The nice people at Westgard QC sent their
update today. Perhaps a tad heavy going, but all useful stuff…
This is (supposed to be) a reflective diary by a (not very) anonymous biomedical scientist who works somewhere in the south of England. One day this diary may well be submitted to the Health and Care Professions Council as evidence of ongoing continual professional development....
22 April 2025 (Tuesday) - Westgard QC Update
20 April 2025 (Sunday) - Slide Saturday Challenge
Well… the question is worded rather badly. The cell is a neutrophil. One showing toxic granulation and with a Dohle body. You see these in septic conditions and when there’s a lot going on in the bone marrow – like when the patient is being treated with stimulating factors.
18 April 2025 (Friday) - ASH Update
The nice people at the American Society
of Hematology sent an update about various clinical trials today. Perhaps a tad
over my head, but all useful stuff…
16 April 2025 (Wednesday) - BTLP-TACT Exercise
Time for another BTLP-TACT exercise. I was presented with one case – a forty-year-old woman in the ante-natal clinic requiring group and save.
She grouped as O Rh(D) Negative with a negative antibody screen
I got it right
15 April 2025 (Tuesday) - Transfusion Evidence Library Update
The nice people at the Transfusion Evidence Library
sent their update today. Quite a bit to take in, but it pays to pay attention.
I’m not quite sure how to word it… either best practice is modified by
experience, or fashions change.
Back in the day whole blood transfusion was a thing. Then it became frowned upon. Now it is back in vogue.
Back in the day whole blood transfusion was a thing. Then it became frowned upon. Now it is back in vogue.
ARTICLE OF THE MONTH
Safety and efficacy of rilzabrutinib vs placebo in adults with immune thrombocytopenia: the phase 3 LUNA3 study.
Kuter, D.J., et al. (2025). Blood. [Record in progress].
PICO SUMMARY
TOP ARTICLES
The effect of delayed cord clamping on early cardiac and cerebral hemodynamics, mortality, and severe intraventricular hemorrhage in preterm infants < 32 weeks: a systematic review and meta-analysis of clinical trials.
Aljohani, E., and Goyal, M. (2025). European Journal of Pediatrics.
A cost-effective measure to prevent hemorrhage in ultrasound-guided percutaneous liver biopsy.
Cai, Q., and Wu, X. (2025). BMC Gastroenterology.
Multicentre randomised controlled trial of a self-assembling haemostatic gel to prevent delayed bleeding following endoscopic mucosal resection (PURPLE Trial).
Drews, J., et al. (2025). Gut. [Record in progress].
Plasma exchange therapy for the post COVID-19 condition: a phase II, double-blind, placebo-controlled, randomized trial.
España-Cueto, S., et al. (2025). Nature Communications.
Facilitators of and barriers to blood donation among voluntary non-remunerated blood donors in sub-Saharan Africa: a scoping review.
Gondwe, A., et al. (2025). Vox Sanguinis. [Record in progress].
Early, very high-titre convalescent plasma therapy in clinically vulnerable individuals with mild COVID-19: an international, randomised, open-label trial.
Hoffmann, S., et al. (2025). EBioMedicine.
Effect of fresh whole blood donation on human performance in United States Special Forces.
Houser, A.P., et al. (2025). Journal of Special Operations Medicine.
Implementation strategies for WHO guidelines to prevent, detect, and treat postpartum hemorrhage.
Semrau, K., et al. (2025). The Cochrane Database of Systematic Reviews.
Red blood cell transfusion management for people undergoing cardiac surgery for congenital heart disease.
Wilkinson, K.L., et al. (2025). The Cochrane Database of Systematic Reviews.
14 April 2025 (Monday) - Resource Management
Here’s
something interesting which appeared on the Facebook “Blood Bank Professionals”
group. Although it is aimed at service users, it rather highlights the point
that someone needs to keep track of a very valuable and limited resource –
blood products.
How many times have we been asked to provide platelets or FFP only to find that what was needed was “just in case” rather than for actual and immediate use? How many times have we told junior medics that sometimes we use a dozen units of platelets in a day and sometimes none, and with a limited supply and short shelf-life the things aren’t stored locally but at a transfusion centre some way away.
Having found this page, I’m hoping that the parent website will prove to
be a source of useful CPD.
Will it? Time will tell – it always does.
How many times have we been asked to provide platelets or FFP only to find that what was needed was “just in case” rather than for actual and immediate use? How many times have we told junior medics that sometimes we use a dozen units of platelets in a day and sometimes none, and with a limited supply and short shelf-life the things aren’t stored locally but at a transfusion centre some way away.
Will it? Time will tell – it always does.
13 April 2025 (Sunday) - Slide Saturday Challenge
Gaucher cells… I won’t lie. I’d never
heard of them. There are those that would blag, but I’m seeing this as a result.
CPD in action. After forty-odd years in this game I’ve learned something. Which
is why I’m so keen on CPD.
While primarily found in the bone
marrow, Gaucher cells can also be observed in the peripheral blood,
particularly in individuals with Gaucher disease. These cells are macrophages
that have accumulated glucocerebroside, a fatty substance, due to a deficiency
of the enzyme acid-β-glucosidase.
They are Gaucher cells in blood smears
are typically large, with a small, eccentric nucleus and abundant cytoplasm
that may appear fibrillar or "onionskin".
While bone marrow aspirates are often
used for diagnosis, the presence of Gaucher cells in peripheral blood, along
with clinical symptoms and enzyme assays, can aid in diagnosis.
It's important to note that Gaucher-like
or "pseudo-Gaucher" cells can also be seen in other
conditions, such as thalassemia, leukemias, and lymphomas, making accurate
diagnosis crucial.
Measuring acid-β-glucosidase activity (beta-glucosidase
leukocyte test) is a key diagnostic tool, as reduced or absent enzyme
activity is characteristic of Gaucher disease.
In short, Gaucher cells in peripheral blood can
be indicative of Gaucher disease, but their presence should be evaluated in
conjunction with clinical presentation, bone marrow findings, and enzyme assays
to distinguish them from pseudo-Gaucher cells seen in other conditions.
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