Bilten za hematologiju i transfuziju最新文献

Over the last twelve years, only three cases of a dissiminated form of histiocytosis X, in infancy, have been treated at the Institute for Mother and Child Health Care in Novi Sad. The clinical picture exhibits a very characteristic, prolonged (from two to nine months) first stage of the illness. Its general symptoms are: fever, general decline of the infant, seborrheic dermatitis, coughing and recurrent purulent otitis. In the second stage the symptoms are even more pronounced but they depend on localization and the functional deterioration of the organs involved: the lungs, liver, pancreas, skin, bone marrow and lymph nodes. The article underlines the importance of hematological, cytological and histiopathological analyses in diagnosis, and it gives the results for the cases in question. Particular emphasis is placed on the importance of a cytological analysis of the skin scarificate. Two of the patients in question were treated with antibiotics and corticosteroids, while the third received antibiotics, corticosteroids and cytostatics, yet the outcome of all three cases was fatal. This is attributed, in part, to the late beginning of treatment and, in part, to the early age of the patients.

Analysis of the karyotype from bone marrow tissue and lymphocyte culture of the peripheral blood was performed in 25 children either with Hodgkin's or non-Hodgkins' lymphoma prior to any treatment. numeric aberrations were confirmed in 40% of the patients; in these the hyperdiploid number of chromosomes ranged from 52 to 94, while 24% of the cases had cells with 47 chromosomes of which the surplus chromosome corresponded to those of the group C and, in one case, of the group G. The occurence of cells with abnormal chromosome sets confirmed presence of clonal evolution. This was also a poor prognostic sign. By using cytogenetic of high accuracy and by studying further the chromosome abnormalities, problems concerning the importance of these abnormalities in the etiology and epidemiology of these diseases might be solved.

Determination of chromosomal aberration in the lymphocyte cell culture of the peripheral blood in 50 children with malignant and nonmalignant diseases was the test applied in the investigation of the adverse effects of the cytostatic therapy on the human genome. The study included the cytostatic drugs cyclophosphamide, methotrexat and cytosine arabinoside which are used in the treatment for the autoimmune diseases, in organ and bone marrow transplantations and in malignant diseases. It was confirmed that these cytostatics could be the cause of considerable structural aberrations in chromosomes, particularly so when high dosages and long application are involved. Therefore it is understandable that these drugs as mutagens can be the cause of the secondary cancer in patients treated with cytostatic therapy and also of the congenital malformations in children by mothers treated with these medications.

Albumin is the most effective oncotic agent and has wide clinical application. In the resuscitation of injured patients with hypovolemic shock (during war and peace) the use of supplemental albumin is purported to be more effective in restoring plasma volume, increasing cardiac output, preventing pulmonary oedema and maintaining organ perfusion than resuscitation without supplemental albumin. Most important in a study of albumin are criterias for appropriate use because it was sometimes unjustified. Therapeutic use of albumin should not be dictated by arbitrary or pragmatic restriction but rather by rational prescribing from physicians well educated in its use.

The examinations of 30 blood samples each preserved with three Yugoslav different ACD-solutions were performed. The blood samples were stored at 2-6 degrees C and examinations were performed at the day of blood donation and after on the 7th, 14th and 21st day during the storage. Differences in hematocrit (well known dilution effect of the ACD-solutions used) and intensive morphological and chemical changes were found in all blood samples regardless the type of ACD-solution used. It was shown that the permanently increasing number morphologically altered erythrocytes (echinocytes and spherocytes) and the excessive release of hemoglobin and potassium from erythrocytes were occurred during the storage of blood samles. Too, there were noticed significant decrease of pH values enormous accumulation of ammoniac and other metabolic producta.

The use of blood and components was analysed during the period of two years in the Dept. of Med. "O. Novosel", Med. Fak. of Zagreb. The blood use factors were compared with those from other hospitals and hospital staff's transfusion practice was judged by them. The use of blood was higher than in the compared hospitals due to the extremly high use in the Dept. of Haematology. This department is highly specialised with predominancy of patients with haematologycal malignancies. The blood factors of other departaments compare well with these from other hospitals. Blood component therapy in an accepted principle and is fully practiced. 77% of all transfusons were given as PRC. Difficulity in management of haemotherapy is clearly seen by the fact that only 72% of reqested doses were supplied by Blood Transfusion Service. For each Rhesus positive received dose of blood it was neccessary to order 1,4 doses and for each A Rhesus negative dose, 2 doses. The worst situation was with B and AB Rhesus negative blood. For one received dose it was neccessary to order 2.9 and 2,8 doses respectively. Similar situation was with blood components. Only 64% of requested platelet concentrates and less than 42% of granulocyte concentrates were obtained. The shortage of blood and blood components is a serious hindrance to the optimal treatment of patients.

In the group of 391 examined children in the third trimester of their life the mean values have been established for the principal hematological parameters of the red family (hemoglobin = 11,52 +/- 0,87 g/100 ml, hematocrit = 36,12 +/- +/- 3,12%), as well as anemia frequency which is 29,06% if the lower lewel of the normal hemoglobin value is 11 g/100 ml for that period of infants' life. These investigations have been stated statistically significant lower hemoglobin values and a higher anemia frequency in group of infants with low weight at birth (17,5 of anemic children were prematurely born, and 55,38% weighted under 3.250 g. at their birth), than in the group of infants with non-adequate nutrition, and among infants with frequent infections. The prophylactic measures were suggested to decrease frequency of sideropenic anemia - the most widely spread type of anemia in early life of children.

In order to evaluate the specificity of hemostatic mechanism in premature Infants, the following examinations of coagulation and fibrinolytic parameters have been done: platelet number, concentrations of fibrinogen prothrombin, factors V, VII X, X, VIII, IX and XIII, antithrombin III, plasminogen, euglobulin lysis time, fibrin degradation products, alpha-1 antiplasmin and alpha-2 macroglobulin. The examinations have been done in the whole of 18 premature infants of both sexes. The obtained results show that lowered level of coagulant activity was not exclusively the consequence of low activity of vitamin-K dependent factors, but the result of more complex disorders partly connected with the transient reduction of factors VIII, XIII and fibrinogen. The total fibrinolytic activity, in the meantime, was of the normal intensivity. The established disorder of coagulation-fibrinolytic balance probably represents the certain contributing factor in more frequent occurrence of haemorrhagic syndrome in premature infants.