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Objective Methods Results Conclusion To assess the uptake of a multidisciplinary team approach in obstetric disseminated intravascular coagulopathy (DIC) management in a low‐ to middle‐income country.A cross‐sectional observational study, in which a semi‐structured and pre‐tested questionnaire was used to collect data on the uptake by Nigerian obstetricians of the multidisciplinary team approach to obstetric DIC management.A total of 171 obstetricians responded, 82 (48.0%) were consultants and 89 (52.0%) were specialist registrars. Most (165; 96.5%) practiced in tertiary healthcare facilities and the multidisciplinary team approach was the most preferred (162; 94.7%) management approach. In all, 142 (83.0%) supported the invitation of hematologists always in the management whereas 115 (67.3%) participants recommended that involvement of specialists in the treatment should be when clinical presentation was suggestive of DIC. No significant association existed between years of obstetric practice and adoption of a multidisciplinary team‐based approach (χ2 = 9.590; P = 0.252).A multidisciplinary approach is widely adopted in the management of obstetric DIC, with hematologists being a key member of the team. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to evaluate the awareness and knowledge of hematologists about hepatitis B virus reactivation (HBVr) to draw attention to this subject’s importance. Material and Methods: Sixty-six hematologists included in Turkey. A 13-item questionnaire was administered to the study group to evaluate awareness, knowledge, and experience of HBVr. Results: It was thought by 97% of the participants that all patients who were to receive immunosuppressive treatment (IST) should be screened in respect of HBV. While 98.5% of the hematologists thought HBsAg should be examined in the screening, 89.4% thought anti-HBcIgG should be examined. A total of 89.4% of the hematologists stated that prophylaxis should be started before IST. HBV prophylaxis had been previously administered to patients receiving IST by 97% of the hematologists, and 44% had encountered HBVr at least once in patients. Training related to HBVr after IST had been received following graduation by 75.8% of the hematologists. Conclusions: Awareness about HBVr was found to be high in the hematologists in this study. However, it is worrying that there are clinicians not using anti-HBcIgG test in screening, and the screening rate before treatment with tyrosine kinase inhibitors was low. There was seen to be no standard follow-up protocol either for patients who had started or had not started prophylaxis. This study can be considered to be a stimulus on the subjects of preventing patients with isolated anti-HBcIgG positivity being overlooked, determining the HBVr risk associated with IST, and optimizing the follow-up of patients. [ABSTRACT FROM AUTHOR]

The article highlights historic aspects of medical and research work of the hematologist Eric Adolf von Willebrand by describing his contribution to investigating blood coagulation issues.

Cardiovascular (CV) disease is a common comorbidity in acute leukemia (AL) patients and can be worsened by the use of anthracyclines. Interruptions and underutilization of CV medications during AL treatments may negatively impact the CV health of these patients. A 30-question electronic survey was distributed to Canadian hematologists who treat adults with AL to determine the frequency, timing and rationale for interruptions in statins, antiplatelets and angiotensin antagonists in patients undergoing intensive chemotherapy. Strategies for mitigating anthracycline cardiotoxicity, methods of establishing baseline CV risk and utilization of clinical pharmacists were also assessed. Results indicate that it is common for AL patients undergoing intensive chemotherapy to require CV medication interruptions. This highlights the need for collaboration between hematology and cardiology healthcare teams and utilization of multidisciplinary healthcare professionals to improve CV care during AL. [ABSTRACT FROM AUTHOR]

Andra H James,1 David L Cooper,2 Michael J Paidas3 1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke University, Durham, NC, 2Clinical, Medical and Regulatory Affairs, Novo Nordisk Inc., Plainsboro, NJ, 3Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale Women and Children’s Center for Blood Disorders and Preeclampsia Advancement, Yale University, New Haven, CT, USA Purpose: Coagulopathy may be a serious complicating or contributing factor to postpartum hemorrhage (PPH), and should be promptly recognized to ensure proper bleeding management. This study aims to evaluate the approaches of obstetrician-gynecologists worldwide towards assessing massive PPH caused by underlying bleeding disorders. Methods: A quantitative survey was completed by 302 obstetrician-gynecologists from 6 countries (the UK, France, Germany, Italy, Spain, and Japan). The survey included questions on the use of hematologic laboratory studies, interpretation of results, laboratory’s role in coagulation assessments, and experience with bleeding disorders. Results: Overall, the most common definitions of “massive” PPH were >2,000 mL (39%) and >1,500 mL (34%) blood loss. The most common criteria for rechecking a “stat” complete blood count and for performing coagulation studies were a drop in blood pressure (73%) and ongoing visible bleeding (78%), respectively. Laboratory coagulation (prothrombin time/activated partial thromboplastin time [PT/aPTT]) and factor VIII/IX assays were performed on-site more often than were mixing studies (laboratory coagulation studies, 93%; factor VIII/IX assays, 63%; mixing studies, 22%). Most commonly consulted sources of additional information were colleagues within one’s own specialty (68%) and other specialists (67%). Most respondents had consulted with a hematologist (78%; least, Germany [56%]; greatest, UK [98%]). The most common reason for not consulting was hematologist unavailability (44%). The most commonly reported thresholds for concern with PT and aPTT were 13 to 20 seconds (36%) and 30 to 45 seconds (50%), respectively. Most respondents reported having discovered an underlying bleeding disorder (58%; least, Japan [35%]; greatest, Spain [74%]). Conclusion: Global survey results highlight similarities and differences between countries in how PPH is assessed and varying levels of obstetrician-gynecologist experience with identification of underlying bleeding disorders and engagement of hematology consultants. Opportunities to improve patient management of PPH associated with bleeding disorders include greater familiarity with interpreting PT/aPTT test results and identification of and consistent consultation with hematologists with relevant expertise. Keywords: postpartum hemorrhage, acquired hemophilia, bleeding disorders, hematologist, coagulation studies

Meera Chitlur,1 Madhvi Rajpurkar,1 Michael Recht,2 Michael D Tarantino,3 Donald L Yee,4 David L Cooper,5 Sriya Gunawardena5 1Carman and Ann Adams Department of Pediatrics, Wayne State University and Children’s Hospital of Michigan, Detroit, MI, USA; 2Oregon Health and Science University, Portland, OR, USA; 3Bleeding and Clotting Disorders Institute, Peoria, IL, USA; 4Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; 5Clinical Development, Medical and Regulatory Affairs, Novo Nordisk Inc., Plainsboro, NJ, USA Abstract: Patients with rare qualitative platelet disorders or platelet function disorders (PFDs) may present to the hospital physician with severe bleeding episodes or excessive surgical bleeding. Although standard treatment consists of platelet transfusions, repeated transfusions may result in the development of antiplatelet antibodies (APA) or clinical refractoriness, rendering further platelet therapy ineffective. In such settings, an approved treatment option for patients with Glanzmann’s thrombasthenia (GT), one of the well-known rare PFDs, is recombinant activated coagulation factor VII (rFVIIa). Data regarding the efficacy of rFVIIa in patients with GT and platelet refractoriness are available from a large patient registry, an international survey, and multiple case reports and demonstrate efficacy in patients with and without refractoriness or APA. This article reviews the rFVIIa clinical data in patients with GT and platelet refractoriness and discusses clinical implications relevant to the hospital-based physician. Because uncontrolled bleeding can be life-threatening, hospital physicians should be alert to the signs of platelet refractoriness, be able to recognize continued internal or external bleeding, and know how to adapt treatment regimens for the effective management of bleeding. The management of patients who receive rFVIIa should occur in consultation with a hematologist with experience in PFDs, and patients with suspected platelet refractoriness should be referred to such a hematologist as early as possible. A critical unmet need is the development of a definition of an adequate response to platelet transfusion, which would facilitate early recognition of platelet refractoriness in patients with PFDs who exhibit a normal platelet count. Keywords: platelet function disorder, Glanzmann’s thrombasthenia, alloantibodies, antiplatelet antibodies, platelet refractoriness, bleeding management

Background: Treatment advancements have improved young cancer patients' survival rate considerably. Fertility preservation has become a very important tool in the prevention of treatment-induced gonadal toxicity. This study aimed to examine hematologists' awareness of its necessity and importance.Methods: Questionnaires were mailed to the directors of 230 institutes that treated hematological malignancies in adults. The directors were asked to provide information regarding their institutes, collaboration with sperm banks, the number of patients treated per year, selection criteria for patients providing information, and their awareness of and attitudes toward sperm preservation.Results: The response rate was 40.0%. Municipal and private hospitals treated patients significantly less frequently relative to university hospitals (p = .002). Of the 92 participating hematology institutions, 17 included sperm banks and 69 collaborated with sperm banks in neighboring institutions. Many participants stated that sperm preservation should be performed before chemotherapy; however, only 38% provided sperm preservation information to all patients. Participants in facilities without sperm banks exhibited significantly lower levels of knowledge regarding sperm preservation, relative to those from institutions with sperm banks, and found discussing fertility preservation burdensome. This trend was identical to that observed in a survey conducted 10 years earlier.Conclusion: Many hematologists did not appear to possess sufficient knowledge regarding fertility preservation. Moreover, few institutions included sperm banks, and a considerable burden was exerted on hematologists. The introduction of support systems is required to promote sperm preservation before cancer treatment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate differences between pediatricians and internists in the practice of and barriers to advance care planning (ACP) for adolescent patients with cancer.Study Design: A self-reported questionnaire was administered to assess the practice of ACP, advance directives, and barriers to ACP for adolescent patients with cancer. All 3392 Japanese board-certified hematologists were surveyed, and 600 hematologists (227 pediatricians, 373 internists) who take care of adolescent patients with cancer with decision-making capacity were analyzed.Results: If a patient's prognosis for survival was <3 months, pediatricians were significantly less likely to discuss ACP with their patients than internists, including discussions regarding the patient's medical condition (59% vs 70%), the patient's understanding of his/her medical condition (55% vs 66%), do not attempt resuscitation orders (17% vs 24%), and ventilator treatment if the patient's condition worsened (19% vs 25%). More than 75% of hematologists (both pediatricians and internists) discussed all ACP topics with patients' families. Similarly, with regard to advance directives, pediatricians were less likely than internists to discuss cardiopulmonary resuscitation (24% vs 47%) and the use of ventilators (31% vs 51%), vasopressors (24% vs 42%), and antibiotics (21% vs 31%) with their patients. Both pediatricians and internists discussed these issues more often with patients' families than with patients, especially cardiopulmonary resuscitation (98%) as well as the use of ventilators (98%) and vasopressors (91%).Conclusions: Pediatricians were less likely than internists to discuss ACP and advance directives with patients, and both pediatricians and internists tended to discuss ACP and advance directives more often with patients' families. [ABSTRACT FROM AUTHOR]

Hematologist (coagulation, hemoglobin, sedimentation rate and haematocrit) is a parameter to know Arab chicken's physiology condition. Unfortunately there is however lack information of hematologist Arab chicken available in a farm which the chicken is raising. Twenty Arab chickens which different ages ( 5 months, 7 months and 1.5 years) and different sex (female and male) is used as samples. Blood samples is taken from vena cava in left and right wings. Results of the present study showed that the chicken is healthy, even though the hematocrit is different with literature. The differences is expe,,1.ed by the chicken which used in experiment different with the chicken in the literature.