31 October 2023 (Tuesday) - Transfusion Evidence Alert

The nice people at Transfusion Evidence Alert sent their update today. Far from being entirely hi-tec, tranexamic acid and cell salvage are very much the way forward.

ARTICLE OF THE MONTH Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery. Lloyd, T. D., et al. (2023). The Cochrane Database of Systematic Reviews. PICO Summary available +++++

TOP ARTICLES Associated criteria used in investigating suspected septic transfusion reactions: a scoping review. Acharya, D., et al. (2023). Vox Sanguinis. [Record in progress]. Cryotherapy following total knee replacement. Aggarwal, A., et al. (2023). The Cochrane Database of Systematic Reviews. LIBERTY randomized withdrawal study: relugolix combination therapy for heavy menstrual bleeding associated with uterine fibroids. Al-Hendy, A., et al. (2023). American Journal of Obstetrics and Gynecology. [Record in progress]. [Efficacy and safety of multiple-dose intravenous tranexamic acid for reducing blood loss in complex tibial plateau fractures: a prospective randomized controlled trial]. Bao, W., et al. (2023). Chinese Journal of Reparative and Reconstructive Surgery. Endoscopic versus conservative therapy for bleeding peptic ulcer with adherent clot: a comprehensive systematic review and meta-analysis. Beran, A., et al. (2023). Digestive Diseases and Sciences. Comparison between two different local hemostatic methods for dental extractions in patients on dual antiplatelet therapy: a within-person, single-blind, randomized study. Guardieiro, B., et al. (2023). The Journal of Evidence-Based Dental Practice. IRON NOF trial: IV iron for anaemic patients with femoral fracture. O'Loughlin, E., et al. (2023). BJA Open. An analysis of quality of life and functional outcomes as reported in randomized trials for red cell transfusions. Pagano, M. B., et al. (2023). Transfusion. [Record in progress]. The health impacts of blood donation: a systematic review of donor and non-donor perceptions. Thorpe, R., et al. (2023). Blood Transfusion. [Record in progress].

26 October 2023 (Thursday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise… This time I was presented with two cases:

 

98067 – A thirty-nine year old woman in maternity requiring a group and save from pre-eclampsia. 

She grouped as O Rh(D) Negative with an antibody screen positive in cell 1. I requested antibody panels.

The IAT and enzyme screens both came up positive in cells 2, 4, 5, 8, 9 and 10 which was consistent with anti-Jk(b)

54739 – a twenty-seven year old woman in the ante-natal clinic requiring group and antibody screening.

She grouped as AB Rh(D) Positive with a negative antibody screen

 

I got the green light…

20 October 2023 (Friday) - Corrected Counts

Here’s an interesting case from the nice people at Lablogatory. Correcting the counts for massively high white cell counts…

You can read the article by clicking here. This is the sort of thing we should be paying attention to. But just how practical is it in a busy laboratory?

19 October 2023 (Thursday) - HCPC Newsletter

The nice people at the HCPC sent their update today. You can read it by clicking here.

I’m reminded of my rant about the UKAS yesterday. Like them, the HCPC is trying to have one set of standards which are applicable to a very disparate group of professions and are translated into practical applications in all sorts of workplaces by all sorts of assessors.

 

What the HCPC present is far more practical than that which the UKAS have come up with… but still it is aimed at professions who deal with real-live patients which (for the most part) we don’t.

 

19 October 2023 (Thursday) - Oncology Central Update

Diagnosis of myelodysplastic syndromes, immunotherapy… More good stuff from the nice people at Oncology Central. I like their new format – not so much and manageable…

Does that MDS diagnosis need a second opinion? An interview with Mikkael Sekeres   A study has demonstrated that blood cancers known as myelodysplastic syndromes/neoplasms (MDS) are commonly misdiagnosed, putting patients at risk for treatment mistakes and other potentially harmful consequences. In this interview we provide you with a breakdown of key points of the research.

Latest articles

AI detection software achieves 100% sensitivity rate for melanoma   Presented at this year’s European Academy of Dermatology and Venereology Congress (EADV; 11–14 October, Berlin, Germany), impressive results have emerged from a study using AI software to detect skin cancer. Read the full news piece on Future Medicine AI Hub.

Tackling disparities in cancer care across Europe: how can we improve access for all patients in Europe?   Across Europe there are significant disparities in access to cancer care. Access to new medicines varies from 4 months to almost 2 years post-market authorization across countries and regions. In this opinion piece Gerwin Winter (BeiGene, Basel, Switzerland) and Eric Low (ELC, UK) discuss potential innovative solutions to address these disparities.

Looking to the future of immunotherapy in cancer treatment   Millions of people with cancer already benefit from immunotherapy, but there is always more we can do to develop transformative treatments. Find out about patient-focused solutions, such as immune-cell engagers and next-generation cell therapies in our latest opinion article.

18 October 2023 (Wednesday) - UKAS Update

The nice people at the United Kingdom Accreditation Service sent their update today. You can read it by clicking here. It makes for interesting reading. There’s no denying that I’m not the UKAS’s greatest fan, but to be fair to them they are trying to achieve the impossible. They seem to be trying to have one set of standards written in what I can only describe as “management catchphrases” which are then translated into practical applications in all sorts of workplaces by all sorts of assessors.

 

Perhaps it is time to admit that this isn’t working and going back to having something directly applicable to blood testing just like the old Clinical Pathology Accreditation used to be. And while we’re at it, let’s stop re-inventing the wheel at every turn and having the people who make each bit of apparatus produce one standard operating procedure for that bit of kit which is applicable worldwide.

Is that really so unreasonable?

16 October 2023 (Monday) - BTLP-TACT Exercise

I’m sitting quietly with the dogs as the wife has gone bowling. I could be watching anything I like on the telly, I could be playing any of a myriad of computer games. I could be reading anything I like on my Kindle.

Instead I’m doing a BTLP-TACT exercise at quarter to ten at night…

I was presented with one case – a twenty-four year old woman in theatre requiring group and save for a caesarean section.

The cell group was AB; the serum group B. That makes the blood group indeterminate and would need referral to NHSBT. The Rh group was negative though

The antibody screen was negative.

I got the green light… and the red mist. Quite frankly what a nonsensical exercise. Given that someone is having a caesarean section what is the likelihood of being unaware of such an unlikely blood group until the labour is at such a stage that surgery is required.

At the risk of sounding very ungrateful for something which is very useful to me (and free to me!), the BTLP-TACT simulator is very much something of a work in progress. Sadly there’s not much progress going on.