Acta Clin Belg
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Hemoglobin released into the circulation during hemolysis or therapy with chemically modified hemoglobins, exert oxidative and NO-scavenging toxic effects. Pyridoxalated hemoglobin polyoxyethylene conjugate (PHP) is one of the second-generation hemoglobin-based oxygen carriers (HBOCs). We wanted to investigate the metabolism of PHP with a special focus on its consequences for interpreting hemolysis-related diagnostic parameters in PHP-treated patients. ⋯ In contrast to expectations, clearance of PHP by hemopexin, instead of haptoglobin was documented by increased hemolysis indices, absence of decreased haptoglobin values, presence of free PHP-hemoglobin and exhausted hemopexin concentrations. The present case report is important for both clinicians and laboratorians since it nicely illustrates that a hemolytic aspect of plasma is not necessarely synonymous with hemolysis. A hemolytic aspect of plasma or serum (high hemolysis index) in combination with normal or increased haptoglobin values should draw the attention; additional determination of lactate dehydrogenase and hemopexin may then be useful to distinguish the condition from in vitro hemolysis and to monitor the in vivo elimination of the heme compounds.
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Hospital Acquired Infections (HAIs) are considered to be one of the most serious patient safety issues in healthcare today. It has been shown that HAIs contribute significantly not only to morbidity and mortality, but also to excessive costs for the health care system and for hospitalized patients. Since possibilities of prevention and control exist, hospital quality can be improved while simultaneously the cost of care is reduced. The objectives of this study were to examine the prevalence and the excess costs associated with HAIs. ⋯ HALs are associated with important additional healthcare costs. Although not all hospital-acquired infections can be prevented, an opportunity to increase cost-effectiveness of hospital care delivery presents itself. This study is the first to estimate the annual economic burden of HALs for Belgium at a national level, incorporating all associated hospital costs. Apart from the fact that the cost of prolonged length of stay is of major importance, we have also shown that the cost of additional procedures and pharmaceutical products cannot be neglected when estimating the financial burden of HAIs.
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Recent observations have disclosed that the galactose-alpha (1,3)-galactose (alpha-gal) moiety of non-primate glycoproteins can constitute a target for meat allergy. ⋯ This series confirms the importance of the alpha-gal carbohydrate moiety as a potential target for allergy to mammalian meat, dairy products and gelatin (oral, topical or parenteral) in a Flemish population of meat allergic adults. It also confirms in vitro tests to mammalian meat generally to be more reliable than mammalian meat skin tests, but that diagnosis can benefit from skin testing with cetuximab. Specific IgE to gelatin is far too insensitive to diagnose alphaa-gal related gelatin allergy. IgE binding studies indicate a potential risk of alpha-gal-containing human recombinant proteins produced in mammalians.
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Anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis is a severe form of encephalitis that has been identified within the context of acute neuropsychiatric manifestations. We report the case of an 18-year-old adolescent referred for a first episode of acute psychosis. ⋯ Immunosuppressive treatment and repeated plasma exchange resulted in slow recovery. The literature on diagnosis and treatment of this specific type of encephalitis is reviewed.