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Biomedical subjects

O Halil

Publications and source records attributed to O Halil.

15 recordsLinked to original sources
PubMed2000

Neutrophil dysplasia caused by mycophenolate mofetil.

Two transplant recipients developed striking morphological abnormalities in their circulating neutrophils while receiving mycophenolate. The changes included nuclear hypolobulation and abnormal clumping of nuclear chromatin and were presumably related to inhibition of guanosine nucleoside synthesis. In both cases the neutrophil abnormalities preceded the development of neutropenia and were thus a sign of impending hematological toxicity. The hematological changes resolved after the drug was discontinued.

Adult↗
PubMed2000

The BCSH guideline on addressograph labels: experience at a cardiothoracic unit and findings of a telephone survey.

In 1998 we implemented a BCSH recommendation that addressograph labels should not be used on blood transfusion specimen tubes. Over a 12-month period before the ban was introduced our laboratory received 5964 red cell transfusion requests, 182 (3.1%) of which contained an error in the identification details (ID) supplied on the request form and/or specimen. Three of these errors were of the 'wrong patient' type, i.e. the sample belonged to a different patient from the one whose ID appeared on the specimen tube and request form. Over the 12 months after the ban was introduced 511 (8. 1%) of 6326 requests contained a labelling error, an increase in error rate of 165%; no wrong-patient errors were identified, however. In a survey, seven (29.2%) of 24 transfusion laboratories in the UK accepted specimens labelled with addressograph stickers; in four of these cases a local blood transfusion committee had agreed that the BCSH guideline should not be followed. We believe the BCSH guideline is valid; its implementation, however, has major financial and workload implications, which probably explains why many hospitals apparently do not comply with it.

Blood Banks↗
PubMed1999

Is a man's facial appearance predictive of how he will die?

The ability of a range of health professionals including an oncologist, a haematologist, a cardiologist, a general practitioner and a counsellor to predict the cause of death from facial appearance has been evaluated. Each participant was asked to predict the cause of death from facial photographs of 200 caucasian male doctors whose cause of death was known to be due to either arterial disease or neoplasia. Statistically significant concordance was found between the oncologist and both the GP and the counsellor in their predictions of cause of death, although the individual accuracy was no greater than would be expected by chance. This suggests that common judgments based on facial appearances may be shared among certain health professionals.

Adult↗
PubMed1996

Myelosuppression associated with azathioprine-allopurinol interaction after heart and lung transplantation.

It is widely recommended that, during concurrent therapy with allopurinol, the azathioprine dosage should be decreased by at least two thirds. We retrospectively studied compliance with this guideline in 24 patients who had commenced allopurinol at a median of 33 months (range, 2-145 months) after heart and/or lung transplantation. The median reduction in azathioprine dose at initiation of allopurinol was 73.3% but ranged from 0% to 90% (>67% in 14 patients). Within 3 months, 11 (46%) of the patients became leukopenic (white blood cell count <4 x 10(9)/L), 7/23 (30%) became moderately anemic (hemoglobin <10 g/dl), and 5/23 (22%) became thrombocytopenic (platelets <150 X 10(9)/L). Decreasing the dose of azathioprine by two thirds or greater reduced but did not abolish the risk of myelotoxicity. These data highlight the need for close hematological monitoring of patients treated with this drug combination. Agents other than allopurinol should be considered for treating hyperuricemia after thoracic organ transplantation.

Adult↗
PubMed1995

Red cell alloantibody development associated with heart and lung transplantation.

The development and persistence of clinically significant red cell alloantibodies were studied in 1132 patients who underwent a heart and/or lung transplant at Harefield Hospital. Clinically significant antibodies were detected in 15 patients (1.3%) preoperatively and appeared in a further 15 (2.1%) of 704 patients followed up 1-404 weeks after surgery. Anti-D developed in only 1 of 52 D-negative recipients of a D-positive donor graft and in only 2 of 6 D-negative patients who were transfused with between 6 and 32 units of D-positive red cells. Most antibodies that appeared after transplantation remained detectable for only a few weeks. Antibodies detected preoperatively that reacted only with papain-treated cells became persistently undetectable in 4 patients who were transfused with red cells expressing the corresponding antigen specificity. By contrast, antibodies detected preoperatively by indirect antiglobulin test were still detectable after periods of up to 260 weeks in 4 patients who received only antigen-negative red cells. Immunosuppressive therapy appeared to profoundly affect the natural history of red cell alloantibody production in these patients. The underlying mechanisms warrant further study.

ABO Blood-Group System↗
PubMed1995

Visceral leishmaniasis after cardiac surgery.

An English child developed visceral leishmaniasis (kala-azar) after cardiac surgery. Neither he nor his mother had ever been out of the UK, and his disease was probably transmitted by blood transfusion. Kala-azar should be considered in patients with unexplained fever and hepatosplenomegaly, even if there is no history of foreign travel.

Blood Transfusion↗
PubMed1994

Demonstration by the monoclonal antibody-specific immobilization of erythrocyte antigens assay that a new red cell antigen belongs to the Kell blood group system.

BACKGROUND: The Kell blood group system comprises 21 antigens residing on a red cell membrane glycoprotein of apparent M(r) 93,000. STUDY DESIGN AND METHODS: Serologic techniques were used to identify a new red cell antigen. The monoclonal antibody-specific immobilization of erythrocyte antigens (MAIEA) assay was used to identify the red cell membrane component carrying that antigen. RESULTS: A new high-frequency red cell antigen was identified and provisionally named RAZ. RAZ is absent from K.o red cells and from red cells treated with 2-amino-ethylisothiouronium bromide and is expressed weakly on McLeod phenotype cells. It differs from all other Kell system antigens, and no depression of other Kell system antigens on RAZ+ red cells was noticed. The RAZ antigen was shown by the MAIEA assay to be located on the Kell glycoprotein. CONCLUSION: RAZ is a new high-frequency antigen located on the Kell glycoprotein. The MAIEA assay is a very effective method of demonstrating the membrane structure carrying a red cell antigen.

Antibodies, Monoclonal↗
PubMed1992

The prevalence, course, and characteristics of chronic anemia after heart and lung transplantation.

A retrospective study of the 99 surviving heart and lung transplant (HLT) recipients at one center showed that 31% had significant anemia (hemoglobin less than 100g/L) six months after transplantation. Chronic anemia persisted in 18% of HLT recipients two years posttransplantation. A similar study of 100 heart transplant recipients showed no unexplained anemic patients. The prevalence of anemia after HLT was unrelated to the original diagnosis, immunosuppression, or acute rejection. All HLT recipients appeared to be unduly sensitive to the myelosuppressive effects of azathioprine. Detailed studies in 16 representative patients showed a normochromic, anisocytotic anemia with normal reticulocyte counts, B12 and folate levels, and haptoglobin levels and appropriate erythropoietin levels--but increased ESRs, low/normal iron levels and low/normal total iron binding capacity, normal or raised ferritin levels, and autoantibodies in 4 (25%). Bone marrow aspirates in 10 patients showed dyshemopoiesis out of proportion to the degree of anemia and colonies of activated lymphoid cells. The cause for this anemia appears to be a combination of anemia of chronic disease and dyshemopoiesis, both of uncertain etiology.

Adult↗
PubMed1985

Acute biphenotypic leukaemia (myeloid and null-ALL type) supervening in a myelodysplastic syndrome.

An acute leukaemia was seen in a 72-year-old patient with a myelodysplastic syndrome (MDS) of 14 months duration, who had been treated only with steroids. The morphological appearance of the blast cells suggested a poorly differentiated cell type. Surface marker analysis, including double staining studies, showed the coexistence of a population of null acute lymphoblastic leukaemia (ALL) blast cells together with acute myeloid leukaemia type cells. No chromosomal alterations were detected. The change from a chronic MDS to an acute leukaemia of mixed (myeloid and null ALL) type suggests either transformation of a pre-existing abnormal clone or de novo appearance of two separate leukaemic clones.

Aged↗
PubMed1981

Response of graft versus host disease to high doses of methyl prednisolone.

High dose methyl prednisolone (HDMP) was used to treat 25 episodes of graft versus host disease (GVHD) in 13 patients after bone marrow transplantation for aplastic anaemia or acute leukemia. All patients showed rapid improvement of GVHD following HDMP with resolutions of gut and skin manifestations over several days, but liver GVHD was less responsive to treatment. The major complication of treatment was infection and four patients died from infection following HDMP. The mode of action of HDMP may be a nonspecific anti-inflammatory effect but it appears to be rapidly effective in controlling GVH reactions.

Adolescent↗