PubMed · 16600658
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P Rouger. 2006-04-04. [Formation-information].. https://doi.org/10.1016/j.tracli.2006.03.012
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Thalassemia intermedia encompasses a wide clinical spectrum of beta-thalassemia phenotypes. Some thalassemia intermedia patients are asymptomatic until adult life, whereas others are symptomatic from as young as 2 years of age. A number of clinical complications commonly associated with thalassemia intermedia are rarely seen in thalassemia major, including extramedullary hematopoiesis, leg ulcers, gallstones and thrombophilia. Prevention of these complications, possibly with blood transfusion therapy, is ideal since they may be difficult to manage. Currently, many patients with thalassemia intermedia receive only occasional or no transfusions, since they are able to maintain hemoglobin levels between 7-9 g/dl; the risk of iron overload, necessitating adequate chelation therapy, is also a contributing factor. At present, there are no clear guidelines for initiating and maintaining transfusions in thalassemia intermedia for the prevention or treatment of complications. Here, we review the major clinical complications in thalassemia intermedia and suggest some therapeutic strategies based on retrospective clinical observations.
A Consensus Conference was convened by the Italian National Institute of Health on May 5-6, 2005, to address the issue of the screening for hepatitis C virus infection in adults in Italy. It was concluded that a mass screening for hepatitis C virus infection is inappropriate. It was recommended that the following high-risk groups be tested for hepatitis C virus infection, particularly if they are potentially eligible for antiviral treatment: subjects with history of intravenous drug use; haemodialysis patients; subjects who received blood coagulation factors before 1987; subjects who received blood transfusions or organ transplantation before 1992; households of hepatitis C virus-infected individuals; subjects with multiple sexual partners which have or have had a sexually transmitted disease. A screening for hepatitis C virus infection was considered unjustified for persons who are scheduled for an invasive procedure (e.g. surgery, endoscopy) and during pregnancy.
BACKGROUND: Blood and blood products are scarce in developing countries due to increasing demand and declining supply. Rational utilization of blood products is imperative and prompted this study, which identifies the risk factors for blood transfusion during C-sections in a tertiary hospital in Nigeria. MATERIAL/METHODS: This retrospective case-controlled study reviewed all C-sections in our hospital from January 1, 1998, to December 31, 2002. Clinical variables including demographic characteristics, surgical events, EBL, indication for transfusion, and the number of units transfused were recorded. RESULTS: A total of 1117 cesarean sections were performed within the study period. Sixty-three patients (5.6%) received blood transfusions. An unbooked patient was six times more likely to receive a blood transfusion during cesarean section than women who had had antenatal care (p<0.001). Grand-multiparous women were associated with intraoperative transfusion during cesarean section (p=0.004). Placental previa was significantly associated with transfusion during cesarean section (p=0.0002). Previous cesarean section was an associated factor for intraoperative transfusion at cesarean section (p=0.02). CONCLUSIONS: The factors associated with transfusion at cesarean section were lack of prenatal care, grand multiparity, previous cesarean section, and pregnancies complicated by placenta previa. These factors should be considered in the care of parturients for cesarean section, especially in developing countries.