An effective diagnostic strategy for accurate detection of RhD variants including Asian DEL type in apparently RhD-negative blood donors in Korea.

BACKGROUND AND OBJECTIVES: The purpose of this study was to provide an effective RHD genotyping strategy for the East Asian blood donors. MATERIAL AND METHODS: RhD phenotyping, weak D testing and RhCE phenotyping were performed on 110 samples from members of the RhD-negative club, private organization composed of RhD-negative blood donors, in the GwangJu-Chonnam region of Korea. The RHD promoter, intron 4, and exons 7 and 10 were analysed by real-time PCR. Two nucleotide changes (c.1227 G>A, and c.1222 T>C) in exon 9 were analysed by sequencing. RESULTS: Of 110 RhD-negative club members, 79 (71·8%) showed complete deletion of the RHD gene, 10 (9·1%) showed results consistent with RHD-CE-D hybrid, and 21 (19·1%) showed amplification of RHD promoter, intron 4, and exons 7 and 10. Of the latter group, 16 (14·5%) were in the DEL blood group including c.1227 G>A (N = 14) and c.1222 T>C (N = 2), 2 (1·8%) were weak D, 1(0·9%) was partial D, and 2 (1·8%) were undetermined. The RhD-negative phenotype samples consisted of 58 C-E-c+e+, 19 C-E+c+e+, 3 C-E+c+e-, 21 C+E-c+e-, 6 C+E-c+e+ and 3 C+E-c-e + . Notably, all 58 samples with the C-E-c+e+ phenotype were revealed to have complete deletion of the RHD gene. The C-E-c+e+ phenotype showed 100% positive predictive value for detecting D-negative cases. CONCLUSIONS: RHD genotyping is not required in half of D-negative cases. We suggest here an effective RHD genotyping strategy for accurate detection of RhD variants in apparently RhD-negative blood donors in East Asia.

Clinical audit: recent practice in caring for patients with acute severe colitis compared with published guidelines--is there a problem?

BACKGROUND: Acute severe colitis (ASC) is a serious condition with possible outcomes of emergency colectomy and mortality. Validated guidelines exist to help avoid these. AIMS: To examine local adherence to guidelines and identify (a) opportunities to improve care and (b) possible barriers to adherence. METHODS: Retrospective, hospital-wide audit of all patients with ASC during a 2-year period (2009-2010) at a major metropolitan hospital. Cases were identified by an electronic search of all discharges with International Classification of Diseases-10 codes for colitis, colectomy, ulcerative colitis or Crohn disease. RESULTS: Twenty-six patients had 30 ASC admissions (14 female). Most admissions were under gastroenterology (25), 4 (13%) were under general medicine and 1 was under general surgery. Only 8 patients' (26%) management (all under gastroenterology) included all major details: blood investigations, Clostridium difficile test, abdominal X-ray, colonic examination and venous thromboembolism prophylaxis. Only one patient had formal severity scoring on admission, and seven patients (24%) had descriptive severity recorded. On day 3, nine patients (30%) had some recorded severity assessment; however, no formal criteria were used. Four had colectomy, three during first admission and one on re-admission. Of these patients, three received cyclosporine prior to colectomy. The mean duration of admission was 10 days (standard deviation 10.54, range 1-61). CONCLUSION: Opportunities to optimise care exist including formal severity assessments on days 1 and 3, better deep vein thrombosis/pulmonary embolism prophylaxis and prompt colonic examination. Admission under teams other than gastroenterology appeared to be a barrier to better care. Despite the low rate of ideal management, the colectomy rate was acceptably low at 20%.

A novel HLA-B*54 allele, B*54:25, identified by sequence-based typing.

The novel allele B*54:25 allele showed a single nucleotide difference with B*54:01:01 at nt 208 C > G in exon 2.

A novel HLA-B*35 allele, B*35:188, identified by sequence-based typing.

The novel allele B*35:188 allele showed a single nucleotide difference with B*35:96 at nt 347 T>C in exon 3.

A novel HLA-DRB1*12 allele, DRB1*12:16:02, identified by sequence-based typing.

The novel allele DRB1*12:16:02 allele showed two single nucleotide differences with HLA-DRB1*12:16:01 at nucleotides 303 G>C and 321 C>T in exon 2.

A novel HLA-A*31 allele, A*31:57, identified by sequence-based typing.

The novel allele A*31:57 allele showed a single nucleotide difference with A*31:01:02 at nt 235 G>C in exon 2.

Physicochemical Properties of Honey from Contract Beekeepers, Street Vendors and Branded Honey in Sabah, Malaysia.

The chemical properties of honey depend on the source of collection to packaging, but little is known about honey in Sabah. The aim of this study was to distinguish between the physicochemical properties and mineral content of 76 honey samples from local sources and supermarkets in Sabah, which were from contract beekeepers, unknown sources and branded honey. Raw honey was collected from contract beekeepers, while honey from unknown source was obtained from street vendors and wet markets, while branded honey was purchased from local supermarkets. The chemical parameters of the honey were assessed using established methods, while the mineral content of the honey was determined using inductively coupled plasma optical emission spectroscopy (ICP-OES). Significant differences were found in several parameters measured in honey from different sources, with principal component analysis (PCA) showing clear separation between the measured parameters, yielding five factors that accounted for up to 72.25% of the total explained variance. Honey from contract beekeepers showed significant differences and higher mineral content (Ca, Cu, Fe, K, Mg, Na and Zn) compared to honey from unknown source and branded honey. Potassium was the most important element in the study with an average of 2.65 g/kg and 629.4 mg/kg for sources from contract beekeepers and branded honey, respectively. The honey from the contract beekeepers was of better quality due to its high mineral content. The results suggest that honey from contract beekeepers could be a good choice when it comes to high mineral content.

Sifat kimia madu adalah bergantung kepada sumber pengumpulan hingga ke peringkat pembungkusan, namun demikian, maklumat tentang madu di Sabah kurang diketahui. Matlamat kajian ini adalah untuk membezakan antara sifat fisikokimia dan kandungan mineral bagi 76 sampel madu daripada sumber tempatan dan pasar raya di Sabah, iaitu daripada penternak lebah kontrak, sumber yang tidak diketahui dan madu berjenama. Madu mentah diperoleh daripada penternak lebah kontrak, manakala madu daripada sumber yang tidak diketahui telah diperoleh daripada peniaga jalanan dan pasar basah, manakala madu berjenama dibeli dari pasar raya tempatan. Parameter kimia madu dinilai menggunakan kaedah sedia ada yang telah ditetapkan, manakala kandungan mineral madu ditentukan menggunakan inductively coupled plasma optical emission spectroscopy (ICP-OES). Terdapat perbezaan bererti bagi beberapa parameter yang diukur dalam madu daripada sumber yang berbeza dan analisis komponen utama (PCA) menunjukkan perbezaan yang jelas antara parameter yang diukur, menghasilkan lima faktor yang menyumbang sehingga 72.25% daripada jumlah varians yang dijelaskan. Madu dari penternak lebah kontrak menunjukkan perbezaan yang ketara dan kandungan mineral yang lebih tinggi (Ca, Cu, Fe, K, Mg, Na dan Zn) berbanding madu dari sumber yang tidak diketahui dan madu berjenama. Kalium merupakan unsur terpenting dalam kajian dengan purata 2.65 g/kg dan 629.4 mg/kg masing-masing untuk sumber daripada penternak lebah kontrak dan madu berjenama. Madu dari penternak lebah kontrak adalah lebih berkualiti kerana kandungan mineralnya yang tinggi. Keputusan menunjukkan bahawa madu daripada penternak lebah kontrak boleh menjadi pilihan yang baik kerana ia mempunyai kandungan mineral yang tinggi.