Journal du sang et de la lymphe

Hepatitis B Virus (HBV) infection is one of the leading causes of death worldwide. The most important marker for HBV infection is Hepatitis B Surface Antigen (HBSAg). HBSAg rapid screening test methods are the most popular methods used in most developing countries even though the Enzyme-Linked Immunosorbent Assay (ELISA) and Nucleic Acid Testing methods are considered as more reliable methods worldwide. The aim of this study was to compare the analytical sensitivity of a rapid kit and ELISA method in the detection of HBV infection among blood donors. One hundred (100) blood donor samples which tested negative with Rapid screening test kit were re- tested using ELISA method. Out of 100 rapid test negative blood donor samples tested, 9 (9%) tested positive with ELISA method. Thirty blood samples which tested positive with rapid screening test kit were also re-tested using ELISA method. All 30 samples (100%) tested positive with ELISA method. This study shows that the rapid screening test kits are inferior and are associated with more false negatives compared to the ELISA technique. There is need for the Nigerian Government to develop a safe blood donor screening strategy for HBV by combining the use of the less sensitive rapid screening techniques with the more sensitive ELISA and NAT screening method to ensure the safety of blood donation in the country and to limit the risk of transfusion-transmissible hepatitis B infection.

A 69-year-old man presented with severe pain in hands and feet related to necrosis. Extensive explorations revealed type I cyroglobulinemia associated to monoclonal IgG kappa. Unfortunately he died a few months after.

Introduction: Hypocalcemia is a potentially life-threatening biochemical disorder often misdiagnosed and mistreated.

Case report: A case of a female patient with unilateral visual acuity drop, significant neurological and cardiologic problems caused by severe hypocalcemia is presented. Supplementation therapy led to withdrawal of neurological symptoms, improvement of the heart function and stabilization of the left eye visual acuity. Right eye visual acuity was excellent with occasional drops correlating to low serum calcium level.

Discussion: Physicians should be aware of hypocalcemia because time between the onset of symptoms and diagnosis averages ten years and adequate treatment can prevent severe eye, heart and neurological complications. Hopefully, this case would be instructive for future medical practice, especially for recognition and treatment of the extremely rare case of unilateral hypocalcemia-induced optic neuritis.

Background: In patients with venous thromboembolism (VTE), assessment of the risk of recurrent VTE and major bleeding may help to guide intensity and duration of anticoagulant therapy. Methods: We used the Registro Informatizado de Enfermedad Tromboemb?lica (RIETE) to identify predictors of poor adherence to guidelines in patients with- and without cancer, and to assess the rate and severity of VTE recurrences and major bleeding during the course of anticoagulation in Italian patients with deep vein thrombosis (DVT). Results: A total of 3541 patients with objectively diagnosed VTE were enrolled in Italy, of whom 1832 (52%) initially presented DVT. Of these, 409 (22%) patients had already known cancer at baseline. In all, 32% of patients with cancer and 74% of those without cancer received long-term therapy with vitamin K antagonists, 55% and 19% respectively received long-term therapy with low-molecular-weight heparin, and 11% and 5.3% respectively received long-term therapy with Fondaparinux. During the 3-month study period, DVT patients with cancer experienced an increased rate of DVT recurrences (odds ratio: 3.1; 95% CI: 1.2-8.2), major bleeding episodes (odds ratio: 4.3; 95% CI: 2.2-8.4), all-cause death (odds ratio: 11; 95% CI: 6.7-19), and fatal bleeding (odds ratio: 11; 95% CI: 1.1-101), compared with those without cancer. Interestingly, the rate of major bleeding events outweighed the rate of VTE recurrences, both in patients with cancer (19 major bleeds vs. 4 PE recurrences and 8 DVT recurrences) and in those without cancer (16 major bleeds vs. 5 PE recurrences and 9 DVT recurrences). Conclusions: In real life, adherence of VTE therapy to guidelines is poor. During the course of anticoagulation, the rate of major bleeding events exceeded the rate of VTE recurrences.

Oxidants play an important role in homeostatic function, but excessive oxidant generation has an adverse effect on health. The manipulation of Reactive Oxygen Species (ROS) can have a beneficial effect on various lung pathologies. However indiscriminate uses of anti-oxidant strategies have not demonstrated any consistent benefit and may be harmful. Here we propose that nuanced strategies are needed to modulate the oxidant system to obtain a beneficial result in the lung diseases such as Acute Lung Injury (ALI) and Chronic Obstructive Pulmonary Disease (COPD). We identify novel areas of lung oxidant responses that may yield fruitful therapies in the future.