Epidemiology of enteric virus infections in children living in the Amazon region.

OBJECTIVES: To verify the frequency of viruses causing acute gastroenteritis (AGE) in association with the histo-blood group antigen (HBGA) and Rotarix™ vaccination coverage in children from the Amazon region. DESIGN: Fecal and saliva samples were collected from children with AGE (n = 485) and acute respiratory infection (ARI) (n = 249) clinical symptoms. Rotavirus A (RVA), norovirus, human adenovirus (HAdV), and sapovirus (SaV) were verified in feces by molecular detection. Saliva samples were used for HBGA phenotyping/FUT3 genotyping. Blood group types, clinical aspects and Rotarix™ RVA vaccination data were recorded. RESULTS: Norovirus remained the most prevalently detected cause of AGE (38%, 184/485 and ARI 21.3%, 53/249). High HAdV frequencies were observed in AGE children (28.6%, 139/485) and ARI children (37.3%, 93/249). RVA was the third most prevalent virus causing AGE (22.7%, 110/485 and ARI 19.3%, 48/249) and a low RV1 coverage (61%, 448/734) was verified. The SaV frequencies were lower (7.2%, 35/485 for AGE and 6.8%, 17/249 for ARI). Secretor children were HBGA susceptible to HAdV infection (OR 1.5, 95% CI 1.0-2.3; P = 0.04) but not to RVA, norovirus or SaV infection. CONCLUSIONS: Norovirus could be considered the main etiological agent of AGE. No association was verified for HBGA susceptibility to RVA, norovirus and SaV. Secretor children showed a slight susceptibility to HAdV infection and the Le (a-b-) heterogeneous SNPs on the FUT3 gene.

Blood use and transfusion needs at a large health care system in Washington state during the SARS-CoV-2 pandemic.

BACKGROUND: This report evaluates hospital blood use trends during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, and identifies factors associated with the need for transfusion and risk of death in patients with coronavirus 2019 (COVID-19). METHODS: Overall hospital blood use and medical records of adult patients with COVID-19 were extracted for two institutions. Multivariate logistic regression models were conducted to estimate associations between the outcomes transfusion and mortality and patient factors. RESULTS: Daily blood use decreased compared to pre-COVID-19 levels; the effect was more significant for platelets (29% and 34%) compared to red blood cells (25% and 20%) at the two institutions, respectively. Surgical and oncologic services had a decrease in average daily use of platelets of 52% and 30%, and red blood cells of 39% and 25%, respectively. A total of 128 patients with COVID-19 were hospitalized, and 13 (10%) received at least one transfusion due to anemia secondary to chronic illness (n = 7), recent surgery (n = 3), and extracorporeal membrane oxygenation (n = 3). Lower baseline platelet count and admission to the intensive care unit were associated with increased risk of transfusion. The blood group distribution in patients with COVID-19 was 37% group O, 40% group A, 18% group B, and 5% group AB. Non-type O was not associated with increased risk of mortality. CONCLUSION: The response to the SARS-CoV-2 pandemic included changes in routine hospital operations that allowed for the provision of a sufficient level of care for patients with and without COVID-19. Although blood type may play a role in COVID-19 susceptibility, it did not seem to be associated with patient mortality.

Asymptomatic carriage of Plasmodium falciparum by individuals with variant blood groups and haemoglobin genotypes in southern Ghana.

BACKGROUND: The ABO and the Rhesus blood group systems, as well as various abnormal haemoglobin (Hb) variants (haemoglobinopathies) are known to influence malaria parasite carriage and disease severity in individuals living in malaria endemic areas. This study identified the blood group and Hb variant distribution and Plasmodium falciparum infection status of afebrile individuals living in southern Ghana. METHODS: Afebrile participants were recruited from Obom (358) in the Greater Accra Region and Ewim (100) and Simiw (329) in the Central Region of Ghana. Venous blood (1 ml) was collected into EDTA vacutainer tubes. Three 20 µl drops of blood were used for blood group analysis using the tile method. Another 500 µl aliquot was used for the qualitative sickling test using sodium metabisulphite and haemoglobin electrophoresis. Genomic DNA was extracted from 100 µl of whole blood and used in P. falciparum species-specific PCR. RESULTS: The most abundant blood group and abnormal haemoglobin variant in both sites was blood group O + (47.4%) and HbAS (15.8%). A total of 13 (1.7%) of the participants had full haemoglobinopathies (SS, SC and CC), whilst 196 (25.4%) were carriers (AS and AC). Although there was a significantly higher prevalence of sickling positive participants from the Central Region, genotyping identified a similar prevalence of each of the abnormal haemoglobin genes in both sites. Asymptomatic parasite carriage estimated by PCR was 40.9% in the Central Region and 41.8% in the Greater Accra Region. CONCLUSIONS: Asymptomatic carriage of P. falciparum parasite in the study population was not associated with any particular blood group variant or haemoglobin genotype.

Frecuencias de grupos sanguíneos de interés clínico en donantes y pacientes de Costa Rica / The frequency of blood groups of interest in donors and patients from Costa Rica

Introducción: Los sistemas sanguíneos ABO, Rh y Kell son lo más relevantes desde el punto de vista clínico por su inmunogenicidad y ser los principales causantes de reacciones hemolíticas. Objetivo: Determinar las frecuencias de los grupos sanguíneos ABO y Rh, y la frecuencia del antígeno Kell en pacientes y donantes de Costa Rica. Métodos: Durante el periodo de 2009 al 2018 se obtuvo de las bases de datos de los bancos de sangre de tres hospitales de adultos de Costa Rica, las frecuencias de los grupos sanguíneos ABO, Rh y Kell en muestras de donantes y pacientes. Para contrastar las frecuencias de cada grupo sanguíneo se realizó una prueba de independencia de variables Chi cuadrado, con el 95 por ciento de confianza. Los datos se analizaron con el paquete estadístico SPSS versión 23. Resultados: Las frecuencias de los grupos ABO en las muestras de donantes y pacientes mostraron diferencias pequeñas pero significativas. La frecuencia del fenotipo Rh D negativo fue más alta en pacientes (8,0 por ciento) que en donantes (6,1 por ciento). Se estimaron las frecuencias de los antígenos C (67,8 por ciento), c (80,5 por ciento), E (41,4 por ciento), e (94,4 por ciento) y K (3,1 por ciento) a partir de las muestras de los donantes. Conclusiones: Las estrategias de reclutamiento de donantes de sangre aumentan la frecuencia del fenotipo Rh negativo en donantes con respecto a los pacientes. Las estadísticas recopiladas demuestran un aumento en la frecuencia del grupo O en comparación con los últimos estudios relacionados. Finalmente, los otros antígenos presentaron pocas variaciones en comparación a estudios previos(AU)

Introduction: The ABO, Rh and Kell blood systems are the most relevant from the clinical point of view, due to their immunogenicity and because they are the main causes of hemolytic reactions. Objective: To determine the frequencies of ABO and Rh blood groups, and the frequency of the Kell antigen in patients and donors from Costa Rica. Methods: During the period from 2009 to 2018, the frequencies of ABO, Rh and Kell blood groups in donor and patient samples were obtained from the blood bank databases of three adult hospitals in Costa Rica. To contrast the frequencies of each blood group, a chi-square test of independence of variables was performed, with 95 percent confidence interval. The data were analyzed with the statistical package SPSS version 23. Results: The frequencies of ABO groups in donor and patient samples showed small but significant differences. The frequency of the negative Rh D phenotype was higher in patients (8.0 percent) than in donors (6.1 percent). The frequencies of the antigens C (67.8 percent), c (80.5 percent), E (41.4 percent), e (94.4 percent), and K (3.1 percent) were estimated from donor samples. Conclusions: Blood donor recruitment strategies increase the frequency of negative Rh phenotype in donors compared to patients. The statistics collected demonstrate an increase in the frequency of the O group compared to recent related studies. Finally, the other antigens did not show as much variation compared to previous studies(AU)

Mass-scale red cell genotyping of blood donors: from data visualization to historical antigen labeling and donor recruitment.

Donor red cell genotyping provides efficiencies to identify "in demand" blood donors for transfusion recipients requiring antigen-negative blood. Donor red cell genotype information can be used to label units with historical types and introduced throughout the supply chain from the blood center to the hospital transfusion service and has potential to be used in recruitment strategies.

Detection of Intragraft Anti-Blood Group A and B Antibodies Following Renal Transplantation.

BACKGROUND: Graft immunocomplex capture fluorescence analysis is an attractive method to detect intragraft donor-specific anti-HLA antibodies. In ABO-incompatible transplantation, anti-A and B antibodies are also considered to be important donor specific antibodies (ABO-DSA). Therefore, it is useful to monitor intragraft ABO-DSAs to assess antibody-mediated rejection. METHODS: To capture A and B antigens, anti-Band III, von Willebrand factor (VW), and plasmalemma vesicle-associated protein (PLVAP) beads were produced. The allograft specimen was homogenized in a lysis buffer. Subsequently, A and B antigens were captured by anti-Band III, VW, or PLVAP beads. The immune complexes were then detected by phycoerythrin-conjugated anti-human IgG antibodies and analyzed using a Luminex system. RESULTS: Although Band III and VW beads yielded false positives and false negatives, PLVAP beads captured A and B antigens with high sensitivity (91.7%) and specificity (100%) when an index > 1.5 was considered positive. The proximity in A and B antigens and PLVAP expression was confirmed using immunohistochemical evaluation. Furthermore, sodium dodecyl sulfate polyacrylamide gel electrophoresis supported that PLVAP is an A and B antigen carrier protein. CASE REPORT: Biopsies were conducted following an ABO-incompatible renal transplant (type A to O) and evaluated for ABO-DSA. Graft immunocomplex capture fluorescence analysis was demonstrated as follows: 3.19 (1 h, serum creatinine [s-Cr] 3.95 mg/dL, titer IgG 1:512, glomerulitis [g] 0, peritubular capillaritis [ptc] 0, complement 4d [C4d] 1); 1.8 (4 d, s-Cr 2.29 mg/dL, titer 1:256, g 0, ptc 0, C4d 3); 1.2 (22 d, s-Cr 1.58 mg/dL, titer 1:128, g 0, ptc 2, C4d 3). This result indicated that the remnant ABO-DSA were adsorbed and subsequently removed from the allograft successfully. CONCLUSIONS: This novel application could be used to detect intragraft ABO-DSAs, which could lead to a correct diagnosis and shed light on the ABO-DSA kinetics following ABO-incompatible transplantation.

Frequência do grupo sanguíneo DEA 1.1 em cães atendidos no Hospital Veterinário da UFMT (Sinop/MT), risco de sensibilização de cães DEA 1 negativos e da ocorrência de reação transfusional hemolítica por ocasião de uma segunda transfusão de sangue / DEA 1.1 blood group frequency in dogs attended at the veterinary hospital of UFMT (Sinop/MT), risk of DEA 1 negative dog sensitization and occurrence of hemolytic transfusion reaction in a second blood transfusion

Objetivou-se identificar a frequência do grupo sanguíneo DEA 1.1 em cães de Sinop, Mato Grosso, Brasil, para auxiliar a seleção de doadores e receptores de sangue compatíveis e, adicionalmente, avaliar o risco de reações transfusionais em cães sensibilizados. Além disso, a partir dos resultados obtidos, selecionar potenciais doadores de sangue para compor um banco de dados. Um total de 195 cães adultos (de 1 a 4 anos de idade), machos e fêmeas, mestiços e puros, que nunca haviam recebido transfusões de sangue, foram triados no Hospital Veterinário da Universidade do Mato Grosso. A tipagem sanguínea DEA 1.1 foi realizada utilizando-se ensaio imunocromatográfico comercialmente disponível para DEA 1.1 (Quick Test DEA 1.1, Alvedia, Lyon, França). Os resultados demonstraram uma frequência geral de 65% para cães DEA 1.1 positivos (n = 126) e 35% para cães DEA 1 negativos (n = 69). O risco geral de sensibilização de cães DEA 1 negativos após uma primeira transfusão com sangue DEA 1.1 positivo foi calculado em 23%, enquanto o risco deste receptor sensibilizado receber sangue DEA 1.1 positivo em uma segunda transfusão e desenvolver uma reação hemolítica aguda foi calculado em 5%. A tipagem sanguínea dos cães permitiu sua inserção como doadores de sangue tipados para o grupo DEA 1 em um banco de dados preliminar e garantiu a segurança das transfusões de sangue.

The goal of this research was to identify the frequency of the DEA 1.1 blood group in dogs from Sinop, Mato Grosso, Brazil, to help in the recruitment of compatible blood donors and recipients, and to assess the risk of transfusion reactions in previously sensitized dogs. Also, from the obtained results, to pick potential blood donors to compose a data bank. 195 adult dogs (1 to 4 years old), males and females, mongrel and purebred dogs were screened at the Veterinary Hospital of the University of Mato Grosso. The DEA 1.1 blood typing was performed using commercially available immunochromatographic strip for DEA 1.1 (Quick Test DEA 1.1, Alvedia, Lyon, France). The results showed a general frequency of 65% for DEA 1.1 positive dogs (n = 126) and 35% for DEA 1 negative dogs (n = 69). The general risk of sensitization of a DEA 1 negative dog following a first transfusion with DEA 1.1 positive blood was 23%, while the risk of this sensitized recipient to receive DEA 1.1 positive blood in a second transfusion and to develop an acute hemolytic reaction was calculated to be 5%. The blood typing of the dogs allowed their classification as DEA 1 typed blood donors, in a preliminary data bank, and also ensured the safety of blood transfusions.

DEA 1. 1 blood group frequency in dogs attended at the veterinary hospital of UFMT (Sinop/MT), risk of DEA 1 negative dog sensitization and occurrence of hemolytic transfusion reaction in a second blood transfusion / Frequência do grupo sanguíneo DEA 1. 1 em cães atendidos no Hospital Veterinário da UFMT (Sinop/MT), risco de sensibilização de cães DEA 1 negativos e da ocorrência de reação transfusional hemolítica por ocasião de uma segunda transfusão de sangue

The goal of this research was to identify the frequency of the DEA 1.1 blood group in dogs from Sinop, Mato Grosso, Brazil, to help in the recruitment of compatible blood donors and recipients, and to assess the risk of transfusion reactions in previously sensitized dogs. Also, from the obtained results, to pick potential blood donors to compose a data bank. 195 adult dogs (1 to 4 years old), males and females, mongrel and purebred dogs were screened at the Veterinary Hospital of the University of Mato Grosso. The DEA 1.1 blood typing was performed using commercially available immunochromatographic strip for DEA 1.1 (Quick Test DEA 1.1, Alvedia, Lyon, France). The results showed a general frequency of 65% for DEA 1.1 positive dogs (n = 126) and 35% for DEA 1 negative dogs (n = 69). The general risk of sensitization of a DEA 1 negative dog following a first transfusion with DEA 1.1 positive blood was 23%, while the risk of this sensitized recipient to receive DEA 1.1 positive blood in a second transfusion and to develop an acute hemolytic reaction was calculated to be 5%. The blood typing of the dogs allowed their classification as DEA 1 typed blood donors, in a preliminary data bank, and also ensured the safety of blood transfusions.

Objetivou-se identificar a frequência do grupo sanguíneo DEA 1.1 em cães de Sinop, Mato Grosso, Brasil, para auxiliar a seleção de doadores e receptores de sangue compatíveis e, adicionalmente, avaliar o risco de reações transfusionais em cães sensibilizados. Além disso, a partir dos resultados obtidos, selecionar potenciais doadores de sangue para compor um banco de dados. Um total de 195 cães adultos (de 1 a 4 anos de idade), machos e fêmeas, mestiços e puros, que nunca haviam recebido transfusões de sangue, foram triados no Hospital Veterinário da Universidade do Mato Grosso. A tipagem sanguínea DEA 1.1 foi realizada utilizando-se ensaio imunocromatográfico comercialmente disponível para DEA 1.1 (Quick Test DEA 1.1, Alvedia, Lyon, França). Os resultados demonstraram uma frequência geral de 65% para cães DEA 1.1 positivos (n = 126) e 35% para cães DEA 1 negativos (n = 69). O risco geral de sensibilização de cães DEA 1 negativos após uma primeira transfusão com sangue DEA 1.1 positivo foi calculado em 23%, enquanto o risco deste receptor sensibilizado receber sangue DEA 1.1 positivo em uma segunda transfusão e desenvolver uma reação hemolítica aguda foi calculado em 5%. A tipagem sanguínea dos cães permitiu sua inserção como doadores de sangue tipados para o grupo DEA 1 em um banco de dados preliminar e garantiu a segurança das transfusões de sangue.

Blood group genotyping.

Genomics is affecting all areas of medicine. In transfusion medicine, DNA-based genotyping is being used as an alternative to serological antibody-based methods to determine blood groups for matching donor to recipient. Most antigenic polymorphisms are due to single nucleotide polymorphism changes in the respective genes, and DNA arrays that target these changes have been validated by comparison with antibody-based typing. Importantly, the ability to test for antigens for which there are no serologic reagents is a major medical advance to identify antibodies and find compatible donor units, and can be life-saving. This review summarizes the evolving use and applications of genotyping for red cell and platelet blood group antigens affecting several areas of medicine. These include prenatal medicine for evaluating risk of fetal or neonatal disease and candidates for Rh-immune globulin; transplantation for bone marrow donor selection and transfusion support for highly alloimmunized patients and for confirmation of A2 status of kidney donors; hematology for comprehensive typing for patients with anemia requiring chronic transfusion; and oncology for patients receiving monoclonal antibody therapies that interfere with pretransfusion testing. A genomics approach allows, for the first time, the ability to routinely select donor units antigen matched to recipients for more than ABO/RhD to reduce complications. Of relevance, the growth of whole-genome sequencing in chronic disease and for general health will provide patients' comprehensive extended blood group profile as part of their medical record to be used to inform selection of the optimal transfusion therapy.

[When A is not A anymore: problems and pitfalls with blood group typing]. / Wenn A nicht mehr A ist: Schwierigkeiten und Fallstricke bei der Blutgruppenbestimmung.

Correct blood group typing is a prerequisite for transfusion. In most cases blood group determination is without problems; however, in individual cases various factors can complicate blood group determination and sometimes lead to confusing findings. For a better understanding the clinician should have basic knowledge of blood typing. Blood group determination usually covers the AB0 blood groups, Rhesus and Kell systems; in addition, a direct Coombs test and an antibody screening test for the detection of irregular antibodies in the recipient are performed. Confusion of patients, blood samples, results or preparations can lead to severe consequences due to incompatible transfusion and must be prevented. In this context, bedside blood type testing before transfusion is of utmost importance. Problems in laboratory analysis as well as patient-related factors, such as the existence of irregular antibodies against red blood cells can complicate the immunohematology diagnostics. Certain medications, such as daratumumab, lead to a significantly increased complexity in laboratory analyses. Massive transfusions can lead to chimerism with more than one population of circulating red blood cells. Hematopoetic stem cell transplantation can also lead to a change in blood groups as well as chimerism. In addition, there are various other rare causes that can result in difficulties in blood group determination, such as rare blood groups or rare disease-associated phenomena. In the case of problems in blood group determination, early and close cooperation with transfusion medicine is essential for the clinician.

Clinical Associations with ABO Blood Group and Rhesus Blood Group Status in Patients with Breast Cancer: A Nationwide Retrospective Study of 3,944 Breast Cancer Patients in Turkey.

BACKGROUND The aim of this study was to investigate the association between A, B, O, Rhesus (Rh)-positive and Rh-negative blood groups and breast cancer in a nationwide cohort of 3,944 patients in Turkey. MATERIAL AND METHODS A retrospective study included 3,944 patients diagnosed with breast cancer between 2004 and 2015 and with known blood type. Clinical and demographic patient data included age, sex, body mass index (BMI), menopausal status. The breast tumor type, size, grade, TNM stage, and the presence of lymph node and distant metastases were noted. Histopathology of the breast tumors had included routine detection of human epidermal growth factor receptor 2 (HER2) and estrogen receptor (ER) levels. RESULTS The 3,944 patients with breast cancer were blood group, type A, B, O, and Rh-positive or Rh-negative; the median age was 47.9 years (range, 18.2-89.6 years); 99.5% (3923/3,844) were women, and 0.5% (21/3944) were men. Patients with blood type 0 had a significantly smaller tumor size compared with patients with blood types A or B. There were no significant differences between blood groups and patient age, BMI, menopausal status, tumor histology, ER status, HER2 status, lymph node and distant metastasis. However, there was a significant difference in the prevalence of lobular breast cancer, levels of ER-positive tumor cells, and prevalence of cases with tumor metastases in Rh-positive patients compared with Rh-negative patients. CONCLUSIONS The findings of this retrospective study showed that the type, grade, stage, and hormonal status of breast cancer showed no significant associations with ABO blood grouping.

Routine blood group and antibody screening prior to emergency laparoscopy.

Introduction Studies show that rates of blood transfusion associated with general surgical laparoscopy are low. Currently, there are no national guidelines in the UK regarding blood group and antibody screening (G&S) for patients undergoing emergency laparoscopy. The aim of this study was to assess whether using G&S before emergency laparoscopic general surgery routinely is worthwhile by identifying rates of perioperative transfusion. Methods Data were collected retrospectively on all emergency laparoscopic procedures at a single district general hospital between January 2014 and 31 December 2016. Emergency laparoscopic general surgical cases were included and gynaecological cases excluded. Records were reviewed to ascertain whether G&S was performed, whether antibodies were detected and whether patients were transfused. Results A total of 562 emergency laparoscopic cases were performed. The median age was 28 years (range: 6-95 years). Laparoscopic appendicectomy (n=446), diagnostic laparoscopy (n=47) and laparoscopic cholecystectomy (n=25) were the most common procedures. Of the total patient cohort, 514 (91.5%) and 349 (70.1%) had a first and second G&S respectively while 30 (5.3%) had no G&S. Four patients (0.71%) had antibodies detected. One patient (0.18%) received a transfusion. This patient had undergone laparoscopic repair of a perforated duodenal ulcer and there was no major intraoperative haemorrhage but he was transfused perioperatively for chronic anaemia. Conclusions These results demonstrate a low rate of blood transfusion in emergency laparoscopic general surgery. The majority of these patients had a low risk of major intraoperative haemorrhage and we therefore argue that G&S was not warranted. We propose a more targeted approach to the requirement for preoperative G&S and the use of O negative blood in the event of acute haemorrhage from major vessel injury.

Scanning Electron Microscopy Reveals Two Distinct Classes of Erythroblastic Island Isolated from Adult Mammalian Bone Marrow.

Erythroblastic islands are multicellular clusters in which a central macrophage supports the development and maturation of red blood cell (erythroid) progenitors. These clusters play crucial roles in the pathogenesis observed in animal models of hematological disorders. The precise structure and function of erythroblastic islands is poorly understood. Here, we have combined scanning electron microscopy and immuno-gold labeling of surface proteins to develop a better understanding of the ultrastructure of these multicellular clusters. The erythroid-specific surface antigen Ter-119 and the transferrin receptor CD71 exhibited distinct patterns of protein sorting during erythroid cell maturation as detected by immuno-gold labeling. During electron microscopy analysis we observed two distinct classes of erythroblastic islands. The islands varied in size and morphology, and the number and type of erythroid cells interacting with the central macrophage. Assessment of femoral marrow isolated from a cavid rodent species (guinea pig, Cavis porcellus) and a marsupial carnivore species (fat-tailed dunnarts, Sminthopsis crassicaudata) showed that while the morphology of the central macrophage varied, two different types of erythroblastic islands were consistently identifiable. Our findings suggest that these two classes of erythroblastic islands are conserved in mammalian evolution and may play distinct roles in red blood cell production.

Are Routine Blood Group and Save Samples Needed for Laparoscopic Day Case Surgery?

BACKGROUND: Common day case laparoscopic procedures are usually safe, with low rates of bleeding complications. At our trust, most patients undergo pre-operative group and save (G&S) for these procedures, at a cost of £18.39 per sample excluding laboratory staffing costs. Our aim was to assess if routine G&S is indicated. METHODS: We performed a retrospective review of all patients who underwent laparoscopic cholecystectomy (LC), laparoscopic inguinal hernia repair (LIH) and diagnostic laparoscopy (DL) in our institution between April 2012 and March 2014. Patients were identified using hospital coding records. Transfusion department records were reviewed to see which patients had undergone pre-operative G&S or cross-match, and peri-operative transfusion. RESULTS: Five hundred and thirty-two procedures were performed in 2 years: 293 LC, 123 LIH and 116 DL. G&S was performed in 256 (87 %; LC), 67 (54 %; LIH) and 88 (76 %; DL), respectively. Zero patients were transfused for bleeding complications. One patient was transfused following diagnostic laparoscopy to optimise pre-existing anaemia. The total cost of G&S over the study period was £7558. CONCLUSION: Blood transfusion rates for bleeding complications following laparoscopic day case surgery are 0 % in our unit. G&S samples for these procedures cost £7558 over 2 years. Abandoning pre-operative G&S for these patients appears to be clinically indicated and would lead to substantial financial savings.

Noninvasive buccal swab antigen sample and molecular testing provides extended antigen typing for patients with hemoglobinopathies.

OBJECTIVE: To demonstrate the feasibility of performing a noninvasive, molecular-based red blood cell (RBC) antigen test on infants and very young children with sickle cell disease as part of a statewide newborn screening follow-up program. STUDY DESIGN: A prospective pilot project was conducted using a noninvasive buccal swab and test kit to perform DNA-based, extended RBC phenotyping in 92 children participating in a newborn hemoglobinopathy screening follow-up program. Reported data include the extended panel of antigens detected by molecular analysis compared with unaffected population estimates. RESULTS: Molecular-based RBC antigen testing was successful, with extended RBC typing generated for all subjects. Molecular testing detected several rare negative or rare positive phenotypes, demonstrating the utility of obtaining an extended antigen panel. CONCLUSION: This study demonstrates the feasibility of performing antigen testing on buccal swab specimens from children with sickle cell disease as part of a newborn screening follow-up program with the aim of allowing specific unit matching to prevent alloimmunization with RBC transfusions. The general applicability of testing may be limited by a lack of uniform insurance coverage for buccal swab testing, however.

[Analysis of erythroid-specific blood group genes using un-mobilized peripheral stem cells cultured in vitro].

OBJECTIVE: To analyze specific expression of blood group genes using nucleated erythroid cells cultured from un-mobilized peripheral stem cells in vitro. METHODS: Hematopoietic stem cells(HSC) bearing the CD34 antigen were isolated from peripheral blood by centrifugation and magnetic beads sorting, followed by suspension culture in vitro. Cells were collected from medium on various stages and analyzed by immunofluorescence. The RNA transcription of RH and ABO blood group genes was analyzed using culture cells on day 12. RESULTS: A total of(3.19±0.13) ×10 (4) CD34+cells were isolated from about 50 mL peripheral blood with a recovery rate of 67.3%±2.7%. The cells amount in erythroid-lineage culture system on day 9 reached a plateau of a 237.1±15.5-fold amplification of the initial cell input. The stem cell-specific CD34 antigen was dropped off, while the erythroid-specific CD235a and CD240D antigens were increased in culture period. RHD/CE and ABO genes can be amplified using RNA extracted from culture cells on day 12, and genotypes of Rh and ABO systems by DNA sequencing were consistent with their serologic phenotypes. CONCLUSION: A method was established to analyze the gene expression of erythroid blood group derived from un-mobilized peripheral stem cells cultured in vitro. It can be used to study the expression of various erythroid-specific genes.

Increase in genogroup II.4 norovirus host spectrum by CagA-positive Helicobacter pylori infection.

BACKGROUND: Noroviruses (NoVs) represent a considerable public health burden. Despite their enormous genetic diversity, most outbreaks are due to the single GII.4 genotype, but the reasons for this are poorly understood. NoVs use histo-blood group antigens (HBGAs) as attachment factors. Since HBGAs are present in saliva, binding of strains to saliva is commonly used as a surrogate for recognition of the gut surface by specific strains, although the relationship between saliva and gut tissue expression of HBGAs is not well defined. METHODS: The presence of fucosylated HBGAs in saliva and stomach biopsy specimens, as well as that of genogroup I.1 and genogroup II.4 virus-like particles, were compared in a series of 109 donors from Portugal. RESULTS: An overall good concordance between HBGA expression in saliva and stomach surface mucosa was observed. However, unexpected mucosal expression of α(1,2)fucosylated epitopes in nonsecretor individuals was frequently detected, allowing for GII.4 attachment. Although all individuals were infected with Helicobacter pylori, abnormal expression of α(1,2)fucosylated motifs and binding of GII.4 virus-like particles in nonsecretors' mucosa were associated with positivity for the H. pylori CagA virulence factor. CONCLUSIONS: Infection by CagA-positive H. pylori induces expression of GII.4 attachment factors in nonsecretors' mucosa, expanding the host range of these strains and thereby possibly contributing to their epidemiological dominance.

Desempenho e parâmetros sanguíneos de bezerros leiteiros que receberam sucedâneo lácteo ou silagem de colostro / Performance and plasma metabolites of dairy calves fed a milk replacer or colostrum silage

O objetivo deste estudo foi avaliar o desempenho e os parâmetros sanguíneos de bezerros que consumiram colostro bovino fermentado sob condições anaeróbias. Após o nascimento, 18 bezerros da raça Holandês foram alojados em abrigos individuais e passaram a receber 4L da dieta líquida, sucedâneo lácteo ou silagem de colostro, divididos em duas refeições. O consumo de concentrado inicial e o escore fecal foram registrados diariamente, enquanto a pesagem e as colheitas de amostras de sangue para a determinação das concentrações plasmáticas de glicose, nitrogênio ureico, ácidos graxos livres, β-hidroxibutirato e proteínas totais séricas foram realizadas semanalmente. Os animais alimentados com silagem de colostro apresentaram menores consumo de concentrado, ganho de peso diário e peso vivo. Todos os parâmetros sanguíneos avaliados foram afetados pelos tratamentos, exceto a concentração plasmática de proteínas totais. O escore fecal foi afetado pelos tratamentos durante a segunda semana de vida, com animais alimentados com silagem de colostro apresentando fezes anormais e secas. O fornecimento de silagem de colostro como dieta líquida exclusiva não resultou em desempenho animal adequado, não sendo uma boa alternativa de substituto de leite.

The aim of this study was to evaluate the performance and plasma metabolites of calves fed colostrum fermented under anaerobic conditions as an exclusive liquid feed during the whole milk-feeding period. After birth, eighteen Holstein male calves were housed in individual hutches and fed four liters of liquid diet, milk replacer or colostrum silage, divided into two meals. The starter feed intake and fecal scores were recorded daily, and body weight and blood samples for the determination of plasma glucose, urea nitrogen, free fatty acids, β-hydroxybutyrate and serum total protein were taken weekly. Animals fed colostrum silage had lower intake of starter feed during the experimental period. Significant effects were also observed for average daily gain and body weight. All blood parameters measured were affected by the treatments, except the total protein plasma concentration. The fecal score was affected by treatments during the second week of life, with animals fed colostrum silage presenting abnormal and very dry feces. Feeding colostrum silage as exclusive liquid diet during the whole milk-feeding period resulted in inadequate animal performance, being considered a bad alternative as milk replacer.

Mean platelet volume reflect hematopoietic potency and correlated blood group o in cord blood from healthy newborn.

We evaluated the relationship between mean platelet volume (MPV) and characteristics of 10,577 cord blood (CB) units in a public CB bank in Korea. Blood group O has the highest MPV (P = 0.002). MPV correlated with CB volume (r = 0.121), Hb (r = 0.377), WBC (r = 0.111), TNCs (r = 0.110), CD34+ cell (r = 0.174), CD34+ cells/TNCs (r = 0.157), gestational age (r = -0.102), and birth weight (r = 0.023); (P < 0.001 in all). MPV may be one of the useful decision parameters of process priority in CB bank.

Frecuencia del antígeno Dia en donantes y de anticuerpos anti-Dia en pacientes de Hospitales Públicos y del Instituto Guatemalteco de Seguridad Social / Frequency of Dia antigen among blood donors and anti-Dia of patients from public hospitals and the Guatemalan Security Social Institute

Introducción: es muy raro encontrar al antígeno Dia en caucásicos, negros, polinesios y esquimales, pero se encuentra presente en alta frecuencia en etnias autóctonas de Latinoamérica y población en Asia. El anticuerpo anti-Dia es clínicamente significativo porque se ha asociado con reacciones hemolíticas pos­transfusionales y la Enfermedad Hemolítica del Recién Nacido. Objetivos: Establecer la importancia de investigar el antígeno Dia en donantes y anticuerpos anti-Dia en pacientes transfundidos en los bancos de sangre de hospitales públicos y hospitales del Instituto Guatemalteco de Seguridad Social. Metodología: La detección del antígeno Dia se realizó utilizando la prueba de antiglobulina indirecta. A los donantes se dividieron en dos grupos étnicos indígenas y mestizos. Las diferencias en las prevalencias se analizaron me­diante la prueba X2 (chi cuadrado) y valor de p<0,05 para mostrar si hay diferencia significativa. Las muestras para la detección de anticuerpos se realizó en un equipo Wadiana-Grifols utilizando células pantalla Serascan 1, 2, 3 y Serascan Diego. Resultados: Se encontró que el antígeno Dia posee una frecuen­cia de 7.5%. Al ser estratificado la muestra por etnia, la población indígena posee una frecuencia de 12.99% y la población mestiza de 3.90%, encontrándose una di­ferencia significativa (p<0.005). La frecuencia de anticuerpos anti-Dia fue de 3.50%. Conclusiones: La frecuencia de antígeno Dia en la población bajo estudio fue de 7.32%. La frecuencia de Dia en la población indígena fue de 12.99% y en la población mestiza fue de 3.9%, con una diferencia significativa entre po­blaciones (p= 0.03120). La frecuencia de anti-Dia en 227 pacientes politranfundidos fue de 3.5%.