Articles related to BLEEDING/BLOOD DISORDERS

In a cluster-randomized trial conducted across multiple countries, a multicomponent clinical intervention was evaluated for the management of postpartum hemorrhage in patients undergoing vaginal delivery. The intervention involved the use of a calibrated blood-collection drape for early detection of postpartum hemorrhage and a treatment bundle consisting of various interventions. The study found that the intervention group had a lower risk of severe postpartum hemorrhage, laparotomy for bleeding, or death from bleeding compared to the usual-care group. The intervention group also had higher rates of postpartum hemorrhage detection and adherence to the treatment bundle.

The business launched a precautionary global recall of desmopressin formulations used to treat mild-to-moderate hemophilia A and von Willebrand disease after higher-than-specified amounts of desmopressin were discovered in various formulations. Stimate, a nasal spray containing a synthetic form of desmopressin acetate used to control bleeding in hemophilia patients, is among the recalled products, as is Octostim Nasal Spray 1.5 mg/ml, DDAVP 10 micrograms (mcg)/0.1 ml, Minirin Nasal Spray 0.1 mg/ml, and Generic Desmopressin Acetate Nasal Spray 10 mcg/0.1 ml. Products containing higher-than-specified amounts of desmopressin were recalled due to concerns that increased desmopressin exposure can result in water retention, low blood pressure, and low blood salt levels in mild cases, as well as seizure, coma, and death.

Anti-Xa levels could be helpful for determining current medication concentrations, determining the immediate safety of therapy, and providing direction for potential clinical actions. Further study is needed to determine how dose titration and reversal therapy based on anti-Xa level results in significant bleeding.

Twelve-hundred (1,200) patients admitted for 48 hours or more for COVID were randomized to 2.5mg of apixaban or placebo twice daily for 30 days. The incidence of death or thromboembolism was low and similar in the two arms of this study. The study was terminated early and the authors say the results are imprecise.

The researchers discovered that 11 of the participants had likely somatic variants at known pathogenic UBA1 positions, and all 11 had clinical symptoms consistent with VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome. Five people (45 percent) did not meet the criteria for previous rheumatologic and/or hematologic diagnoses associated with VEXAS syndrome, but all 11 had anemia, which was macrocytic in 10 people and had concomitant thrombocytopenia in 10 people. One male patient had a pathogenic variant identified prior to the onset of VEXAS-related signs or symptoms, and two female patients had disease caused by heterozygous variants. A previously unreported UBA1 variant was found in one symptomatic patient, with in vitro data supporting a catalytic defect and pathogenicity. Disease-causing UBA1 variants were found in one of 13,591 unrelated individuals, as well as in one of 4,269 men and one in 26,238 women over the age of 50.

The CBC, ordered hundreds of millions of times a year in the US alone, typically reports 19 different values, some of which are redundant and inconsequential. These authors suggest three distinct CBCs. [Subscription Required]