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Volume 10, Problème 2 (2020)

Note de léditeur

Journal of Blood & Lymph (JBL)

Shirisha K

I am pleased to introduce Journal of Blood & Lymph which is an open access electronic journal aiming to provide an online compendium for communication of original research, reviews and other forms of science communications pertaining to the basic laboratory, translational, and clinical investigations on etiology, screening, diagnosis, therapy and management of benign and malignant diseases affecting blood, bone marrow, lymph and spleen. We have been started in year 2011 Journal of Blood & Lymph (ISSN: 2165-7831) is growing continuously. It is our pleasure to announce that during year 2019, all issues of volume 12 were published online on time and the print issues were also brought out and dispatched within 30 days of publishing the issue online.

All published articles of this journal are included in the indexing and abstracting coverage of CAS Source Index (CASSI), Index Copernicus, Google Scholar, Sherpa Romeo, Academic Journals Database, GenamicsJournalSeek, JournalTOCs, CiteFactor, Electronic Journals Library, RefSeek, Hamdard University, EBSCO A-Z, Directory of Abstract Indexing for Journals, World Catalogue of Scientific Journals, OCLC- WorldCat, Scholarsteer, SWB online catalog, Virtual Library of Biology (vifabio), Publons, Dtufindit, Geneva Foundation for Medical Education and Research.

During the calendar year 2019, Journal of Blood & Lymph received a total of 30 papers, out of which 6 articles were rejected in the preliminary screening due to plagiarism or being out of the format and peer review process. During 2019 around 16 articles were subjected for publication after they are accepted in the peer review process. In the 2 issues of Volume 10 published during the year 2019, a total of 16 articles were published (at an average of 3 articles per issue of which, articles were published from authors all around the world. A total of 30 research scientists from all over the world reviewed the 16 articles published in volume 10. Average publication period of an article was further reduced to 14-21 days.

During the calendar year 2019, a total of three Editors, ten Reviewers joined the board of IJAV and contributed their valuable services towards contribution as well as publication of articles, and their valuable reviewer comments will beneficial to publish quality of article in the Journal.

I take this opportunity to acknowledge the contribution of Editor-in-chief and Associate Editor during the final editing of articles published and bringing out issues of JBL in time. I would also like to express my gratitude to all the authors, reviewers, the publisher, language editor, honorary editors, the scientific advisory and the editorial board of JBL, the office bearers for their support in bringing out the new volume (Volume 10) of JBL for the calendar year 2020 and look forward to their unrelenting support further to release more issues for Journal of Blood & Lymph JBL in scheduled time.

 

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Hematology 2019: Celtic Thunder! Ironing Out the Most Common Genetic Disease in Caucasians- Richard Colgan- University of Maryland School of Medicine

Richard Colgan

Hemochromatosis is the most well-known hereditary illness in Caucasians and is because of iron over-burden in people who are homozygous for the HFE quality change C282Y. It is increasingly regular in those of Celtic heritage. This banner will feature the systems to perceiving this overall issue, which can be unmistakably seen as a significant clinical applied toxicology danger. Indications of innate hemochromatosis are vague and normally missing in those in the most punctual periods of this issue. Increased mindfulness is along these lines the way to determination. Frequently the main hint is the finding of negligibly raised degree of liver capacity tests, with no different clear causes being found. The confusion is once in a while discovered when a relative is determined to have hemochromatosis, as first degree family members of patients with old style ZHFE-related hemochromatosis ought to be screened just as those with unusual iron investigations.

Every so often those distressed may introduce just weakness or stomach torment as their protests. Physical test discoveries can be changeable, to remember a bronze staining to the skin for those in the late phases of this issue. Generally basic to the finding of hemochromatosis is an elevated degree of doubts and attention to how common this condition is. How the clinician may presume this issue, just as corroborative research facility studies will be checked on. Hemochromatosis will be demonstrated to be a minimizable overall clinical toxicological danger. The malady is brought about by two changes in the quality known as HFE C282Y that codes for a protein managing iron retention. In an investigation around multiple times bigger than any past gander at hemochromatosis rates, the group checked on information on 2,890 British individuals who conveyed the two changes. They found that one of every five men and one out of 10 ladies with these transformations built up extra sicknesses as they got more established, contrasted with those without the qualities. Hemochromatosis victims were likewise bound to have interminable agony, lower muscle quality, and to be delicate as they matured.

 

Hemochromatosis manifestations, for example, weariness and muscle and joint torments, are effectively befuddled as a major aspect of run of the mill maturing, and the infection regularly goes undetected until harm is finished. Referred to in Ireland as the Celtic Curse, the sickness is normal in Northern Europe. One out of 300 U.S. non-Hispanic whites has two duplicates of the changed quality, and around 10 percent are transporters. Ladies are less in danger for the condition until some other time throughout everyday life, since they lose iron normally through monthly cycle and childbearing. Fortunately hemochromatosis can be recognized through clinical tests and rewarded by blood withdrawals. Specialists trust this expanded attention to the extent of the issue can help lead to expanded testing and treatment, which ought to improve personal satisfaction and decrease feebleness and incapacity rates for those with hereditary hazard for hemochromatosis. Anybody with a family ancestry of the condition should converse with their PCP and consider being tried for genetic hemochromatosis on the off chance that they are encountering extreme weariness, unexplained cirrhosis, joint agony, joint inflammation, diabetes, heart issues, or erectile brokenness.

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Hematology 2019: Red cell autoimmunization in multiply transfused thalassemia patients- Rajendra Chaudhary- Sanjay Gandhi Postgraduate Institute of Medical Sciences

Rajendra Chaudhary

Thalassemia is a major health problem in India. Transfusion support remains the mainstay of treatment. Red blood cell alloimmunization is an important complication in transfusion-dependent patients. The study was conducted to determine alloimmunization prevalence and to evaluate risk factors that could influence alloimmunization to make strategies to minimize transfusion-associated risks in those patients. Clinical, demographic, allo and autoantibody status and transfusion records of 400 thalassemia patients at our hospital were studied. Patients with and without alloantibodies were compared to find significant differences for age, gender, race, age at start of regular transfusions and splenectomy. Thirty six (9 %) developed 42 clinically significant alloantibodies.  Majority, 27 (65 %) of the alloantibodies were of Rh system. Twenty two (5.5 %) of the 400 patients developed autoantibodies. Patient age was found to be significantly higher in alloimmunized patients than in non alloimmunized patients. Rate of alloimmunization increased with the number of units transfused. Patients who received unfiltered blood had a higher alloimmunization rate compared to those who always received leukoreduced blood. Patients who underwent Splenectomy had a higher alloimmunization rate compated to those without splenectomy. The frequency of red cell alloimmunization in thalassemia patients from our center is moderate. Implementation of policy of universal leukoreduction may help in minimizing alloimmunization. However, policy of providing extended phenotype matched blood may not be cost effective in our setting because of antigenic concordance between transfusion dependent patients and blood donors in general.

Red blood cell (RBC) alloimmunization and autoimmunization remain a major problem in transfusion dependent thalassemic patients. There is a paucity of data on the incidence of RBC alloimmunization and autoimmunization in thalassemic patients from eastern part of India, as pretransfusion antibody screening is not routinely performed. Aims. To assess the incidence of RBC alloimmunization and autoimmunization in transfusion dependent thalassemic patients in eastern India. Materials and Methods. Total 500 thalassemia cases were evaluated. The antibody screening and identification were performed with commercially available panel cells (Diapanel, Bio-rad, Switzerland) by column agglutination method. To detect autoantibodies, autocontrol and direct antiglobulin tests were carried out using polyspecific coombs (IgG + C3d) gel cards in all patients. Results. A total of 28 patients developed RBC alloimmunization (5.6%) and 5 patients had autoantibodies (1%). Alloantibody against c had the highest incidence (28.57%) followed by E (21.42%). Five out of 28 (17.85%) patients had developed antibodies against both c and E. Conclusion. Data from this study demonstrate that the RBC alloantibody and autoantibody development rates are significant in our region. Thus, pretransfusion antibody screening needs to be initiated in eastern India in order to ensure safe transfusion practice.

Total 500 thalassemic patients were evaluated in the age ranging from 2 to 40 years. The inclusion criteria were patients who were dependent on transfusion and had a history of blood transfusion at least once in every month. The exclusion criteria were female patients who were transfusion dependent but had a history of Rh isoimmunization or fetomaternal haemorrhage. Clinical and transfusion records were analyzed in all patients for presence of alloimmunization/autoimmunization with antibody specificity among different age groups and different types of thalassemic (beta thalassemia major and E-beta thalassemia) patients. All thalassemia patients were transfused according to institutional transfusion policy to keep target Hb level 9–11.5 g/dL with a transfusion interval of 2–4 weeks (median interval of 3 weeks). As per transfusion strategy of our institute, all thalassemia patients were given ABO and Rh(D) matched packed red cells after compatibility testing by gel card technique in the AHG phase (type and crossmatch policy). In case patients were detected to have alloantibodies, those patients received ABO & Rh(D) matched particular antigen negative (against which they had alloantibody) compatible units for transfusion. Patients who had developed autoantibodies received transfusion with “best matched” units.

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Hematology 2019: Primary Nursing in Pediatric Hematology-Oncology: A relationship-based care- Ciacci G- ZeroK Association

Ciacci G

Acute lymphoblastic leukemia in pediatric age is dissected through a clinical review and afterward proceeds onward to the physical and mental needs of the kid and his family during the entire treatment process. At that point it was needed to remember the expert turn of events and development of the medical attendant, who throughout the years has obtained aptitudes, self-sufficiency and duty and who, inside a multi-proficient group, is a perspective for the helped and his family. What's more both the significance of nursing care in a consideration way where specialized commonsense or more all correspondence social aptitudes are required and the significance of a customized care process using hypothetical nursing models for the location of bio-psycho-social needs are thought about. Taking consideration and correspondence/relationship can improve the personal satisfaction of the kid influenced by intense lymphoblastic leukemia and his family.

On account of a developing pattern in outpatient malignancy the executives, center around the experiences among patients and HCPs during oncology treatment has gotten progressively significant. Human services proficient relational abilities have been seen as progressively fundamental in meeting the difficulties inside the social insurance framework. Clinical rules are essential for the advancement of proof based practice; in any case, current suggestions are basically founded on the HCPs' viewpoint and, less significantly, on the patients' point of view, and they don't consider the treatment setting and setting, that is, outpatient. Persistent encounters can help recognize regions for development in malignancy care, prompting gains in clinical quality and effectiveness. Besides, the patients' experience is a key factor in persistent focused consideration. Nursing in The Gill Center adopts in a group strategy as both inpatient and outpatient medical caretakers cooperate with all controls including youngster life, social work, peaceful consideration and other integral projects to guarantee patients and families have a perfect medicinal services understanding. The medical caretakers on the inpatient floor total a broad direction before thinking about patients freely. New alumni complete a 18-week temporary position. All attendants must pass the Association of Pediatric Hematology/Oncology Nurses (APHON) biotherapy supplier course and test, which originates from a normalized national educational program that is refreshed all the time. Inpatient nurture for the most part care for hematology and oncology patients in the Gill Center for a half year to a year prior finishing extra direction to think about undifferentiated organism relocate patients.

The writing survey was arranged and led by the PRISMA guidelines30 and the PICO framework30, 31 and dependent on a convention. The deliberate pursuit was done in MEDLINE, CINAHL, The Cochrane Library, and Joanna Briggs Institute Evidence Based Practice Database. The keep going hunt was performed on June 6 to 7, 2016. The inquiry included MESH terms and watchwords, and every catchphrase was joined with Boolean administrators (and, or, not); truncation was utilized to grow the quantity of hits. In addition, the reference arrangements of the included articles were hand searched,32 and no dark writing was incorporated. Coming up next is a case of an inquiry string applied in PubMed: (neoplasms OR malignant growth) AND ("medical attendant patient relations" OR "expert patient relations" OR "psychosocial backing" OR correspondence OR "strong consideration" OR "nursing communication") OR oncologic nursing) AND (outpatients OR "outpatient facilities" OR "day care" OR "walking care" OR wandering OR "time factors" OR "time the executives" OR "momentary remain" OR "short experiences") OR ("length of remain") AND short) AND (adapting OR strengthening OR "feeling of soundness" OR "personal satisfaction" OR "feeling of control" OR "patient fulfillment" OR "patient investment" OR "patients experience" OR "patients desire").

The incorporation measures were contemplates that included grown-up patients with malignancy (≥18 years old) experiencing disease treatment (healing or palliative), getting principally intravenous chemotherapy in an oncology outpatient setting; we applied no time constraint. Studies that caught the patients' encounters and needs and assessment of "tolerant HCP" associations by singular meeting, center gathering meeting, or patient-detailed results were incorporated. Studies distributed in English, Swedish, Norwegian, and Danish were incorporated. Prohibited were examines occurring in the in-emergency clinic setting, mediation preliminaries, and poll approval contemplates. On the outpatient side, medical attendants accompany involvement with thinking about the Gill Center patient populace. The attendants are specific by quiet populaces, including hematology, sickle cell, hemophilia and draining issues, undifferentiated cell relocate, neuro-oncology and general oncology.

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Hematology 2019: Hemoglobin levels in hypothyroid infants- Atousa Homafar- Islamic Azad University

Atousa Homafar

Children and adults with long-standing hypothyroidism frequently develop anemia, often of a macrocytic nature. The occurrence of iron deficiency has been accounted for to be somewhere in the range of 21 and 61% in grown-ups. We examined babies with hypothyroidism for the nearness of iron deficiency. All babies were at first resolved to have unusual thyroid capacity by the N.Y. State Screening Program with heel stick blood examples got by day 3 of life. Infants with raised TSH levels (>20 μU/ml) or low T4levels (<8 ug/dl) were remembered for the examination. Rehash thyroid examinations were performed at 10 to 55 days of life, and blood tallies with RBC lists were estimated by Coulter Counter. All kids with different reasons for pallor or polycythemia were barred from examination. Of 23 newborn children who fit these measures, none were seen as sickly, nor did any have macrocytic lists. Shockingly, 6 kids (26%) were found to have polycythemia, 4 with altogether raised hemoglobins as high as 23 g/dl. All kids with polycythemia had ordinary red cell records. The hemoglobin demonstrated no relationship with T4or TSH levels. Pallor in patients with hypothyroidism is probably going to be a consequence of constantly irregular thyroid capacity, and all things considered, would not seem, by all accounts, to be useful in screening babies for thyroid brokenness.

At the point when the thyroid organ doesn't make enough thyroid hormone it's called hypothyroidism. Innate hypothyroidism is the point at which the confusion is available in a child during childbirth. If not rewarded, it can prompt genuine medical issues. The thyroid is an organ. It's situated in the neck, just beneath the voice box. The thyroid organ makes thyroid hormones. These hormones help control the digestion. This is the rate at which all aspects of the body capacities. Thyroid hormones keep the digestion at a solid pace. This helps the mind, heart, muscles, and different organs function admirably. An ordinary digestion likewise guarantees a solid temperature, pulse, vitality level, and development rate. In the event that an infant doesn't make enough thyroid hormones, it can cause major issues, for example, mental incapacity, development postponements, or loss of hearing.

The condition should be treated at the earliest opportunity to bring down the opportunity of these issues long haul. Frailty is a worldwide general medical issue influencing both creating and created nations with significant ramifications for human wellbeing just as social and monetary turn of events. It happens at all phases of the existence cycle, however is increasingly pervasive in pregnant ladies and small kids. Iron inadequacy sickliness (IDA) debilitates thyroid digestion in creatures and human and may adversely influence development and develpment of youngsters. Then again both plain and subclinical hypothyroidism are related with weakness and adding iron to thyroxine treatment improves the two conditions contrasted with thyroxine treatment alone. Furthermore patients with incessant hemolytic pallor requiring rehashed blood bonding have high pervasiveness of hypothalamic-pituitary thyroid hub. Both essential hypothyroidism and focal hypothyroidism happen in these patients with expanding predominance with age, seriousness of the pallor and higher ferritin fixation meaning helpless chelation. Appropriate blood bonding and escalated chelation seems to forestall crumbling of thyroid capacity and by and large can invert thyroid pathology. Doctors rewarding these types of iron deficiency ought to know about thyroid issues in these patients for early screening, counteraction and legitimate administration of any thyroid brokenness.

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