Apheresis medicine education during the early phase of the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic introduced challenges and disruption across healthcare, including apheresis medicine (AM). In this study, we report findings from a survey conducted among American Society for Apheresis Physician Committee (ASFA-PC) members to describe the impact of the COVID-19 pandemic on AM education practices. STUDY DESIGN AND METHODS: A voluntary, anonymous, 24-question, institutional review board-approved survey regarding AM teaching during the pandemic was distributed to ASFA-PC members in the United States between December 1, 2020, and December 15, 2020. Descriptive analyses were reported as number and frequency of respondents for each question. Free text responses were summarized. RESULTS: Responses were received from 14/31 (45%) of ASFA-PC members, of whom 12 practiced at academic institutions. Among these, 11/12 (92%) transitioned to virtual platform for AM trainee conferences during the pandemic. A variety of resources were employed to support independent AM learning. While 7/12 (58%) respondents did not change the informed consent process for AM procedures, others delegated this process or introduced remote alternatives. The most common method respondents used to conduct AM patient rounding was a hybrid in-person/virtual model. CONCLUSION: This survey describes the adaptations and changes AM practitioners made to trainee education in response to the early phase of the COVID-19 pandemic. The transition to virtual and/or hybrid trainee learning and AM rounds underscores the importance of digital AM resources. Further study of the effects of the pandemic and its impact on AM trainee education, as well as patient care is warranted.

Correlation of Chemical Urinalysis to Microscopic Urinalysis and Urine Culture: Implications for Reflex Urinalysis Workflows.

BACKGROUND: Urinalysis (UA) reflex testing approaches, which offer potential for savings in labor and result turnaround time, may rely on the performance of a chemical UA screen to determine which urine samples need microscopic UA and/or urine culture. We correlated chemical UA, microscopic UA, and urine culture results to determine the performance of chemical UA as a screening tool for reflex testing approaches. METHODS: Consecutive UA results for 9127 tests (simultaneous chemical UA and microscopic UA) were retrospectively reviewed and correlated. Urine culture results were also correlated for 3127 samples that had urine culture ordered within 24 h of UA. Positivity criteria for each UA method were predefined. RESULTS: Chemical UA yielded the following performance specifications for predicting microscopic findings: 93.0% sensitivity, 56.9% specificity, 64.7% positive predictive value, 90.5% negative predictive value. 3.2% of samples were negative by chemical UA but positive by microscopic UA. Of the samples with urine culture results available, 6.3% were negative by chemical UA but had clinically-significant positive urine cultures. CONCLUSIONS: Reflex testing of microscopic UA and/or urine culture dependent from chemical UA results provides a feasible opportunity to reduce unnecessary testing.

A 13-year-old girl with cold agglutinin syndrome caused by anti-i.

SUMMARY: A 13-year-old girl with cold agglutinin syndrome caused by anti-i was serologically positive for Epstein-Barr virus. The anti-i had a high titer at 4 degrees C and high thermal amplitude (reacting up to 37 degrees C with both cord i RBCs and the patient's autologous RBCs). The patient's hemoglobin dropped to 48 g/L. The age of the patient, the severity of the hemolysis, and the antibody specificity were unusual features of cold agglutinin syndrome. Transfusions with adult (I) red blood cells were effective.