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Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Haematology is the study of blood and the diseases that affect it. It covers a broad spectrum of conditions from inherited disorders such as the haemoglobinopathy to aggressive malignancies such as acute leukaemia. Haematologists are heavily involved in the diagnostic process and in many countries have dual qualifications in clinical medicine and pathological sciences. With the advent of the ‘genomic era’, haematology has made huge strides forward in our understanding of disease processes and new therapeutic approaches. Haematology can seem impossibly complicated initially, but a basic understanding of how blood and its different components (cells and molecules) function and interact will give any inquisitive student the keys to a fascinating, varied specialty that is at the cutting edge of modern medicine and advanced therapeutics including gene therapy.
Pyrexia Two Weeks after an Attack of Alcohol-Induced Acute Pancreatitis
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Routine bloods were sent on readmission and this confirmed that serum lipase was elevated at > 4× upper limit of normal, now two weeks after initial admission. He also had a blood alcohol level of 280 mg/dL. Hematology revealed a hemoglobin of 132 g/L, total white blood count of 15.2 × 10-9/L, and a platelet count of 224 × 10-9/L. The hematocrit was 0.45. Electrolytes were normal but his renal function was impaired, with a blood urea nitrogen of 11 mmol/L (Normal range = 2.5–7.1). Liver function tests were normal other than a mildly elevated gamma glutamyl transferase. Random blood glucose was 11.2 mmol/L. An arterial blood gas confirmed hypoxemia and respiratory acidosis (pH 7.32, bicarbonate 30 mEq/L, partial pressure of carbon dioxide of 49 mmHg).
HIV and AIDS
Published in Rae-Ellen W. Kavey, Allison B. Kavey, Viral Pandemics, 2020
Rae-Ellen W. Kavey, Allison B. Kavey
In retrospect, these were extremely conservative recommendations given the gravity of the situation: since 1979, the number of patients diagnosed by the strict CDC definition had doubled every 6 months. Approximately 50 new cases of AIDS were being registered each week by the CDC and more than 2000 cases had been reported by the end of 1983. Despite this exponential increase, abstinence was the only recommendation for individuals “known or suspected to have AIDS” as was “awareness that multiple sexual partners increased the probability of developing AIDS”; there was no mention of condoms. Individuals from groups at increased risk for AIDS – not named – were asked to not donate blood and blood banks were taxed with communicating this message, but there was no recommendation for blood donation centers to question potential donors themselves. With no public education program, it was unclear how this information would reach the groups that needed it. Development of AIDS screening tests was recommended – who could disagree with that? – and doctors were asked to limit blood transfusions as much as possible; patients were encouraged to donate their own blood prior to surgical procedures with infusion of the donated blood as needed. Hemophiliacs were referred to hematology recommendations developed specifically for them.87 There was a strong sense of handwringing with no practical, evidence-based guidelines for prevention.
Building the foundation for a community-generated national research blueprint for inherited bleeding disorders: research priorities for mucocutaneous bleeding disorders
Published in Expert Review of Hematology, 2023
Robert F. Sidonio, Jr, Paulette C. Bryant, Jorge Di Paola, Sarah Hale, Meadow Heiman, G Shellye Horowitz, Christi Humphrey, Julie Jaffray, Lora C. Joyner, Raj Kasthuri, Barbara A. Konkle, Peter A. Kouides, Robert Montgomery, Keith Neeves, Anna M. Randi, Nikole Scappe, Cristina Tarango, Kelly Tickle, Pamela Trapane, Michael Wang, Brittany Waters, Veronica H. Flood
The mission of the NHF, the largest US patient advocacy organization serving people with inheritable blood disorders, is to find cures and to address and prevent the complications of these disorders through research, education, and advocacy enabling people and families to thrive [69]. NHF recognizes that this vision starts with research and that the people who live with these disorders are true lived experience experts (LEE) with unique and valuable expertise [70,71]. In 2014 NHF brought together VWD LEEs and research, care, policy, clinician, payer, industry, and federal agency stakeholders. This VWD Summit prioritized raising awareness, improving access to care, the development of evidence-based clinical practice guidelines, and a recommitment to collaborative efforts to improve VWD research [72]. In 2021, the American Society of Hematology (ASH), International Society on Thrombosis and Haemostasis (ISTH), NHF, and World Federation of Hemophilia (WFH) World Federation of Hemophilia (WFH) developed clinical guidelines on the diagnosis and management of VWD [45,73]. This precedent-setting extensive international collaboration was motivated by the joint LEE-clinician identified need; the clinical questions it addressed were prioritized through a trilingual stakeholder survey with equal proportions of LEE and HCP respondents [74], and approximately one quarter of the expert guideline development panel members were LEEs [75]. The valuable contributions of LEEs to all aspects of the evidence base are increasingly being recognized and capitalized upon.
Biochemical and histopathological analysis after sub-chronic administration of oxyresveratrol in Wistar rats
Published in Drug and Chemical Toxicology, 2023
Nisat Alam, Hasina Najnin, Maidul Islam, Sonam Shakya, Ishaat M. Khan, Rana Zaidi
After overnight fasting, animals were anesthetized with ketamine (75 mg/kg B.W. i.p.) and xylazine (10 mg/kg B.W. i.p.) followed by collection of blood from retro-orbital plexus. EDTA-coated tubes were used for hematological analysis. Red blood cells (RBC), hemoglobin (Hb), hematocrit (HCT), total and differential counts of white blood cells (WBC), platelets (PLT) were assayed on the automatic hematology analyzer (Sysmex Xn350, Germany). Commercially available glucometer and strips (Accu-chek, India) were used for blood glucose (GLU) estimation. Blood was collected in tubes without anticoagulant for other biochemical estimations and allowed to clot before centrifugation (4000 rpm for 10 min), to obtain the serum. Urea (UREA), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (CHOL), creatinine (CRE), triglycerides (TG), alkaline phosphatase (ALP), and total protein (TP) assessment were performed using Estimation kits (Agappe Company, India). Levels of serum Na+ and K+ were measured with an automatic electrolyte analyzer (Smartlyte Electrolyte Analyzer, U.S.A.).
Endocarditis-associated rapidly progressive glomerulonephritis mimicking vasculitis: a diagnostic and treatment challenge
Published in Annals of Medicine, 2022
Sanxi Ai, Jianzhou Liu, Guotao Ma, Wenling Ye, Rongrong Hu, Shangzhu Zhang, Xiaohong Fan, Bingyan Liu, Qi Miao, Yan Qin, Xuemei Li
On review of laboratory studies, abnormalities in haematology were common, including anaemia (100%, 24/24), thrombocytopenia (58%, 14/24) and pancytopenia (13%, 3/24) (Table 1). Various markers usually seen in autoimmune diseases were detected with high frequency (Table 2). ANCA was positive in 45% (10/22) of patients, predominantly proteinase 3 (PR3)-ANCA. The titres of PR3-ANCA ranged from 35 to 819 RU/ml with a median titre of 138 RU/ml (reference range <20 RU/ml in our centre). Six patients showed high titres of PR3-ANCA (>100 RU/ml). One patient (case 9) showed dual positivity for PR3-ANCA (>200 RU/ml) and myeloperoxidase (MPO)-ANCA (34 RU/ml). Anti-nuclear antibody was positive in 54% (13/24) of patients, while only one patient showed positive anti-double strand DNA. Hypocomplementemia and elevated rheumatoid factor were presented in 87% (20/23) and 90% (18/20) of patients, respectively.