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Total 23 results found since Jan 2013.

Managing uncertainty: Physicians' decision-making for stroke prevention for patients with atrial fibrillation and intracerebral haemorrhage
Conclusion Physicians described the process of deciding on stroke prevention in patients with AF post-ICH as 'challenging' due to considerable 'clinical equipoise'. Key factors that affected decision-making was patient comorbidities, functional status, and patient willingness to engage with oral anticoagulation therapy. Shared decision-making was believed to be beneficial, but physicians believed that the ultimate responsibility to decide on stroke prevention lay with the clinician.PMID:35253141 | DOI:10.1055/a-1789-4824
Source: Thrombosis and Haemostasis - March 7, 2022 Category: Hematology Authors: Elena Ivany Robyn Lotto Gregory Yh Lip Deirdre Lane Source Type: research

Transcranial Doppler Screening in a Regional Care Network for Sickle Cell Disease in the United Kingdom
The risk of stroke in children screened with transcranial Doppler ultrasound in the United Kingdom is not known. We evaluated a clinician-led program using a risk assessment modified from the STOP protocol. High-risk classification included abnormal velocities in the anterior cerebral artery, and single abnormal scan if initial velocity>220 cm/s (high abnormal) or if preceded by at least 2 conditional scans. In total, 1653 scans were performed in 542 children, followed for 2235 patient-years. Fifty-eight (10.7%) high-risk subjects were identified, including 18 (31%) with high abnormal, and 15 (26%) with previous conditiona...
Source: Journal of Pediatric Hematology Oncology - September 30, 2016 Category: Hematology Tags: Original Articles Source Type: research

How I manage sickle cell patients with high transcranial doppler results
Summary Stroke is one of the most severe complications to affect children with sickle cell anaemia (SCA). Transcranial doppler (TCD) is an accurate and non‐invasive method to determine stroke risk. Randomised controlled trials have demonstrated the efficacy of chronic transfusion therapy in stroke prevention based on risk stratification determined by TCD velocities. This has led to the regular use of TCD monitoring for children with SCA in order to determine stroke risk. Significant resource allocation is necessary to facilitate training, quality assurance and failsafe arrangements for non‐attenders. In a subgroup of p...
Source: British Journal of Haematology - August 2, 2017 Category: Hematology Authors: John Brewin, Banu Kaya, Subarna Chakravorty Tags: Review Source Type: research

Effectiveness and safety of apixaban vs. rivaroxaban in patients with atrial fibrillation and type 2 diabetes mellitus
CONCLUSIONS: Among patients with NVAF and T2DM, apixaban was associated with a similar risk of stroke, and a lower risk of major bleeding compared with rivaroxaban.PMID:35292949 | DOI:10.1055/a-1798-2116
Source: Thrombosis and Haemostasis - March 16, 2022 Category: Hematology Authors: Krishna Roy Chowdhury Jonathan Michaud Oriana Hoi Yun Yu Hui Yin Laurent Azoulay Christel Renoux Source Type: research

Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease
Summary Stroke risk in children with sickle cell disease (SCD) is currently assessed with routine transcranial Doppler ultrasound (TCD) measurements of blood velocity in the Circle of Willis (CoW). However, there is currently no biomarker with proven prognostic value in adult patients. Four‐dimensional (4D) flow magnetic resonance imaging (MRI) may improve risk profiling based on intracranial haemodynamics. We conducted neurovascular 4D flow MRI and blood sampling in 69 SCD patients [median age 15 years (interquartile range, IQR: 12–50)] and 14 healthy controls [median age 21 years (IQR: 18–43)]. We measured veloci...
Source: British Journal of Haematology - December 21, 2017 Category: Hematology Authors: Lena V áclavů, Zelonna A. V. Baldew, Sanna Gevers, Henri J. M. M. Mutsaerts, Karin Fijnvandraat, Marjon H. Cnossen, Charles B. Majoie, John C. Wood, Ed VanBavel, Bart J. Biemond, Pim Ooij, Aart J. Nederveen Tags: Research Paper Source Type: research

How I manage red cell transfusions in patients with sickle cell disease
Summary Sickle cell disease is one of the commonest serious inherited diseases in the world, and red cell transfusion is still one of the few effective treatments for acute and chronic complications. Transfusion corrects anaemia and dilutes out the number of red cells able to cause vaso‐occlusion and vascular damage. Urgent red cell transfusions are used to correct acute anaemia, treat acute chest syndrome and patients with acute neurological symptoms. We use elective transfusions preoperatively for moderate risk surgery, and in some pregnant women. There is good evidence for the use of long‐term regular transfusions i...
Source: British Journal of Haematology - January 29, 2018 Category: Hematology Authors: David C. Rees, Susan Robinson, Jo Howard Tags: Annotation Source Type: research

Transcranial Doppler velocity among Jamaican children with sickle cell anaemia: determining the significance of haematological values and nutrition
This study investigated the association of nutritional and haematological variables with maximum time‐averaged mean velocity (TAMV) measured by transcranial Doppler (TCD) velocity and the agreement of classification between two protocols. TCD categories included: normal (<170 cm/s), conditional (170–199 cm/s) and abnormal (≥200 cm/s) based on TAMV in distal internal carotid artery (dICA), middle cerebral artery (MCA), internal carotid bifurcation, anterior and posterior cerebral arteries. Of 358 children with sickle cell anaemia (SCA) examined, the mean age (±standard deviation) was 7·4 ± 2·7 years; 13·...
Source: British Journal of Haematology - March 1, 2018 Category: Hematology Authors: Angela E. Rankine ‐Mullings, Nadine Morrison‐Levy, Deanne Soares, Karen Aldred, Lesley King, Susanna Ali, Jennifer M. Knight‐Madden, Margaret Wisdom‐Phipps, Robert J. Adams, Russell E. Ware, Marvin Reid Tags: Research Paper Source Type: research

Characterization and treatment of congenital thrombotic thrombocytopenic purpura
In conclusion, prespacer mutations are associated with earlier development of cTTP symptoms. Prophylactic ADAMTS13 replacement decreases the risk of end-organ damage such as ischemic stroke and resolved previously unrecognized symptoms in patients with nonovert disease.
Source: Blood - April 10, 2019 Category: Hematology Authors: Alwan, F., Vendramin, C., Liesner, R., Clark, A., Lester, W., Dutt, T., Thomas, W., Gooding, R., Biss, T., Watson, H. G., Cooper, N., Rayment, R., Cranfield, T., van Veen, J. J., Hill, Q. A., Davis, S., Motwani, J., Bhatnagar, N., Priddee, N., David, M., Tags: Thrombocytopenia, Platelets and Thrombopoiesis, Clinical Trials and Observations Source Type: research

Bendamustine, bortezomib and rituximab produces durable complete remissions in patients with previously untreated, low grade lymphoma
Abstract This Phase II trial evaluated the efficacy of bendamustine, bortezomib and rituximab in patients with previously untreated low‐grade lymphoma. Eligible patients had low grade lymphoma with no previous systemic disease treatment. Treatment for all patients was given in 28‐day cycles for a maximum of 6 cycles. Patients received rituximab 375 mg/m2 intravenously (IV) on days 1, 8 and 15 of cycle 1 and day 1 of cycles 2–6; bendamustine 90 mg/m2 IV on days 1 and 2; and bortezomib 1·6 mg/m2 IV on days 1, 8 and 15. Patients were permitted to begin maintenance treatment with rituximab 6 months after completion ...
Source: British Journal of Haematology - November 28, 2017 Category: Hematology Authors: Ian W. Flinn, Dana S. Thompson, Ralph V. Boccia, Gerald Miletello, Andrew Lipman, Douglas Flora, Daniel Cuevas, Steven W. Papish, Jesus G. Berdeja Tags: Research Paper Source Type: research

Interleukin ‐6 G‐174C polymorphism predicts higher risk of stroke in sickle cell anaemia
British Journal of Haematology, EarlyView.
Source: British Journal of Haematology - May 23, 2017 Category: Hematology Source Type: research

Hydroxyurea Therapy Does Not Impact Current Survival Estimates in the East London Sickle Cell Newborn Cohort Study
Conclusions: The study is the first to evaluate survival in a newborn cohort past the age of 20 years. We have confirmed a low mortality rate in childhood, but increased number of deaths in young adults including those with HbSC. This study provides evidence of the benefit of newborn screening and comprehensive care which is accessible at all ages, free of charge. The uptake of HU, particularly at a young age, has been low and a positive effect of HU on survival as described in other studies has not yet been observed in this cohort. Earlier initiation of disease-modifying treatment and longer-term follow-up will be require...
Source: Blood - November 21, 2018 Category: Hematology Authors: Telfer, P., Kaya, B., Tsitsikas, D. A., Barroso, F., Sangarappillai, C. Tags: 114. Hemoglobinopathies, Excluding Thalassemia-Clinical: Poster III Source Type: research

Macrocytosis in Mitochondrial DNA Deletion Syndromes
Large single mtDNA (mitochondrial DNA) deletion syndrome is a rare inborn error of metabolism with variable heteroplasmy levels and clinical phenotype among affected individuals. Chronic progressive external ophthalmoplegia (CPEO) is the most common phenotype in adults with this form of mitochondrial disease [1-2]. The common CPEO clinical manifestations are ptosis and ophthalmoplegia. More variable phenotypic manifestations of CPEO (CPEO plus) include involvement of the peripheral nervous system and myopathy. Here, we describe a 62-year-old female with CPEO and the major mitochondrial DNA deletion present at 40% heteropla...
Source: Acta Haematologica - February 10, 2023 Category: Hematology Source Type: research