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Indian Pediatrics Jan 2023
Topics: Humans; Infant; Rh Isoimmunization; Iron Overload
PubMed: 36639977
DOI: No ID Found -
Clinical Medicine Insights. Pediatrics 2023Rh incompatibility has been an important cause of severe neonatal hyperbilirubinemia, hydrops fetalis, and stillbirth. Among those outcomes, neonatal jaundice is the...
BACKGROUND
Rh incompatibility has been an important cause of severe neonatal hyperbilirubinemia, hydrops fetalis, and stillbirth. Among those outcomes, neonatal jaundice is the most common problem.
OBJECTIVE
The study is assessed the prevalence of Rhesus (Rh) negativity and neonatal outcomes among pregnant women who delivered at Bule Hora University Teaching Hospital over a 5-year period from January 2017 to December 31, 2022.
METHODS
A retrospective study was conducted on 110 women who delivered at Bule Hora University Teaching Hospital (BHUTH) from January 2017 to December 31, 2021. The complete data of the mother's and neonates' status were extracted from the registration book of the hospital using checklists. The data were double entered using EpiData version 3 and exported to the Statistical Package for Social Sciences (SPSS) version 26 for analysis. Descriptive statistics to determine prevalence and frequencies were used to describe the study population in relation to relevant variables, and the results are presented in tables and charts.
RESULTS
The study shows that the prevalence of Rh D-negative among women who delivered was 6.4% [95% CI: 1.83,10.98]. Among Rh-negative women, 1 (25%) of blood group AB, 3 (6.5%) of blood group O, and 2 (6.1%) of blood group A were Rh-D negative. The distributions of O, A, B, and AB blood groups among pregnant women who delivered this hospital were 41.8%, 30%, 24.6%, and 3.6%, respectively. Out of neonates born to Rh-negative women, 1 (14.3%) was born with jaundice. Of women who delivered at BHUT hospital, 61 (55.5%) did not have a previous delivery, 7 (6.4%) had a previous abortion, 5 (4.5%) stillbirth, 1 (0.9) died after birth, 4 (3.6%) had a birth child weight less than 2.6 kg.
CONCLUSION
The study revealed that the prevalence of Rh-negative was comparable with finding of different similar studies. To reduce Rh incompatibility-related HDN, the government should educate mothers and encourage them as they follow ANC facilities and after delivery to health facilities.
PubMed: 36632148
DOI: 10.1177/11795565221145598 -
Journal of Veterinary Internal Medicine Jan 2023
Topics: Animals; Blood Grouping and Crossmatching; Blood Group Incompatibility; Anemia, Hemolytic, Autoimmune; Agglutination
PubMed: 36598027
DOI: 10.1111/jvim.16626 -
Laryngoscope Investigative... Dec 2022Cochlear implant (CI) infection is the most common complication after CI surgery. We investigated whether the preoperative neutrophil-lymphocyte ratio (NLR) and...
OBJECTIVES
Cochlear implant (CI) infection is the most common complication after CI surgery. We investigated whether the preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) values could predict the CI infection and the NLR and PLR values obtained at the first admission to the hospital with an CI infection could help the clinician in the diagnosis.
METHODS
This retrospective case-controlled study included 26 patients with postsurgical CI infection. To prevent age-related incompatibility in the blood analysis of the infected group, the patients were divided into three age groups: 0-4 years, 5-18 years, and over 18 years old. To compare the infected group, 29 patients who did not have implant infection after CI surgery and whose age ranges were compatible with the infected group were randomly selected from the hospital records as the control group. The infected group preimplantation (PREs) and postinfection (POSTi) NLR and PLR values were compared with each other and the control group values. The area under the curve, sensitivity, specificity, and cutoff values were calculated by ROC analysis.
RESULTS
The POSTi NLR values of the infected group patients aged 0-4 years and over 18 years were significantly greater than the PREs NLR values ( = .038 and = .008, respectively). Significant differences were found between the POSTi NLR values of the infected group patients aged 0-4 years and over 18 years and those of PREs in the control group ( = .011 and = .015, respectively).
CONCLUSIONS
Preoperative NLR and PLR values cannot predict postoperative CI infection. However, NLR and PLR values increased significantly after CI infection, even if systemic symptoms did not occur. At the first admission to the hospital, NLR values can guide the clinician in diagnosing the CI infection in patients between 0 and 4 years and over 18 years.Trial Registration Clinical Trials.gov Identifier: .
PubMed: 36544965
DOI: 10.1002/lio2.900 -
Turkish Journal of Haematology :... Feb 2023Acute hemolytic transfusion reactions (AHTRs) are feared complications of packed red blood cell (PRBC) transfusions. This study aimed to investigate the clinical...
Acute hemolytic transfusion reactions (AHTRs) are feared complications of packed red blood cell (PRBC) transfusions. This study aimed to investigate the clinical consequences of isolated enzyme-phase crossmatch-incompatible PRBC transfusions by clinically observing all events during the study period at a single institution with the primary goal of detecting AHTRs. Ninety-four transfusions of interest were administered during the study period. Laboratory investigations were adequate in 73 episodes, where no AHTR developed and a mean hemoglobin concentration rise of 1.1 g/dL was documented. Three transfusions were terminated prematurely; however, further investigations ruled out AHTR. The remaining 21 transfusions were also completed uneventfully without noteworthy clinical deterioration. This study’s results provide clinical validation to omit pretransfusion screening with enzyme-phase crossmatch and document the safety and short-term efficacy of isolated enzyme-phase incompatible transfusions. The findings may encourage future clinical research to better understand the long-term efficacy of such transfusions, which may be valuable for transfusion-dependent patients.
Topics: Humans; Erythrocyte Transfusion; Cross-Sectional Studies; Blood Transfusion; Blood Grouping and Crossmatching; Blood Group Incompatibility; Transfusion Reaction
PubMed: 36510383
DOI: 10.4274/tjh.galenos.2022.2022.0284 -
Journal of Clinical Medicine Nov 2022(1) Background: ABO blood group incompatibility between the mother and fetus protects against anti-D immunization by pregnancy. The possible role of ABO incompatibility...
(1) Background: ABO blood group incompatibility between the mother and fetus protects against anti-D immunization by pregnancy. The possible role of ABO incompatibility in protecting against anti-human platelet antigen-1a immunization is unclear. (2) Methods: This study retrospectively screened 817 families (mother-father-neonate trios) of suspected fetal and neonatal alloimmune thrombocytopenia for inclusion. ABO genotypes were determined in 118 mother-child pairs with confirmed alloimmune thrombocytopenia due to anti-HPA-1a antibodies, and 522 mother-child pairs served as the control group. The expression of blood group antigen A on platelets was determined in 199 consecutive newborns by flow cytometry and compared with adult controls. (3) Results: ABO incompatibility between mother and fetus did not protect against anti-human platelet antigen-1a immunization by pregnancy. ABO blood groups of mothers and/or fetuses were not associated with the severity of fetal and neonatal alloimmune thrombocytopenia. The expression pattern of blood group A antigens on the platelets of newborns mirrored that of adults, albeit on a lower level. Blood group A antigen was detected on a subpopulation of neonatal platelets, and some newborns revealed high platelet expression of A determinants on all platelets (type II high-expressers). (4) Conclusion: The lack of a protective effect of ABO incompatibility between mother and fetus against anti-human platelet antigen-1a immunization by pregnancy may indicate that fetal platelets are not the cellular source by which the mother is immunized.
PubMed: 36431288
DOI: 10.3390/jcm11226811 -
Cureus Oct 2022Background The immunoglobulin G of mothers with O blood type may sensitize the platelets of their neonates with A (O-A incompatibility) or B (O-B incompatibility) blood...
Background The immunoglobulin G of mothers with O blood type may sensitize the platelets of their neonates with A (O-A incompatibility) or B (O-B incompatibility) blood type. As the expression and antigenicity of the B antigen on platelets is less than that of the A antigens, we have hypothesized that platelet count is higher in the O-B incompatibility group compared to the O-A incompatibility group. There is controversy about whether glucose-6-phosphate dehydrogenase (G6PD) deficiency, without evidence of hemolysis, is associated with a lower platelet count than G6PD-normal. Aim To assess whether platelet count is higher in the O-B than in the O-A incompatible neonates and whether it correlates with their G6PD levels. Methods This study was a retrospective cohort study on a sample of 835 healthy neonates born at ≥38 weeks gestation who were either A or B blood types with mothers that carried the blood type O Rh-positive. The platelet count (thousand per microliter) from umbilical cord venous blood (UCVB) was used. A G6PD level of 11.0 units/gram of hemoglobin (U/g Hb) was considered the lower reference limit. G6PD deficiency was defined as a G6PD level of <3.3 U/g Hb in both sexes. Intermediate G6PD deficiency in females was described as a G6PD level of 3.3-8.8 U/g Hb. Results The mean UCVB platelet count was higher in female neonates compared to male neonates (n=389, 283±65 versus n=446, 272±73, p=0.01). The mean UCVB platelet count was higher in the O-B incompatibility group in both male (n=114, 291±82 versus n=103, 266±63) and female neonates (n=83, 303±66 versus n=81, 278±58) with G6PD levels of >8.8 U/g Hb. There was a positive weak correlation between UCVB platelet counts and G6PD levels only in O-B incompatible female neonates (n=176, r=0.23, p=0.002). The partitioning and combined 95% reference intervals (RIs) of the UCVB platelet count were presented. Conclusion The platelet count was higher in the O-B incompatibility group compared to the O-A incompatibility group, but only when the G6PD level was >8.8 U/g Hb. A correlation between UCVB platelet count and G6PD levels was found only among O-B incompatible female neonates. These findings may have an important implication in estimating RIs of the UCVB platelet count, however, they need to be confirmed and explored in future research.
PubMed: 36407223
DOI: 10.7759/cureus.30284 -
Journal of Family Medicine and Primary... Jul 2022Perinatal asphyxia affects different organs of body depending upon the severity of hypoxemia and ischemia. This study was carried out to evaluate severity of...
OBJECTIVE
Perinatal asphyxia affects different organs of body depending upon the severity of hypoxemia and ischemia. This study was carried out to evaluate severity of hyperbilirubinemia in relation to severity of asphyxia.
STUDY DESIGN
A case-control study.
METHODOLOGY
Asphyxiated newborns with Apgar score ≤7 at 1 min. and categorized as severe birth asphyxia according to the WHO classification of diseases (ICD10) were matched with controls without birth asphyxia. All babies were examined twice daily for dermal icterus until start of phototherapy. Babies with congenital heart disease, sepsis, cephalohematoma, blood group incompatibility were excluded. Arterial blood gas analysis was done along with serial TSB measurement as per standard guidelines.
RESULTS
50 cases and 50 matched controls were enrolled. The average birth weight and gestation in cases was 2427 ± 30.05 g and 35.9 ± 2.5 weeks and among control it was 2633 ± 378.62 g and 37.76 ± 0.116 weeks. Among cases, onset of jaundice was 56.64 ± 20.43 h compared to 63.36 ± 23 h in control group. In the cases, the average pH was 7.31 ± 0.06, CO was 41.52 ± 84, O was 94.98 ± 14.83, and HCO was 18.56 ± 2.04. The rise and peak of serum bilirubin differed between the case and control groups; in the cases, the peak occurred at the 22 h of life, then plateaued from the 40 to the 78 hour of life, and ultimately fell at the 96 hour of life. In comparison, the rise and peak of serum bilirubin occurred comparatively late in the control group. The rise and peak in the control group occurred at the 80 and 96 h of life, respectively. The multiple linear regression analysis showed CRP, Apgar at 5 min. below 7 and male gender significantly affects the rise of serum bilirubin ( < 0.05).
CONCLUSION
The peak serum bilirubin in asphyxiated newborns occurs earlier, and plateau for longer duration compared to normal newborns. Low Apgar at 5 min. has significant correlation to earlier rise of bilirubin.
PubMed: 36387686
DOI: 10.4103/jfmpc.jfmpc_1018_21 -
Revista Medica Del Instituto Mexicano... Jan 2023Hematopoietic stem cell transplants (HSCT) can be performed regardless of the ABO group compatibility between donor and recipient. ABO incompatibility in HSCT is related... (Observational Study)
Observational Study
BACKGROUND
Hematopoietic stem cell transplants (HSCT) can be performed regardless of the ABO group compatibility between donor and recipient. ABO incompatibility in HSCT is related to pure red cell aplasia (PRCA), or passenger lymphocyte syndrome. The impact of ABO incompatibility on graft-versus-host disease and transplant-related mortality is controversial due to the heterogeneity of procedures carried out in different transplant centers.
OBJECTIVE
To determine the prevalence of ABO incompatibility and its complications in a hematopoietic stem transplant unit.
MATERIAL AND METHODS
An observational, retrospective study was carried out in patients undergoing HSCT from January 2014 to January 2020. All trasplant patients were included. Qualitative variables were analyzed using chi-squared test, and Wilcoxon and Student's t tests were used for quantitative variables. A p < 0.05 was considered significant.
RESULTS
124 patients undergoing HSCT were analyzed, out of which 31 had ABO incompatibility, with a punctual prevalence of 24.4%; among them, 54% presented with major incompatibility, 32% minor incompatibility and 13% bidirectional incompatibility. Three cases of PRCA were reported. There were no differences in survival at one year in both groups.
CONCLUSIONS
The ABO incompatibility ant its complications were not related to the increase in mortality. Randomized prospective studies are required to define the role of ABO incompatibility in HSCT prognosis.
Topics: Humans; Blood Group Incompatibility; Transplantation, Homologous; Retrospective Studies; Hematopoietic Stem Cell Transplantation; ABO Blood-Group System; Red-Cell Aplasia, Pure
PubMed: 36378017
DOI: No ID Found -
Canadian Journal of Kidney Health and... 2022Living kidney donation is considered generally safe in healthy individuals; however, there is a need to better understand the long-term effects of donation on blood...
BACKGROUND
Living kidney donation is considered generally safe in healthy individuals; however, there is a need to better understand the long-term effects of donation on blood pressure and kidney function.
OBJECTIVES
To determine the risk of hypertension in healthy, normotensive adults who donate a kidney compared with healthy, normotensive non-donors with similar indicators of baseline health. We will also compare the 2 groups on the rate of decline in kidney function, the risk of albuminuria, and changes in health-related quality of life.
DESIGN PARTICIPANTS AND SETTING
Prospective cohort study of 1042 living kidney donors recruited before surgery from 17 transplant centers (12 in Canada and 5 in Australia) between 2004 and 2014. Non-donor participants (n = 396) included relatives or friends of the donor, or donor candidates who were ineligible to donate due to blood group or cross-match incompatibility. Follow-up will continue until 2021, and the main analysis will be performed in 2022. The anticipated median (25th, 75th percentile, maximum) follow-up time after donation is 7 years (6, 8, 15).
MEASUREMENTS
Donors and non-donors completed the same schedule of measurements at baseline and follow-up (non-donors were assigned a simulated nephrectomy date). Annual measurements were obtained for blood pressure, estimated glomerular filtration rate (eGFR), albuminuria, patient-reported health-related quality of life, and general health.
OUTCOMES
Incident hypertension (a systolic/diastolic blood pressure ≥ 140/90 mm Hg or receipt of anti-hypertensive medication) will be adjudicated by a physician blinded to the participant's donation status. We will assess the rate of change in eGFR starting from 12 months after the nephrectomy date and the proportion who develop an albumin-to-creatinine ratio ≥3 mg/mmol (≥30 mg/g) in follow-up. Health-related quality of life will be assessed using the 36-item RAND health survey and the Beck Anxiety and Depression inventories.
LIMITATIONS
Donation-attributable hypertension may not manifest until decades after donation.
CONCLUSION
This prospective cohort study will estimate the attributable risk of hypertension and other health outcomes after living kidney donation.
PubMed: 36325263
DOI: 10.1177/20543581221129442