Aspects périopératoires de la transfusion sanguine en pédiatrie

In pediatric elective surgery, the main indications of blood transfusion are cardiac surgery, neurosurgery and abdominal tumors. Blood saving techniques are also available. The transfusion threshold has to take into account the physiological age-related particularities. Underestimation of blood loss and delayed transfusion are associated with a severe morbidity. In the absence of specific literature, the management of hemorrhagic shock is based on extrapolation of the adult recommendations.     

4e Congrès international de la Société malgache de pédiatrie: la pédiatrie au XXIe siècle

Bulletin de la Société de pathologie exotique -     

Connaissances et attitudes du personnel médical en matière de transfusion sanguine au Mali

Purpose of the studyWe undertook a study to determine the level of knowledge and practice of medical staff personnel on transfusion medicine in Mali at Bamako and Kati.Patients and methodsThe study was conducted from January to April 2010 in the three main teaching hospitals of Bamako and Kati and in the six referral health centers of the district of Bamako. Medical staff knowledge and practice were assessed using a questionnaire. The study population consisted of specialized practitioners (15%), general practitioners (21.4%), nurses (41.6%), and midwives (22%).ResultsOverall, 70.9% of the staff did not receive any training in blood transfusion since their graduation. The general knowledge about blood transfusion was insufficient in 53.9% of staff and excellent in 46.1%. Only 42.9% of medical staff has a good basic knowledge of blood products, their indications, and related accidents.ConclusionOur study showed weaknesses in the transfusion system in Bamako, with insufficient knowledge of the medical staff in blood transfusion and little experience.     

Réalisation d’une transfusion sanguine en néonatologie : état des lieux des pratiques en 2016 en France ; situations aiguës ou chirurgicales exclues

Background

Blood transfusion is common in neonatology, especially in preterm or low birth weight infants. Recommendations were proposed by the French National Authority of Health (HAS) in 2014 and 2015 for red blood cells and platelet transfusion respectively, but an heterogeneity of practical attitudes persist. The objective of this survey is to evaluate transfusion practices in neonatal intensive care units.

Homocystéine et statut antioxydant en hémodialyse pédiatrique

Many metabolic disruptions in the terminal chronic renal insufficiency treated by hemodialysis are known. We are interested in this study to the homocysteine assay, and to two markers of the antioxydant status: the Super-Oxyde Dismutase (SOD) and the Total Antioxydant Status (TAS). The 17 studied patients are reached of a chronic renal insufficiency and treated by hemodialysis in the pediatric department since 12,5 ± 7,6 months and during a middle length of 12h a week. All of Them are supplemented with folates and some with B6 and B12 vitamins. The total plasmatic homocysteine before and after hemodialysis and the B12 vitamin assays have been done with immunometric methods. The basic SOD and the before and after hemodialysis TAS have been determined by colorimetric methods. Significantly increased rates (p < 0.001) of homocysteine (15.7 ± 5.6 μmol l^–1) in comparison to a control population (5.5 ± 0.5 μmol l^–1) have been noted. A significantly decrease of this rate (P = 0.003) has been observed after hemodialysis (11.6 ± 3.7 μmol l^–1) whereas the average of the B12 vitamin in this studied population was normal (682.2 ± 433.4 pg ml^–1). Erythrocytes SOD concentrations before hemodialysis (1619 ± 521 SOD unit g^–1 of Hemoglobin) are located to the superior normal ranges limit. We noted that the hemodialysis sitting entails a meaningful (P < 0.0001) SAT increase (2.57 ± 0.33 mmol l^–1 versus 1.96 ± 0.44 mmol l^–1). Two questions are layed: is the hemodialysis a good purifier of the plasmatic homocysteine, the cardiovascular risk factor? And, will the hemodialysis induce an increase of the antioxydant capacities of the organism by the elimination of free radicals or by the increase of the antioxydant capacities?     

Caractérisation de l’allo-immunisation anti-HLA et impact clinique en transfusion et en transplantation d’organe

Allo-immunizations against HLA antigens are known to be deleterious in transfusion and organ transplantation. The development of new tests based on solid phase assays for screening and identification of HLA antibodies in particular those using Luminex^® bead based technology has completely changed the way of allo-immunization monitoring because of their extreme sensitivity. They allow a better characterization of these antibodies, identification of acceptable antigens and the use of virtual cross-matches. All these new possibilities improve the managing of patients before and after platelets transfusion or organ transplantation. However, this technology displays some limits that should be known in order to interpret correctly the results. Beside these bead based assays, cellular cross-matches based on Complement Dependent Cytotoxicity (CDC) and flow cytometry are still used and useful in organ transplantation since beads are produced in vitro and do not reflected exactly what happens physiologically. Moreover, differences of sensitivity between these methods make results interpretation and decision making difficult in some cases.     

La participación universitaria directa en la formación de médicos especialistas en México

Introduction

The University of Veracruz implemented the General Study Plan for Medical Specialties in 2013. The courses included in this study plan are mandatory, as they are important to improve specialised medicine skills for medical specialists of the future. Since it is not possible to deliver attendance-based courses, medical education, health services and systems and human development courses were offered online.