Subcutaneous bolus injection of deferoxamine in adult patients affected by onco-hematologic diseases and iron overload

Background and Objective. Chelation therapy is often necessary for patients who undergo chronic transfusion therapy for myelodysplastic syndromes. In these patients, deferoxamine, the most widely used chelating agent, has been reported to be effective in reducing the iron burden and the transfusion requirement. Unfortunately, compliance with the drug, that is usually administered by slow subcutaneous infusion via a battery operated pump, is often poor, especially in elderly patients

Efficiency of plasmapheresis: a comparison of three Italian Centres

Background. In order to support the economic and financial sustainability of the Italian health system, there is a need to define technically and economically efficient strategies that assure the self-sufficient apheretic production of plasma. Material and methods. Process and product costs at the Casa del Donatore (CD) in Bologna were determined on the basis of costing models used at Verona's Inter-hospital Department of Transfusional Medicine (IDTM) by academics from the University of Turin and those used at the Marche Regional IDTM by academics from Marche Polytechnic University. During the first phase, data was collected concerning donors, biological screening tests, the number of units produced/discarded, the materials used (individual pharmacy codes and related final expenditure), human resources (number, professional status, time involved, the number of activities per day, percentage productivity), equipment, and general costs. During the second phase, direct costs were verified and the costs common to the units produced were attributed using the functional principle. Results. The overall cost of a litre of plasma collected by means of apherisis (about \u20ac 280) was similar at the three centres, but there were differences in their cost structures that could be attributed to organisational choices, economic factors and/or structural variables. Plasmapheresis accounts for 24% of the plasma collected in Marche and the CD, but 17% of that collected in Verona, whereas the donation index is lower in the CD (1.8) than in the other two centres (2.2). The annual donor screening tests are substantially similar, but there are some differences in their timing (at the time of screening candidate donors or at the time of first donation). There are also some differences in the use of tests that are not required by law but are carried out in order to protect donors and recipients. The working times in three centres are similar, but personnel costs vary because of their different retribution policies. Discussion. Comparing the cost determinants at each centre made it possible to highlight changes that each can make in order to improve efficiency, and may lay the basis for doing the same in other organisational contexts

Transfusion therapy in the peri-operative period

No abstract availabl

Mesenchymal stem cells: from biology to clinical use

Stem cells are immature progenitor cells capable of self-renewal and multilineage differentiation through a process of asymmetric mitosis that leads to two daughter cells, one identical to the stem cell and one capable of differentiation into more mature cells. Stem cells may be: 1) totipotent, i.e. early embryonic cells (1-3 days from oocyte fertilization), which can give rise to all the embryonic tissues and placenta; 2) pluripotent, i.e. embryonic cells from blastocystis (days 4-14 after oocyte fertilization), which can differentiate only into embryonic tissues belonging to the inner cell mass (ectoderm, mesoderm, and endoderm); or 3) multipotent, i.e. embryonic cells from the 14th day onwards, fetal stem cells, cord blood stem cells, and adult stem cells, which can give rise only to tissues belonging to one embryonic germ layer (ectoderm or mesoderm or endoderm). Mesenchymal stem cells (MSC) are non-haematopoietic cell precursors initially found in the bone marrow, but actually present in many other tissues. MSC in culture are adherent, proliferating, and capable of multilineage differentiation into several tissues of mesenchymal origin, such as bone marrow stroma, adipose tissue, bone, cartilage, tendon, skeletal muscle, visceral mesoderm, and endothelial cells1-5. Well known and used for bone regeneration for many years, MSC came in the limelight at the end of the 1990s thanks to the evidence that, despite their adult stem cell nature, these cells are capable of pluripotent differentiation, which may be useful for regenerative medicine. In addition, since the beginning of 2000 it has become clear that MSC possess immune regulatory properties that may make them useful in autoimmune diseases

Acupuncture and auricular cryotherapy for chronic headache in a patient with type III von Willebrand disease

[No abstract available

SIMTI recommendations on blood components for non-transfusional use.

[No abstract available