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The increasing number of patients undergoing antithrombotic therapy and a higher prevalence of skin neoplasia implies an adequate management of these drugs in the perioperative period during dermatological surgery. The authors present and discuss the protocol for clinical practice followed in the Dermatology and Venereology Department of Centro Hospitalar Universitario Sao Joao. Suspension or maintenance of therapy with antiplatelet and/or anticoagulant drugs should be assessed individually, taking into account the patient and intervention’s bleeding risk and the degree of thrombotic risk of the patient. In these patients, local hemostatic measures are particularly relevant in the management of perioperative haemorrhage and should be thorough. The Immunohemotherapy Department provides collaboration in situations of difficult bleeding management.

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Inherited thrombophilias are a group of clinical conditions in which there is a genetic variant defect associated with a predisposition to thrombosis. Genetic testing for inherited thrombophilias has been used in the diagnosis of specific thrombophila at our centre for the last 20 years, this work will summarize our experience.

SUMMARY Background One of the biggest concerns in transfusion medicine is to avoid red blood cell alloimmunization. We evaluated the rate of alloimmunization in two groups of chronically transfused patients (A – not phenotyped and B – phenotyped for Rh/K antigens before the first transfusion) with primary haematological disorders and its distribution among the main haematological diseases, in order to adopt an efficient transfusional strategy. Study design and methods As methodology, we used the SIBAS and SAM databases for the retrospective study of all patients with primary haematological disorder between January 2011 and April 2013. Results A statistical difference in the rate of alloimmunization comparing groups A and B was found (P

Introduction/Objectives: Monitoring the residual risk of transfusion-transmitted viral infections is important to evaluate the improvement achieved in the blood donation safety and to adopt policies to reduce risks. The present study calculates the incidence of the key infectious diseases, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) as well as the residual risk of transfusion-transmitted viral infections, during twelve years, 1999 through 2010. Data were analyzed over 3 periods of 4 years (1999-2002, 2003-2006 and 2007-2010). The risk estimates were compared to those previously obtained for blood donations occurred between 1991 and 1998. Material and Methods: The study included 209 640 blood donations, from 42 634 regular, volunteers and unpaid donors. The residual risk of transfusion-transmitted infection per million donations was calculated, for each virus, through mathematical model “Incidence rate/window period”, described by Schreiber et al. All donations were screened according to Portuguese legislation. In January 2001, the nucleic acid testing in minipool was implemented on all blood donations, for screening simultaneously HIV-1 and HCV ribonucleic acid (RNA) (Cobas Amplicor Ampliscreen-Roche©). This test was replaced, in January 2007, by the simultaneous screening of HBV deoxyribonucleic acid, HCV RNA and HIV-1/HIV-2 RNA, in minipool (Cobas Taqscreen MPX Test-Roche©). Results: The residual risk of transmitting viral infections during the transfusion of blood components is very small and has declined over the years. After the implementation of the nucleic acid testing in minipool for the three viruses, the risk of giving blood during an infectious window period was estimated as follows: for human immunodeficiency virus, 1 in 1.67 million, for hepatitis C virus 1 in 3.33 million and for hepatitis B virus 1 in 526 000. Conclusions: During the 12 years under study, we found a decrease in residual risk for the three viruses, by a factor around five for human immunodeficiency virus and hepatitis B virus, and 32 for hepatitis C virus. If we compare the estimates previously calculated for 1991-1998 period to 2007-2010 period (over 20 years), the decrease is still more relevant with a residual risk of human immunodeficiency virus, hepatitis B virus and hepatitis C virus respectively 19-fold, 6-fold and 54-fold lower.

Background HIV clinical presentation in the acute stage is variable and some of its virological and immunological aspects are not completely understood. Most cases of HIV- associated reactive hemophagocytic syndrome have been reported in patients with advanced stages of HIV and to our knowledge, there are only 8 cases in the English literature presenting during acute HIV infection, most in East Asia, being this the first case in a European patient. Case presentation We report a case of a European Caucasian 27- year old woman with a primary HIV- infection presenting with extremely low CD4+ T cell count who developed a haemophagocytic syndrome after starting ART and in whom we documented a very unusual serological and virological response, characterized by an impaired HIV- antibody production and a 12 month time frame to reach an undetectable viral load, despite no evidence of resistance. Conclusions This case report apart from describing an unusual clinical presentation of an acute HIV infection as hemophagocytic syndrome provides useful information that might contribute for understanding some subtle issues in acute HIV infection, namely the dynamics of virological and immunological aspects after antiretroviral therapy initiation. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1945-9) contains supplementary material, which is available to authorized users.