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T Vuk

Publications and source records attributed to T Vuk.

10 recordsLinked to original sources
PubMed2004

Morganella morganii causing fatal sepsis in a platelet recipient and also isolated from a donor's stool.

Bacterial contamination of blood products causes significant patient morbidity and mortality. Contaminated platelet transfusion is a frequent cause of bacteraemia and sepsis because of the storage conditions of platelets. A fatal case of Morganella morganii platelet transfusion associated with sepsis is described, along with procedures traced back to the isolation of M. morganii from a donor's stool. Molecular typing was performed, and the same M. morganii strain was found in blood and post-mortem organ cultures of platelet recipient and platelet bag and in the donor's stool. The route of contamination is unknown. The contamination could be due to either insufficient venipuncture site disinfection or the donor's transient bacteraemia. Patient died 5 days after the transfusion.

Adult↗
PubMed1998

A perception of transfusion safety and risks.

Transfusion therapy is today safer than ever. However, administration of homologous transfusions still has a number of different, even serious potential hazards. Therefore, transfusion therapy should only be given when the reasons for it are clear, its benefits outweigh the hazards, and the patient has accepted them after being well informed about them.

Humans↗
PubMed1998

Croatian blood transfusion service in prevention of HIV spread during the war.

Beside the war, an unfavorable epidemiological situation and a large number of foreign peace troops that entered the country without having been previously tested for infectious diseases, the number of AIDS cases in our country remained relatively low. The transfusion service played a considerable part in the prevention of HIV infection spread. Although the blood transfusion service was faced with higher demands for blood and blood products, throughout the period of the war not a single blood unit was imported and no single unit of blood components was transfused without having been previously tested for the presence of viral disease markers. Despite enormous economic difficulties, three new diagnostic tests were then introduced in our transfusion practice as a regular procedure: anti-HCV in 1993, anti-HIV 2 in 1994 and anti-HIV 1/0 in 1995.

AIDS Serodiagnosis↗
PubMed1997

[Pseudothrombocytopenia caused by ethylenediaminetetraacetic acid (EDTA) (case report)].

Pseudothrombocytopenia is a laboratory artefact that can introduce serious problems in diagnosis and treatment in patients with low platelet count. The most common reason for this artefact is in vitro platelet clumping in blood samples collected into ethilenediaminetetraacetic acid (EDTA) anticoagulant. The clumping activity is greater at temperatures less than 37 degrees C, and the EDTA concentrations required for clumping are 20 times below anticoagulant concentrations. In this article we described the case of a female patient with diagnosed EDTA induced pseudothrombocytopenia. The cause of incorrectly low platelet counts was proved by simultaneous analysis in blood samples collected into EDTA anticoagulant and into heparin as a control sample. Absences of incorrectly low platelet count in heparin sample and rapid decrease of platelet count in EDTA sample were noticed. Decrease in platelet count was accompanied by increase in the number of leukocytes, so called pseudoleukocytosis. Careful examination of blood film is necessary to establish correct diagnosis, promptly after the blood collection and approximately two hours later. It is important to verify formation of clumps two hours after the blood collection and also progressive reduction in the platelet count in EDTA sample. By blood assessment conducted in this concern it is possible to avoid severe misinterpretation in such patients.

Adult↗
PubMed1997

Autoimmune thrombocytopenia in adults: clinical experience.

Diagnostic and treatment algorithms in autoimmune thrombocytopenia (AITP) are still somewhat controversial. We present our experience in the diagnosis and treatment of 39 AITP patients, hospitalized at our department between 1990 and 1995, and discuss alternative approaches. There were 10 male and 29 female patients, median age 47 (range 18-75) years. All patients had isolated thrombocytopenia and normal or increased number of megakaryocytes in bone marrow. Platelet count lower than 15 x 10(9)/L was found in 25 (64.1%) patients. Eighteen (54.5%) patients responded well to standard and two (6.1%) to high doses of steroids, whereas 18.2% of the patients responded well to other immunosuppressive therapy. Antiplatelet antibodies were found only in 4 (10.2%) patients. Our conclusion was that a half of adult AITP patients achieve satisfactory recovery on standard doses of steroids.

Adolescent↗
PubMedDate not supplied

[Neonatal alloimmune thrombocytopenic purpura caused by anti-HPA-1a alloantibodies. Case report].

We report the case of serologically proven HPA-1a NATP. The child was born after uneventful 4th pregnancy. Immediately after birth generalized petechiae and signs of gastrointestinal bleeding were present. Isolated thrombocytopenia with the platelet number of 29 x 10(9)/L was observed. Serological investigation (PSIFT and MAIPA) showed high titre anti-HPA-1a antibody and low titre anti-HLA antibody in mother's sera. Mother's platelets were HPA-1a negative and she was HLA DR 52 positive. Father's platelets were HPA-1a positive. Cross-match between mother's sera and father's platelets was positive. 24 hours after the introduction of corticosteroid therapy platelet number increased to 73 x 10(9)/L and 48 hours later to 155 x 10(9)/L. The child was treated by corticosteroids because the NATP was severe and antigen negative platelets (mother or donor) or IVGG were not available. According to data from the literature the efficiency of corticosteroid therapy in NATP is questionable, but in this case it provided sufficient increase of platelet number with the stop of newborn bleeding.

Antigens, Human Platelet↗
PubMedDate not supplied

[What we can learn from refusal of transfusion therapy from experience with Jehovah's Witnesses].

Patients who refuse blood transfusion for personal or religious reasons present complex medical, legal and moral problems. Blood transfusion has been doctrinally forbidden for Jehovah's Witnesses since 1945. Their refusal is based on the strict interpretation of several Biblical passages. A clear understanding of the philosophy of the Jehovah's Witnesses regarding blood transfusion and of the medicolegal and ethical aspects of their care is essential to clinicians who care for such patients. Various ethical principles, including the patient's autonomy, the interest of society in preserving life and the dignity of medical profession can be confronted. There are no clear guidelines which physicians can follow in deciding to treat or not treat in the presence of a patient's refusal. However, most authors agree that a competent adult has an absolute right to decline medical treatment, and that it is not morally or ethically correct to force patient to an unwanted treatment. We wished to present the experiences with the use of alternative methods in the treatment of Jehovah's Witnesses and to discuss ethical and legal aspects of treatment decisions in the presence of blood transfusion refusal.

Adult↗