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Management of acute radiation syndrome 急性辐射综合征的处理。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-07-16 DOI: 10.1016/j.tracli.2024.07.002
Pierre Arnautou , Guillaume Garnier , Jean Maillot , Johanna Konopacki , Michel Brachet , Annabelle Bonnin , Jean-Christophe Amabile , Jean-Valère Malfuson
Acute radiation syndrome encompasses a spectrum of pathological manifestations resulting from exposure to high doses of ionizing radiation. This syndrome typically progresses through three stages with a prodromal phase, a latency phase and a critical phase. Each of them varies in intensity and duration depending on the absorbed dose of radiation. Predominantly affecting the bone marrow, skin, and gastrointestinal tract, its clinical implications are profound and multiorgan failure must be considered. Radiation doses below 2 Gray generally result in insignificant clinical consequences, while exposures surpassing 12 Gray exceeds current therapeutic capacities.
Survival outcomes for patients within this therapeutic range depend on their ability to withstand radiation-induced aplasia, compounded by an increased risk of bleeding and infection due to skin, gastrointestinal, and potentially combined radiation injuries.
Assessing the degree of radiation exposure plays a pivotal role in tailoring patient management strategies and is based on a combination of clinical, biological, and physical parameters. Treatment approaches primarily include intensive hematologic support to manage symptomatic manifestations and etiologic treatment is now based on the administration of growth factors.
The role of hematopoietic stem cell transplant (HSCT) will be carefully considered on an individual basis, especially for patients who do not respond following 3 weeks of cytokine therapy.
This review highlights the pathophysiological mechanisms, assessment modalities, and therapeutic interventions crucial for managing acute radiation syndrome aiming to optimize patient outcomes and guide clinical practice.
急性辐射综合征包括因暴露于高剂量电离辐射而产生的一系列病理表现。这种综合征通常会经历三个阶段:前驱期、潜伏期和临界期。每个阶段的强度和持续时间因吸收的辐射剂量而异。主要影响骨髓、皮肤和胃肠道,其临床影响深远,必须考虑多器官功能衰竭。辐射剂量低于 2 戈瑞时,一般不会造成严重的临床后果,而超过 12 戈瑞时,辐射剂量就超出了目前的治疗能力。在这一治疗范围内的患者能否存活取决于他们是否有能力承受辐射引起的再生障碍,再加上皮肤、胃肠道和可能合并的辐射损伤导致出血和感染的风险增加。评估辐照程度在制定患者管理策略中起着关键作用,并以临床、生物和物理参数为基础。治疗方法主要包括强化血液学支持以控制症状表现,而病因治疗目前则以生长因子的施用为基础。造血干细胞移植(HSCT)的作用将根据个体情况仔细考虑,尤其是对细胞因子治疗 3 周后仍无反应的患者。本综述重点介绍了急性放射综合征的病理生理机制、评估方法和治疗干预措施,旨在优化患者预后并指导临床实践。
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引用次数: 0
Beyond the Microscope: A memoir of Professor Sudha S. Bhat, an iconic Indian pathologist, and a transfusion medicine specialist 显微镜之外印度著名病理学家和输血医学专家 Sudha S. Bhat 教授的回忆录。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-07-09 DOI: 10.1016/j.tracli.2024.07.001
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引用次数: 0
Motivating tomorrow's blood donors: Impact of college-driven blood grouping initiatives 激励未来的献血者:高校血型倡议的影响。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-29 DOI: 10.1016/j.tracli.2024.06.010
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引用次数: 0
WBDD, VBD and India: It’s time for Red revolution WBDD、VBD 和印度:是时候进行红色革命了。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-27 DOI: 10.1016/j.tracli.2024.06.009
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引用次数: 0
Hepatitis A and leptospirosis dual infection-induced Fulminant Hepatic Failure successfully treated with standard volume Therapeutic Plasma Exchange 标准量治疗性血浆置换成功治疗甲型肝炎和钩端螺旋体病双重感染引发的暴发性肝衰竭
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-22 DOI: 10.1016/j.tracli.2024.06.005
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引用次数: 0
Anti-A and anti-B titers in A, B and O whole blood donors: Beyond “dangerous O” A、B 和 O 型全血献血者的抗 A 和抗 B 滴度:超越 "危险的 O 型血"。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.tracli.2024.06.007

Background and Objectives

Hemolytic transfusion reactions (HTRs) pose significant risks in transfused patients, with anti-A and anti-B antibodies in donor plasma being potential contributing factors. Despite advancements in component preparation, HTRs remain a concern, particularly with apheresis-derived platelets. This study aimed to determine the prevalence of high anti-A and anti-B titers among A, B, and O blood group donors and to explore factors associated with high titers.

Materials and Methods

A cross-sectional observational study was conducted over 18 months, enrolling 978 participants from a tertiary care teaching hospital in Western India. Anti-A and anti-B titers were determined using the Conventional Tube Technique (CTT). Statistical analysis assessed correlations between high titers and demographic factors.

Results

The majority of participants were young males (98.8%). Prevalence of high titers for IgM anti-A was 12.2% and IgG anti-A was 2.5%. For anti-B, IgM titers were 2.3% and IgG titers were 0.2%. The prevalence of dangerous O was found to be 14.1%, while 3.52% and 10.5% of A and B blood group donors were found to have high titers, respectively. Factors associated with high titers included female gender, vegetarian diet, age <30 years, and O blood group.

Conclusion

The study sheds additional light and provides supplementary information regarding the prevalence and correlation of high anti-A and anti-B titers among O, A and B blood donors. Understanding these factors is crucial for optimizing transfusion safety protocols, including selective screening of platelet units and tailored transfusion strategies based on donor characteristics.
背景和目的:溶血性输血反应(HTR)对输血患者构成重大风险,供体血浆中的抗 A 和抗 B 抗体是潜在的诱因。尽管成分制备技术不断进步,但溶血性输血反应仍是一个令人担忧的问题,尤其是无细胞血浆来源的血小板。本研究旨在确定高抗A和抗B滴度在A、B和O型血献血者中的流行率,并探讨与高滴度相关的因素:这项横断面观察研究历时 18 个月,从印度西部一家三级医疗教学医院招募了 978 名参与者。采用传统试管技术(CTT)测定抗 A 和抗 B 滴度。统计分析评估了高滴度与人口统计学因素之间的相关性:结果:大多数参与者为年轻男性(98.8%)。高滴度 IgM 抗 A 为 12.2%,IgG 抗 A 为 2.5%。抗 B 的 IgM 滴度为 2.3%,IgG 滴度为 0.2%。危险 O 型血的流行率为 14.1%,而 A 型和 B 型血献血者中分别有 3.52% 和 10.5% 滴度较高。与高滴度相关的因素包括女性性别、素食、年龄 结论:这项研究揭示了 O、A 和 B 型献血者中高抗 A 和抗 B 滴度的流行率和相关性,并提供了补充信息。了解这些因素对于优化输血安全方案至关重要,包括血小板单位的选择性筛查和基于献血者特征的定制输血策略。
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引用次数: 0
Exploring the perceptions and experiences of female’s with ß-thalassemia major in a Tertiary Care Private Hospital in Pakistan 探索巴基斯坦一家三级私立医院中患有重型地中海贫血症的女性患者的看法和经历。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.tracli.2024.06.008

Introduction

ß-Thalassemia, a genetic condition which influences both the physical and emotional facets of individuals specially females while also exerting substantial financial strain on families and healthcare systems. Recognizing the pivotal influence of social support, particularly on mental well-being, this study endeavors to delve into the shared psychosocial challenges experienced by females grappling with ß-thalassemia major.

Methods

Employing a qualitative-descriptive methodology and purposive sampling, this study conducted in-depth interviews with forty-two young girls, 18.64 ± 4.27, diagnosed with ß-thalassemia major and representing diverse academic backgrounds, using a semi-structured in-depth interview guide. NVIVO-12 software facilitated extended data analysis, encompassing coding, categorization, theme development, and mind-mapping techniques to unravel nuanced insights from the collected data.

Findings

This groundbreaking study delves into the psychosocial factors that impact the well-being of female ß-thalassemia patients. The research highlights the key factors that positively contribute to their quality of life by conducting thorough inductive content analysis. These include receiving an education, having robust family support, experiencing overall life satisfaction, and making meaningful societal contributions. The findings of this study can be used to improve the lives of female ß-thalassemia patients and enhance their overall well-being. Contrariwise, notable impediments encompassed depression, social isolation, limited access to insurance services, challenges in educational and employment spheres, as well as difficulties in nurturing social relationships. These findings underscore the multifaceted influences shaping the quality of life for girls navigating ß-thalassemia, shedding light on empowering and challenging elements within their experiences.

Conclusion

In conclusion, psychosocial factors supporting or hindering the well-being of young girls with ß-thalassemia major in Pakistan include an inductive environment at homes, organizations, education, institutions with adequate knowledge of thalassemia disease among patients, and society. More research is needed to understand their needs and advocate for societal support and acceptance. Family and friends support are crucial for improving their quality of life, necessitating focused efforts to provide understanding and aid within the community.
导言:重型地中海贫血症(ß-Thalassemia)是一种遗传性疾病,不仅会影响患者的身体和情绪,还会给家庭和医疗系统带来巨大的经济压力。认识到社会支持的关键影响,尤其是对心理健康的影响,本研究试图深入探讨患有ß-地中海贫血症的年轻女孩所经历的共同社会心理挑战:本研究采用定性描述法和目的取样法,使用半结构化深度访谈指南,对 42 名确诊患有重型地中海贫血症、具有不同学术背景的女孩(18.64 ± 4.27)进行了深度访谈。NVIVO-12软件促进了扩展数据分析,包括编码、分类、主题发展和思维导图技术,以从收集的数据中揭示细微的见解:这项开创性的研究深入探讨了影响女性 ß 地中海贫血症患者福祉的社会心理因素。研究通过对内容进行全面的归纳分析,强调了对她们的生活质量产生积极影响的关键因素。这些因素包括接受教育、拥有强大的家庭支持、总体生活满意度以及对社会做出有意义的贡献。这项研究的结果可用于改善地中海贫血症女性患者的生活,提高她们的整体幸福感。与此相反,ß-地中海贫血症女性患者面临的显著障碍包括抑郁、社会隔离、获得保险服务的机会有限、在教育和就业领域面临挑战,以及在培养社会关系方面遇到困难。这些发现强调了影响ß-地中海贫血女孩生活质量的多方面因素,揭示了她们的经历中既有激励因素,也有挑战因素:总之,支持或阻碍巴基斯坦ß-地中海贫血症少女幸福生活的社会心理因素包括家庭、组织、教育、对地中海贫血症有充分了解的机构和社会的诱导性氛围。需要开展更多的研究,以了解她们的需求并倡导社会支持。个性化的援助对于提高他们的生活质量至关重要,因此必须集中精力,在社区内提供理解和援助。
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引用次数: 0
Blood type identification and pedigree analysis of D variant with RHD*01W.100/RHD*15 带有 RHD*01W.100/RHD*15 的 D 变异血型鉴定和血统分析。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-21 DOI: 10.1016/j.tracli.2024.06.006
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引用次数: 0
Personalized autologous stem cell harvesting improves patient collection outcomes 个性化自体干细胞采集改善了患者采集结果。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-12 DOI: 10.1016/j.tracli.2024.06.004

Objectives

This study aims to demonstrate that utilizing a personalized approach to apheresis stem cell collection, can safely optimize the collection outcomes, especially in the context of poor mobilizers and high cell targets.

Background

The optimal mobilization and harvesting of peripheral blood stem cells is critical to the success of the stem cell transplant. The ideal strategy that promotes better cell yields, with sustainable use of resources and assuring patient safety, should be pursued.

Methods

PBSC collections for autologous stem cell transplant data according to a fixed-processed volume strategy (One Size Fits All) or individualized to patients CD34+ peripheral blood content and target approach (Custom-Tailored or CT) were retrospectively compared.

Results

A total of 263 collections from 142 patients were assessed. The majority of patients were male, had multiple myeloma and were mobilized with isolated G-CSF. The CT strategy promoted a significantly higher CD34+ cell yield when the pre-collection CD34 was lower than 20/µl (1.02 ± 0.16 versus 1.36 ± 0.23, p < 0.001) and also a decrease in the proportion of mobilization cycles that needed 3 apheresis (31% versus 14%, p = 0.02). There was no difference in apheresis-related adverse events between the groups.

Conclusion

Tailoring the apheresis procedures to the patient-specific characteristics and objectives, can effectively promote better patient outcome.

研究目的本研究旨在证明,利用个性化方法进行无创干细胞采集,可安全地优化采集结果,尤其是在动员能力差和细胞目标高的情况下:背景:外周血干细胞的最佳动员和采集是干细胞移植成功的关键。应采取理想策略,提高细胞产量,可持续利用资源,确保患者安全:方法:对根据固定处理量策略("一刀切")或根据患者CD34+外周血含量和目标方法("定制 "或 "CT")进行的自体干细胞移植PBSC采集数据进行了回顾性比较:结果:共评估了 142 名患者的 263 例采集。大多数患者为男性,患有多发性骨髓瘤,并使用分离的 G-CSF 进行动员。当采集前的CD34低于20/µl时,CT策略能明显提高CD34+细胞的产量(1.02±0.16对1.36±0.23,p <0.001),同时降低需要3次血液净化的动员周期比例(31%对14%,p = 0.02)。两组间与血液净化相关的不良事件没有差异:结论:根据患者的具体特点和目标调整无细胞抽吸术,可有效改善患者的预后。
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引用次数: 0
Icepack-Induced transient vasospasm leading to acrocyanosis in an Indian blood donor: A rare occurrence 一名印度献血者因冰袋诱发一过性血管痉挛而导致红细胞增多症:罕见病例。
IF 1.4 4区 医学 Q4 HEMATOLOGY Pub Date : 2024-06-10 DOI: 10.1016/j.tracli.2024.06.003
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引用次数: 0
期刊
Transfusion Clinique et Biologique
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