis of the heme oxygenase-1 gene and fetal hemoglobin composition in cord blood. AU - Kanai, Masayo. AU - Akaba, Kazuhiro. AU - Sasaki, Ayako. AU - Sato, Michihiko. AU - Harano, Teruo. AU - Shibahara, Shigeki. AU - Kurachi, Hirohisa. AU - Yoshida, Tadashi. AU - Hayasaka, Kiyoshi. N1 - Copyright: Copyright 2008 Elsevier B.V., All rights reserved.. PY - 2003/8/1. Y1 - 2003/8/1. N2 - Neonatal hyperbilirubinemia is frequent and severe in Japanese infants. Although the G71R mutation of the bilirubin uridine diphosphate-glucuronosyltransferase gene is associated with severe neonatal hyperbilirubinemia in this population, it accounts for only half of the neonates with severe hyperbilirubinemia. It was suggested that increased bilirubin production would also be associated with severe neonatal hyperbilirubinemia in Japanese infants. To elucidate the genetic factors causing severe hyperbilirubinemia in these patients, we studied ...

TY - JOUR. T1 - Spontaneous bacterial peritonitis in patients with hepatitis B-related cirrhosis and hepatocellular carcinoma. AU - Wang, Sun Sang. AU - Tsai, Yang Te. AU - Lee, Shou Dong. AU - Chen, How Tshung. AU - Lu, Chi Wen. AU - Lee, Fa Yauh. AU - Jeng, Jin Shiung. AU - Liu, Yung Ching. AU - Lo, Kwang Juei. PY - 1991. Y1 - 1991. N2 - To delineate the natural clinical course of spontaneous bacterial peritonitis in hepatitis B-related cirrhosis and to determine if it occurs in hepatocellular carcinoma, a prospective survey was conducted in 262 patients over 2 1 2 years. The in-hospital incidence and mortality rates of spontaneous bacterial peritonitis were 21.6% and 36.4%, respectively, in cirrhosis and 7.3% and 50% in hepatocellular carcinoma. In cirrhosis, the cumulative probability of annual recurrence of spontaneous bacterial peritonitis was 47.3%, which was significantly higher than the annual probability of occurrence of 11.3% in those with no previous attack (P ,0.0001). The ...

Serum resistin levels were significantly elevated in patients with Gram-positive, as compared with Gram-negative, septic shock (P = 0.004). Analyses of tissue biopsies revealed that resistin was highly expressed at the local site of infection. Dual-staining for cell markers confirmed published findings that monocytes are a source of resistin in humans, but importantly the stainings revealed that the majority of resistin-producing cells were negative for the monocytic marker CD68. Further analyses identified these cells as neutrophils. A positive correlation between resistin levels and neutrophil counts was found in blood of septic shock patients (P = 0.005). In vitro cell cultures revealed resistin release by neutrophils stimulated with lipopolysaccharide or superantigens. ...

None of the studies were conducted without flaws, and because of the very low certainty in the results, the authors cannot suggest which antibiotic, given alone or in combination to remove the bacteria from one's tummy, is better or worse than other antibiotics in the treatment of spontaneous bacterial peritonitis.. The funding source was unclear in 10 studies; industrial organisations funded two studies.. What was studied in the review?. This review studied people, of any sex, age, and origin, with advanced liver disease due to various causes, and who had developed spontaneous bacterial peritonitis. People were administered different antibiotics for the treatment of spontaneous bacterial peritonitis. The authors excluded studies with liver transplanted participants and bacterial peritonitis due to other causes. The participants' age, when reported, ranged from 42 to 60 years. The number of females, when reported, ranged from 18 to 42 out of 100. The administered antibiotic groups were ...

Aprotinin has been shown to be effective in reducing peri-operative blood loss and the need for re-operation due to continued bleeding in cardiac surgery. The lysine analogues tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) are cheaper, but it is not known if they are as effective as aprotinin. Studies were identified by searching electronic databases and bibliographies of published articles. Data from head-to-head trials were pooled using a conventional (Cochrane) meta-analytic approach and a Bayesian approach which estimated the posterior probability of TXA and EACA being equivalent to aprotinin; we used as a non-inferiority boundary a 20% increase in the rates of transfusion or re-operation because of bleeding. Peri-operative blood loss was significantly greater with TXA and EACA than with aprotinin: weighted mean differences were 106 mls (95% CI 37 to 227 mls) and 185 mls (95% CI 134 to 235 mls) respectively. The pooled relative risks (RR) of receiving an allogeneic red blood cell (RBC)

TY - JOUR. T1 - Long-term erythrocytapheresis is associated with reduced liver iron concentration in sickle cell disease. AU - Myers, Scott N.. AU - Eid, Ryan. AU - Myers, John. AU - Bertolone, Salvatore. AU - Panigrahi, Arun R. AU - Mullinax, Jennifer. AU - Raj, Ashok B.. PY - 2016/1/1. Y1 - 2016/1/1. N2 - Background: Erythrocytapheresis procedures are increasingly used in sickle cell disease. Serum ferritin and noninvasive magnetic resonance imaging measurements of liver iron concentration (LIC) are frequently used to monitor iron overload secondary to hypertransfusion. There is a paucity of data describing the impact of long-term erythrocytapheresis (LTE) on LIC. Materials and Methods: We measured magnetic resonance imaging liver and cardiac iron on LTE subjects and stratified them into 2 groups: higher LIC (,3 mg/g) and lower LIC (,3 mg/g). χ2 and t test were used to test for differences between the 2 groups. Logistic regression and generalized linear mixed-effects models were used to test ...

Objective: To compare efficacy of special blue compact fluorescent lamp (CFL) phototherapy with special blue standard-length tube lights (STL) phototherapy in terms of rate of fall of serum bilirubin levels, required duration of phototherapy and to compare the incidences of clinically observable side effects between both groups. Study design: Randomized prospective Observational Study. Setting: Tertiary level of neonatal intensive care unit. Study was conducted from December 2011 to September 2012. Participants: Stable neonates of gestation ,34 weeks with hyperbilirubinemia requiring phototherapy, were included. Sick babies, Rh iso-immunized babies, those who required and underwent exchange transfusion and whose parents refused for consent were excluded. Intervention: Babies were enrolled on consecutive basis and after randomization were allocated to receive phototherapy by CFL or STL. CFL and STL were both special blue lights with irradiance maintained above 15 µW/nm/cm2. Total serum bilirubin ...

BACKGROUND Neonates with ABO hemolytic disease are at greater risk for developing significant hyperbilirubinemia. We aimed to determine whether sixth hour transcutaneous bilirubin (TcB) could predict such a risk. METHODS TcB measurements were obtained at the 6th hour of life in blood group A or B neonates born to blood group O, rhesus factor compatible mothers. Subsequent hyperbilirubinemia was monitored and considered significant if a neonate required phototherapy/exchange transfusion. The predictive role of sixth hour TcB was estimated. RESULTS Of 144 ABO incompatible neonates, 41(OA, 24; O-B, 17) had significant hyperbilirubinemia. Mean sixth hour TcB was significantly higher among neonates who developed significant hyperbilirubinemia than those who did not (5.83±1.35 mg/dL vs. 3.65±0.96 mg/dL, P|0.001). Sixth hour TcB value |4 mg/dL had the highest sensitivity of 93.5% and |6 mg/dL had the highest specificity of 99%. Area under receiver operating characteristic curve was 0.898. CONCLUSION

A 10-year-old male child came to our out-patient department (OPD) for evaluation of refractory anemia. He had received adequate dietary and oral iron supplementation but still required multiple blood transfusions. He had no anorexia, nausea, vomiting, diarrhea, abdominal cramps or bleeding from any site. There was no family history of blood transfusions. Laboratory investigations showed hemoglobin of 6.4 gm/dl, total leucocyte count 7600 cells/cumm, erythrocyte sedimentation rate (ESR) 18 mm/hr at end of 1 hour, packed cell volume 22%, mean corpuscular volume 54.1fL, mean corpuscular hemoglobin concentration (MCHC) 25.4gm/dL, Red blood cell distribution width (RDW) 17.2%, reticulocyte count 1.13%, serum ferritin 2.6ng/dL, serum iron 15ug/dL and Total Iron Binding Capacity (TIBC) 570 mcg/dL suggestive of iron deficiency anemia (IDA). Peripheral film showed microcytic hypochromic anemia. Hemoglobin electrophoresis and thyroid function tests were normal. Routine stool examination was normal and ...

Current treatment guidelines for community-acquired respiratory tract infections no longer depend solely on the characteristics of the patient and the clinical syndrome, but on those of the offending pathogen, including presence and level of antimicrobial resistance. The most common respiratory tract pathogens known to cause acute bacterial rhinosinusitis (ABRS) and community-acquired pneumonia (CAP) include Streptococcus pneumoniae and Haemophilus influenzae. The prevalence of antimicrobial resistance, especially b-lactum and macrolide resistance, among S pneumoniae and H influenzae has increased dramatically during the past 2 decades, diminishing the activity of many older antimicrobials against resistant organisms. A pharmacokinetically enhanced formulation of amoxicillin/clavulanate has been developed to fulfill the need for an oral b-lactam antimicrobial that achieves a greater time that the serum drug concentration exceeds the minimum inhibitory concentration (T \textgreater MIC) of ...

Three small studies, enrolling a total of 170 infants, were eligible for inclusion in this review. None blinded intervention or outcome assessment. In all three studies some patients were excluded after randomization. Metalloporphyrin-treated infants appeared to have short-term benefits compared to controls, including a lower maximum plasma bilirubin level in one study, a lower frequency of severe hyperbilirubinemia in one study, a decreased need for phototherapy, fewer plasma bilirubin measurements and a shorter duration of hospitalization. None of the enrolled infants required an exchange transfusion in the two studies that described this outcome. None of the studies reported on neonatal kernicterus, death, long-term neurodevelopmental outcomes or iron deficiency anemia. Though a small number of metalloporphyrin-treated as well as control infants developed a photosensitivity rash, the trials were too small to rule out an increase in the risk of photosensitivity or other adverse effects from ...

Background. Trimethoprim-sulfamethoxazole (TMP-SMZ) has been used extensively for the prevention of Pneumocystis carinii (also referred to as "Pneumocystis jiroveci") pneumonia (PCP) and other opportunistic infections in human immunodeficiency virus (HIV)-infected children. Because the efficacy of TMP-SMZ for treatment of bacterial infections is limited, it is sometimes poorly tolerated, and there is risk of emergence of drug-resistant strains associated with widespread use, we evaluated a regimen that included atovaquone and azithromycin.. Methods. A randomized, double-blind, placebo-controlled trial was designed to determine whether atovaquone-azithromycin had equivalent efficacy to TMP-SMZ for the prevention of serious bacterial infections and to compare the long-term tolerance, PCP breakthrough rates, and nonserious bacterial infection rates among HIV-infected children aged 3 months to 19 years. Children qualified for PCP prophylaxis (on the basis of Centers for Disease Control and ...

Background. Maternal alloantibodies against HPA-1a can cross placenta, opsonize foetal platelets, and induce neonatal alloimmune thrombocytopenia (NAIT). In a study of 100, 448 pregnant women in Norway during 1995-2004, 10.6% of HPA-1a negative women had detectable anti-HPA-1a antibodies. Design and Methods. A possible correlation between the maternal ABO blood group phenotype, or underlying genotype, and severe thrombocytopenia in the newborn was investigated. Results. We observed that immunized women with blood group O had a lower risk of having a child with severe NAIT than women with group A; 20% with blood group O gave birth to children with severe NAIT, compared to 47% among the blood group A mothers (relative risk 0.43; 95% CI 0.25-0.75). Conclusion. The risk of severe neonatal alloimmune thrombocytopenia due to anti-HPA-1a antibodies is correlated to maternal ABO types, and this study indicates that the observation is due to genetic properties on the maternal side ...

The purpose of this study is to determine the effects of the oral iron chelator Deferasirox on liver iron content after one year of treatment in patients with iron overload from repeated blood transfusions. Beta-thalassemia patients unable to be treated with deferoxamine or patients with rare chronic anemias such as Myelodysplastic Syndrome, Fanconi's Syndrome, Blackfan-Diamond Syndrome, and Pure Red Blood Cell Anemia are eligible for this study. Liver iron content will be measured by liver biopsy at the beginning of the study and after one year of treatment. However, those patients living in the San Francisco/Oakland area may have a SQUID in place of the liver biopsy if the biopsy is not medically possible for them. The SQUID is a non-invasive magnetic means to measure liver iron content ...

Please cite this paper as: Madani K, Kamphuis M, Lopriore E, Porcelijn L, Oepkes D. Delayed diagnosis of fetal and neonatal alloimmune thrombocytopenia: a cause of perinatal mortality and morbidity. BJOG 2012;119:1612-1616.. Objective To evaluate the rate and consequences of a late or missed diagnosis of fetal and neonatal alloimmune thrombocytopenia (FNAIT).. Design Retrospective analysis of prospectively collected data of a national cohort.. Setting National referral centre for fetal therapy in the Netherlands.. Population Twenty-six women with pregnancies complicated by FNAIT and at least one previous pregnancy with a thrombocytopenic child.. Methods Retrospective analysis of data from our electronic FNAIT database. In a consecutive cohort managed between July 2008 and July 2010, timing of first diagnosis of FNAIT was correlated to severity and outcome in the subsequent pregnancies.. Main outcome measures Occurrence of delayed diagnosis of FNAIT, and possibly associated intracranial ...

Objective. The management of nonhemolytic hyperbilirubinemia in term newborns is controversial. To evaluate the usefulness of serum unbound bilirubin concentrations (UBCs) in the management of hyperbilirubinemia, we compared the concentrations with abnormal auditory brainstem responses (ABRs).. Methods. ABRs and serum UBCs in 37 hyperbilirubinemic term newborns (total bilirubin concentrations [TBCs] ≥20 mg/dL and direct bilirubin concentrations ,2 mg/dL) were measured before treatment with either phototherapy or exchange transfusions. Eight of these newborns had blood incompatibilities. These hyperbilirubinemic newborns were divided into three groups according to the findings of ABR: group A, normal ABR (n = 18); group B, prolonged latency of wave I only (n = 8); and group C, prolonged interpeak latency of wave I-III/I-V and/or poor amplitude (n = 11).. Results. The peak TBC was significantly different between groups A and C (22.8 ± 2.2 mg/dL and 25.4 ± 2.5 mg/dL, respectively; P , .05), ...

Twin-to-twin transfusion syndrome is a rare condition that occurs when blood moves from one identical twin (the Òdonor twinÓ) to the other (the Òrecipient twinÓ) while in the womb. The donor twin may be born smaller, with paleness, anemia, and dehydration. The recipient twin may be born larger, with redness, too much blood, and increased blood pressure, resulting in an increased risk for heart failure. Treatment may require repeated amniocentesis during pregnancy. Fetal laser surgery may be done to interrupt the flow of blood from one twin to the other. After birth, treatment depends on the infant's specific symptoms. The donor twin may need a blood transfusion to treat anemia. The recipient twin may need to have the volume of body fluid reduced. This may involve an exchange transfusion. Medications may be given to treat heart failure in the recipient twin ...

Anaphylaxis and severe allergic transfusion reactions (ATR) are uncommon complications after blood transfusion. Nevertheless, these complications are associated with very severe outcomes, such as dyspnea, shock, and death. Patients with end-stage liver disease who require liver transplantation have a high tendency for bleeding because of splenomegaly-induced thrombocytopenia and decreased production of coagulation factors in the liver. Liver transplantation is a very long procedure and a significant perioperative blood loss is highly likely. Therefore, transfusion of platelets and other blood products is often necessary. We report a successful ABO-incompatible living donor liver transplantation in a patient with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma who had a history of platelet transfusion-related anaphylaxis.. Keywords: Published on: Apr 30, 2016 Pages: 10-12. Full Text PDF Full Text HTML DOI: 10.17352/2455-2283.000012 ...

Arterial blood collection devices market information, by type (blood collection tubes, lancet, needles, vacuum blood collection system, microfluidic system, others), by application (arterial blood gas sampling, intraoperative blood salvage), and by end users (hospitals & clinics, blood banks, laboratories, others) - Global forecast till 2023. Introduction:. Arterial blood collection devices are used to collect blood samples from the artery which is used of arterial gas sampling. The most common site for arterial puncture is the radial artery at the wrist.Femoral and radial artery puncture is most commonly performed to obtain arterial blood sampling for gas analysis. Pulmonary function can be assessed with the help of partial pressure of oxygen and carbon dioxide. Before performing arterial puncture, it is important to check the patency of ulnar artery. This can be examined by performing Allen test. A Positive Allen Test indicates normal blood supply to the hand. In radial artery puncture, needle ...

Treatment of community acquired skin and soft tissue infections (SSTIs) is a common indication for outpatient parenteral antibiotic therapy (OPAT) in USA, UK and Australasia, however data from Asia are lacking. OPAT is well established within the Singapore healthcare since 2002, however, systematic use of OPAT for the treatment of SSTIs remains infrequent. In this report, we describe the treatment and outcome of patients with SSTIs referred directly from Emergency Department (ED) to OPAT for continuation of intravenous (IV) antibiotics in Singapore, thus avoiding potential hospital admission. This is a single center university hospital retrospective study of patients with SSTIs presenting to ED who were assessed to require IV antibiotics and accepted to the OPAT clinic for continuation of IV treatment. Exclusion criteria were: haemodynamic instability, uncontrolled or serious underlying co-morbidities, necessity for inpatient surgical drainage, facial cellulitis and cephalosporin allergy. Patients

From above study we concluded that out of 100, only 21% health care professional knows and aware about the terminology "antimicrobial stewardship" and 79% health care professional did not knew about this program. 21% health care professional who knew that ask to fill further questions in which 91% health care professional said that this program focused on accurate and justifiable use of antibiotic. 82% health care professional said that it is a core function of medical staff, 100% health care professional this program promotes rationalism of antibiotic use, 73% health care professional said that Specialist antimicrobial stewardship team limit inappropriate and excessive antibiotic use, 91% health care professional said that antimicrobial stewardship program start in every local, private and government hospitals, 86% said that pharmacist can do any betterment in this program and 78% health care professional said that pharmacist are necessary. ...

Today, more than 100 Jehovah's Witnesses in wool coats and soggy boots gathered silently outside the courtroom doors. Many said they were prepared to wait as long as it takes for the judge to reach a resolution, even weeks.. ''We cherish our truth,'' said Lena Sijanova, 27, who joined the Jehovah's Witnesses with her mother, ''and they are trying to take it away. But you cannot forbid people's right to their faith because that right comes only from God.''. According to the complaint filed by a Moscow district prosecutor, the Jehovah's Witnesses have violated the 1997 law by preaching religious discrimination, breaking up families, withholding medical treatment -- all in the name of their ''one true religion.'' After an exhaustive textual analysis of literature disseminated by the Witnesses' door-to-door proselytizers, the prosecutors concluded that ''overseers'' in Russia and abroad ''not only control the spiritual environment of the congregation, but also subject the manner of life, thinking, ...

BACKGROUND AND OBJECTIVES: Serological evaluation of maternal sera for platelet antibodies in suspected fetal/neonatal alloimmune thrombocytopenia (FNAITP) discloses in only approximately 30% of individuals a platelet-specific antibody. Transfusion-induced alloimmunization against human platelet antigen-15 (HPA-15) has been reported to be about as common as against HPA-5, the second most common platelet antibody. Thus, anti-HPA-15 may also contribute significantly to yet-unclear cases of FNAITP.. MATERIALS AND METHODS: In this retrospective analysis, we provide data on maternal platelet antibodies from 309 mothers who delivered an offspring with suspected FNAITP.. RESULTS: Genotyping maternal and paternal samples (together n = 573) revealed a gene frequency of 0.496 for HPA-15a and a gene frequency of 0.504 for HPA-15b. HPA-15 antibodies were detected in 2% of all samples. Anti-HPA-15a and -15b were detected in two and three samples, respectively. One serum reacted equally with HPA-15a and -15b ...

Children who lived in a slum and were diagnosed with small intestinal bacterial overgrowth showed lower H/A Z-scores and hemoglobin levels. Furthermore, differences were observed in the fecal microbiota of children with small intestinal bacterial overgrowth, when compared to those without it; specif …

A 72-year-old man suffering from congestive heart failure, swelling of the lower limbs and hematuria was transferred from another hospital with a diagnosis of large aneurysms of the abdominal aorta and the left common iliac artery. Iliac arteriovenous fistula (AVF) was definitively diagnosed preoperatively by contrast-enhanced CT and angiogaphy. At operation, an infrarenal abdominal aortic aneurysm of 8cm and left iliac arterial aneurysm of 12cm were identified. After proximal and distal aortic clamping, the aneurysm was entered and an AVF orifice of 1cm communicating with the left common iliac vein was disclosed at the right posterior wall of the left common iliac artery. Venous blood reflux was controlled by inserting an occlusive balloon catheter to the fistula and intraoperative shed blood was aspirated and returned by an autotransfusion system. The AVF was closed from inside the iliac aneurysm by three interrupted 3-0 monofilament mattress sutures with pledgets. The aneurysms were resected ...

Transfusion medicine involves many hot-seat decisions that span a wide patient spectrum-from surgery and hematology/oncology to obstetrics and neonatology. Transfusion Medicine in the Hot Seat is a useful text for pathology trainees and an educational resource for pathologists who cover transfusion medicine. The text is divided into three sections: antibodies, blood components, and complications. Each section presents numerous short cases that illustrate real-world transfusion scenarios, with 26 cases total. The short-case format makes the information easily accessible and can serve as the basis for a transfusion medicine curriculum in clinical pathology.

A process for preparing a stroma-free hemoglobin solution is provided. The process includes washing blood cells to remove noncellular components to obtain a mixture of erythrocytes and leukocytes. The leukocytes are removed from the mixture and the erythrocytes are lysed to form a mixture of stroma and hemoglobin. The stroma is precipitated from the hemoglobin by treating the stroma-hemoglobin mixture with a polyvalent cation; a polysulfate, and a polyvalent anion. The supernatant hemoglobin solution is separated and dialyzed to obtain a substantially pure hemoglobin solution.