24 January 2020 (Friday) - Look At This...

I saw this in a blood film today, and fetched everyone to come and have a look

MOUSE M              D1234567           01.02.33 M TW12   Dr D Duck R,20.3005334.Q       R 24.01.20  Clinical details  UGI bleed, possible pneumonia​             HBM   WBCM    PLT    HCT   RBCM   MCVM   MCHM  MCHCM    RDW      N 220120 F     97  10.41    125  0.289   2.88  100.3   33.7    336   18.6   8.29 230120 F     90   9.16    117  0.267   2.58  103.5   34.9    337   19.1   7.44 230120 F     90   9.40    132  0.276   2.69  102.6   33.5    326   19.2   7.92 240120 F     94   7.59    134  0.285   2.74  104.0   34.3    330   19.3   6.18               L      M      E      B   NRBC    ESR     GF 220120 F   1.10   0.89   0.09   0.04   0.05               230120 F   0.78   0.83   0.08   0.03   0.07               230120 F   0.62   0.72   0.09   0.05   0.08               240120 F   0.54   0.79   0.05   0.03   0.06

What’s caused the basophilic stippling in this case? I don’t really know. But from this link https://www.ncbi.nlm.nih.gov/pubmed/6202140 and this link https://en.wikipedia.org/wiki/Basophilic_stippling​ (good old wikipedia!!) basophilic stippling would seem to be a rather non-specific finding, and has been replaced by more specific tests in cases of suspected lead poisoning.

23 January 2020 (Thursday) - Bcr-Abl tyrosine-kinase inhibitors

The subject of Bcr-Abl tyrosine-kinase inhibitors came up at work today. I’m not going to pretend that I had the faintest idea, so I looked it up. As always Wikipedia gave the most concise description to the layman.

I won’t pretend that I understood it all, but I understand more than I did, and (as I always say) a day when you learn nothing is a day wasted…

20 January 2020 (Monday) Transfusion Evidence Alert Update

Age of donor blood, over-transfusion in thalassemia, platelets and babies, tranexamic acid… There’s always far too much to take in from the Transfusion Evidence Alert Library (but I’m not complaining)

TOP ARTICLES

Systematic literature review of the burden of disease and treatment for transfusion-dependent beta-thalassemia
Betts, M., Flight, P. A., et al, Clinical therapeutics 2019.

The Role of Platelets in Premature Neonates with Intraventricular Hemorrhage: A Systematic Review and Meta-Analysis
Grevsen, A. K., Hviid, C. V. B., et al. Seminars in thrombosis and hemostasis 2019.

Tranexamic acid use in high-risk blood transfusion patients undergoing total hip replacement: a randomised controlled trial
Kimura, O. S., Freitas, E. H., et al. Hip international 2019.

Effect of red blood cell storage duration on major postoperative complications in cardiac surgery: A randomized trial
Koch, C. G., Sessler, D. I., et al. The Journal of thoracic and cardiovascular surgery 2019.

Comparative Effectiveness of a Web-Based Patient Decision Aid for Therapeutic Options for Sickle Cell Disease: Randomized Controlled Trial
Krishnamurti, L., Ross, D., et al. Journal of medical Internet research 2019.
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Intravenous iron therapy for non-anaemic, iron-deficient adults
Miles, L. F., Litton, E., et all. The Cochrane database of systematic reviews 2019.
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Association of Prehospital Plasma Transfusion With Survival in Trauma Patients With Hemorrhagic Shock When Transport Times Are Longer Than 20 Minutes: A Post Hoc Analysis of the PAMPer and COMBAT Clinical Trials
Pusateri, A. E., Moore, E. E., et al. JAMA surgery 2019.

Effect of Fresh vs Standard-issue Red Blood Cell Transfusions on Multiple Organ Dysfunction Syndrome in Critically Ill Pediatric Patients: A Randomized Clinical Trial
Spinella, P. C., Tucci, M., et al. Jama 2019.

Tranexamic acid in gynecologic surgery
Zakhari, A., Sanders, A. P., et al. Current medical research and opinion 2019.

ARTICLE OF THE MONTH Donor Deferral Due to Low Hemoglobin-An Updated Systematic Review A Browne, SA Fisher, et al. Transfusion medicine reviews 2019.