Blood Bank Practices for Sickle Cell Patients in North Carolina

Sickle cell disease (SCD) remains an important public health problem. Predominantly affecting African Americans, SCD is associated with significant health, financial, and psychosocial costs. Therefore, it is vital to find new ways to improve delivery of care to this patient population. The hospital blood bank plays a key role in delivering transfusion therapy to SCD patients. Because transfusion therapy represents the mainstay of treatment for most SCD patients, we hypothesized that a systematic review of blood bank practices for these patients might uncover new opportunities to improve this care. Current blood bank practices for SCD patient have not been previously described. This paper discusses blood bank practices for SCD patients in North Carolina. The layout is as follows. First, the underlying cause, history, and costs of sickle cell disease are described. Next, evidence supporting the use of transfusions for SCD management and its associated risks are considered. Data from a crosssectional study of NC blood bank practices for SCD patients are then presented. Finally, the significance and implications of this research are discussed.Master of Public Healt

Alloimmunization in sickle cell disease: changing antibody specificities and association with chronic pain and decreased survival: Alloimmunization in SCD

Alloimmunization remains a significant complication of transfusion and has been associated with multiple factors, including inflammation, an important pathophysiologic mechanism in sickle cell disease (SCD). We explored whether alloimmunization is associated with disease severity in SCD

Seasonal Association of Thrombotic Thrombocytopenic Purpura

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP), a thrombotic microangiopathy, is a clinical diagnosis, characterized by microangiopathic hemolytic anemia and thrombocytopenia without another likely explanation. Some initiators of the disease are well represented in the literature, such as certain drugs, malignancies, and viral illness; however, there are less objective factors still being investigated, with references to hormonal, stress, and seasonal variations considered anecdotally. A better insight of these factors would aid in understanding the pathophysiology of the disease. STUDY DESIGN AND METHODS: We performed a retrospective review of all idiopathic TTP cases treated with therapeutic plasma exchange at our institution from 1999 to 2008 to determine whether there was seasonal variation in TTP presentation. Seasons were defined as follows: winter = December to February; spring = March to May; summer = June to August; and fall = September to November. With the use of Poisson regression models, the incidence between seasons was compared. RESULTS: During this study period, a total of 97 cases were recorded. Summer had the highest occurrence of TTP (35%). This was significant compared to the fall (p = 0.012) and the winter (p = 0.019). There were more cases in the summer compared to the spring, but this was not significant. CONCLUSION: In our population, there was a significant difference in the number of TTP cases presenting in summer compared to fall and winter. This supports a possible environmental, infectious, or physiologic influence associated with the summer