New guideline's published in Annals of Internal Medicine by the AABB (formerly known as the American Association of Blood Banks), recommends a restrictive red blood cell transfusion strategy for stable adults and children. Between patients on a restrictive strategy or a liberal transfusion strategy, evidence shows no difference in the length of hospitalization, ability to walk unaided, or in mortality, and therefore physicians should consider transfusing at a hemoglobin threshold of 7 to 8g/dL. According to the 20-member panel of experts, in many settings patients are receiving unnecessary transfusions in the United States. Jeffery L. Carson, M.D., Chief of the Division of General Internal Medicine at UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, and lead author of the guideline, explained: "Our recommendation is based on the evidence that restrictive transfusion is safe and associated with less blood use.
Interventional radiology treatments re-establish blood flow in people with chronic deep vein thrombosis (DVT), reducing disabling symptoms and improving the quality of life for those afflicted with post-thrombotic syndrome - an under-recognized but frequent long-term complication of DVT. Researchers presented these findings during March's DVT Awareness Month at the Society of Interventional Radiology's 37th Annual Scientific Meeting in San Francisco. Blood clots within the legs are a major problem in the United States, affecting up to 600, 000 individuals annually. Despite appropriate medical management, as many as 50 percent of individuals with DVT that affects the large veins in the lower leg and thigh will go on to develop post-thrombotic syndrome (PTS). PTS is characterized by chronic, life-altering symptoms that include leg pain, swelling, fatigue and sometimes permanent skin changes including open sores (ulcers).
How and when our blood clots is one of those incredibly complex and important processes in our body that we rarely think about. If your blood doesn't clot and you cut yourself, you could bleed to death, if your blood clots too much, you could be in line for a heart attack or stroke. Dr. Hans Vogel, a professor at the University of Calgary, has thought a lot about blood clotting and recently published research in the prestigious Journal of the American Chemical Society that helps to better understand the clotting process. Vogel and his graduate student Hao Huang were able to determine the molecular 3D structure of a protein in blood platelets and a receptor that sticks through the membrane of the cell to the outside. Platelets are tiny cells specialized for clotting reactions. The receptor protein is unique for platelets and directly controls blood clot formation.
ONCOLOGY Promise of new treatment options for chemotherapy-resistant breast cancers p53 is lost or functionally impaired in many human cancers, and its absence is often associated with a poor response to conventional chemotherapy. Thus, much effort is currently devoted to developing novel treatments for p53-deficient malignancies. One approach is to target pathways that are selectively required for the survival of p53-deficient cancer cells, in effect exploiting a synthetic lethal interaction. Previous studies have demonstrated that inhibition of the ATR/CHK1 pathway in p53-deficient cells can induce such a synthetic lethal outcome. In this issue of the JCI, Ma et al. take these findings a step closer to the clinic by demonstrating that highly specific inhibitors of CHK1 synergize with chemotherapy to stem progression of p53-deficient triple-negative breast cancers in a xenotransplant model of this disease.
The diagnosis of myelodysplastic syndrome, a blood cancer, often causes confusion. While some patients can be treated with repeated blood transfusions, others require chemotherapy, leaving some uncertainty about whether the syndromes actually are cancer. Now, using the latest DNA sequencing technology, scientists at the Washington University School of Medicine in St. Louis have shown that the blood disease is an early form of cancer with characteristics that are very similar to the fatal leukemia to which it often progresses. And by mapping the genetic evolution of cancer cells in seven patients with myelodysplastic syndromes who later died of leukemia, they have found clues to suggest that targeted cancer drugs should be aimed at mutations that develop early in the disease. The research, by a large team of Washington University researchers at the Siteman Cancer Center, appears online in the New England Journal of Medicine.