mgybel.bsky.social
@mgybel.bsky.social
MD, Transfusion Medicine specialist. Hemostasis and treatment of bleeding patients. Research interests: Blood product quality, blood bank storage lesion, donor health and donor factors. Brønshøj Boldklub 🐝🐝🐝
OK #SkyBrain Hotel to stay at in Manhattan for family with teenage kids? preferably with nice breakfast (not necessarily buffet-style). Probably SoHo, NoHo East Village, Greenwich Village, Chelsea, Midtown S.
December 24, 2024 at 12:09 PM
Reposted
New from the #Transfusion Evidence Round-Up: Best of the TEL 2024:

Two-year outcomes following a randomised platelet transfusion trial in preterm infants
by Moore et al.
www.transfusionevidencelibrary.com/alerts/artic...
December 23, 2024 at 8:17 AM
Reposted
99% of the circulating cells, 84% of the cells in the body are RBCs. These 25 trillion cells shed 1 vesicle/h (more under stress). With >250 transporters and receptors, RBCs pick up/release metabolites, at times even against gradient, throughout the body. Yet, they are not part of 👇 conversation
December 22, 2024 at 12:54 PM
Recommandation in favor of using platelet function testing for tailoring anti-platelet therapy in coronary disease… #HemeSky #TMSky

www.sciencedirect.com/science/arti...
International Consensus Statement on Platelet Function and Genetic Testing in Percutaneous Coronary Intervention: 2024 Update
Current evidence indicates that dual antiplatelet therapy with aspirin plus a P2Y12 inhibitor is essential for the prevention of thrombotic events aft…
www.sciencedirect.com
December 4, 2024 at 7:17 PM
Benefits of VHA in bleeding patients - less transfusion, less reintervention, less bleeding - and lower mortality ? (RR 0.76, 95% CI 0.57–1.00). #TMSky #HemeSky
onlinelibrary.wiley.com/doi/10.1111/...
Thromboelastography or rotational thromboelastometry guided algorithms in bleeding patients: An updated systematic review with meta‐analysis and trial sequential analysis
Background Bleeding patients face significant morbidity and mortality due to impaired haemostasis. Haemostatic resuscitation has evolved, yet the optimal approach remains unclear. The primary object...
onlinelibrary.wiley.com
December 4, 2024 at 1:59 PM
December 2, 2024 at 3:18 PM
Reposted
🩸Platelets!

Lifespan 7-10 days
150-450 × 10⁹/L
Stimulated by TPO
1/3 sequestered in spleen

Receptors:
GpIIbIIIa -> fibrinogen
GPIb-IX-V -> vWF
P2Y12 -> ADP

Granules:
Alpha = fibrinogen, vWF, V, VEGF, PF4, PDGF, P-selectin
Dense = ADP, Ca, Serotonin
#hemesky #MedSky

van der Meijden et al, 2019
December 1, 2024 at 1:05 PM
Two fab threads on Andexanet-Alfa summing up published data and FDA data. I agree that Andexanet is NOT the holy grail of anti-anti-Xa! #MedSky #TMSky #HemeSky
The other day, I summarised the new data on thrombotic events with andexanet alfa, presented to/by the FDA.

Now, let's focus on new efficacy data

A🧵
Tons of NEW DATA about andexanet, presented as part of FDA hearing last week. If you couldn’t make it through the short 6h meeting, GOOD NEWS, I’ve watched it and highlighted the important points.
A🧵
December 1, 2024 at 7:23 AM
Reposted
Så er det juletid i Folketinget og politikerne deler pakker og garantier ud til de raske. Men ‘Når du strammer garnet, kvæler du jo barnet’.
Hvis alle sygdomme skulle behandles inden 30 dage så blev ingen behandlet inden 30 dage.#dksund #dksund jyllands-posten.dk/indland/ECE1...
Nye tal viser, at sygehusene ikke har fjernet ventetidspuklen for en stor gruppe af plagede patienter: »Det er skandaløst, at patienters rettigheder ikke tages mere alvorligt«
Behandlingsgarantien er »et spil for galleriet«, der har meget negative konsekvenser for patienterne, mener sundhedsprofessor.
jyllands-posten.dk
November 25, 2024 at 6:08 AM
Pilot study comparing daily to alternate days and thrice weekly oral iron in pregnant women.
- Interestingly, thrice weekly seems unfavorable mainly due to peripartum outcomes… #TMsky #Hemesky

ashpublications.org/bloodadvance...
November 22, 2024 at 7:18 PM
There is a reason for not recommending #andexxanetalfa for #DOAC reversal - we simply do not know enough…! #TMSky #HemeSky
1/ FDA hearing on #andexanet alfa is tomorrow (21 Nov 2024). The documents contain some more data on thrombotic events that weren't published in ANNEXA-I.

To be honest, reading through, I have found this data pretty shocking.

A 🧵
November 21, 2024 at 12:47 PM
Reposted
In summary:
1. Phlebotomy = 30-50 ml/day blood loss
2. This worsens anemia and increases costs/transfusion
3. Simple strategies can be taken, including drawing fewer labs, using smaller volume tubes, using closed loop sampling, and using non-invasive technologies.

#anemia #medsky #ansky #emimcc
November 18, 2024 at 3:54 AM
Brief review on options for immune platelet refractoriness… interesting that using a MFI cut-off of 10.000 still yields works in immune-refractory patients w/ HLA-Abs, might change our guidelines. #hemesky #tmsky

onlinelibrary.wiley.com/doi/abs/10.1...
Management of human leukocyte antigen‐mediated platelet transfusion refractoriness: Brief synopsis and recent literature review
Click on the article title to read more.
onlinelibrary.wiley.com
November 16, 2024 at 5:04 PM