7 March 2024 (Thursday) - Sample Transport

Here’s another interesting thought from the nice people at Lablogatory. The results we produce can only be as good as the samples with which we operate.
For example… you won’t see *that* many unexpected massively high platelet counts tomorrow. However in a few months time you may well do so. And you will have a batch pf them… the samples that were laying in the sun on the dashboard of the car which drove them to the lab…
Packaging of samples is important.

 

4 March 2024 (Monday) - Fritsma Factor Newsletter

The Fritsma Factor newsletter appeared in my in-box today. As always a very useful source of information…

This month there was quite the focus on mixing studies. These days that is the closest to specialist haemostatic testing that I do. 

 

4 March 2024 (Monday) - Cold Agglutinins

The nice people at Lablogatory sent a rather interesting case study on cold agglutinins today. You can read it by clicking here.

It illustrates the importance of a high MCHC, but never forget that the MCHC might be high in absolute terms, or relative to what it had been previously.

 

All of which begs the question should we be running blood counts in a lower temperature than that which we normally do to pick these up, or should we be running them in a higher temperate so that this isn’t an issue (assuming that the condition would be picked up on clinical grounds).

 

And here’s a tip – when you warm your samples to run them warmed, don’t use the analyser directly underneath the air conditioning’s cold air blower. Not that I ever got told to shut up for pointing that out ten years ago…

1 March 2024 (Friday) - BTLP-TACT Exercise

It has to be said that I get rather frustrated with the BTLP-TACT simulator. It could be such a good thing but it is most definitely a work in progress on which all work seems to have stopped. As was illustrated today.

But I had a go… It gave me one case – a nineteen year old woman with factor VIII deficiency needing cryoprecipitate tomorrow.

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

 

But section 5.5.3 of the latest guidelines says “For patients with hemophilia, cryoprecipitate is not recommended due to concerns about the safety and quality… The use of cryoprecipitate can only be justified in situations where clotting factor concentrates are not available as there is no proven advantage for their use over CFCs. It is strongly encouraged that viral-inactivation procedures be used, if available”.

So bearing in mind the stuff wasn’t needed until tomorrow I didn’t issue cryoprecipitate. Plenty of time to get the proper stuff.

But how was I supposed to put this onto the exercise? I chose not to select the issue at all as I’ve not seen any option to cancel it once requested. In reality we would have a conversation with the requestor.

It would seem not requesting the stuff was the right option as I got the green light.

29 February 2024 (Thursday) - UKAS Update

The UK Accreditation Service sent their update today… You can see it here. Am I being incredibly cynical in wondering if they might benefit from taking that quality management course I did recently?

26 February 2024 (Tuesday) - Transfusion Evidence Alert Update

The people at Transfusion Evidence Alert sent their update today. In a novel break with tradition there was no mention of tranexamic acid…

ARTICLE OF THE MONTH Pharmacological interventions for the prevention of bleeding in people undergoing elective hip or knee surgery: a systematic review and network meta-analysis. Gibbs, V.N., et al. (2024). The Cochrane Database of Systematic Reviews. PICO Summary available +++++

TOP ARTICLES Standard of care versus octreotide in angiodysplasia-related bleeding (the OCEAN study): a multicenter randomized controlled trial. Goltstein, L., et al. (2023). Gastroenterology. [Record in progress]. Long-term outcomes of plasma exchange versus intravenous immunoglobulin for the treatment of Guillain-Barré Syndrome: a double-blind, randomized clinical trial. Haridy, N.A., Shehab, M.M., and Khedr, E.M., (2024). Restorative Neurology and Neuroscience. Iron and erythropoietin to heal and recover after intensive care (ITHRIVE): a pilot randomised clinical trial. Litton, E., et al. (2023). Critical Care and Resuscitation. Prevention strategies for vasovagal reaction in whole blood donors: a quadri-armed randomised control trial. Meher, R., et al. (2024). Transfusion Medicine. [Record in progress]. Efficacy and cost-effectiveness of darbepoetin alfa once every 4 weeks versus continuous erythropoietin receptor activator once every 4 weeks for anemia correction in patients with chronic kidney disease not on dialysis. Park, G.N., et al. (2024). Kidney Research and Clinical Practice. [Record in progress]. Effective management of foetal anaemia in Rh(D) alloimmunised pregnant women with intrauterine transfusion: a systematic review. Prescott, B. and D.E. Jackson (2023). Hematology, Transfusion and Cell Therapy. [Record in progress]. Reported outcomes in patients with iron deficiency or iron deficiency anemia undergoing major surgery: a systematic review of outcomes. Stangl, S., et al. (2024). Systematic Reviews. Desmopressin to reduce periprocedural bleeding and transfusion: a systematic review and meta-analysis. Wang, C., et al. (2024). Perioperative Medicine. Effects of albumin and crystalloid priming strategies on red blood cell transfusions in on-pump cardiac surgery: a network meta-analysis. Wang, T., et al. (2024). BMC Anesthesiology. +++++

23 February 2024 (Friday) - Oncology Central Update

The nice people at Oncology Central sent their update today. All a bit over my head, but stuff I need to be aware of…

Uncovering the link between cancer disparities and climate change   What disparities exist in cancer screening and how does this impact patient outcomes? Listen to our latest podcast episode with Dr Kilan Ashad-Bishop from the American Cancer Society to find out.

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Could imaging after just 1 week predict advanced melanoma treatment response? READ MORE >>>

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Real-world clinical scenarios during introduction of trastuzumab biosimilar for HER2-positive breast cancer in the European Union Trastuzumab-anns is a biosimilar to trastuzumab, which is approved by the EMA and US FDA for treatment of HER2+ early and metastatic breast cancer. Read about its use in seven clinical oncology practices in the EU. MORE >>>

BIPOC involvement in oncological research: insights from Future Oncology In this special edition of editor’s highlights, Michael Bell Managing Editor, looks at three articles published over the last 12 months in Future Oncology, concerning greater engagement and representation for Black, Indigenous and People of Colour (BIPOC) people in oncological research. MORE >>>

P-REALITY X: prolonging metastatic breast cancer survival by adding palbociclib to an aromatase inhibitor Find out details of a real-world database analysis exploring how adding palbociclib to an aromatase inhibitor could prolong the life of people with metastatic HR+/HER2– breast cancer in routine clinical practice.  MORE >>>

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