Smjernice Hrvatskog društva za hematologiju i transfuzijsku medicinu u dijagnostičko-terapijskom postupku za trombocitopeniju izazvanu heparinom (HIT) [Croatian Society for Haematology and Transfusion Medicine Guidelines on the diagnosis and management of heparin induced thrombocytopenia (HIT)]

Heparin induced thrombocytopenia (HIT) is a serious complication of heparin administration. In the last decade, this clinical syndrome has come into the focus of interest, primarily because of the severe thromboembolic complications that may lead to lethal outcome. In addition, great improvements have been made in the treatment with direct thrombin inhibitors and in laboratory diagnosis of HIT. As guidelines for diagnostic and management of HIT upgrade the quality of patient treatment, activities for their development have been launched in the Republic of Croatia. Based on British Committee for Standards in Haematology (BCSH) recommendations on diagnostic and treatment of HIT from 2006, activities for the introduction of new assays for anti-heparin antibodies were launched in 2008 and 2009, including algorithm of laboratory testing for HIT, sheet for clinical assessment of HIT (4T score), and education oftransfusiologists and clinicians. Upon evaluation of the results collected during one-year period, the Croatian Society of Haematology and Transfusion Medicine nominated a task force for the development of guidelines for HIT in January 2010. Following wide-ranging discussion, the guidelines were adopted in May 2011

MALDI TOF Mass Spectrometry Imaging of Blood Smear: Method Development and Evaluation

The aim of this study was to develop and evaluate matrix assisted LASER desorption ionization (MALDI) time-of-flight (TOF) mass spectrometry imaging (MSI) of blood smear. Integrated light microscope and MALDI IT-TOF mass spectrometer, together with a matrix sublimation device, were used for analysis of blood smears coming from healthy male donors. Different blood plasma removal, matrix deposition, and instrumental settings were evaluated using the negative and positive ionization modes while agreement between the light microscopy images and the lateral distributions of cellular marker compounds served as the MSI quality indicator. Red and white blood cells chemical composition was analyzed using the differential m/z expression. Five seconds of exposure to ethanol followed by the 5 min of 9-aminoacridine or α-cyano-4-hydroxycinnamic acid deposition, together with two sets of instrumental settings, were selected for the MALDI TOF MSI experiments. Application of the thin and transparent matrix layers assured good correspondence between the LASER footprints and the preselected regions of interest. Cellular marker m/z signals coincided well with the appropriate cells. A metabolite databases search using the differentially expressed m/z produced hits which were consistent with the respective cell types. This study sets the foundations for application of blood smear MALDI TOF MSI in clinical diagnostics and research

Yeast-Derived Nucleotides Enhance Fibroblast Migration and Proliferation and Provide Clinical Benefits in Atopic Dermatitis

Nucleotides, glycosaminoglycans, and omega-3 essential fatty acids (O3s) could be used for improving skin health, although their modes of action, alone or in combination, are not yet fully understood. To gain some insight into these mechanisms, we performed two in vitro tests and one in vivo pilot trial. The effects on human dermal fibroblast proliferation and migration were evaluated with the following compounds and combinations: 0.156 mg/mL O3s, 0.0017 mg/mL hyaluronic acid (HA), 0.0004 mg/mL dermatan sulfate (DS), 0.0818 mg/mL nucleotides, and [O3s + HA + DS] and [O3s + HA + DS + nucleotides] at the same concentrations. In both in vitro assays, adding nucleotides to [O3s + HA + DS] provided significant improvements. The resulting combination [O3s + HA + DS + nucleotides] was then tested in vivo in dogs with atopic dermatitis by oral administration of a supplement providing a daily amount of 40 mg/kg nucleotides, 0.9 mg/kg HA, 0.18 mg/kg DS, 53.4 mg/kg EPA, and 7.6 mg/kg DHA. After 30 days, the pruritus visual analog scale (pVAS) score was significantly reduced, and no adverse effects were observed. In conclusion, the combination of nucleotides plus glycosaminoglycans and O3s could serve as a useful therapeutic alternative in skin health applications

Smjernice Hrvatskog društva za transfuzijsku medicinu za određivanje Rh(D) krvne grupe i primjenu RhD genotipizacije

SAŽETAK Radna skupina Hrvatskog društva za transfuzijsku medicinu pripremila je smjernice za određivanje Rh(D) krvne grupe i primjenu RhD genotipizacije. U smjernicama je opisan klinički značaj antigena D, povijest i ograničenja serološkog testiranja antigena D te mogućnosti RhD genotipizacije. Cilj smjernica bio je objava novih postupnika serološkog određivanja Rh(D) krvne grupe bolesnicima, trudnicama i novorođenčadi s uputama za specijaliste transfuzijske medicine u hitnom i redovnom radu te tumačenjima nalaza namijenjenim ginekolozima, pedijatrima, neonatolozima, anesteziolozima, internistima, liječnicima obiteljske medicine te svim liječnicima koji se u svom radu susreću s bolesnicima koji primaju krvne pripravke i donose odluku o primjeni RhIG imunoprofilakse. Kao rezultat provođenja smjernica predviđeno je praćenje i periodično izvještavanje u slučaju sumnje na RhD imunizaciju kod osoba nositelja D-varijante. Tijekom trudnoće postoji i mogućnost neinvazivnog određivanja prijenatalnog fetalnog RhD genotipa iz majčine plazme iza 16. tjedna gestacije, kao važnog alata u procjeni rizika razvoja hemolitičke bolesti fetusa i novorođenčeta. Radi lakšeg snalaženja navedene su vrste spremnika za uzorkovanje krvi i potrebna količina uzoraka. Navedena pretraga dostupna je u Hrvatskom zavodu za transfuzijsku medicinu na zahtjev ginekologa, a preporučuje se prvenstveno RhD imuniziranim trudnicama te u slučaju donošenja odluke o ranoj prijenatalnoj anti-D imunoprofilaksi i svim Rh(D) negativnim neimuniziranim trudnicama

Recommendations for Diagnosis, Prevention and Treatment of Cytomegalovirus in Solid Organ Transplant Recipients

Infekcija citomegalovirusom (CMV) još uvijek predstavlja jednu od najčešćih komplikacija u primatelja solidnih organa. Povezana je s povećanim rizikom različitih komplikacija, uključujući gubitak presatka i smrt primatelja. Multidisciplinarni panel stručnjaka koji se bave transplantacijom solidnih organa okupio se radi donošenja preporuka za dijagnostiku, prevenciju i liječenje CMV infekcije. Preporuke su prvenstveno posvećene suvremenom pristupu dijagnozi CMV infekcije, mogućnostima liječenja novim antivirusnim lijekovima i načinima liječenja rezistentne/refraktorne CMV bolesti.Cytomegalovirus (CMV) infection remains one of the most common complications in solid organ transplant recipients. It is associated with an increased risk of different complications, including graft loss and mortality. A multidisciplinary panel of solid organ transplant experts gathered to revise and adopt consensus recommendations on CMV diagnostics, prevention, and treatment. Recommendations focus on the current approach to diagnosing CMV infection, different methods of prevention, possibilities of treatment with novel antiviral therapies, and approaches to treating resistant/refractory disease

Recommendations for Diagnosis, Prevention and Treatment of Cytomegalovirus in Solid Organ Transplant Recipients

Infekcija citomegalovirusom (CMV) još uvijek predstavlja jednu od najčešćih komplikacija u primatelja solidnih organa. Povezana je s povećanim rizikom različitih komplikacija, uključujući gubitak presatka i smrt primatelja. Multidisciplinarni panel stručnjaka koji se bave transplantacijom solidnih organa okupio se radi donošenja preporuka za dijagnostiku, prevenciju i liječenje CMV infekcije. Preporuke su prvenstveno posvećene suvremenom pristupu dijagnozi CMV infekcije, mogućnostima liječenja novim antivirusnim lijekovima i načinima liječenja rezistentne/refraktorne CMV bolesti.Cytomegalovirus (CMV) infection remains one of the most common complications in solid organ transplant recipients. It is associated with an increased risk of different complications, including graft loss and mortality. A multidisciplinary panel of solid organ transplant experts gathered to revise and adopt consensus recommendations on CMV diagnostics, prevention, and treatment. Recommendations focus on the current approach to diagnosing CMV infection, different methods of prevention, possibilities of treatment with novel antiviral therapies, and approaches to treating resistant/refractory disease

Recommendations for Diagnosis, Prevention and Treatment of Cytomegalovirus in Solid Organ Transplant Recipients

Infekcija citomegalovirusom (CMV) još uvijek predstavlja jednu od najčešćih komplikacija u primatelja solidnih organa. Povezana je s povećanim rizikom različitih komplikacija, uključujući gubitak presatka i smrt primatelja. Multidisciplinarni panel stručnjaka koji se bave transplantacijom solidnih organa okupio se radi donošenja preporuka za dijagnostiku, prevenciju i liječenje CMV infekcije. Preporuke su prvenstveno posvećene suvremenom pristupu dijagnozi CMV infekcije, mogućnostima liječenja novim antivirusnim lijekovima i načinima liječenja rezistentne/refraktorne CMV bolesti.Cytomegalovirus (CMV) infection remains one of the most common complications in solid organ transplant recipients. It is associated with an increased risk of different complications, including graft loss and mortality. A multidisciplinary panel of solid organ transplant experts gathered to revise and adopt consensus recommendations on CMV diagnostics, prevention, and treatment. Recommendations focus on the current approach to diagnosing CMV infection, different methods of prevention, possibilities of treatment with novel antiviral therapies, and approaches to treating resistant/refractory disease