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Background: Transfusions are a common intervention within pediatrics and require unique considerations to optimize patient care. Poor knowledge of evidence‐based transfusion practice can lead to misuse of transfusion therapy and harm. While there have been assessments of transfusion medicine knowledge of physicians caring for adult patients, there is little data regarding pediatricians. Study Design and Methods: Using a published transfusion medicine knowledge exam for internal medicine physicians as a backbone, pediatric transfusion medicine experts, using an iterative process, developed a pediatric‐specific examination. Pilot testing and Rasch analysis, a method used in high‐stakes testing, was used to validate the exam. The exam and a previously validated survey on transfusion medicine training, attitudes, and perceived ability were administered to pediatric residents. Analysis consisted of descriptive statistics as well as comparisons of exam scores based on survey responses. Results: 330 pediatric residents from 19 sites in 6 countries participated in the study. The vast majority (91%) of residents had obtained blood product consent. The mean exam score was 37.1% (range 9.5%–71.4%) with no statistical differences based on amount or perceived quality of transfusion medicine education or perceived ability. Discussion: A rigorously validated exam has now been developed that can be used to assess pediatric transfusion medicine knowledge. A large international group of pediatric residents performed poorly on the exam demonstrating a pressing need for improved transfusion medicine education to ensure safe and appropriate administration of blood components to infants and children. [ABSTRACT FROM AUTHOR]

Background: Pregnancy is a time of dynamic physiological changes occurring as a continuous spectrum. Smoothed centile curves describe the distribution of measurements as a function of age. There has been no application of centile charts in pregnancy for haematological parameters. Aims: To derive gestational age‐specific centile curves for six haematological parameters and compare these with published reference intervals. Materials and Methods: An LMS approach was used with haematology results from an obstetric hospital laboratory database. After application of exclusion criteria, smoothed centiles conditional on gestational age were obtained by a two‐step process: (i) finding the best model within four response distributions using Bayesian information criteria, and (ii) selecting the best model among the response distributions based on test‐dataset global deviance. Results: In total, 11 255 deliveries were extracted from 10 813 patients. There was little difference between distributions, and Box‐Cox power exponential was selected overall. Red cell parameters showed similar trends: values fell until the second trimester and increased thereafter. Leukocyte and neutrophil counts rapidly increased and plateaued around 15 weeks. Platelets exhibited a gradual fall with advancing gestation. Conclusions: This is the first study to use an LMS approach to model gestational age‐dependent variations in haematological parameters. Proposed haemoglobin reference intervals were lower than those published but reflect our patient population. Serial monitoring of antenatal patients, as is the standard of care, in conjunction with these centile charts, may highlight trends in red cell changes with advancing gestation, allowing early identification of adverse pregnancy outcomes and evolving anaemia. [ABSTRACT FROM AUTHOR]

The article offers information on a study related to Iron deficiency (ID) diagnosis with the help of ferritin which act as functional biomarker of iron status in children and young adults. It notes the functional relationship of ferritin with various haematological parameters. It mentions the measurement of Ferritin by Roche Cobas c6000 platform using Roche Tina-quant reagent.

The article offers information on the importance of the compatibility and red cell phenotype calculators to clinicians.

SUMMARY A 3-year-old girl receiving chemotherapy for acute lymphocytic leukaemia developed a rapidly expanding red annular plaque on her thigh, initially without signs of systemic toxicity or local pain. Subsequently she developed Pseudomonas aeruginosa sepsis and purpura at the leading edge of the plaque. Skin biopsy showed an extensive necrotizing vasculitis with numerous Gram-negative bacilli in the blood vessel walls. In immunocompromised individuals, skin biopsy and culture of cutaneous lesions for bacteria and fungi should be considered even in the absence of signs of systemic toxicity or multiple lesions. [ABSTRACT FROM AUTHOR]

Drugs used for remission induction therapy for childhood precursor-B acute lymphoblastic leukemia (ALL) are nonselective for malignant cells. Several garlic compounds have been shown to induce apoptosis of cancer cells and to alter lymphocyte function. To investigate the effect of garlic on the apoptosis of ALL cells and lymphocyte immune function, cells from newly diagnosed childhood ALL patients were cultured with several commonly used chemotherapeutic agents and several garlic compounds. Apoptosis, lymphocyte proliferation and T-cell cytokine production were determined using multiparameter flow cytometry. At concentrations of garlic compounds that did not result in significant increases in Annexin V and 7-AAD staining of normal lymphocytes, there was a significant increase in apoptosis of ALL cells with no alteration of T-cell proliferation as determined by CD25/CD69 upregulation or interferongamma, interleukin-2 or tumor necrosis factor-alpha intracellular cytokine production. In contrast, the presence of chemotherapeutic agents resulted in nonselective increases in both lymphocyte and ALL apoptosis and a decrease in T-cell proliferation and cytokine production. In conclusion, we show selective apoptosis of malignant cells by garlic compounds that do not alter T-cell immune function and indicate the potential therapeutic benefit of garlic compounds in the treatment of childhood ALL.