Frequency of double population of Rh blood group C and E antigen after transfusion of allogeneic red blood cells and its influence on blood transfusion efficacy / 中国输血杂志

【Objective】 To prove the necessity of precise red blood cell transfusion by studying the frequency of double population of Rh blood group C and E antigen after allogeneic red blood cell transfusion in our hospital and its influence on blood transfusion efficacy. 【Methods】 From June 2021 to March 2022, 296 blood recipients, transfused with ABO homogeneous but RhC/E phenotypes unknown 2U-RBC suspension, were enrolled from Beijing Jishuitan Hospital, and the ABO, RhD, RhC, RhE blood type before transfusion and double population frequency of C and E antigens after transfusion were detected. Patients with RhC and E not changed in comparison with pre-transfusion were set as group A(n=135), with RhC becoming double population as group B (n=18), with RhE becoming double population as group C (n=116), and with both RhC and RhE changed to double population as group D(n=27). The levels of red blood cell (RBC), haemoglobin (Hb) and hematocrit (HCT) before and after blood transfusion were compared among the four groups. 【Results】 The negative rates of RhD, RhC and RhE in 296 patients were 0.34%(1/296), 20.27%(60/296) and 67.57%(200/296), respectively. There were 17 cases out of positive screening for unexpected antibodies, among which 7 cases were of anti-E, with the highest proportion. After RBCs transfusion, the double population frequencies of C and E antigens were 15.20%(45/296) and 48.31%(143/296), respectively. The levels of RBC, Hb and HCT in group A, B, C and D were significantly increased, and the difference was statistically significant (P group C > group B> group D. 【Conclusion】 The Rh blood group C and E antigen double population has an significant influence on the efficacy of blood transfusion.

Acesso do idoso ao tratamento oncológico no estado do Rio de Janeiro - uma discussão a partir dos dados do Registro Hospitalar de Câncer dos anos 2016 e 2017 / Access of the elderly to cancer treatment in the state of Rio de Janeiro - a discussion from the Hospital Records of Cancer of the years 2016 and 2017

O presente estudo objetivou analisar o acesso do idoso ao tratamento oncológico ofertado pelo SUS no estado do Rio de Janeiro nos anos 2016 e 2017, por meio de uma análise quantitativa e qualitativa de algumas variáveis disponibilizadas no Integrador-RHC. Para a discussão, utilizou-se de consulta bibliográfica sobre os temas acesso em saúde, rede de atenção ao câncer, políticas de atenção ao controle do câncer e políticas de atenção ao idoso no Brasil, bem como foram levantados dados do Plano de Atenção Oncológica do Estado (PAOE) 2017/2021 e Plano Estadual de Saúde (PES) 2020/2023. Como resultados, obteve- se que o acesso aos serviços oncológicos é condição multifatorial, que depende tanto de aspectos sociodemográficos, como de fatores organizacionais dos serviços, sobressaindo as características da oferta e da acessibilidade geográfica como fatores determinantes para o desempenho dos serviços de saúde, capazes de favorecer o acesso dos idosos. Houve indicação de déficit na capacidade hospitalar instalada para tratamento do câncer no estado; evidências de desequilíbrio na produção de procedimentos terapêuticos entre os hospitais habilitados e subnotificação de registros de câncer no sistema do RHC pelas unidades estaduais. É necessária uma revisão do planejamento com intervenção sobre a rede, adequando as referências pactuadas e indicando possíveis regionalizações alternativas, levando em consideração os fluxos residência-local de atendimento, a acessibilidade geográfica, os custos dos deslocamentos e a malha viária existente, no caminho da construção de uma efetiva rede regionalizada de atenção oncológica, garantindo um acesso mais universal, equitativo e integral.

This study aimed to analyze the access of the elderly to the cancer treatment offered by the SUS in the State of Rio de Janeiro in the years 2016 and 2017, through a quantitative and qualitative analysis of some variables available in the Integrator-RHC. For the discussion, we used a bibliographic consultation on the themes health access, cancer care network, cancer control care policies and policies for the elderly care in Brazil, as well as data from the State Oncological Care Plan (PAOE) 2017/2021 and State Health Plan (PES) 2020/2023. As a result, it was obtained that access to cancer services is a multifactorial condition, which depends both on sociodemographic aspects and organizational factors of the services, including the characteristics of supply and geographic accessibility as determining factors for the performance of health services, capable of favoring the access of the elderly. There is an indication of a deficit in hospital capacity installed for cancer treatment in the state; evidence of imbalance in the production of therapeutic procedures among qualified hospitals and underreporting of cancer records in the RHC system by state units. It is necessary to review and adapt the planning and intervention on the service network of the SUS, reviewing the agreed references and indicating possible alternative regionalization, considering the residence-place flows of care, geographical accessibility, travel costs and the existing road network, on the way to build an effective regionalized network of oncological care, ensuring more universal, equitable and comprehensive access.

Determination of the RhC/c Blood Group by Polymerase Chain Reaction with Sequence-specific Primers of the Intron 2 Insert of the RHCE Gene / 대한수혈학회지

BACKGROUND: RhC/c blood group antigens are of clinical importance and molecular genotyping for them can be useful when serological typing is difficult. A method to determine the RhC/c genotype, by targeting exon 1 nt48 and exon 2 nt307, has been used. However, this approach is not accurate for the RHc(cyt48) variant allele. We applied a more accurate genotyping method, using the intron 2 109 bp insert of the RHCE gene, and evaluated its performance in comparison with the standard method. METHODS: RhD and RhC/c serotypes of 236 subjects were determined. We compared two genotype results with the serological phenotype. One method examined the allele-specific exon 1 nt48 and exon 2 nt307 polymorphism area (Method 1), while the other method detected the intron 2 insert instead of the exon 1 nt48 (Method 2) by polymerase chain reaction with sequence-specific primers (PCR-SSP). RESULTS: The predicted phenotypes by Method 1 were not matched with the true phenotypes in 24 cases (24/236, 10.2%). By contrast, the predicted results by Method 2 matched with true phenotypes in all cases except one. The RHc(cyt48) variant was suspected in 22 cases (23.7%) of the 93 Rhc cases. CONCLUSION: For the determination of the RhC/c genotype in Koreans, the method that analyzes exon 1 nt48 is inaccurate. Instead, intron 2 insert analysis with exon 2 nt307 by PCR-SSP appears to be a more accurate alternative.