BackgroundSeveral irregular red blood cell alloantibodies, produced by alloimmunization of antigens in transfusions or pregnancies, have clinical importance because they cause hemolysis in the fetus and newborn and in transfused patients.Objectivea prospective analysis of patients treated by the surgical and clinical emergency services of Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro (HC/UFTM), Brazil was performed to correlate alloimmunization to clinical and epidemiological data.MethodsBlood samples of 143 patients with initial negative antibody screening were collected at intervals for up to 15 months after the transfusion of packed red blood cells. Samples were submitted to irregular antibody testing and, when positive, to the identification and serial titration of alloantibodies. The Fisher Exact test and Odds Ratio were employed to compare proportions.ResultsFifteen (10.49%) patients produced antibodies within six months of transfusion. However, for 60% of these individuals, the titers decreased and disappeared by 15 months after transfusion. Anti-K antibodies and alloantibodies against antigens of the Rh system were the most common; the highest titer was 1:32 (anti-K). There was an evident correlation with the number of transfusions.ConclusionsGiven the high incidence of clinically important red blood cell alloantibodies in patients transfused in surgical and clinical emergency services, we suggest that phenotyping and pre-transfusion compatibilization for C, c, E, e (Rh system) and K (Kell system) antigens should be extended to all patients with programmed surgeries or acute clinical events that do not need emergency transfusions.

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OBJECTIVES:To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients.INTRODUCTION:Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services.METHODS:Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT) and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA).RESULTS:Of the 16 patients evaluated (median age: 53 years), nine (56%) were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43% of the transfusion events, being more frequent in transfusions of random platelet concentrates (54%). Platelet refractoriness was confirmed in three patients (19%), who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50%) by the PIFT and in three (19%) by the PRA-HLA. Among alloimmunized patients, nine (64%) had a history of transfusion, and three as a result of pregnancy (43%). Of the former, two were refractory (29%). No significant differences were observed, probably as a result of the small sample size.CONCLUSION:The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management.

Objetivou-se com este trabalho avaliar os efeitos de diferentes níveis de salinidade da água de irrigação e doses de nitrogênio sobre variáveis de crescimento da mamoneira cv. BRS Energia em experimento conduzido em lisímetros sob condições de campo no CCTA/UFCG, entre os meses de outubro de 2010 e fevereiro de 2011, usando delineamento de blocos ao acaso, com três repetições. Os tratamentos consistiram de cinco níveis de salinidade da água de irrigação-CEa (0,4-controle; 1,4; 2,4; 3,4 e 4,4 dS m-1) associados a cinco doses de adubação nitrogenada (50; 75; 100; 125 e 150% da dose recomendada para ensaio). O número de folhas, a área foliar, a altura de planta, a fitomassa seca das folhas e da parte aérea da mamoneira cv. BRS Energia são afetados negativamente e de forma linear pelo aumento da salinidade da água a partir de 0,4 dS m-1. As características mais afetadas pelo aumento da salinidade da água de irrigação foram às taxas de crescimento absoluto e relativo do diâmetro caulinar. A aplicação de doses crescentes de nitrogênio reduziu o efeito da salinidade sobre o diâmetro de caule e fitomassa seca da parte aérea da mamoneira cv. BRS Energia.

Objective: Iron deficiency is the most common cause of anemia and one of the main factors in the clinical deferral of blood donors. This fact prompted the current study that aimed to determine the prevalence and etiology of anemia in blood donor candidates and to evaluate the hematological screening technique used for the exclusion of these donors. Methods: This was a prospective study that compared two groups (Anemic and Non-anemic). Initially screening for anemia was performed by manually measuring hemoglobin (Bioclin® Kit); the results were subsequently compared with an automated screening method (Coulter T-890). The etiology was investigated by hemoglobin electrophoresis in alkaline and acid pH, Hb A2 dosage and measurement of the ferritin concentration by immunoagglutination. Differences and associations of interest were analyzed using the Yates and McNemar's Chi-square tests and the Fisher, Mann-Whitney, Wilcoxon and Kruskal-Wallis tests. Results: The deferral rate due to anemia was 4.2%; iron deficiency was identified in 37.5% and beta thalassemia in 9.3% of the excluded candidates. There was a significant discrepancy between the two techniques used to measure hemoglobin with 38.1% of initially deferred donors presenting normal hemoglobin levels by the automated method. Conclusion: The results show a high rate of blood donors being deferred for anemia and confirm that iron deficiency is the most prevalent cause. The discrepancies found by comparing screening methods suggest that hemoglobin and hematocrit levels should be confirmed before deferring a donor due to anemia; this may increase supplies in blood banks.

IntroduçãoHemofilia é uma coagulopatia hereditária recessiva ligada ao sexo, ocorrendo devida à falta ou produção defeituosa de moléculas dos fatores VIII ou IX da coagulação. A deficiência de fator VIII (Hemofilia A) é a mais frequente, ficando com 85% dos casos; já a deficiência do fator IX (Hemofilia B) corresponde a 15% . 1,2A incidência na população mundial é de 1/10.000 (pelo fator VIII) e de 1/30.000 (pelo fator IX) nascimentos do sexo masculino. É caracterizada pela ocorrência de hemorragias que aparecem espontaneamente ou em consequência de traumatismos leves e são comuns nas articulações. As hemorragias geralmente ocorrem nas grandes articulações, podendo causar muita dor, danos permanentes e incapacitantes se não forem tratados adequadamente. [1][2][3] Segundo Ritterman, 4 três componentes podem afetar os hemofílicos: o primeiro corresponde à atitude do indivíduo frente a sua enfermidade, seu sentimento de impotência frente aos sangramentos e a visão de não ser uma pessoa normal. O segundo refere-se ao contexto familiar em que, dentre as considerações, há a de que a hemofilia interfere na relação entre os pais e irmãos; o complexo de culpa que

We report a 55-year-old white woman with an angiosarcoma of the left breast, anemia and thromobocytopenia due to a consumptive coagulopathy (Kasabach-Merritt syndrome).

RESUMOObjetivou-se, com esta pesquisa, avaliar os efeitos da irrigação com água de diferentes salinidades e doses de nitrogênio, sobre a acumulação de NPK e sódio na parte aérea da mamoneira, em experimento conduzido em lisímetros. Utilizou-se aleatorização em bloco em esquema fatorial 5 x 5, com três repetições, estudando-se os cinco níveis de condutividade elétrica da água (CEa), variando de 0,4 a 4,4 dS m -1 , associados a cinco doses de nitrogênio (50 a 150% da recomendada). Os teores de NPK e de sódio na cv. BRS Energia foram maiores nas folhas que no caule e entre as épocas de avaliação, aos 120 dias após a semeadura (DAS) em relação aos 46 DAS. Nas folhas os teores acumulados aos 46 DAS, variou na sequência K > Na > N > P e aos 120 DAS K > N > Na > P; enquanto no caule variaram em ambas as épocas, a ordem foi Na > K > P ≥ N e em função da CEa e K > Na > P ≥ N em função das doses de N aos 46 DAS níveis crescentes de CEa promoveram aumento no teor de N folha e K folha assim como o incremento da adubação com N inibiu o teor de Na folha; aos 120 DAS o maior teor de N folha foi obtido com a CEa de 4,4 dS m -1 e a dose de N de 150%, já o teor de K folha e K caule foi obtido na dose de 150% de N enquanto o teor de P não foi influenciado por nenhum fator estudado. Palavras-chave: Ricinus communis L., nutrição mineral, condutividade elétricaAccumulation of NPK and sodium in castor bean under saline stress and nitrogen fertilization ABSTRACT The aim of this study was to evaluate the effects of irrigation with water of different salinities and doses of nitrogen fertilization on accumulation of NPK and sodium in the aerial parts of the castor bean, the experiment was conducted in lysimeters. A randomized block design in 5 x 5 factorial arrangement with three replications was used, and the effects of electrical conductivity of water (ECw) varying from 0.4 to 4.4 dS m -1 associated with nitrogen dose (50 to 150% of recommended dose) were studied. The NPK and sodium contents in the aerial parts of to plant in the leaves in comparison to stems and evaluation times 120 days after sowing (DAS) > 46 DAS. In leaves the content at 46 DAS varied according to following sequence K > Na > N > P and at 120 DAS K > N > Na > P while in the stem in both study periods it accumulated in the order Na > K > P ≥ N under water salinity and K > Na > P ≥ N depending on nitrogen fertilization. At 46 DAS, the increasing levels of ECw caused an increase in the N leaf and K leaf and nitrogen dose inhibited Na leaf content. At 120 DAS the highest content of N leaf was obtained in treatment ECw 4.4 dS m -1 and in dose of 150% N while the contents of K leaf and K stem were obtained in the dose of 150% N. The P content was not affected by any of the studied factors.