Nous avons etudie les marqueurs hemorheologiques, hematologiques et biochimiques chez des sujets drepanocytaires homozygotes SS (HbS/HbS) et heterozygotes composites SC (HbS/HbC) dans deux cohortes, pediatriques et adultes, de patients drepanocytaires, et ce, a travers 7 complications recurrentes de la drepanocytose : 2 appartenant au profil hemolytique (l’ulcere de jambes et la glomerulopathie) et 5 appartenant au phenotype visqueux/vaso-occlusif (l’hypertension arterielle, le syndrome thoracique aigu (STA), la crise vaso-occlusive (CVO), la retinopathie et l’osteonecrose). Nous avons montre que : 1) une viscosite sanguine et une deformabilite erythrocytaire elevees sont des facteurs de risques de CVO chez les enfants homozygotes ; 2) Une viscosite sanguine elevee est associee a une hypertension arterielle systemique relative chez des adultes SS ; 3) les enfants SC presente une fonction vasculaire mieux preservee que les enfants SS pour faire face a une augmentation de la viscosite sanguine ; 4) les patients adultes SS avec une osteonecrose presentent une deformabilite erythrocytaire plus elevee que les patients sans osteonecrose ; 5) une viscosite sanguine elevee est associee a la presence d’une retinopathie chez les adultes SC mais pas chez les SS ; 6) les patients adultes SS presentant une glomerulopathie ont un taux d’hemolyse eleve, une deformabilite erythrocytaire reduite et des agregats erythrocytaires tres robustes ; 7) les patients adultes SS avec des ulceres de jambes recurrents ont un taux d’hemolyse accru et une deformabilite erythrocytaire reduite. De plus, nos travaux confirment que l’-thalassemie module les proprietes de deformabilite erythrocytaire, mais montrent pour la premiere fois qu’elle module aussi les proprietes d’agregation erythrocytaire, et notamment la force des agregats erythrocytaires. En conclusion, ces travaux permettent de preciser le role de la rheologie sanguine dans un certain nombre de complications de la drepanocytose et d’enrichir le modele preexistant divisant les complications de la drepanocytose selon 2 phenotypes : hemolytique versus visqueux/vaso-occlusif. Nous montrons pour la premiere fois que le phenotype hemolytique est caracterise aussi par des anomalies de la rheologie du globule rouge : rigidite accrue et agregats erythrocytaire robustes.
La anemia hemolítica autoinmune es producto de la destrucción de los hematíes a causa de que el organismo actúa formando anticuerpos específicos contra antígenos de sus propios eritrocitos, a pesar de ser un tipo de anemia poco común, es importante realizar un diagnóstico a tiempo. Los anticuerpos irregulares son aquellas proteínas naturales que pueden ocurrir como resultado de la exposición a antígenos de glóbulos rojos extraños por trasplante, transfusión o incompatibilidad materno-fetal. El objetivo del estudio fue analizar incompatibilidad de anticuerpos eritrocitarios y la importancia en el diagnóstico inmunohematológico de anemias hemolíticas. Se utilizó un diseño documental de tipo descriptivo, basado en la revisión sistemática de información. Los artículos fueron obtenidos de las bases de datos Scielo, PubMed, NCBI, Dialnet, Redalyc, Springer y Google académico. Los resultados mostraron que los síntomas clínicos y parámetros evaluados en pacientes diagnosticados con anemia fue más frecuente la ictericia como característica clínica asociada al aumento de bilirrubina. Se evidenció la presencia de anticuerpos irregulares desencadenantes de anemias hemolíticas, los más frecuentes fueron: el sistema Kell y Rhesus, para la detección de este trastorno autoinmune prevalecieron las técnicas inmunohematológicas de antiglobulina directa e indirecta para su detección, mientras que para su identificación predominaron los paneles celulares. Las complicaciones más destacadas en la anemia hemolítica fueron las coagulopatías causantes de varios decesos que han contribuido al aumento del índice de mortalidad en distintos territorios.
OBJECTIVE: Thalassemia, an inherited hemoglobin synthesis disorder, imposes a significant health burden in Asian regions with high prevalence. Detailed patterns and trends of the disease across countries and territories within these regions remain underexplored. Our study focuses on the disease burden indices of thalassemia within the four GBD-defined Asian regions and the twenty-five included countries and territories. It provides insights into the gender-age distribution, temporal changes, and economic aspects of the thalassemia burden. METHODS: Data on thalassemia prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs) were extracted from the Global Burden of Disease (GBD) 2021 study for South, East, Southeast, and high-income Asia regions, encompassing the relevant countries and territories from 1990 to 2021. The Average Annual Percent Change (AAPC) in age-standardized rates of thalassemia was determined to assess temporal trends. Age-gender cohort proportions were considered. The economic aspect of the disease burden and frontier analysis were evaluated using the GBD Socio-Demographic Index and Global Health Expenditure data. RESULTS: Southeast Asia exhibited notably high age-standardized mortality rate (ASMR), age-standardized prevalence rate (ASPR), and age-standardized DALYs rate among the four studied Asian regions in 2021. The East Asia region had recorded the highest age-standardized incidence rate (ASIR). A general decline in disease burden indices across the four regions from 1990 to 2021 was evident, with the exception of ASIR in Southeast Asia. The ASMR was highest among pediatric population under five years old, with a significant male preponderance. An unusual increase in ASMR was detected among females of childbearing age and the elderly within the studied region. Further analysis had identified six high-burden countries and territories, particularly those with low-middle Socio-Demographic Index (SDI) rankings and limited health expenditure. CONCLUSION: Although the overall burden of thalassemia has decreased substantially, the disease burden was influenced by gender, age, geography, temporal trends, and economic factors in distinct manners. Based on the current SDI, many countries and regions still have greater improvement potential in the disease burden. There is a necessity for enhanced attention and resource allocation, particularly in low-middle and low SDI countries, with an emphasis on policies that promote early diagnosis and comprehensive care.
La dénutrition chez le patient obèse, à l’instar du patient non obèse, expose à de nombreuses conséquences cliniques et aboutit à un accroissement de la morbi-mortalité mais reste fortement sous-estimée. Il est donc impératif de la prévenir, de la dépister et de la prendre en charge le plus tôt possible. Objectif : Examiner l’association entre la surcharge pondérale et la survenu de carences en fer et en vitamine B12 en réalisant un bilan martial et un dosage de la vitamine B12, ainsi qu’une numérotation de la formule sanguine. Méthode : Cette étude cas-témoins a été réalisée au niveau du laboratoire de biochimie CHU TLEMCEN, entre Octobre 2018 et Avril 2019, sur un échantillon de 72 volontaires sains (18 ♂et 54♀), âgés de 18 à 46 ans, répartis en fonction de l’IMC en deux groupes : un groupe des normopondéraux et un groupe des patients en surpoids et obèses. Les prélèvements sanguins ont été pris pour effectuer un bilan biochimique classique, un bilan martial, un dosage de la vitamine B12 et une NFS. Résultats : Les valeurs moyennes de fer sérique, ferrtitine, transferrine, TIBC, vitamine B12, Hb, VGM et CCMH étaient adéquates dans les deux groupes. Cependant la moyenne du fer sérique était un peu plus basse dans le groupe des cas mais sans différence significative avec le groupe témoin. Conclusion : nos résultats indiquent que le statut en fer et en vitamine B12 était comparable chez les adultes obèses/surpoids et les normopondéraux.
La transfusion sanguine est un acte thérapeutique prouvé par sa capacité à sauver les personnes qui souffre de déficit en produits sanguins labiles (PSL). D’autre part, elle présente des risques directement liés aux infections et réponses immunologiques. Celles-ci sont principalement dues au polymorphisme génétique des antigènes érythrocytaires entraînant une allo-immunisation anti-érythrocytaire qui peut conduire à des situations d'impasse transfusionnelle. Notre étude réalisé au centre de transfusion sanguine du CHU Tlemcen sur 428 donneurs de sang de groupe A et groupe O est pour but de déterminer les fréquences phénotypiques et géniques des antigènes des systèmes ABO, rhésus D, Kell, Duffy, Kidd, MNS et p1 chez les donneurs de sang dans la wilaya de Tlemcen et pour objectif d’améliorer la sécurité transfusionnelle dans une population de l’ouest d’Algérie. Un prélèvement sur tube citraté a été fait suivis du phénotypage érythrocytaire des systèmes cités. Les résultats obtenus montre la prédominance du groupe O (79.91%) dans le système ABO, du DCcee (35.15%) dans le système Rh, Fy (-a ; +b) avec 39.14% dans le système Duffy, Jk (+a ; +b) avec 35.15% dans le système Kidd, le phénotype M+N+S+s+ domine avec 31.51%, avec la présence des antigènes Kell (7.27%) et P1 (70.33%) . On a trouvés aussi des phénotypes rares tels que le Fy (-a ; -b) et le M-N-S-s+ En conclusion, la connaissance du phénotype des globules rouges des donneurs de sang du groupe O et du groupe A est nécessaire pour créer une base de données liée à la préparation d'un panel local des hématies test. D'autre part, la prévention de l'allo-immunité anti- érythrocytaire par l'utilisation de sang compatible avec les antigènes est essentielle, tout comme la gestion de la présence d'allo-anticorps anti-érythrocytes en fournissant du sang sérocompatible aux patients polytransfusés. Mots clés : phénotypage érythrocytaire, donneurs de sang, panel d’hématies test, allo immunisation, Recherche d’agglutinines irrégulières
AIM: Preoperative anemia remains a common condition in elderly patients undergoing orthopedic surgery, and the choice of transfusion strategy may affect perioperative outcomes. Therefore, this study aims to investigate the effect of a restrictive transfusion strategy on perioperative outcomes in this population. METHODS: A retrospective analysis was conducted on 782 preoperatively anemic patients (aged ≥60 years) who underwent hip replacement, knee replacement, or spine surgery at Xuanwu Hospital Capital Medical University, China, between January 2018 and June 2024. Patients were categorized into the restrictive (n = 380) and liberal (n = 402) transfusion strategy groups. Perioperative indicators included estimated blood loss, transfusion volume, length of hospital stay, as well as additional relevant variables. Primary outcomes were 30-day all-cause mortality, transfusion-related adverse reactions, and postoperative infection rates. Secondary outcomes included postoperative hemoglobin levels, readmission rates, reoperation rates, thrombosis, and cardiovascular events. RESULTS: In hip replacement and spine surgery patients, the estimated blood loss was significantly lower in the restrictive transfusion group than in the liberal transfusion group (p < 0.001), while higher in knee replacement patients (p < 0.001). The restrictive transfusion strategy reduced transfusion requirements and shortened hospital stay across all surgical types (p < 0.001). No significant difference in 30-day all-cause mortality was observed between the groups (p > 0.05). However, the restrictive transfusion group had significantly lower rates of transfusion-related adverse reactions (1.3% vs. 5.0%, p < 0.001) and infections (2.6% vs. 6.5%, p = 0.017). Additionally, transfusion strategy was identified as an independent risk factor for transfusion-related adverse reactions [odds ratio (OR) = 3.96, 95% CI: 1.468-10.682, p = 0.007)]. CONCLUSIONS: A restrictive transfusion strategy reduces transfusion volume, minimizes the incidence of transfusion-related adverse reactions and infections. This study supports individualized perioperative anemia management to optimize outcomes in elderly patients.
Aim: The aim of this scoping review protocol is to explore the current blood transfusion administration training and education system within the United Kingdom (UK) for healthcare professionals and if it identifies or includes the emotional components of transfusion care such as empathy and compassion. Background: Blood transfusions are commonly performed procedures within healthcare and carry significant safety related responsibilities for those administering them, with potentially significant emotional and psychological consequences for recipients. The emotional and relational aspects of blood transfusion education for healthcare professionals in the UK remains underexplored whilst technical competence is widely discussed in literature. There can be emotional responses to receiving a blood transfusion and this protocol will review the inclusion of a patient’s emotional experience of receiving a blood transfusion within contemporary training. Design: This scoping review protocol is guided by the JBI methodology for scoping reviews using the Population, Concept and Context (PCC) framework to define inclusion and exclusion criteria. This protocol has been uploaded to the Open-Source framework. A protocol is the first stage of a scoping review preceding a research study on the project. Method & analysis: A comprehensive search of e-databases will be conducted including the following e-databases: CINAHL Complete, Embase, Scopus, MEDLINE (via PubMed), Web of Science, and ERIC. The searches will include educational materials, reports, and research articles available in English language. The inclusion criteria are broad to include any material referencing blood transfusion training that does not fit into straight forward categorisation. This scoping review protocol will use the PCC template to guide identification and selection of relevant search terms, ensuring a systematic and structured search by three independent reviewers. An initial search to test the viability of the hypothesis found n=307, reduced to n=11 and after application of the inclusion and exclusion criteria reduced to n=3, reinforces the need for a scoping review.
Bu araştırma hemşirelerin, kan transfüzyonu hakkındaki bilgi düzeylerini ve güvenli kan transfüzyonu uygulama basamaklarını gerçekleştirme durumlarını değerlendirmek amacıyla yapıldı. Tanımlayıcı olarak yürütülen araştırma bir hastanenin yoğun bakım üniteleri ile dahili ve cerrahi kliniklerinde Ekim 2018-Temmuz 2019 tarihleri arasında yapıldı. Araştırmanın evrenini bu kliniklerinde çalışan 391 hemşire oluşturdu. Araştırma örneklemi ise kan transfüzyonu yapan ve araştırmaya katılmayı kabul eden 141 hemşireden oluştu. Veriler Bilgi Formu ve Gözlem Formu kullanılarak toplandı. Verilerin SPSS 22.00 programı kullanılarak ortalama ve yüzdelik hesapları yapıldı. Hemşirelerin en fazla “Bir ünite taze donmuş plazmanın transfüzyonu ne kadar sürede tamamlanmalıdır?” (%93.6) sorusunu doğru yanıtladığı, en az “Aşağıdakilerden hangisi erken kan transfüzyonu reaksiyonlarından birisi değildir?” (%46.8) sorunu doğru yanıtladıkları belirlendi. Tüm hemşirelerin uygulama sırasında; kan transfüzyonuna uygun kanül seçtiği, eritrosit süspansiyonunda crossmatch testini, kan ürününün ve torbanın görünümünü, transfüzyon formundaki ürün bilgileri ile ürün etiketindeki bilgilerin uyumunu kontrol ettiği belirlendi. Hemşirelerin uygulama sırasında; transfüzyon öncesi el yıkama (%27.9), transfüzyon sebebini (%36.2) ve reaksiyonlarını (%37.6) hasta ve yakınlarına anlatma oranları ise düşük olarak bulundu. Hemşirelerin transfüzyon uygulama basamaklarını gerçekleştirme durumlarının yüksek olduğu belirlendi. Özellikle güncellenen uygulamalara ilişkin bilgi sorularının yanlış cevaplandığı belirlendi.
This paper summarizes the arguments and counterarguments within the scientific discussion on the marketing activities of blood service for over the last 20 years. The main purpose of the research is to understand the content and characteristics of existing research in the field of marketing in blood service to determine the direction of future research for both scientists and practitioners. Systematization of the literary sources and approaches for solving the problem of marketing in blood service indicates that a large amount of research in the field of marketing activities of blood service for the last 20 years requires a synthesis of existing research. The relevance of this scientific problem decision is that one of the criteria for the health level of the country’s population is the availability of a sufficient number of blood donors (Global, 2017). Moreover, marketing activities of blood service allow to attract and retain the required number of donors and receive from them a sufficient amount of blood and its components. Investigation of the topic of the marketing activities in the blood service in the paper is carried out in the following logical sequence: it was determined the influence of authors, journals, and articles about marketing in the blood service, studied and identified marketing clusters in the blood service, conducted the content analysis and presented the visualization of scientific literature on marketing activities in the blood service. Methodological tools of the research methods were 2000-2019 years. The object of research is 262 relevant articles published in 25 journals over the period 2000–2019 because, namely, they explain the essence of marketing activity in blood service facilities. The paper presents empirical analysis publications on marketing in the blood service during the last 20 years, which showed that the most influential journals were Transfusion, Vox Sanguinis, and Transfusion Medicine Reviews. The most famous authors are Wakefield M.A., Gillespie T.W., Glynn S.A., Lemmens K.P.H., Bednall T.C., Sojka B.N., Masser B.M. The classification literature on marketing in the blood service is presented in the areas of recruitment and retention strategies, influence, and incentives for planned behavior, decision-making on donation. Each five-year plan covers research in the following areas: understanding donor behavior to develop engagement and use strategies, finding ways to recruit new donors, marketing tools to work with donors, focusing on donor retention, and using modern marketing communication tools. The research empirically confirms and theoretically proves that it is advisable to focus on the introduction of the most modern tools of marketing communications (messengers, mobile applications, ringtones on mobile phones, social networks) in combination with traditional (radio, brochures, videos, SMS messages, motivational interviews, and loyalty programs). It is also recommended to pay attention to average when building the loyalty of existing donors to increase the amount of blood donated by more donors and improve the quality of donors and blood safety. The results of the research can be useful for blood services and companies who promote unpaid voluntary donation. Keywords: blood donor, blood service, marketing, marketing activities, motivation, promotion, recruitment, retention.
Background: Transfusions reactions are frequently reported among patients treated with blood products worldwide.Data are lacking to provide guidance regarding the common transfusions reactions in poor health facilities.Method: In this descriptive study, we reviewed the medical records of all patients who have been transfused at two hospitals in Butembo City, and who had adverse transfusion reactions.Descriptive statistics followed by binary logistic regression were conducted.Data were analyzed using STATA 14.2.Results: Between January 2014 and December 2019, a total of 1628 transfusion patients received blood products and 55 (3.4%) had transfusion reactions.The common reactions were the non-hemolytic fever and the allergic reactions.The predictors of transfusions reactions were lifetime history of transfusion therapy (aOR= 1.55, 95%CI= 1.02-2.84;p=0.02), the AB blood group (aOR=5.2;95%CI: 4.0-11.6;p=0.001), and the acute transfusions reactions (a0R= 0.35, 95%CI= 0.26-0.62,p=0.001), with immediate life threatening (aOR= 1.55, 95%CI= 1.02-2.84;p=0.02).Death has occurred in 3.6% of case.Conclusions: The mortality rate from blood transfusion is 3.6%, nearly the prevalence of transfusion reactions.Lifetime history of transfusion, blood group, the occurrence and the severity of clinical features are the predictors of transfusions reactions.This study highlights the importance of specific guidelines for transfusion therapy to patients with severe anemia in low and middle income countries.Blood transfusions must be carefully administered to patient to reduce either the adverse reactions or the increased for next transfusions therapy.
Introduction. Blood donation is not without risk to the donor. It results in a substantial loss of iron and decreased hemoglobin. In our country, no predonation assessment is carried out and the selection of blood donors is only clinical. Objectives. To determine the prevalence of iron deficiency, anemia, and iron deficiency anemia and to identify the factors associated with anemia and iron status in a blood donor population at the National Center for Blood Transfusion (NCBT). Methodology. A prospective study is carried out that consists of 120 blood donors in three NCBT branches in the capital from June to November 2021. The donors were divided into 3 groups: first time donors (FTDs), occasional donors (ODs) who have already made between 1 and 3 previous donations, and regular donors (RDs) with at least 4 previous donations. Iron deficiency was defined by a serum ferritin value of less than 30 ng/mL in men and 20 ng/mL in women. Anemia was defined by Hb levels below 13 g/dL in men and 12 g/dL in women. Iron deficiency anemia was defined by association of anemia and iron deficiency. The chi-square test was used for the comparison of the proportions. The odds ratio with the 95% confidence interval was calculated to assess the association between two variables. The <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>p</a:mi> </a:math> value of the probability was considered significant for a value < 0.05. Results. Mean serum ferritin and hemoglobin values were lower in RD in both sexes. The prevalence of iron deficiency, anemia, and iron deficiency anemia were 16.66%, 31.66%, and 10.83%, respectively. The factors associated with the three abnormalities were female sex, donor type, including RD, and number of previous donations. Conclusion. Iron deficiency, anemia, and iron deficiency anemia are common among blood donors in Brazzaville. Anemia affects almost a third of blood donors and is not always linked to iron deficiency. Safety of donors should be improved by systematic measurement of ferritinemia and hemoglobin levels before allowing donations for appropriate management in the event of abnormalities.
Background: Glucose-6-phosphate-dehydrogenase (G6PD) deficiency is the most frequent enzymopathy worldwide; it is a genetic disorder that affects red blood cells and causes hemolysis. Here, we conducted a study on G6PD-deficient subjects in Mauritania to evaluate the molecular characteristics associated with a deficiency in this enzyme and the frequency of nucleotide polymorphisms in the glucose-6-phosphate dehydrogenase gene. Method and Materials: A total of 943 blood samples were collected from blood donors (803 males and 140 females; 364 white Moors; 439 black Moors; 112 Pulaar; 18 Wolof; 10 Soninke). All blood samples were analyzed using a rapid screening test. G6PD status was analyzed quantitatively by the Randox G6PD test. Samples deficient in G6PD were extracted from the whole blood samples and subjected to DNA genotyping. The most frequent G6PD variants were determined by two molecular techniques: restriction fragment length polymorphism (RFLP) and multiplex PCR using the GENESPARK G6PD African kit. A total of six single nucleotide polymorphisms (SNPs) (G202A, A376G, A542T, G680T, C563T, and T968C) were identified. Results: The prevalence of G6PD deficiency in this population sample was 8.1%. The most common mutation was A376G/202A and was characterized by the G6PD A-phenotype, which is more common in the G6PD-deficient black Moors population. The wilaya in Nouakchott was the most affected among the 13 wilayas studied. Conclusions: This study shows, for the first time, the presence of the G680T mutation.
OBJECTIVE: To systematically review and synthesize available epidemiological data on hepatitis C virus (HCV) prevalence and incidence in the Maghreb region and to estimate the country-specific population-level HCV prevalence. METHODS: We conducted a systematic review of HCV antibody prevalence and incidence in the Maghreb countries as outlined by the PRISMA guidelines. Meta-analyses were conducted using DerSimonian-Laird random-effect models with inverse variance weighting to pool HCV prevalence estimates among general population groups. RESULTS: We identified 133 HCV prevalence measures and two HCV incidence measures. Among high risk groups, HCV prevalence ranged between 22% and 94% among people who inject drugs, 20% and 76% among dialysis patients, and 2% and 51% among hemophiliacs. Among intermediate-risk groups, considerable but widely variable HCV prevalence was found. Most common risk factors cited across studies were the duration of dialysis, number of transfusions, and having a history of surgery or dental work. The national HCV prevalence in Algeria was estimated at 0.3% (95%CI: 0.1-0.5), Libya 1.2% (95%CI: 1.1-1.3), Mauritania 1.1% (95%CI: 0-2.3), Morocco 0.8% (95%CI: 0.5-1.2), and Tunisia 0.6% (95%CI: 0.5-0.8). CONCLUSIONS: HCV prevalence in the Maghreb region of the Middle East and North Africa is comparable to that in developed countries of about 1%. HCV exposures appear often to be linked to medical care and are suggestive of ongoing transmission in such settings. Injecting drug use appears also to be a major, though not dominant, contributor to HCV transmission. Further research is needed to draw a more thorough understanding of HCV epidemiology, especially in the countries with limited number of studies. HCV prevention policy and programming in these countries should focus on the settings of exposure.
Abstract The extracellular vesicle release in red blood cell concentrates reflects progressive accumulation of storage lesions and could represent a new measure to be implemented routinely in blood centres in addition to haemolysis. Nevertheless, there is currently no standardized isolation protocol. In a previous publication, we developed a reproducible ultracentrifugation‐based protocol (20,000 × g protocol) that allows to classify red blood cell concentrates into three cohorts according to their vesiculation level. Since this protocol was not adapted to meet routine requirements, the goal of this study was to develop an easier method based on low‐speed centrifugation (2,000 × g protocol) and limited red blood cell concentrate volumes to match with a non‐destructive sampling from the quality control sampling tubing. Despite the presence of contaminants, mainly in the form of albumin and lipoproteins, the material isolated with the 2,000 × g protocol contained red blood cell‐derived vesicular structures. It was reproducible, could predict the number of extracellular vesicles obtained with the 20,000 × g protocol and better discriminated between the three vesiculation cohorts than haemolysis at the legal expiry date of 6 weeks. However, by decreasing red blood cell concentrate volumes to fit with the volume in the quality control tubing, particle yield was highly reduced. Therefore, centrifugation time and relative centrifugal force were adapted (1,000 × g protocol), allowing for the recovery of a similar particle number and composition between small and large volumes sampled from the main unit, in different vesiculation cohorts over time. A similar observation was made with the 1,000 × g protocol between small volumes sampled from the quality control tubing and the mother‐bag. In conclusion, our study paves the way for the use of the 2,000 × g protocol (adapted to a 1,000 × g protocol with the quality control sampling tubing) for particle measurement in blood centres.
Purpose: Previous studies have shown low levels of comfort and knowledge regarding transfusion medicine among physicians in training. Pediatric hematology and Blood Bank teams at our institution collaborated to create a structured curriculum for pediatric residents, consisting of an interactive lecture followed by a problem-based learning (PBL) session with pediatrics-specific case vignettes. The objective of this study was to assess the effect of this curriculum on residents’ knowledge and impact on transfusion management (TM). Knowledge improvement was assessed using a previously validated test. Confidence levels regarding TM and curriculum feedback were assessed using surveys. Transfusion practices at our center were reviewed for the final three months of the academic year before and after implementation of the curriculum. Results: Twenty-five residents consented and participated in the 21-question pre-and post-curriculum knowledge assessment with significant improvement in the test scores from 7.9 (SD 1.8) to 9.7 (SD 2.3) (P Conclusions: The combination of lecture-based learning and PBL was a successful model for improving resident knowledge and confidence levels regarding TM. Our curriculum serves as an example of cross-departmental collaboration using practically feasible and clinically relevant teaching methods, and ultimately for improved patient care.
Microfluidic devices exploit combined physical, chemical and biological phenomena that could be unique in the sub-millimeter dimensions. The current goal of development of Point-of-Care (POC) medical devices is to extract the biomedical information from the blood. We examined the characteristics of blood flow in autonomous microfluidic devices with the aim to realize sensitive detection of interactions between particulate elements of the blood and the appropriately modified surfaces of the system. As a model experiment we demonstrated the fast analysis of the AB0 blood group system. We observed that the accumulation of red blood cells immobilized on the capillary wall leads to increased lateral movement of the flowing cells, resulting in the overall selective deceleration of the red blood cell flow column compared to the plasma fraction. We showed that by monitoring the flow rate characteristics in capillaries coated with blood type reagents it is possible to identify red blood cell types. Analysis of hydrodynamic effects governing blood flow by Finite Element Method based modelling supported our observations. Our proof-of-concept results point to a novel direction in blood analysis in autonomous microfluidic systems and also provide the basis for the construction of a simple quantitative device for blood group determination.
BACKGROUND: Both Red Blood Cell (RBC) transfusion and anemia are thought to negatively impact cancer survival. These effects have been reported with mixed findings in cancer of the esophagus. The potential impact of the application of restrictive transfusion strategies on this patient population has not been defined. MATERIALS AND METHODS: We conducted a retrospective study of esophagectomies and studied cases based on whether they were anemic or were transfused peri-operatively. Clinical characteristics and known clinicopathologic prognosticators were compared between these groups. Survival was compared by Cox proportional hazard modeling. Post-operative transfusions were assessed for compliance with restrictive transfusion thresholds. RESULTS: Three-hundred ninety-nine esophagectomy cases were reviewed and after exclusions 348 cases were analyzed. The median length of follow-up was 33 months (range 1-152 months). Sixty-four percent of patients were anemic pre-operatively and 22% were transfused. Transfusion and anemia were closely related to each other. Microcytic anemia was uncommon but was evaluated and treated in only 50% of cases. Most anemic patients had normocytic RBC parameters. Transfusion but not anemia was associated with a protracted/prolonged post-operative stay. Transfusion and anemia were both associated with reduced survival however only anemia was associated with decreased survival in multi-variable modeling. Sixty-eight percent of patients were transfused post-operatively and 11% were compliant with the restrictive threshold of 7 g/dL. CONCLUSIONS: Pre-operative anemia and transfusion are closely associated, however only anemia was found to compromise survival in our esophageal cancer cohort, supporting the need for more aggressive evaluation and treatment of anemia. Adherence to restrictive transfusion guidelines offers an opportunity to reduce transfusion rates which may also improve short-term outcomes.
BACKGROUND: Very few studies have been conducted on the seroprevalence of syphilis in Gabon. According to the World Health Organization, the average seroprevalence of syphilis has declined from 5.5 to 1.1% in Central Africa. The aim of this study was to test the hypothesis that syphilis decreased in Gabon between 2004 and 2016 and to identify factors involved in this pattern by testing a large sample of first-time blood donors in the capital Libreville. METHODS: The detection of Treponema pallidum was done using a Rapid Plasma Reagin test (RPR) and confirmed by an ELISA test using the Biorad Syphilis Total Antibody EIA II kit or BioMerieux Trepanostika TP recombinant. Assays were performed by dedicated technicians according to manufacturers' recommendations and following the laboratory standard operating procedures. Test results were manually transferred into the laboratory Excel files and hand-written in the laboratory logbook for syphilis testing. Logistic regression was used to assess the impact of sociodemographic characteristics on syphilis marker seroprevalence in both univariate and multivariable analysis. Odds ratios (OR) and 95% confidence intervals were calculated. RESULTS: The seroprevalence of syphilis markers was 8.4% (95% CI = 7.9-8.9) in 2004 and 2.4% (95% CI = 2.1-2.7) in 2016. The difference was significant [OR = 3.78; 95% CI (3.26-4.38); P < 0.001]. The decrease in syphilis seroprevalence was significant in both women and men and in each age group in univariate analysis. In multivariable analysis, controlling for all sociodemographic factors, the decrease in syphilis seroprevalence from 2004 to 2016 remained significant (OR = 3.29; 95% CI = 2.88-3.88, P < 0.001). The seroprevalence of syphilis decreased significantly in men compared to women and young donors compared to donors aged ≥36 years. CONCLUSIONS: This study shows a significant decline in syphilis seroprevalence in first-time blood donors in Libreville, Gabon. Government actions, including multiple HIV prevention activities, are a likely part of this decline.
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia and associated with severe complications, including neuropathy, nephropathy, and retinopathy. Oxidative stress plays a crucial role in the progression of these complications. Antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) are essential in mitigating oxidative stress; however, their activity is often impaired in diabetic patients. Despite global research on oxidative stress in diabetes, there is limited evidence from Iraq examining the relationship between antioxidant enzyme activity and glycemic control. This study aimed to assess the levels of antioxidant enzymes (SOD, CAT, and GPx) and their association with glycemic indices (fasting blood glucose and HbA1c) in patients with type 2 diabetes mellitus compared to healthy controls. A case-control study including 60 diabetic patients and 30 healthy controls revealed significantly reduced activities of SOD, CAT, and GPx in diabetic patients (p < 0.05). In contrast, fasting blood glucose and HbA1c were significantly elevated in diabetic subjects compared to controls. A negative correlation was observed between antioxidant enzyme activity and glycemic indices, indicating that poor glycemic control exacerbates oxidative stress. This is among the first studies in Iraq to demonstrate the association between impaired antioxidant defense mechanisms and hyperglycemia in type 2 diabetes mellitus. The findings emphasize the importance of monitoring oxidative stress biomarkers alongside glycemic indices to improve management strategies and prevent diabetic complications. Highlights: Vitamin D deficiency was prevalent in 62% of patients with type 2 diabetes mellitus. Low vitamin D levels were significantly associated with poor glycemic control and longer disease duration. Age, obesity, and limited sun exposure were identified as key risk factors for vitamin D deficiency in diabetic patients.
Blood transfusion is a medical procedure that requires prolonged intervention. In clinical treatment, red blood cells (RBCs) play a vital role and most demanded product in blood transfusion. The ABO/RhD system was considered in several research projects in the absence of subtypes of blood inventory management (BIM). In the issuing process, without considering the age of the blood, it becomes a risk factor for the recipient after transfusion. To overcome this problem and provide effective treatment, BIM should enhance its stock of specific subtypes and classify the blood's age (shelf-life). In past, no studies on issuing policies have examined A_1 A_2 BO substitution in inventory management with a new A_1 A_2 BO compatible and A_2 O priority table. For this reason, in this paper blood units of different ages are examined from two perspectives: (1) the current age of each unit and its substitution possibilities, and (2) providing effective medical services. Furthermore, the proposed system can determine the optimal order up to level quantities. Medical procedures and inventory management can both be managed effectively with this model. Hence, the goal of this research proposal is to minimize wastage and shortages along with service level substitution with age-dependent demand. By providing a numerical example, the model can validate the fact that compatibility substitution reduces wastage and blood shortages. Using a cross-matching policy, the enhanced model significantly improves the objective of this model compared to ABO substitution.