Rod-Shaped Hemoglobin Crystals: Clues to the Diagnosis of Hemoglobin C Disease.

The typical rod-shaped HbC crystals in the peripheral blood smear often provide the diagnostic clue to the HbC disease. This case highlights that a careful review of blood film morphology may be helpful to detect HbC disease, although this case's routine blood test is normal and do not meet the rules of re-examinations.

Optimizing Haemophilia Care in Resource-Limited Countries: Current Challenges and Future Prospects.

About 75% of persons with hemophilia live in the developing world and do not have access to routine care due to many barriers. There are a lot of challenges associated with hemophilia care in resource-limited settings, ranging from financial to organisational and government commitments. This review discusses some of these challenges and future prospects, while highlighting the important role of the World Federation of Hemophilia in hemophilia patient care. A participative approach involving all stakeholders is key to optimizing care in resource-limited settings.

Abacavir has no prothrombotic effect on platelets in vitro.

OBJECTIVES: HIV patients exposed to abacavir have an increased risk of myocardial infarction, with contradictory results in the literature. The aim of our study was to determine whether abacavir has a direct effect on platelet activation and aggregation using platelets from healthy donors and from HIV-infected patients under therapy with an undetectable viral load. METHODS: Platelet-rich plasma (PRP) or whole blood from healthy donors was treated with abacavir (5 or 10 µg/mL) or its active metabolite carbovir diphosphate. Experiments were also performed using blood of HIV-infected patients (n = 10) with an undetectable viral load. Platelet aggregation was performed on PRP by turbidimetry and under high shear conditions at 4000 s-1. Platelet procoagulant potential was analysed by measuring thrombin generation by thrombinography. RESULTS: Abacavir and carbovir diphosphate significantly increased the aggregation of platelets from healthy donors induced by collagen at 2 µg/mL (P = 0.002), but not at 0.5 µg/mL. No effect of abacavir or carbovir diphosphate was observed on platelet aggregation induced by other physiological agonists or by high shear stress, or on thrombin generation. Pretreatment of blood from HIV-infected patients with abacavir produced similar results. CONCLUSIONS: Our results suggest that abacavir does not significantly influence platelet activation in vitro when incubated with platelets from healthy donors or from HIV-infected patients. It is, however, not excluded that a synergistic effect with other drugs could promote platelet activation and thereby play a role in the pathogenesis of myocardial infarction.