Digital resources for transfusion education.

INTRODUCTION: Regular training in the blood transfusion process is crucial for transfusion safety. Hospital transfusion committees have an obligation to provide this education to hospital employees through training activities. E-learning is positioning itself as a valid alternative to physical-presence courses. MATERIALS AND METHODS: We describe a training course on blood transfusion to members of our hospital who are involved in the transfusion process, including technicians, nurses, and doctors. The course uses Moodle as the e-learning platform; it is evaluated using a satisfaction survey along with a knowledge-transfer and impact survey a year after taking the course. RESULTS: From 2015 to 2018, seven editions of the online transfusion course were developed. Six hundred and eighty students enrolled; of these, 124 did not take the final examination (18.2%); 60 never began the course (8.8%). Of the 556 students who completed the course, 546 passed (98.2%). The average score from the initial self-assessment was 7.3 while the average score from the final self-assessment was 9.2; the mean improvement was 1.9 (out of 10). The level of general course satisfaction was 9.27 (an average out of 10). More than 90% of the students stated that they were able to apply the acquired knowledge in the workplace after a year. CONCLUSIONS: E-learning has demonstrated itself as an affordable solution that could help in the training of all staff involved in the transfusion process at our hospital, with the advantage that it includes general knowledge and particular skills in local transfusion medical practice.

Paludismo por Plasmodium falciparum en pacientes sin viaje reciente a zona endémica / Plasmodium falciparum malaria in patients without a recent travel history to an endemic area

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Diagnóstico de doble heterocigosis hemoglobina O-Arab y alfa-talasemia tras detección de variante de hemoglobina inusualmente baja / Diagnosis of a double heterozygous Hb O-Arab and alpha-thalassaemia after the detection of an unusually low haemoglobin variantc

Las hemoglobinopatías constituyen los trastornos monogénicos más frecuentes, sobre todo en determinadas razas y áreas, por su efecto protector frente a la malaria. Los cambios migratorios están provocando un aumento de estas alteraciones en el mundo occidental. La cromatografía líquida de alta resolución (HPLC) es el método de elección actual para la detección de hemoglobinopatías estructurales y cuantificación de hemoglobina A2 y fetal. Describimos un caso clínico donde se identificó una doble heterocigosis Hb O-Arab y α-talasemia tras detección de microcitosis y una variante anómala de hemoglobina de menor valor del esperado, destacando la idoneidad del estudio multidisciplinar de este tipo de enfermedades (AU)

Haemoglobinopathies are the most frequent monogenic disorders, particularly in certain races and areas, because of their protective effect against malaria. Migratory changes are leading to an increase in these conditions in the western world. High Performance Liquid Chromotography (HPLC) is nowadays a method of choice in detecting structural haemoglobinopathies and in the quantification of foetal and haemoglobin (Hb) A2. A clinical case is described in which a double heterozygous Hb O-Arab and α-thalassaemia was identified following the detection of microcytosis and an anomalous haemoglobin variant, which was lower than expected - highlighting the appropriateness of a multidisciplinary study for these types of pathologies (AU)

Bosentan and oral anticoagulants in HIV patients: what we can learn of cases reported so far.

Pulmonary arterial hypertension is an infrequent but nevertheless serious life-threatening severe complication of HIV infection. It can be treated with bosentan and oral anticoagulants. Bosentan could induce the acenocoumarol metabolism and it increases the INR values. Until now, no study of interaction between bosentan and oral anticoagulants in HIV patients has reported. So we present a case of this interaction between these drugs and we reviewed MEDLINE to identify all the papers published so far. In our case, several weeks after increasing dose of bosentan acenocoumarol dose had to be progressively increased to 70 mg/week (+33%) without obtaining an adequate INR level (2.0-3.0). Forty-nine days later, we achieved a therapeutic INR with 90 mg/week of warfarin. The use of bosentan and oral anticoagulants together in these patients require a closer monitoring during first weeks of treatment, after increasing the bosentan dose and even during longer periods of time.

La exposición a plaguicidas se asocia con la disminución del recuento espermático / Pesticide exposure and decreased sperm count

Introducción. Recientes estudios han demostrado un posible descenso de la calidad seminal en el hombre, debido, en parte, a sustancias químicas exógenas al organismo, y entre éstas, algunas con actividad hormonal, consideradas disruptores endocrinos, como son los plaguicidas. Estos estudios se han criticado por el sesgo que pueden presentar en cuanto a la selección de las poblaciones de estudio y en cuanto a la metodología analítica empleada. Material y métodos. El objetivo de nuestro estudio es valorar la concentración de plaguicidas en las muestras de sangre, así como el recuento espermático y la calidad en las muestras de semen, según los criterios de la OMS, de una población de 273 varones con una media de edad de 20,7 años, sin antecedentes patológicos del Sudeste de España y reclutados en colaboración con la Universidad de Almería. Resultados. En la totalidad de las 224 muestras de suero disponibles se cuantificó al menos un plaguicida, con una mediana de 11 plaguicidas por muestra; el p,p’-DDE es el más frecuente, presente en el 95,98% de las muestras. Únicamente con el endosulfán-sulfato (presente en el 45,1% de los voluntarios) se encontró una fuerte tendencia a la reducción de más 1,23 millones en el número total de espermatozoides, por lo que se alcanzó la significación estadística (p = 0,009; con un intervalo de confianza del 95%: −1,43 a −1,05). En cuanto al número de espermatozoides móviles, también únicamente con el endosulfán-sulfato, se presentó un descenso estadísticamente significativo de 1,23 millones (p = 0,02; con un intervalo de confianza del 95%: −1,47 a −1,04) (AU)

Introduction. Recent studies have demonstrated a possible decline in semen quality in men. One of the reasons for this is due, in part, to exogenous chemical substances, some of which have hormonal activity, and are considered to be endocrine-disrupting chemicals. Pesticides can be included in this group. Material and methods. These studies have been criticized both for errors in selecting the study group as well as for the analytical methods employed. The objective of our study is to evaluate the concentration of pesticides in blood samples-in addition to the sperm count and semen quality parameters (according to criteria set out by the W.H.O.) in a population of 273 healthy men with an average age of 20.7 years; all from Southern Spain and recruited in collaboration with the University of Almeria. Results. Out of the total of 224 serum samples available, at least one pesticide was quantified per sample, with an average of 11 pesticides per sample; the most frequent being p,p’-DDE, present in 95.98% of the samples. Only in the case of endosulfan sulphate (present in 45.1% of the volunteers) was there a strong reduction tendency in the number of spermatozoa of more than 1.23 million, reaching statistical significance(P=0.009), with a 95% confidence interval of −1.43 to −1.05. As far as the number of motile spermatozoa were concerned, it was also only with endosulfan sulphate that a statistically significant reduction of 1.23 million (P=0.02) in the total number appeared, with a 95% confidence interval of −1.47 to −1.04) (AU)

[Typification and screening of irregular antibodies. Establishing its use at a urology department]. / Tipificación y detección de anticuerpos irregulares (type and screen). Implantación de su uso en una unidad de urología.

OBJECTIVES: To achieve a better use of the packed red blood cells stock at our centre's blood bank, and to analyse cost-savings associated with the implementation of the type and screen (T/S) technology. METHODS: We analyse the results, complications and cost-savings achieved with the use of T/S at the Urology Department in our centre, for the transurethral resection of bladder tumour and prostate. RESULTS: A total of 232 T/S were performed; 3 patients required blood transfusions (1.3%). No complications appeared. Total cost-savings from December 1999 to December 2001 were 7.620 Euros (1,267,861.3 pesetas). CONCLUSIONS: T/S is a safe procedure allowing a better use of blood stocks in a hospital with a substantial economic saving.

Tipificación y detección de anticuerpos irregulares (Type and Screen). Implantación de su uso en una unidad de urología / Blood typing and screening of irregular antibodies. Implementation of its use in an Urology department

OBJETIVOS: Conseguir una mejor utilización del stock de hematíes del Depósito de Sangre de nuestro centro y analizar el ahorro conseguido con la implantación de la metodología de Type and Screen (T/S).MÉTODOS: Analizamos los resultados de la utilización de T/S en la Unidad de Urología de nuestro centro en los procedimientos de resección transuretral de vejiga y próstata, las complicaciones presentadas y el ahorro conseguido. RESULTADOS: Se realizaron un total de 232 T/S, hubo que transfundir a 3 pacientes (1,3 per cent). No se presentó ninguna complicación. El ahorro conseguido fue de 7.620 E (1.267.861,3 pesetas) desde diciembre de 1999 a diciembre del 2001.CONCLUSIONES: El T/S es un procedimiento seguro que permite una mejor utilización de los depósitos de sangre de un hospital con un ahorro económico considerable (AU)