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Babesia divergens is an intra-erythrocytic parasite that causes malaria-like symptoms in infected people. As the erythrocyte provides the parasite with the infra-structure to grow and multiply, any perturbation to the cell should impact parasite viability. Support for this comes from the multitude of studies that have shown that the sickle trait has in fact been selected because of the protection it provides against a related Apicomplexan parasite, Plasmodium, that causes malaria. In this paper, we examine the impact of both the sickle cell anemia and sickle trait red blood cell (RBC) environment on different aspects of the B. divergens life-cycle, and reveal that multiple aspects of parasite biological processes are altered in the mutant sickle anemia RBC. Such processes include parasite population progression, caused potentially by defective merozoite infectivity and/or defective egress from the sickle cell, resulting in severely lowered parasitemia in these cells with sickle cell anemia. In contrast, the sickle trait RBC provide a supportive environment permitting in vitro infection rates comparable to those of wild-type RBC. The elucidation of these naturally occurring RBC resistance mechanisms is needed to shed light on host-parasite interaction, lend evolutionary insights into these related blood-borne parasites, and to provide new insights into the development of therapies against this disease.

Cryoprecipitate is made from human plasma, and its main constituents are fibrinogen, fibronectin, factor VIII, von Willebrand factor (vWF), and factor XIII. Originally, cryoprecipitate was used as a factor VIII replacement for hemophilia A patients, but now they are more purified and available as virally inactivated or recombinant products, making it essentially contraindicated to use this product for this indication in the developed world. Similarly, this product should not be used to treat von Willebrand disease, as more purified and virally inactivated products containing vWF and factor VIII are available. Thus, cryoprecipitate is used primarily for fibrinogen replacement, occasionally as factor XIII replacement, and in the manufacturing of fibrin sealants and glue. Fibrinogen concentrates and factor XIII are FDA-approved for fibrinogen replacement in patients with congenital fibrinogen deficiency and factor XIII replacement in patients with congenital factor XIII, respectively. Outside the United States, fibrinogen concentrates are used instead of cryoprecipitate for all fibrinogen replacement indications.

Hospital transfusion service (TS) physicians play central and leading role within the hospital, by ensuring a reliable and adequate supply of safe and effective blood products, and ensuring optimal component choice and matching with recipients. Blood components are required 24 hours a day, 7 days a week for the practice of obstetrics, surgery, hematology/oncology, transplantation, trauma, and other disciplines. Hence, TS requires constant medical input and oversight, making the physician's roles and responsibilities both demanding and rewarding. In general, TS physician provides leadership, oversight, clinical care, and strives for continued improvement.

Effective recruitment requires knowing donor motivations and how to appeal to them. Motivations differ dependent on donation history. They range from physical or social incentives to psychic altruism. Various modalities can be used to recruit but should be matched to specific donor populations. Deferrals and poor experiences will decrease future donations. Platelet apheresis recruitment and motivation while similar to whole blood has differences. In addition, frequency and multiple product collection are important. Understand the donor and their motivation to match the message and technology to effectively bring them in.

Blood collection and transfusion should be matched to prevent wastage and shortage. Communication and data gathering between hospital and blood center are essential tools. Each needs to gather data to work with the other to link collection to transfusion. Appropriate transfusion triggers, inventory management and blood ordering will minimize wastage. Modeling supply and demand in conjunction with each other can minimize shortages. Platelet planning is critical given the short shelf life of platelets. Data sharing and benchmarking between and among hospitals and blood centers can lead to better overall inventory management.

Hodgkin's disease (HD) after treatment of non-Hodgkin's lymphoma (NHL) has been reported but is extremely rare, and to the authors' knowledge has not been reported in patients with acquired immune deficiency syndrome (AIDS). The authors present a case of an AIDS patient who developed mixed cellularity type HD 2.5 years after chemotherapy and radiotherapy for Stage II NHL. The patient died of infectious causes 1.5 years after interferon therapy for the HD. Autopsy revealed Stage IV HD, mixed cellularity type.