Point-of-care estimation of haemoglobin concentration in all age groups in clinical practice

Background: The measurement of haemoglobin (Hb) concentration provides a reliable, primary screening test for the presence and severity of anaemia. The HemoCue® is a point-of-care test for Hb measurement. The introduction of point-of-care testing in hospitals and general practice has improved patient care and accessibility. This study was performed to evaluate the utility of point-of-care Hb measurement with the HemoCue® device for the diagnosis of anaemia. Method: In this prospective study, we compared the analytical performance of the HemoCue® to the Coulter® LH 750 automated haematology analyser with regard to accuracy, precision and linearity in the measurement of Hb in adult and paediatric patient samples, referred for routine laboratory testing. Results: Samples from 100 patients were analysed with both instruments, and the results were compared using standard scatter and difference plots. The mean Hb value of the HemoCue® (11.3 g/dl; range 4.6-16.7) was comparable to the Coulter® LH 750 (11.3 g/dl; range 4.7-17.2). The Bland-Altman difference plot revealed good correlation. Bias between the two methods was small, and the imprecision was within acceptable limits. Hb measurement was linear in the range of 4.8-20 g/dl. Conclusion: In all age groups, the HemoCue® point-of-care device can be used to provide accurate and reliable Hb measurements with a smaller sample volume, improved turnaround time, and long-term cost saving.Keywords: haemoglobin, HemoCue®, point-of-care testing, anaemia screenin

Integrated monitoring of water allocation reform in South Africa

South Africa faces significant inequities in the allocation of water for productive purposes. Water allocation is one component of a wider government mandate to address the inequities of the past. Water allocation reform is being implemented by the South African Department of Water Affairs and Forestry (DWAF), through the Water Allocation Reform (WAR) Programme. This paper presents an approach for determining indicators that can be used to monitor targets for WAR and for prioritising areas for specific WAR interventions. The approach integrates water use data with environmental, economic and equity data to provide a holistic picture of the progress and benefits of WAR. Limitations of the approach are discussed, specifically related to the data on which the indicators are based. The development of data for the equity indicator presents specific challenges which are discussed through examples from its application in four case study areas.Keywords: monitoring, water allocation reform, equity, indicators, South Afric

Recombinant factorVIII Fc fusion protein for the prevention and treatment of bleeding in children with severe hemophilia A

This work was supported by funding from Biogen, including funding for the editorial and writing support in the the development of this paper

Local reference ranges for full blood count and CD4 lymphocyte count testing

Objective. Recent advances in full blood count and CD4 technology, coupled with the changing population demographics of the Gauteng region, have necessitated reevaluation of the reference ranges currently in use.Methods. A cross-sectional study of 631 female and 88 male HIV-negative participants from the Gauteng region was performed. Full blood count, automated differential and CD4 count analyses were done using the latest internationally accepted technology. Reference ranges were compiled from the 2.5th and 97.5th percentiles for both male and female participant groups, and gender and ethnic comparisonscalculated by non-parametric tests.Results. Results of 41 females were removed from the statistical analysis because their results were suggestive of possible anaemia. Full blood count reference interval comparison confirmed gender-specific differences in red blood cell and platelet parameters. Ethnic-specific differences were found for some red blood cell parameters in the black female cohort. In addition, black males and females bothgenerally had lower neutrophil and higher lymphocyte counts than a combined Asian/Caucasian/coloured ethnic group.Conclusion. Comparison of the currently calculated referenceranges with published data and reference values in use indicated that a separate ethnic-specific reference range should be introduced for the percentage/absolute neutrophil count and percentage lymphocytes. In addition, locallyerived reference ranges for red cell distribution width(RDW) and CD4 percentage of lymphocytes should be implemented for routine diagnostic testing

Key Issues In Inhibitor Management In Patients With Haemophilia

[No abstract available]12SUPPL.1s319s329Bray, G.L., Gomperts, E.D., Courter, S., A multicenter study of recombinant factor VIII (recombinate): Safety, efficacy, and inhibitor risk in previously untreated patients with hemophilia A. The recombinate study group (1994) Blood, 83, pp. 2428-2435Lusher, J.M., Arkin, S., Abildgaard, C.F., Schwartz, R.S., Recombinant factor VIII for the treatment of previously untreated patients with hemophilia A. Safety, efficacy, and development of inhibitors. Kogenate previously untreated patient study group (1993) N Engl J Med, 328, pp. 453-459Hay, C.R., Baglin, T.P., Collins, P.W., The diagnosis and management of factor VIII and IX inhibitors: A guideline from the UK Haemophilia Centre Doctors' Organization (UKHCDO) (2000) Br J Haematol, 111, pp. 78-90Lawrence, J.S., Johnson, J.B., The presence of a circulating anticoagulant in a male member of a hemophiliac family (1941) Trans Am Clin Climatol Assoc, 57, pp. 223-231Konkle, B.A., Ebbesen, L.S., Erhardtsen, E., Randomized, prospective clinical trial of recombinant factor VIIa for secondary prophylaxis in hemophilia patients with inhibitors (2007) J Thromb Haemost, 5, pp. 1904-1913Leissinger, C., Gringeri, A., Antmen, B., Anti-inhibitor coagulant complex prophylaxis in hemophilia with inhibitors (2011) N Engl J Med, 365, pp. 1684-1692Gouw, S.C., Van Den Berg, H.M., Oldenburg, J., F8 gene mutation type and inhibitor development in patients with severe hemophilia A: Systematic review and meta-analysis (2012) Blood, 119, pp. 2922-2934Gouw, S.C., Van Der Bom, J.G., Auerswald, G., Recombinant versus plasma-derived factor VIII products and the development of inhibitors in previously untreated patients with severe hemophilia A: The CANAL cohort study (2007) Blood, 109, pp. 4693-4697Iorio, A., Halimeh, S., Holzhauer, S., Rate of inhibitor development in previously untreated hemophilia A patients treated with plasma-derived or recombinant factor VIII concentrates: A systematic review (2010) J Thromb Haemost, 8, pp. 1256-1265Wight, J., Paisley, S., The epidemiology of inhibitors in haemophilia A: A systematic review (2003) Haemophilia, 9, pp. 418-435Hay, C.R., The epidemiology of factor VIII inhibitors (2006) Haemophilia, 12 (SUPPL. 6), pp. 23-28. , discussion 8-9Astermark, J., Basic aspects of inhibitors to factors VIII and IX and the influence of non-genetic risk factors (2006) Haemophilia, 12 (SUPPL. 6), pp. 8-13Hay, C.R., Palmer, B., Chalmers, E., Incidence of factor VIII inhibitors throughout life in severe hemophilia A in the United Kingdom (2011) Blood, 117, pp. 6367-6370Wacey, A.I., Kemball-Cook, G., Kazazian, H.H., The haemophilia A mutation search test and resource site, home page of the factor VIII mutation database: HAMSTeRS (1996) Nucleic Acids Res, 24, pp. 100-102Green, P.M., Montandon, A.J., Ljung, R., Haemophilia B mutations in a complete Swedish population sample: A test of new strategy for the genetic counselling of diseases with high mutational heterogeneity (1991) Br J Haematol, 78, pp. 390-397Viel, K.R., Ameri, A., Abshire, T.C., Inhibitors of factor VIII in black patients with hemophilia (2009) N Engl J Med, 360, pp. 1618-1627Viel, K.R., Machiah, D.K., Warren, D.M., A sequence variation scan of the coagulation factor VIII (FVIII) structural gene and associations with plasma FVIII activity levels (2007) Blood, 109, pp. 3713-3724Santos, A., Annichino-Bizzacchi, J.M., Ozelo, M.C., Inhibitors of factor VIII in hemophilia (2009) N Engl J Med, 361, pp. 309-310. , author reply 10Oldenburg, J., Pavlova, A., (2006) Genetic risk factors for inhibitors to factors VIII and IX.Haemophilia, 12 (SUPPL. 6), pp. 15-22Goodeve, A.C., Peake, I.R., The molecular basis of hemophilia A: Genotype-phenotype relationships and inhibitor development (2003) Semin Thromb Hemost, 29, pp. 23-30Jacquemin, M., Vantomme, V., Buhot, C., CD4+ T-cell clones specific for wild-type factor VIII: A molecular mechanism responsible for a higher incidence of inhibitor formation in mild/moderate hemophilia A (2003) Blood, 101, pp. 1351-1358Kane, W.H., Davie, E.W., Cloning of a cDNA coding for human factor V, a blood coagulation factor homologous to factor VIII and ceruloplasmin (1986) Proc Natl Acad Sci USA, 83, pp. 6800-6804Lacroix-Desmazes, S., Repesse, Y., Kaveri, S.V., Dasgupta, S., The role of VWF in the immunogenicity of FVIII (2008) Thromb Res, 122 (SUPPL. 2), pp. S3-6Rivard, G.E., Lillicrap, D., Poon, M.C., Can activated recombinant factor VII be used to postpone the exposure of infants to factor VIII until after 2 years of age? (2005) Haemophilia, 11, pp. 335-339Hermans, C., De Moerloose, P., Fischer, K., Management of acute haemarthrosis in haemophilia A without inhibitors: Literature review, European survey and recommendations (2011) Haemophilia, 17, pp. 383-392Kurnik, K., Bidlingmaier, C., Engl, W., New early prophylaxis regimen that avoids immunological danger signals can reduce FVIII inhibitor development (2010) Haemophilia, 16, pp. 256-262Gouw, S.C., Van Den Berg, H.M., Fischer, K., Intensity of factor VIII treatment and inhibitor development in children with severe hemophilia A: The RODIN study (2013) BloodKreuz, W., Ettingshausen, C.E., Zyschka, A., Inhibitor development in previously untreated patients with hemophilia A: A prospective long-term follow-up comparing plasmaderived and recombinant products (2002) Semin Thromb Hemost, 28, pp. 285-290Santagostino, E., Mannucci, P.M., Bianchi Bonomi, A., Guidelines on replacement therapy for haemophilia and inherited coagulation disorders in Italy (2000) Haemophilia, 6, pp. 1-10Rezende, S.M., Pinheiro, K., Caram, C., Registry of inherited coagulopathies in Brazil: First report (2009) Haemophilia, 15, pp. 142-149Manco-Johnson, M.J., Abshire, T.C., Shapiro, A.D., Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia (2007) N Engl J Med, 357, pp. 535-544Kruse-Jarres, R., Inhibitors: Our greatest challenge.Can we minimize the incidence? (2013) Haemophilia, 19 (SUPPL. 1), pp. 2-7Lobet, S., Detrembleur, C., Francq, B., Hermans, C., Natural progression of blood-induced joint damage in patients with haemophilia: Clinical relevance and reproducibility of threedimensional gait analysis (2010) Haemophilia, 16, pp. 813-821Leissinger, C.A., Prevention of bleeds in hemophilia patients with inhibitors: Emerging data and clinical direction (2004) Am J Hematol, 77, pp. 187-193Gringeri, A., Mantovani, L.G., Scalone, L., Cost of care and quality of life for patients with hemophilia complicated by inhibitors: The COCIS Study Group (2003) Blood, 102, pp. 2358-2363Fischer, K., Van Der Bom, J.G., Molho, P., Prophylactic versus on-demand treatment strategies for severe haemophilia: A comparison of costs and long-term outcome (2002) Haemophilia, 8, pp. 745-752Morfini, M., Haya, S., Tagariello, G., European study on orthopaedic status of haemophilia patients with inhibitors (2007) Haemophilia, 13, pp. 606-612Soucie, J.M., Cianfrini, C., Janco, R.L., Joint range-of-motion limitations among young males with hemophilia: Prevalence and risk factors (2004) Blood, 103, pp. 2467-2473Hay, C.R., Dimichele, D.M., The principal results of the International Immune Tolerance Study: A randomized dose comparison (2012) Blood, 119, pp. 1335-1344Astermark, J., Donfield, S.M., Dimichele, D.M., A randomized comparison of bypassing agents in hemophilia complicated by an inhibitor: The FEIBA NovoSeven Comparative (FENOC) Study (2007) Blood, 109, pp. 546-551Sorensen, B., Dargaud, Y., Kenet, G., On-demand treatment of bleeds in haemophilia patients with inhibitors: Strategies for securing and maintaining predictable efficacy with recombinant activated factor VII (2012) Haemophilia, 18, pp. 255-262Kenet, G., Martinowitz, U., Single-dose recombinant activated factor VII therapy in hemophilia patients with inhibitors (2008) Semin Hematol, 45, pp. S38-41Treur, M.J., McCracken, F., Heeg, B., Efficacy of recombinant activated factor VII vs. Activated prothrombin complex concentrate for patients suffering from haemophilia complicated with inhibitors: A Bayesian meta-regression (2009) Haemophilia, 15, pp. 420-436Knight, C., Dano, A.M., Kennedy-Martin, T., Systematic review of efficacy of rFVIIa and aPCC treatment for hemophilia patients with inhibitors (2009) Adv Ther, 26, pp. 68-88Valentino, L.A., The benefits of prophylactic treatment with APCC in patients with haemophilia and high-titre inhibitors: A retrospective case series (2009) Haemophilia, 15, pp. 733-742Teitel, J., Berntorp, E., Dolan, G., A consensus statement on clinical trials of bypassing agent prophylaxis in inhibitor patients (2011) Haemophilia, 17, pp. 516-521Young, G., Auerswald, G., Jimenez-Yuste, V., When should prophylaxis therapy in inhibitor patients be considered? (2011) Haemophilia, 17, pp. e849-e857Dimichele, D., Negrier, C., A retrospective postlicensure survey of FEIBA efficacy and safety (2006) Haemophilia, 12, pp. 352-362Valentino, L.A., Assessing the benefits of FEIBA prophylaxis in haemophilia patients with inhibitors (2010) Haemophilia, 16, pp. 263-271Brackmann, H.H., Schwaab, R., Effenberger, W., Hemophilia treatment. Side effects during immune tolerance induction (2000) Haematologica, 85, pp. 75-77Young, G., McDaniel, M., Nugent, D.J., Prophylactic recombinant factor VIIa in haemophilia patients with inhibitors (2005) Haemophilia, 11, pp. 203-207Morfini, M., Auerswald, G., Kobelt, R.A., Prophylactic treatment of haemophilia patients with inhibitors: Clinical experience with recombinant factor VIIa in European Haemophilia Centres (2007) Haemophilia, 13, pp. 502-507Jimenez-Yuste, V., Alvarez, M.T., Martin-Salces, M., Prophylaxis in 10 patients with severe haemophilia A and inhibitor: Different approaches for different clinical situations (2009) Haemophilia, 15, pp. 203-209Young, G., Auerswald, G., Jimenez-Yuste, V., PRO-PACT: Retrospective observational study on the prophylactic use of recombinant factor VIIa in hemophilia patients with inhibitors (2012) Thromb ResGupta, S., Siddiqi, A.E., Soucie, J.M., The effect of secondary prophylaxis versus episodic treatment on the range of motion of target joints in patients with haemophilia (2013) Br J Haematol, 161, pp. 424-433Carcao, M., Lambert, T., Prophylaxis in haemophilia with inhibitors: Update from international experience (2010) Haemophilia, 16 (SUPPL. 2), pp. 16-23Dimichele, D.M., Hoots, W.K., Pipe, S.W., International workshop on immune tolerance induction: Consensus recommendations (2007) Haemophilia, 13 (SUPPL. 1), pp. 1-22Lenk, H., The German Registry of immune tolerance treatment in hemophilia-1999 update (2000) Haematologica, 85, pp. 45-47Brackmann, H.H., Oldenburg, J., Schwaab, R., Immune tolerance for the treatment of factor VIII inhibitors-twenty years' 'bonn protocol' (1996) Vox Sang, 70 (SUPPL. 1), pp. 30-35Oldenburg, J., Schwaab, R., Brackmann, H.H., Induction of immune tolerance in haemophilia A inhibitor patients by the 'Bonn Protocol': Predictive parameter for therapy duration and outcome (1999) Vox Sang, 77 (SUPPL. 1), pp. 49-54Mauser-Bunschoten, E.P., Nieuwenhuis, H.K., Roosendaal, G., Van Den Berg, H.M., Low-dose immune tolerance induction in hemophilia A patients with inhibitors (1995) Blood, 86, pp. 983-988Indications and recommended doses for treating patients with factor VIII inhibitors in hemophilia A (2008) Cross-Sectional Guidelines for Therapy with Blood Components and Plasma Derivatives. Executive Committee of the German Medical Association on the Recommendation of the Scientific Advisory Board, p. 91. , German Medical AssociationCoppola, A., Margaglione, M., Santagostino, E., Factor VIII gene (F8) mutations as predictors of outcome in immune tolerance induction of hemophilia A patients with highresponding inhibitors (2009) J Thromb Haemost, 7, pp. 1809-1815Freiburghaus, C., Berntorp, E., Ekman, M., Immunoadsorption for removal of inhibitors: Update on treatments in Malmo-Lund between 1980 and 1995 (1998) Haemophilia, 4, pp. 16-20Auerswald, G., Spranger, T., Brackmann, H.H., The role of plasmaderived factor VIII/von Willebrand factor concentrates in the treatment of hemophilia A patients (2003) Haematologica, 88, pp. EREP05Dimichele, D., The North American Immune Tolerance Registry: Contributions to the thirty-year experience with immune tolerance therapy (2009) Haemophilia, 15, pp. 320-328Mariani, G., Ghirardini, A., Bellocco, R., Immune tolerance in hemophilia-principal results from the International Registry. Report of the factor VIII and IX Subcommittee (1994) Thromb Haemost, 72, pp. 155-158Mariani, G., Kroner, B., Immune tolerance in hemophilia with factor VIII inhibitors: Predictors of success (2001) Haematologica, 86, pp. 1186-1193Franchini, M., Mannucci, P.M., Inhibitors of propagation of coagulation (factors VIII, IX and XI): A review of current therapeutic practice (2011) Br J Clin Pharmacol, 72, pp. 553-562Greninger, D.A., Saint-Remy, J.M., Jacquemin, M., The use of factor VIII/von Willebrand factor concentrate for immune tolerance induction in haemophilia A patients with high-titre inhibitors: Association of clinical outcome with inhibitor epitope profile (2008) Haemophilia, 14, pp. 295-302Gringeri, A., Musso, R., Mazzucconi, M.G., Immune tolerance induction with a high purity von Willebrand factor/VIII complex concentrate in haemophilia A patients with inhibitors at high risk of a poor response (2007) Haemophilia, 13, pp. 373-379Kurth, M.A., Dimichele, D., Sexauer, C., Immune tolerance therapy utilizing factor VIII/von Willebrand factor concentrate in haemophilia A patients with high titre factor VIII inhibitors (2008) Haemophilia, 14, pp. 50-55Astermark, J., Morado, M., Rocino, A., Current European practice in immune tolerance induction therapy in patients with haemophilia and inhibitors (2006) Haemophilia, 12, pp. 363-371Garvey, B., Rituximab in the treatment of autoimmune haematological disorders (2008) Br J Haematol, 141, pp. 149-169Franchini, M., Mengoli, C., Lippi, G., Immune tolerance with rituximab in congenital haemophilia with inhibitors: A systematic literature review based on individual patients' analysis (2008) Haemophilia, 14, pp. 903-912Sorensen, B., Johansen, P., Christiansen, K., Whole blood coagulation thrombelastographic profiles employing minimal tissue factor activation (2003) J Thromb Haemost, 1, pp. 551-558De Paula, E.V., Kavakli, K., Mahlangu, J., Recombinant factor VIIa analog (vatreptacog alfa [activated]) for treatment of joint bleeds in hemophilia patients with inhibitors: A randomized controlled trial (2012) J Thromb Haemost, 10, pp. 81-89Holmberg, H.L., Lauritzen, B., Tranholm, M., Ezban, M., Faster onset of effect and greater efficacy of NN1731 compared with rFVIIa, aPCC and FVIII in tail bleeding in hemophilic mice (2009) J Thromb Haemost, 7, pp. 1517-1522Moss, J., Scharling, B., Ezban, M., Moller Sorensen, T., Evaluation of the safety and pharmacokinetics of a fast-acting recombinant FVIIa analogue, NN1731, in healthy male subjects (2009) J Thromb Haemost, 7, pp. 299-305Sorensen, B., Persson, E., Ingerslev, J., Factor VIIa analogue (V158D/E296V/M298Q-FVIIa) normalises clot formation in whole blood from patients with severe haemophilia A (2007) Br J Haematol, 137, pp. 158-165Allen, G.A., Persson, E., Campbell, R.A., A variant of recombinant factor VIIa with enhanced procoagulant and antifibrinolytic activities in an in vitro model of hemophilia (2007) Arterioscler Thromb Vasc Biol, 27, pp. 683-689Mahlangu, J.N., Coetzee, M.J., Laffan, M., Phase I, randomized, double-blind, placebo-controlled, single-dose escalation study of the rFVIIa variant BAY 86-6150 in hemophilia (2012) J Thromb Haemost, 10, pp. 773-780Karpf, D.M., Sorensen, B.B., Hermit, M.B., Prolonged halflife of glycoPEGylated rFVIIa variants compared to native rFVIIa (2011) Thromb Res, 128, pp. 191-195Sen, P., Ghosh, S., Ezban, M., Effect of glycoPEGylation on factor VIIa binding and internalization (2010) Haemophilia, 16, pp. 339-348Toschi, V., OBI-1, porcine recombinant factor VIII for the potential treatment of patients with congenital hemophilia A and alloantibodies against human Factor VIII (2010) Curr Opin Mol Ther, 12, pp. 617-625Parker, E.T., Craddock, H.N., Barrow, R.T., Lollar, P., Comparative immunogenicity of recombinant B domain-deleted porcine factor VIII and Hyate: C in hemophilia A mice presensitized to human factor VIII (2004) J Thromb Haemost, 2, pp. 605-611Kempton, C.L., Abshire, T.C., Deveras, R.A., Pharmacokinetics and safety of OBI-1, a recombinant B domain-deleted porcine factor VIII, in subjects with haemophilia A (2012) Haemophilia, 18, pp. 798-804Abshire, T.C., Brackmann, H.H., Scharrer, I., Sucrose formulated recombinant human antihemophilic factor VIII is safe and efficacious for treatment of hemophilia A in home therapy-International Kogenate-FS Study Group (2000) Thromb Haemost, 83, pp. 811-816Tarantino, M.D., Collins, P.W., Hay, C.R., Clinical evaluation of an advanced category antihaemophilic factor prepared using a plasma/albumin-free method: Pharmacokinetics, efficacy, and safety in previously treated patients with haemophilia A (2004) Haemophilia, 10, pp. 428-437Young, G., Cooper, D.L., Gut, R.Z., Dosing and effectiveness of recombinant activated factor VII (rFVIIA) in congenital haemophilia with inhibitors by bleed type and location: The experience of the Haemophilia and Thrombosis Research Society (HTRS) Registry (2004-2008) (2012) Haemophilia, 18, pp. 990-99

Screening for falls risk in the older person with haemophilia – a pilot study

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Implementation Dilemma of the Concept ‘Research-Intensive University’ at Institutions of Higher Learning: A Critical Analysis

Critical theory is used in trying to understand the concept of research-intensive universities and the moral collapse of teacher training institutions in higher education. What makes critical scholarship different from interpretive scholarship is that it interprets the acts and the symbols of society in order to understand the ways in which various social groups are oppressed. This article is driven by the researchers’ own experiences at institutions of higher learning in South Africa, as well as literature review. Moral reasoning is important within the professions because of the social status of professions. Claims by various groups about fairness of college access are central to the public discourse about equal treatment. The pressure to publish is keenly felt by all education academics, so considerable tension could arise over who is involved in initial teacher training. There is a danger that training quality teachers may be compromised as research-intensive universities will pay more attention to research at the expense of teaching and learning DOI: 10.5901/mjss.2014.v5n27p3

Exploring the significance of falls in the everyday lives of the older person with haemophilia

Sin financiación3.569 JCR (2016) Q2, 22/70 HematologyUE