BackgroundSeveral irregular red blood cell alloantibodies, produced by alloimmunization of antigens in transfusions or pregnancies, have clinical importance because they cause hemolysis in the fetus and newborn and in transfused patients.Objectivea prospective analysis of patients treated by the surgical and clinical emergency services of Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro (HC/UFTM), Brazil was performed to correlate alloimmunization to clinical and epidemiological data.MethodsBlood samples of 143 patients with initial negative antibody screening were collected at intervals for up to 15 months after the transfusion of packed red blood cells. Samples were submitted to irregular antibody testing and, when positive, to the identification and serial titration of alloantibodies. The Fisher Exact test and Odds Ratio were employed to compare proportions.ResultsFifteen (10.49%) patients produced antibodies within six months of transfusion. However, for 60% of these individuals, the titers decreased and disappeared by 15 months after transfusion. Anti-K antibodies and alloantibodies against antigens of the Rh system were the most common; the highest titer was 1:32 (anti-K). There was an evident correlation with the number of transfusions.ConclusionsGiven the high incidence of clinically important red blood cell alloantibodies in patients transfused in surgical and clinical emergency services, we suggest that phenotyping and pre-transfusion compatibilization for C, c, E, e (Rh system) and K (Kell system) antigens should be extended to all patients with programmed surgeries or acute clinical events that do not need emergency transfusions.

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OBJECTIVES:To identify the occurrence and the causes of platelet refractoriness in oncohematologic patients.INTRODUCTION:Platelet refractoriness (unsatisfactory post-transfusion platelet increment) is a severe problem that impairs the treatment of oncohematologic patients and is not routinely investigated in most Brazilian services.METHODS:Forty-four episodes of platelet concentrate transfusion were evaluated in 16 patients according to the following parameters: corrected count increment, clinical conditions and detection of anti-platelet antibodies by the platelet immunofluorescence test (PIFT) and panel reactive antibodies against human leukocyte antigen class I (PRA-HLA).RESULTS:Of the 16 patients evaluated (median age: 53 years), nine (56%) were women, seven of them with a history of pregnancy. An unsatisfactory increment was observed in 43% of the transfusion events, being more frequent in transfusions of random platelet concentrates (54%). Platelet refractoriness was confirmed in three patients (19%), who presented immunologic and non-immunologic causes. Alloantibodies were identified in eight patients (50%) by the PIFT and in three (19%) by the PRA-HLA. Among alloimmunized patients, nine (64%) had a history of transfusion, and three as a result of pregnancy (43%). Of the former, two were refractory (29%). No significant differences were observed, probably as a result of the small sample size.CONCLUSION:The high rate of unsatisfactory platelet increment, refractoriness and alloimmunization observed support the need to set up protocols for the investigation of this complication in all chronically transfused patients, a fundamental requirement for the guarantee of adequate management.

Objetivou-se com este trabalho avaliar os efeitos de diferentes níveis de salinidade da água de irrigação e doses de nitrogênio sobre variáveis de crescimento da mamoneira cv. BRS Energia em experimento conduzido em lisímetros sob condições de campo no CCTA/UFCG, entre os meses de outubro de 2010 e fevereiro de 2011, usando delineamento de blocos ao acaso, com três repetições. Os tratamentos consistiram de cinco níveis de salinidade da água de irrigação-CEa (0,4-controle; 1,4; 2,4; 3,4 e 4,4 dS m-1) associados a cinco doses de adubação nitrogenada (50; 75; 100; 125 e 150% da dose recomendada para ensaio). O número de folhas, a área foliar, a altura de planta, a fitomassa seca das folhas e da parte aérea da mamoneira cv. BRS Energia são afetados negativamente e de forma linear pelo aumento da salinidade da água a partir de 0,4 dS m-1. As características mais afetadas pelo aumento da salinidade da água de irrigação foram às taxas de crescimento absoluto e relativo do diâmetro caulinar. A aplicação de doses crescentes de nitrogênio reduziu o efeito da salinidade sobre o diâmetro de caule e fitomassa seca da parte aérea da mamoneira cv. BRS Energia.