Building an immune-mediated coagulopathy consensus: early recognition and evaluation to enhance post-surgical patient safety.

Topical hemostats, fibrin sealants, and surgical adhesives are regularly used in a variety of surgical procedures involving multiple disciplines. Generally, these adjuncts to surgical hemostasis are valuable means for improving wound visualization, reducing blood loss or adding tissue adherence; however, some of these agents are responsible for under-recognized adverse reactions and outcomes. Bovine thrombin, for example, is a topical hemostat with a long history of clinical application that is widely used alone or in combination with other hemostatic agents.

Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: potential implications for pneumococcal conjugate vaccines.

Acute otitis media (AOM) is the most common infection following pneumococcal colonization of the upper respiratory tract. Streptococcus pneumoniae causes 30-60% of AOM cases worldwide. However, not all pneumococcal serotypes cause disease and an association exists with nasopharyngeal colonization by certain serotypes and their propensity to cause AOM.

Role of antithrombin concentrate in treatment of hereditary antithrombin deficiency. An update.

Antithrombin (AT) functions as a potent natural anticoagulant and serine protease inhibitor that inactivates many enzymes in the coagulation cascade. Antithrombin also possesses antiinflammatory properties, many of which are mediated by its actions as an anticoagulant. Hereditary AT deficiency is a rare, underrecognised medical condition that is associated with inadequate endogenous anticoagulation thought to result from impaired inhibition of serine protease coagulation factors.

SCF induces gamma-globin gene expression by regulating downstream transcription factor COUP-TFII.

Increased fetal hemoglobin expression in adulthood is associated with acute stress erythropoiesis. However, the mechanisms underlying gamma-globin induction during the rapid expansion of adult erythroid progenitor cells have not been fully elucidated. Here, we examined COUP-TFII as a potential repressor of gamma-globin gene after stem cell factor (SCF) stimulation in cultured human adult erythroid progenitor cells.

Laboratory identification of lupus anticoagulants.

Lupus anticoagulants (LA) are acquired autoantibodies that can cause antiphospholipid syndrome. LAs prolong phospholipid-dependent coagulation tests, acting as nonspecific inhibitors that are neutralized in the presence of excess phospholipid. However, there is no gold standard test and the testing is influenced by a number of variables.

Weight-based dosing of enoxaparin for VTE prophylaxis in morbidly obese, medically-Ill patients.

Introduction: In clinical trials, fixed-dose enoxaparin (40 mg once daily) reduces the risk of venous thromboembolism (VTE) in medically-ill patients. However, morbidly obese patients were under-represented in these trials and using fixed-dose enoxaparin in obese patients may be inadequate. We completed a pharmacokinetic study in morbidly obese, medically-ill patients to determine if weight-based dosing of enoxaparin for VTE prophylaxis was feasible, without excessive levels of anticoagulation, as determined by peak anti-Xa levels.

Unintentional child poisonings treated in United States hospital emergency departments: national estimates of incident cases, population-based poisoning rates, and product involvement.

Objectives: The goals were to develop national estimates of unintentional child poisoning cases treated in US hospital emergency departments, to determine population-based poisoning rates, and to evaluate characteristics of the victims and the products involved.

Methods: Cases reported through the US Consumer Product Safety Commission National Electronic Injury Surveillance System, involving a national probability sample of US hospital emergency departments, were used as a basis for developing national estimates of product-related poisonings involving children<5 years of age treated in US hospital emergency departments in 2004.

Results: There were an estimated 86194 child poisoning incidents treated in US hospital emergency departments in 2004, amounting to 429.

The regulation of OLFM4 expression in myeloid precursor cells relies on NF-kappaB transcription factor.

The human olfactomedin 4 gene (OLFM4, also known as hGC-1, GW112) is thought to be a useful marker for early myeloid development. To understand the molecular mechanisms underlying granulocyte colony-stimulating factor (G-CSF)-stimulated OLFM4 expression, we characterized the promoter region of OLFM4. The 35-bp region (-101 to -66) of the proximal promoter regulated reporter gene expression, and mutation of the nuclear factor (NF)-kappaB binding site within the promoter abolished the binding of the transcription factor and the ability to regulate OLFM4 expression.

BP1 motif in the human beta-globin promoter affects beta-globin expression during embryonic/fetal erythropoiesis in transgenic mice bearing the human beta-globin gene.

The binding of the transcription factor BP1 (beta protein 1) to its site on the promoter of the adult beta-globin gene has a silencing effect on beta-globin transcription in vitro. To better understand the mechanism of BP1's negative regulation of beta-globin expression, we developed transgenic mice bearing a human beta-globin locus-containing cosmid. Specifically, we introduced a mutated BP1 binding site (mtBP1) into the promoter of the beta-globin gene sequence of this cosmid construct.

Establishing an anemia clinic for optimal erythropoietic-stimulating agent use in hematology-oncology patients.

Erythropoietic-stimulating agent (ESA) therapy has significantly impacted the management of chemotherapy-induced anemia (CIA) by decreasing the number of red blood cell transfusions required by patients with cancer. However, managing these patients with ESA therapy has become increasingly difficult since the release of the Centers for Medicare & Medicaid Services' new National Coverage Determination document because of the disparities between this document and recommendations from expert-reviewed national clinical guidelines on the treatment of anemia. This article describes a collaborative practice agreement between pharmacists and physicians as one approach to managing CIA in hematology-oncology patients in an anemia clinic.

Testing for hereditary thrombophilia: a retrospective analysis of testing referred to a national laboratory.

Background: Predisposition to venous thrombosis may be assessed through testing for defects and/or deficiencies of a number of hereditary factors. There is potential for confusion about which of these tests are appropriate in which settings. At least one set of recommendations has been published to guide such testing, but it is unclear how widely these have been disseminated.

Methemoglobinemia due to malachite green ingestion in a child.

Malachite green is a commercially available dye used to treat parasitic and fungal disease in fish. No previous reports of human injury could be located from acute ingestion of malachite green. We report a case of methemoglobinemia of 51% in a 3 year old girl after acute ingestion of malachite green from a commercially available aquarium product.

Factors associated with the all-terrain vehicle mortality rate in the United States: an analysis of state-level data.

The purpose of this article is to determine and quantify the factors associated with the all-terrain vehicle (ATV) mortality rate in the United States, based on an analysis of state-level data. From 1990 through 1999, there were about 2400 reported deaths in the U.S.

Fetal haemoglobin response to hydroxycarbamide treatment and sar1a promoter polymorphisms in sickle cell anaemia.

The hydroxycarbamide (HC)-inducible small guanosine triphosphate (GTP)-binding protein, secretion-associated and RAS-related (SAR) protein has recently been shown to play a pivotal role in HBG induction and erythroid maturation by causing cell apoptosis and G1/S-phase arrest. Our preliminary analysis indicated that HC inducibility is transcriptionally regulated by elements within the SAR1A promoter. This study aimed to assess whether polymorphisms in the SAR1A promoter are associated with differences Hb F levels or HC therapeutic responses among sickle cell disease (SCD) patients.

Reduced hGC-1 protein expression is associated with malignant progression of colon carcinoma.

Purpose: hGC-1 (human granulocyte colony-stimulating factor-stimulated clone 1) is a gastrointestinal protein that is a member of the olfactomedin glycoprotein family. Its biological function remains poorly understood. Aberrant expression of hGC-1 in some human carcinomas has been recently reported.