16 February 2025 (Sunday) - Slide Staurday Challenge

Slide Saturday challenge… it comes out on the Saturday but I wait until the Sunday before the expert comment comes out so I can be sure that I’m right or wrong.
 
Well – I was right this time. Blister cells. You see those in G6PD deficiency. Having confidently announced this, I’ve only ever seen two cases of G6PD deficiency outside of NEQAS exercises.
Am I being a reactionary old fart in suggesting that morphology is all about remembering obscure things that you never actually see in actual practice?
 

16 February 2025 (Sunday) - BTLP-TACT Exercise

Time for a BTLP-TACT exercise. I was presented with one case – a fifteen year-old lad with liver disease needing group and save.

He grouped as O Rh(D) Negative with antibody screen positive in cells 1 and 2. I requested antibody panels. The IAT panel was positive in cells 2, 3, 5, 7 and 9 corresponding with anti-S, but not excluding anti-E or anti Lu(a). But the enzyme panel was negative, so that did exclude them. In this world…
I got the thumbs up.

Whilst I was logged in I had a look at my performance dashboard. I’ve copied a screenshot here.


I’m doing enough to meet my engagement targets… so why is it continually sending me emails saying “You may need to complete further TACT participations to improve your engagement target with the system. Please visit TACT and log in at your earliest convenience”?
Probably for the same reason that it thinks that in today’s case anti-E and anti Lu(a) were both excluded…

14 February 2025 (Friday) - ITP

The nice people at TouchHaematology sent me this link today. The latest thinking on the treatment of ITP.
This is why I need to do CPD. Back in the day the patients either had a massive dose of steroids, and if that didn’t work, out came the spleen. Both were rather effective; as I remember my mate’s mother was rather ill with ITP but soon recovered.
Treatment these days is a lot less like taking a sledgehammer to crack a nut.

13 February 2025 (Thursday) - Transfusion Evidence LIbrary Update

The Transfusion Evidence Library sent its update today. Am I imagining it, or is the move against having blood transfusions gathering momentum?

Top article

Selected articles

Intravenous versus oral iron for anaemia among pregnant women in Nigeria (IVON): an open-label, randomised controlled trial.
Afolabi, B.B., et al. (2024). The Lancet Global Health.

Effect of minimization of early blood sampling losses among extremely premature neonates: a randomized clinical trial.
Balasubramanian, H., et al (2024). The Journal of Pediatrics.

Luspatercept versus epoetin alfa in erythropoiesis-stimulating agent-naive, transfusion-dependent, lower-risk myelodysplastic syndromes (COMMANDS): primary analysis of a phase 3, open-label, randomised, controlled trial.
Della Porta, M.G., et al. (2024). The Lancet Haematology.

Effects of individualized anemia therapy on hemoglobin stability: a randomized controlled pilot trial in patients on hemodialysis.
Fuertinger, D.H., et al. (2024). Clinical Journal of the American Society of Nephrology. [Record in progress].

Standard of care versus octreotide in angiodysplasia-related bleeding (the OCEAN Study): a multicenter randomized controlled trial.
Goltstein, L.C.M.J., et al. (2024). Gastroenterology.

Effect of preoperative recombinant human erythropoietin on the need for blood transfusion and surgical outcomes in adult patients undergoing cardiac surgery: a systematic review and meta-analysis with trial sequential analysis.
Hakim, S.M., Ahmad, A.H.M., and Amer, A.M., (2024). Journal of Cardiothoracic and Vascular Anesthesia.

Interventions for reducing red blood cell transfusion in adults undergoing hip fracture surgery: an overview of systematic reviews.
Lewis,  S.R., et al. (2023). Cochrane Database of Systematic Reviews.

Darbepoetin alfa to reduce transfusion episodes in infants with haemolytic disease of the fetus and newborn who are treated with intrauterine transfusions in the Netherlands: an open-label, single-centre, phase 2, randomised, controlled trial.
Ree, I.M.C., et al. (2023). The Lancet Haematology.

Pharmacotherapy for reducing RBC transfusion for patients in the ICU: a systematic review and network meta-analysis
Yoshihiro, S., et al. (2024). Critical Care Medicine.

11 February 2025 (Tuesday) - Westgard Update

Hot on the heels of the IBMS’s newsletter was the update from Westgard. As always it was rather dry and heavy going, but relevant to what I do on a daily basis.
It’s a shame that when it specifically tackles compliance with the various regulations governing medical laboratories it is looking at the American ones, but there are all sorts of transferable snippets in there.

11 February 2025 (Tuesday) - IBMS Update

The IBMS sent its newsletter today. I’m usually rather disparaging about the IBMS. I don’t want to be. I suspect that my grievances are actually evidence of how out of touch I am with the current state of the profession…
Having admitted that…
 
IBMS congress was always seen as a chance to get paid to go on a booze up with youe current and old colleagues. The sooner that thing is moved to being entirely virtual the sooner it can shake off that reputation.
There was concerns that enterprising students might be blagging their portfolio work using AI. But there was also talk of how AI might be used to assess students’ work.
And tere was no end of support for managers but absolutely nothing that would help those doing the job do their daily round. Again.

 

9 February 2025 (Sunday) - BTLP Exercise

Time for another BTLP-TACT exercise. I was presented with two cases.
 

39634 – a twenty-six year-old woman in the maternity department requiring group and save prior to a caesarian section.

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

 

07685 – an eight year old boy having haematemesis requiring two units of blood.

He grouped as B Rh(D) Negative with a negative antibody screen.

I selected two units of B Rh(D) Negative blood

 
I got the thumbs-up.