Pub Date : 2023-11-28eCollection Date: 2023-01-01DOI: 10.2147/JBM.S415604
Abdulqadir J Nashwan, Mohamed A Yassin
Chronic kidney disease (CKD) is a major global health concern, affecting millions of people worldwide. The progressive decline in kidney function often necessitates renal replacement therapy, such as hemodialysis (HD) or peritoneal dialysis (PD), to maintain a patient's health. Iron overload, which is common in CKD patients on dialysis, can lead to severe complications, including cardiovascular disease and infections where most of the existing iron chelators are deemed unsuitable due to their suboptimal clearance in patients with compromised renal function, it becomes a significant challenge to effectively manage iron overload. Deferasirox (DFX), an oral iron chelator, has emerged as a promising treatment option for managing iron overload in these patients. However, the use of DFX comes with its unique set of challenges, such as its cost, potential side effects, and the need for close monitoring of patients, as well as the noticeable scarcity of comprehensive and rigorous clinical studies confirming its efficacy and safety of DFX. In this review, we delve into both the promising prospects and the emerging challenges associated with DFX use in managing CKD patients on HD or PD, striving for a comprehensive understanding that informs better clinical practice and patient care.
{"title":"Deferasirox in Patients with Chronic Kidney Disease: Assessing the Potential Benefits and Challenges.","authors":"Abdulqadir J Nashwan, Mohamed A Yassin","doi":"10.2147/JBM.S415604","DOIUrl":"10.2147/JBM.S415604","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a major global health concern, affecting millions of people worldwide. The progressive decline in kidney function often necessitates renal replacement therapy, such as hemodialysis (HD) or peritoneal dialysis (PD), to maintain a patient's health. Iron overload, which is common in CKD patients on dialysis, can lead to severe complications, including cardiovascular disease and infections where most of the existing iron chelators are deemed unsuitable due to their suboptimal clearance in patients with compromised renal function, it becomes a significant challenge to effectively manage iron overload. Deferasirox (DFX), an oral iron chelator, has emerged as a promising treatment option for managing iron overload in these patients. However, the use of DFX comes with its unique set of challenges, such as its cost, potential side effects, and the need for close monitoring of patients, as well as the noticeable scarcity of comprehensive and rigorous clinical studies confirming its efficacy and safety of DFX. In this review, we delve into both the promising prospects and the emerging challenges associated with DFX use in managing CKD patients on HD or PD, striving for a comprehensive understanding that informs better clinical practice and patient care.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138477786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07eCollection Date: 2023-01-01DOI: 10.2147/JBM.S428159
Vasiliki Papadopoulou, Giulia Schiavini
We invariably see prolongation of activated partial thromboplastin time in patients treated with asparaginase in our clinical practice, but have noted that, contrary to hypofibrinogenemia and low antithrombin, clotting times' prolongation by asparaginase is largely unreported in the literature and guidelines and is not widely known to clinicians. We report on aPTT prolongations in a small cohort of patients, and on their origin, as investigated by measurements of clotting factors, fibrinogen, and D-dimers before and after asparaginase administration. We observed significant reductions in FIX and FXI (median post-treatment values of 27 IU/dl and 52 IU/dl, respectively), confirming one previous observation. A decrease in FXII was less pronounced but contributed to the prolonged aPTTs (FXII has no effect on in vivo haemostasis). The factor deficits are not due to consumption, as evidenced by unchanged D-dimer levels, and are, therefore, probably caused by disturbed factor synthesis. Our observations and insights contribute to elucidation of the profile of clotting assays during asparaginase treatment, and thus, to optimally monitor for undesirable events or steer situations of therapeutic anticoagulation without the risk of suboptimal or excessive anticoagulation.
{"title":"Acquired Clotting Factor Deficits During Treatment with Asparaginase in an Institutional Cohort.","authors":"Vasiliki Papadopoulou, Giulia Schiavini","doi":"10.2147/JBM.S428159","DOIUrl":"10.2147/JBM.S428159","url":null,"abstract":"<p><p>We invariably see prolongation of activated partial thromboplastin time in patients treated with asparaginase in our clinical practice, but have noted that, contrary to hypofibrinogenemia and low antithrombin, clotting times' prolongation by asparaginase is largely unreported in the literature and guidelines and is not widely known to clinicians. We report on aPTT prolongations in a small cohort of patients, and on their origin, as investigated by measurements of clotting factors, fibrinogen, and D-dimers before and after asparaginase administration. We observed significant reductions in FIX and FXI (median post-treatment values of 27 IU/dl and 52 IU/dl, respectively), confirming one previous observation. A decrease in FXII was less pronounced but contributed to the prolonged aPTTs (FXII has no effect on in vivo haemostasis). The factor deficits are not due to consumption, as evidenced by unchanged D-dimer levels, and are, therefore, probably caused by disturbed factor synthesis. Our observations and insights contribute to elucidation of the profile of clotting assays during asparaginase treatment, and thus, to optimally monitor for undesirable events or steer situations of therapeutic anticoagulation without the risk of suboptimal or excessive anticoagulation.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107606236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-03eCollection Date: 2023-01-01DOI: 10.2147/JBM.S418937
Mouhammad J Alawad, Mohammad Abu-Tineh, Awni Alshurafa, Alaa Al-Taie, Anil Yousaf, Mohamed A Yassin
Glanzmann thrombasthenia is a bleeding disorder with a low incidence. It typically manifests as superficial bleeding episodes, which tend to be mild. Deep organ involvement is not uncommon but remains rare due to the rarity of the disease itself and the unusual association between platelet disorders and deep organ implications. A 17-year-old boy with Glanzmann thrombasthenia since infancy developed ankle pain after a minor trauma. His initial workup was negative, but he continued to experience ankle pain. A magnetic resonance imaging (MRI) done after four weeks suggested siderotic synovitis. The patient was lost to follow-up after that and returned after two years with recurrent left ankle pain. Imaging and studies have shown evidence of chronic arthropathy. A specialized orthopedic team assessed the patient. The patient underwent intra-articular steroid injection for pain relief and was referred to continue physical therapy. In conclusion, hemarthrosis is more common in hemophilia than in platelet disorders and has potential morbidity and quality-of-life implications.
{"title":"Glanzmann Thrombasthenia Associated with Siderotic Synovitis and Arthropathy: A Case Report.","authors":"Mouhammad J Alawad, Mohammad Abu-Tineh, Awni Alshurafa, Alaa Al-Taie, Anil Yousaf, Mohamed A Yassin","doi":"10.2147/JBM.S418937","DOIUrl":"10.2147/JBM.S418937","url":null,"abstract":"<p><p>Glanzmann thrombasthenia is a bleeding disorder with a low incidence. It typically manifests as superficial bleeding episodes, which tend to be mild. Deep organ involvement is not uncommon but remains rare due to the rarity of the disease itself and the unusual association between platelet disorders and deep organ implications. A 17-year-old boy with Glanzmann thrombasthenia since infancy developed ankle pain after a minor trauma. His initial workup was negative, but he continued to experience ankle pain. A magnetic resonance imaging (MRI) done after four weeks suggested siderotic synovitis. The patient was lost to follow-up after that and returned after two years with recurrent left ankle pain. Imaging and studies have shown evidence of chronic arthropathy. A specialized orthopedic team assessed the patient. The patient underwent intra-articular steroid injection for pain relief and was referred to continue physical therapy. In conclusion, hemarthrosis is more common in hemophilia than in platelet disorders and has potential morbidity and quality-of-life implications.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Anemia is one of the most common comorbidities frequently seen in admitted patients. However, there is a scarcity of evidence regarding anemia among hospital admitted patients in Ethiopia, particularly in the Harari Region. Therefore, this study aimed to assess the prevalence and associated factors of anemia among hospital admitted patients in Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted from October 25 to December 30, 2022. Four milliliters of venous blood were collected and complete blood count was done using the DxH 800 (Beckman Coulter, Inc, Miami, FL) hematology analyzer. The data were entered in Epi-data version 4 and exported to SPSS version 26 for statistical analysis. Bivariable and multivariable logistic regression models were fitted. The level of significance was declared at a p-value of < 0.05. Results: Of the 381 hospital admitted patients, 64.8% (95% CI = 60.01, 69.65) of the participants were anemic. Admitted patients who drank standard alcohol daily (AOR = 3.78, 95% CI = 1.71, 8.30), underweight (AOR = 9.39, 95% CI = 2.90, 30.46), and undernourished patients (AOR = 2.59, 95% CI = 1.15, 5.84), patients admitted with chronic kidney disease (AOR = 11.16, 95% CI = 4.06, 30.64), chronic liver disease (AOR = 3.20, 95% CI = 1.21, 8.47), deep vein thrombosis (AOR = 6.22, 95% CI = 1.98, 19.52), infectious disease (AOR = 9.71, 95% CI = 2.77, 34.02), and chronic non-communicable disease (AOR = 7.01, 95% CI = 1.90, 25.99) were all significantly associated with anemia. Conclusion: Anemia was common among hospital admitted patients and should prompt the focus on admission diagnoses that are likely to play leading roles in etiology. This information indicates a need for routine screening of anemia for all admitted patients to improve their health. Keywords: anemia, prevalence, associated factors, admitted patients, Ethiopia
背景:贫血是住院患者中最常见的合并症之一。然而,在埃塞俄比亚,特别是在哈拉里地区,关于住院病人贫血的证据很少。因此,本研究旨在评估埃塞俄比亚东部住院患者中贫血的患病率及其相关因素。方法:于2022年10月25日至12月30日进行以医院为基础的横断面研究。采集静脉血4毫升,使用DxH 800 (Beckman Coulter, Inc, Miami, FL)血液学分析仪进行全血细胞计数。数据输入Epi-data version 4,导出到SPSS version 26进行统计分析。拟合了双变量和多变量logistic回归模型。p值< 0.05为显著性水平。结果:在381名住院患者中,64.8% (95% CI = 60.01, 69.65)的参与者贫血。承认患者每天喝标准酒精(AOR = 3.78, 95% CI = 1.71, 8.30),体重不足(AOR = 9.39, 95% CI = 2.90, 30.46),和营养不良患者(AOR = 2.59, 95% CI = 1.15, 5.84),慢性肾脏疾病患者承认(AOR = 11.16, 95% CI = 4.06, 30.64),慢性肝病(优势比= 3.20,95% CI = 1.21, 8.47),深静脉血栓形成(优势比= 6.22,95% CI = 1.98, 19.52),传染病(AOR = 9.71, 95% CI = 2.77, 34.02),和慢性非传染性疾病(优势比= 7.01,95% CI = 1.90, 25.99)均与贫血显著相关。结论:贫血在住院患者中较为常见,应重视可能在病因学中起主导作用的入院诊断。这一信息表明需要对所有住院患者进行常规贫血筛查,以改善其健康状况。关键词:贫血,患病率,相关因素,住院患者,埃塞俄比亚
{"title":"Prevalence and Associated Factors of Anemia Among Hospital Admitted Patients in Eastern Ethiopia","authors":"Mohammed Umer Yusuf, Nuredin Abdurahman, Haftu Asmerom, Tesfaye Atsbaha, Adisu Alemu, Fitsum Weldegebreal","doi":"10.2147/jbm.s431047","DOIUrl":"https://doi.org/10.2147/jbm.s431047","url":null,"abstract":"Background: Anemia is one of the most common comorbidities frequently seen in admitted patients. However, there is a scarcity of evidence regarding anemia among hospital admitted patients in Ethiopia, particularly in the Harari Region. Therefore, this study aimed to assess the prevalence and associated factors of anemia among hospital admitted patients in Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted from October 25 to December 30, 2022. Four milliliters of venous blood were collected and complete blood count was done using the DxH 800 (Beckman Coulter, Inc, Miami, FL) hematology analyzer. The data were entered in Epi-data version 4 and exported to SPSS version 26 for statistical analysis. Bivariable and multivariable logistic regression models were fitted. The level of significance was declared at a p-value of < 0.05. Results: Of the 381 hospital admitted patients, 64.8% (95% CI = 60.01, 69.65) of the participants were anemic. Admitted patients who drank standard alcohol daily (AOR = 3.78, 95% CI = 1.71, 8.30), underweight (AOR = 9.39, 95% CI = 2.90, 30.46), and undernourished patients (AOR = 2.59, 95% CI = 1.15, 5.84), patients admitted with chronic kidney disease (AOR = 11.16, 95% CI = 4.06, 30.64), chronic liver disease (AOR = 3.20, 95% CI = 1.21, 8.47), deep vein thrombosis (AOR = 6.22, 95% CI = 1.98, 19.52), infectious disease (AOR = 9.71, 95% CI = 2.77, 34.02), and chronic non-communicable disease (AOR = 7.01, 95% CI = 1.90, 25.99) were all significantly associated with anemia. Conclusion: Anemia was common among hospital admitted patients and should prompt the focus on admission diagnoses that are likely to play leading roles in etiology. This information indicates a need for routine screening of anemia for all admitted patients to improve their health. Keywords: anemia, prevalence, associated factors, admitted patients, Ethiopia","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135765131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: sP-selectin is a glycoprotein located in α granules of platelet and endothelial's Weibel Palade body, as expression to platelet activation and endothelial cell stimulation by SARS-CoV-2 binding with ACE2 receptor. Consumptive thrombocytopenia is also related to platelet activation. Elevation of sP-selectin and thrombocytopenia are related to COVID-19 complication and often correlated with severity of COVID-19.
Purpose: Assess the correlation between sP-selectin and platelet in COVID-19 patients at intensive care and non-intensive care.
Patients and methods: The study population was hospitalized COVID-19 patients confirmed by Real-Time PCR that underwent platelet examination within 48 hours upon admission, divided into intensive care and non-intensive care group. sP-selectin examination using ELISA methods. Platelet cell count and sP-selectin divided based on normal reference range.
Results: The subjects consist of 24 were in intensive care, 25 were in non-intensive care group. A 66.7% of subject in intensive care group has an elevation in sP-selection (>44.0 ng/mL). Thrombocytopenia was significantly correlated with intensive group (r =-0.32, p<0.05). The combination of platelet count <150.000/mm3 and sP-selectin >44.0ng/mL was not correlated with the intensive and non-intensive group. Platelet and sP-selectin were not correlated with each other.
Conclusion: Thrombocytopenia is able to induce the expression of sP-selectin.
{"title":"The Correlation Between sP-Selectin and Platelet Count in COVID-19 Patients in Referral Hospital, West Java Indonesia.","authors":"Delita Prihatni, Frany Charisma Budianto, Basti Andriyoko, Suryarini Trisa","doi":"10.2147/JBM.S425667","DOIUrl":"https://doi.org/10.2147/JBM.S425667","url":null,"abstract":"<p><strong>Introduction: </strong>sP-selectin is a glycoprotein located in α granules of platelet and endothelial's Weibel Palade body, as expression to platelet activation and endothelial cell stimulation by SARS-CoV-2 binding with ACE2 receptor. Consumptive thrombocytopenia is also related to platelet activation. Elevation of sP-selectin and thrombocytopenia are related to COVID-19 complication and often correlated with severity of COVID-19.</p><p><strong>Purpose: </strong>Assess the correlation between sP-selectin and platelet in COVID-19 patients at intensive care and non-intensive care.</p><p><strong>Patients and methods: </strong>The study population was hospitalized COVID-19 patients confirmed by Real-Time PCR that underwent platelet examination within 48 hours upon admission, divided into intensive care and non-intensive care group. sP-selectin examination using ELISA methods. Platelet cell count and sP-selectin divided based on normal reference range.</p><p><strong>Results: </strong>The subjects consist of 24 were in intensive care, 25 were in non-intensive care group. A 66.7% of subject in intensive care group has an elevation in sP-selection (>44.0 ng/mL). Thrombocytopenia was significantly correlated with intensive group (r =-0.32, p<0.05). The combination of platelet count <150.000/mm<sup>3</sup> and sP-selectin >44.0ng/mL was not correlated with the intensive and non-intensive group. Platelet and sP-selectin were not correlated with each other.</p><p><strong>Conclusion: </strong>Thrombocytopenia is able to induce the expression of sP-selectin.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Immunohematological abnormalities among human immunodeficiency virus-infected patients are common abnormalities associated with severe depletion of the immune system, covering a stage of acute syndrome to an advanced disease. The greatest impact was observed in the low- and middle-income countries. However, in Ethiopia, little attention has been paid, and only limited published information exists regarding immunohematological abnormalities among individuals receiving highly active antiretroviral treatment.
Objective: This study aimed to assess changes in immunological and hematological parameters in HIV-infected patients receiving HAART for at least six months at the antiretroviral therapy clinic of Yabelo Hospital, Borena, Ethiopia.
Methods: A cross-sectional study was conducted from February to July 2021 using convenient sampling to recruit 333 participants. Sociodemographic data and clinical characteristics were collected using a pretested questionnaire. Baseline data were extracted from medical records and after six month immunohematological measurements were performed on blood samples collected during the study period. Data analysis was performed using SPSS version 25. Descriptive analysis was performed, and the results are presented as numbers and percentages or means ± SD. A paired t-test was used to compare the mean values of the immunohematological parameters before and after six of taking HAART. Statistical significance was set at P < 0.05.
Results: The prevalence of anemia, leucopenia, neutropenia, lymphopenia and thrombocytopenia were 47.4%, 73.3%, 58.3%, 76.9% and 3.3% before initiation of HAART and 23.1%, 36.4%, 23.4%, 35.7% and 2.4% after initiation of HAART, respectively; Compared to baseline, there was also a significant decrease in the rate of Immunosuppression (CD4 < 350) from 62.2% at base line to 20.7% after HAART initiation.
Conclusion: Immunohematological profile of the patients improved after the initiation of HAART. The observation of large proportion of immunosuppressed individuals at baseline warrants advocating for HIV testing in the pastoralist community so that infected patients could benefit from early initiation of HAART.
{"title":"Immunohematological Outcome Among Adult HIV Patients Taking Highly Active Antiretroviral Therapy for at Least Six Months in Yabelo Hospital, Borana, Ethiopia.","authors":"Girma Ashenafi, Melatwork Tibebu, Dagnamyelew Tilahun, Aster Tsegaye","doi":"10.2147/JBM.S419414","DOIUrl":"10.2147/JBM.S419414","url":null,"abstract":"<p><strong>Background: </strong>Immunohematological abnormalities among human immunodeficiency virus-infected patients are common abnormalities associated with severe depletion of the immune system, covering a stage of acute syndrome to an advanced disease. The greatest impact was observed in the low- and middle-income countries. However, in Ethiopia, little attention has been paid, and only limited published information exists regarding immunohematological abnormalities among individuals receiving highly active antiretroviral treatment.</p><p><strong>Objective: </strong>This study aimed to assess changes in immunological and hematological parameters in HIV-infected patients receiving HAART for at least six months at the antiretroviral therapy clinic of Yabelo Hospital, Borena, Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from February to July 2021 using convenient sampling to recruit 333 participants. Sociodemographic data and clinical characteristics were collected using a pretested questionnaire. Baseline data were extracted from medical records and after six month immunohematological measurements were performed on blood samples collected during the study period. Data analysis was performed using SPSS version 25. Descriptive analysis was performed, and the results are presented as numbers and percentages or means ± SD. A paired <i>t</i>-test was used to compare the mean values of the immunohematological parameters before and after six of taking HAART. Statistical significance was set at P < 0.05.</p><p><strong>Results: </strong>The prevalence of anemia, leucopenia, neutropenia, lymphopenia and thrombocytopenia were 47.4%, 73.3%, 58.3%, 76.9% and 3.3% before initiation of HAART and 23.1%, 36.4%, 23.4%, 35.7% and 2.4% after initiation of HAART, respectively; Compared to baseline, there was also a significant decrease in the rate of Immunosuppression (CD4 < 350) from 62.2% at base line to 20.7% after HAART initiation.</p><p><strong>Conclusion: </strong>Immunohematological profile of the patients improved after the initiation of HAART. The observation of large proportion of immunosuppressed individuals at baseline warrants advocating for HIV testing in the pastoralist community so that infected patients could benefit from early initiation of HAART.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/d1/jbm-14-543.PMC10595970.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50161750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-11eCollection Date: 2023-01-01DOI: 10.2147/JBM.S429357
Lisda Amalia
Background: Hypercoagulable state in acute ischemic stroke patients with COVID-19, was found to occur in most cases, may affect the severity and clinical outcome of acute ischemic stroke with COVID-19. Ischemic stroke patients with COVID-19 infection have worsen prognosis in mortality regarding hypercoagulable state condition.
Objective: The study aims to determine the relationship between the hypercoagulable state and the severity of acute ischemic stroke patients with COVID-19.
Methods: This study is a retrospective analytic study using a cross-sectional method in acute ischemic stroke who meet the criteria must have focal clinical symptoms or global dysfunction lasting more than 24 hours, be caused by vascular factors, be confirmed positive for COVID-19, NIHSS (admission and discharge), and have an examination of D-dimer and/or fibrinogen. Chi-Square is used for data processing relationship analysis.
Results: A total of 32 patients met the inclusion and exclusion criteria of this study. Elevated D-dimer and/or fibrinogen were found in 28 patients (87.5%), confirming a hypercoagulable state. In this study, the average value of D-dimer was 5.3 mg/mL, and fibrinogen was 479 mg/dL. Based on the admission NIHSS score, it was found that most of the patients had moderate strokes with an average NIHSS score of 12. The chi-square test results showed no relationship between the hypercoagulable state and the severity of acute ischemic stroke as measured by NIHSS admission (p=0.333), but it was closely related to NIHSS exit (p=0.02). The finding supports that 40.62% of acute ischemic stroke patients with COVID-19 confirmed to have a hypercoagulable state had a death discharge status.
Conclusion: There is no significant relationship between hypercoagulable state and stroke severity on admission, but it closely related to NIHSS on discharge and high mortality in acute ischemic stroke patients with COVID-19.
{"title":"Correlation Between Hypercoagulable State and Severity Level of Ischemic Stroke With Covid-19 Infection.","authors":"Lisda Amalia","doi":"10.2147/JBM.S429357","DOIUrl":"10.2147/JBM.S429357","url":null,"abstract":"<p><strong>Background: </strong>Hypercoagulable state in acute ischemic stroke patients with COVID-19, was found to occur in most cases, may affect the severity and clinical outcome of acute ischemic stroke with COVID-19. Ischemic stroke patients with COVID-19 infection have worsen prognosis in mortality regarding hypercoagulable state condition.</p><p><strong>Objective: </strong>The study aims to determine the relationship between the hypercoagulable state and the severity of acute ischemic stroke patients with COVID-19.</p><p><strong>Methods: </strong>This study is a retrospective analytic study using a cross-sectional method in acute ischemic stroke who meet the criteria must have focal clinical symptoms or global dysfunction lasting more than 24 hours, be caused by vascular factors, be confirmed positive for COVID-19, NIHSS (admission and discharge), and have an examination of D-dimer and/or fibrinogen. Chi-Square is used for data processing relationship analysis.</p><p><strong>Results: </strong>A total of 32 patients met the inclusion and exclusion criteria of this study. Elevated D-dimer and/or fibrinogen were found in 28 patients (87.5%), confirming a hypercoagulable state. In this study, the average value of D-dimer was 5.3 mg/mL, and fibrinogen was 479 mg/dL. Based on the admission NIHSS score, it was found that most of the patients had moderate strokes with an average NIHSS score of 12. The chi-square test results showed no relationship between the hypercoagulable state and the severity of acute ischemic stroke as measured by NIHSS admission (p=0.333), but it was closely related to NIHSS exit (p=0.02). The finding supports that 40.62% of acute ischemic stroke patients with COVID-19 confirmed to have a hypercoagulable state had a death discharge status.</p><p><strong>Conclusion: </strong>There is no significant relationship between hypercoagulable state and stroke severity on admission, but it closely related to NIHSS on discharge and high mortality in acute ischemic stroke patients with COVID-19.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/65/jbm-14-537.PMC10577248.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-21eCollection Date: 2023-01-01DOI: 10.2147/JBM.S417432
Tomislav M Jelic, Oscar C Estalilla, Jeffrey A Vos, Gary Harvey, Caitlin J Stricker, Ayodele O Adelanwa, Ahmed A Khalid, Milton J Plata
Background and aims: Significance of absolute number of CD34+ cells in the peripheral blood of patients with less than 1% myeloblasts by manual differential count is unknown and our aim is to study its relevance in clinical practice.
Methods: We studied 138 peripheral bloods flow cytometric analyses in patients with less than 1% myeloblasts by manual differential, when CD34+ events were present in the gate that encompassed lymphocytes, monocytes, stem cells, and blasts.
Results: The average absolute number of CD34+cells in the peripheral blood was 11 CD34+cells/µL ranging from less than 1 cell/µL to 147 cells/µL. The average absolute number of CD34+ cells in patients with an abnormal expansive process involving bone marrow (metastases, myelodysplasia, granulomas, marrow infections) or if bone marrow biopsy not performed, presumed expansive marrow process was 25 cells/µL, and in patients without an expansive marrow process (or presumed negative) was 4 cells/µL (P<0.00007). Cutoff 12 CD34+ cells/μL had 93% positive predictive value for bone marrow involvement by an expansive process and 78% negative predictive value.
Conclusion: Flow cytometric testing of the peripheral blood is extremely sensitive method for enumerating CD34+ cells and can detect fewer than one CD34+ cell/µL. The absolute number of CD34+ cells in the peripheral blood is a useful parameter in determining marrow involvement by an expansive process and may provide guidance with respect to the necessity for bone marrow biopsy.
{"title":"Flow Cytometric Enumeration of Peripheral Blood CD34<sup>+</sup> Cells Predicts Bone Marrow Pathology in Patients with Less Than 1% Blasts by Manual Count.","authors":"Tomislav M Jelic, Oscar C Estalilla, Jeffrey A Vos, Gary Harvey, Caitlin J Stricker, Ayodele O Adelanwa, Ahmed A Khalid, Milton J Plata","doi":"10.2147/JBM.S417432","DOIUrl":"https://doi.org/10.2147/JBM.S417432","url":null,"abstract":"<p><strong>Background and aims: </strong>Significance of absolute number of CD34<sup>+</sup> cells in the peripheral blood of patients with less than 1% myeloblasts by manual differential count is unknown and our aim is to study its relevance in clinical practice.</p><p><strong>Methods: </strong>We studied 138 peripheral bloods flow cytometric analyses in patients with less than 1% myeloblasts by manual differential, when CD34<sup>+</sup> events were present in the gate that encompassed lymphocytes, monocytes, stem cells, and blasts.</p><p><strong>Results: </strong>The average absolute number of CD34<sup>+</sup>cells in the peripheral blood was 11 CD34<sup>+</sup>cells/µL ranging from less than 1 cell/µL to 147 cells/µL. The average absolute number of CD34<sup>+</sup> cells in patients with an abnormal expansive process involving bone marrow (metastases, myelodysplasia, granulomas, marrow infections) or if bone marrow biopsy not performed, presumed expansive marrow process was 25 cells/µL, and in patients without an expansive marrow process (or presumed negative) was 4 cells/µL (<i>P</i><0.00007). Cutoff 12 CD34<sup>+</sup> cells/μL had 93% positive predictive value for bone marrow involvement by an expansive process and 78% negative predictive value.</p><p><strong>Conclusion: </strong>Flow cytometric testing of the peripheral blood is extremely sensitive method for enumerating CD34<sup>+</sup> cells and can detect fewer than one CD34<sup>+</sup> cell/µL. The absolute number of CD34<sup>+</sup> cells in the peripheral blood is a useful parameter in determining marrow involvement by an expansive process and may provide guidance with respect to the necessity for bone marrow biopsy.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/af/jbm-14-519.PMC10519426.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-27eCollection Date: 2023-01-01DOI: 10.2147/JBM.S381016
Yvon Wangi Ngoy, Mireille Solange Nganga Nkanga, Guy Ndelembo Baina, Audrey Katende Katende, Jacques Bikaula Ngwidiwo, Lethy Mpudi Massamba, Fanny Walo Diessa, Bienvenu Kuyangisa Boloko, Héritier Mawalala Malengele, Benjamin Longo-Mbenza
Introduction: Gynecology and obstetrics are among the specialties where blood transfusion is most practiced. This situation requires the use of good transfusion practices. The objective of this study was to assess the quality of transfusion practice in the Gynecology and Obstetrics Department of the University Hospital of Kinshasa (UHK).
Methods: This is a prospective, evaluative and descriptive study performed at the Department of Gyneco-Obstetrics of the University Hospital of Kinshasa from February 25 to June 25, 2020; which dealt with patients who received at least one blood transfusion.
Results: About 498 patients, 54 patients were transfused and their average age was 36.4 years, with the extremes of 14 and 60 years, the transfusion rate was 10.8%. Most of patients (n=36: 2/3) were transfused during weekend days, sachets were used as delivery materials of blood product in 57.4% of cases (n = 31). Among the prescribers of blood products, 70.4% were nurses. All transfusions were carried out in type-specific and cross-matched Rh. All the transfused patients were not aware of the disadvantages of transfusion. Compatibility tests at the patient's bedside were not performed in 61.1% of cases and the concordance control between the patient and the blood component to be transfused was not performed in 70.4% of cases. Close monitoring of blood transfusion in the first ten minutes was not performed in 59.3% of cases.
Conclusion: Transfusion encounters real practical problems in the gyneco-obstetrical environment of countries with limited resources. However, an assessment and multidisciplinary collaboration would be necessary to improve transfusion practice in medical field.
{"title":"Critical Assessment of Transfusional Practices in the Obstetrics and Gynecology Department At the University Hospital of Kinshasa.","authors":"Yvon Wangi Ngoy, Mireille Solange Nganga Nkanga, Guy Ndelembo Baina, Audrey Katende Katende, Jacques Bikaula Ngwidiwo, Lethy Mpudi Massamba, Fanny Walo Diessa, Bienvenu Kuyangisa Boloko, Héritier Mawalala Malengele, Benjamin Longo-Mbenza","doi":"10.2147/JBM.S381016","DOIUrl":"10.2147/JBM.S381016","url":null,"abstract":"<p><strong>Introduction: </strong>Gynecology and obstetrics are among the specialties where blood transfusion is most practiced. This situation requires the use of good transfusion practices. The objective of this study was to assess the quality of transfusion practice in the Gynecology and Obstetrics Department of the University Hospital of Kinshasa (UHK).</p><p><strong>Methods: </strong>This is a prospective, evaluative and descriptive study performed at the Department of Gyneco-Obstetrics of the University Hospital of Kinshasa from February 25 to June 25, 2020; which dealt with patients who received at least one blood transfusion.</p><p><strong>Results: </strong>About 498 patients, 54 patients were transfused and their average age was 36.4 years, with the extremes of 14 and 60 years, the transfusion rate was 10.8%. Most of patients (n=36: 2/3) were transfused during weekend days, sachets were used as delivery materials of blood product in 57.4% of cases (n = 31). Among the prescribers of blood products, 70.4% were nurses. All transfusions were carried out in type-specific and cross-matched Rh. All the transfused patients were not aware of the disadvantages of transfusion. Compatibility tests at the patient's bedside were not performed in 61.1% of cases and the concordance control between the patient and the blood component to be transfused was not performed in 70.4% of cases. Close monitoring of blood transfusion in the first ten minutes was not performed in 59.3% of cases.</p><p><strong>Conclusion: </strong>Transfusion encounters real practical problems in the gyneco-obstetrical environment of countries with limited resources. However, an assessment and multidisciplinary collaboration would be necessary to improve transfusion practice in medical field.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/02/e2/jbm-14-221.PMC10065013.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9247943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-22eCollection Date: 2023-01-01DOI: 10.2147/JBM.S397722
Usha Rani Kandula, Techane Sisay Tuji, Dinkinesh Begna Gudeta, Kassech Leta Bulbula, Anwar Abdulwahed Mohammad, Ketema Diriba Wari, Ahmad Abbas
Worldwide pandemic with coronavirus disease-2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). As November 2, 2022, World Health Organization (WHO) received 628,035,553 reported incidents on COVID-19, with 6,572,800 mortalities and, with a total 12,850,970,971 vaccine doses have been delivered as of October 31, 2022. The infection can cause mild or self-limiting symptoms of pulmonary and severe infections or death may be caused by SARS-CoV-2 infection. Simultaneously, antivirals, corticosteroids, immunological treatments, antibiotics, and anticoagulants have been proposed as potential medicines to cure COVID-19 affected patients. Among these initial treatments, COVID-19 convalescent plasma (CCP), which was retrieved from COVID-19 recovered patients to be used as passive immune therapy, in which antibodies from cured patients were given to infected patients to prevent illness. Such treatment has yielded the best results in earlier with preventative or early stages of illness. Convalescent plasma (CP) is the first treatment available when infectious disease initially appears, although few randomized controlled trials (RCTs) were conducted to evaluate its effectiveness. The historical record suggests with potential benefit for other respiratory infections, as coronaviruses like Severe Acute Respiratory Syndrome-CoV-I (SARS-CoV-I) and Middle Eastern Respiratory Syndrome (MERS), though the analysis of such research is constrained by some non-randomized experiments (NREs). Rigorous studies on CP are made more demanding by the following with the immediacy of the epidemics, CP use may restrict the ability to utilize it for clinical testing, non-homogenous nature of product, highly decentralized manufacturing process; constraints with capacity to measure biologic function, ultimate availability of substitute therapies, as antivirals, purified immune globulins, or monoclonal antibodies. Though, it is still not clear how effectively CCP works among hospitalized COVID-19 patients. The current review tries to focus on its efficiency and usage in clinical scenarios and identifying existing benefits of implementation during pandemic or how it may assist with future pandemic preventions.
{"title":"Effectiveness of COVID-19 Convalescent Plasma (CCP) During the Pandemic Era: A Literature Review.","authors":"Usha Rani Kandula, Techane Sisay Tuji, Dinkinesh Begna Gudeta, Kassech Leta Bulbula, Anwar Abdulwahed Mohammad, Ketema Diriba Wari, Ahmad Abbas","doi":"10.2147/JBM.S397722","DOIUrl":"10.2147/JBM.S397722","url":null,"abstract":"<p><p>Worldwide pandemic with coronavirus disease-2019 (COVID-19) was caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). As November 2, 2022, World Health Organization (WHO) received 628,035,553 reported incidents on COVID-19, with 6,572,800 mortalities and, with a total 12,850,970,971 vaccine doses have been delivered as of October 31, 2022. The infection can cause mild or self-limiting symptoms of pulmonary and severe infections or death may be caused by SARS-CoV-2 infection. Simultaneously, antivirals, corticosteroids, immunological treatments, antibiotics, and anticoagulants have been proposed as potential medicines to cure COVID-19 affected patients. Among these initial treatments, COVID-19 convalescent plasma (CCP), which was retrieved from COVID-19 recovered patients to be used as passive immune therapy, in which antibodies from cured patients were given to infected patients to prevent illness. Such treatment has yielded the best results in earlier with preventative or early stages of illness. Convalescent plasma (CP) is the first treatment available when infectious disease initially appears, although few randomized controlled trials (RCTs) were conducted to evaluate its effectiveness. The historical record suggests with potential benefit for other respiratory infections, as coronaviruses like Severe Acute Respiratory Syndrome-CoV-I (SARS-CoV-I) and Middle Eastern Respiratory Syndrome (MERS), though the analysis of such research is constrained by some non-randomized experiments (NREs). Rigorous studies on CP are made more demanding by the following with the immediacy of the epidemics, CP use may restrict the ability to utilize it for clinical testing, non-homogenous nature of product, highly decentralized manufacturing process; constraints with capacity to measure biologic function, ultimate availability of substitute therapies, as antivirals, purified immune globulins, or monoclonal antibodies. Though, it is still not clear how effectively CCP works among hospitalized COVID-19 patients. The current review tries to focus on its efficiency and usage in clinical scenarios and identifying existing benefits of implementation during pandemic or how it may assist with future pandemic preventions.</p>","PeriodicalId":15166,"journal":{"name":"Journal of Blood Medicine","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/e1/jbm-14-159.PMC9968437.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9362609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}