1 2008-4595 Iranian Pediatric Hematology and Oncology Society 542 Pediatric Hematology & Oncology Table of contents 1 7 2014 6 4 0 0 20 01 2015 20 01 2015
544 Pediatric Hematology & Oncology Members Information Pack 1 7 2014 6 4 0 0 20 01 2015 20 01 2015 543 Pediatric Hematology & Oncology Editorial M Faranoush 1 7 2014 6 4 1 1 20 01 2015 20 01 2015 499 Pediatric Hematology & Oncology Preparation of Plasminogen by Affinity Chromatography K Mousavi Hosseini M Nikougoftar Zarif 1 7 2014 6 4 165 168 22 08 2014 22 08 2014 Background: Plasminogen is one of the compounds derived from human plasma. Activation of plasminogen produces plasmin. Plasmin is able to lyse fibrinogen, fibrin, and some other human plasma proteins. The aim of the present work was to study the separation of human plasminogen by affinity chromatography using gel lysine Sepharose. Materials and Methods: Normal human plasma was used as the starting material. By increasing its concentration of ethanol from 0% to 8% in pH 7.2 at -3○C the centrifugation was carried out and the supernatant I was separated from precipitate I. Then supernatant fraction I was used for separation of human plasminogen from plasma and further purification was carried out using affinity chromatography using affinity gel lysine Sepharose. Results: In our study we could obtain plasminogen with the concentration of 0.5%. In normal human plasma the concentration of plasminogen is about 200mg/l. Comparing the result with the concentration of plasminogen in normal human plasma shows about 25 folds higher concentration. Conclusion: Using affinity chromatography method a 25-fold increase in plasminogen concentration was achieved which shows this method is a promising method for the preparation of plasminogen from human plasma. 500 Pediatric Hematology & Oncology Microparticle Formation and Platelet Shrinkage in Type-I Glanzmman Thrombasthenia Platelets T Hemmati A Farsinezhad MR Managhchi G Toogeh M Faranoush 1 7 2014 6 4 169 175 22 08 2014 22 08 2014 Background: Activated normal platelets undergo many biochemical and morphological changes, some of which are apoptotic. Platelet derived microparticles and shrinked platelets as hallmark of platelet activation and apoptosis disperse surfaces containing procoagulant activity around injured vessels and tissues. This study was conducted to determine microparticles formation and platelet shrinkage in Glanzmann thrombasthenia upon activation. Patients and Methods: Platelets from twelve unrelated type I Glanzmann thrombasthenia patients were examined as washed platelets. Calcium ionophore A23187 was used as agonist to activate the platelets. Flow cytometry was applied to measure platelet-derived micro particles (forward scatter events <1.0 µm size), and platelet shrinkage (mean-FSC). Anti-CD42b was used as platelet specific marker to distinguish platelets from other likely particles. Annexin A5 Alexa Fluor was used to determine phosphatidylserine exposure and confirm platelet activation and apoptosis. Results: Calcium ionophore A23187, dramatically increased MP formation by type-I GT platelets up to 14.5 fold increase over baseline (Buffer treated: 14.18 ± 5.4% vs. A23187 treated: 34.31 ± 15.2% p<0.005). Also calcium ionophore A23187, increased platelet shrinkage by type-I GT platelets and mean-FSC decreased (Buffer treated: 4.12±1.3 vs. A23187 treated: 1.67±0.2 p<0.0024). Conclusion: This study showed that, type I Glanzmann thrombasthenia platelets demonstrate platelet apoptosis considering two apoptotic targets, including micro particles formation and platelet shrinkage. We conclude that in thrombasthenic Glanzmann platelets at least some aspects of normal apoptosis is ongoing, and this may explain normal platelet count among these patients. Keywords: Apoptosis, Glanzmann thrombasthenia, glycoprotein IIbIIIa, flow cytometry, microparticle. 501 Pediatric Hematology & Oncology The Effect of Knowledge, Attitude and Practice on the Function of Thalassemic Patients Z Kourorian A Azarkeivan B Hajibeigi A Oshidari A Shirkavnd 1 7 2014 6 4 177 181 22 08 2014 22 08 2014 Background: In thalassemia major as a chronic disease patients need to require information about the disease processes and therapeutic interventions. The aim of the present study was to evaluate the knowledge, attitude, and practice behavior of thalassemic patients. Patients and Methods: This was a cross-sectional descriptive knowledge, attitude and practice study conducted in Zafar adult thalassemia clinic, Tehran, Iran, with a simple random sampling. The questionnaire was designed by a research team including an expert physician involved in counseling and education of thalassemic patients for many years. Results: One hundred and ninety thalassemic patients entered the study. Ninety nine patients (52.1%) were female, 91(47.9%) were male, with age range of 14 to 48 years (mean 26.79 ±5.96). Results of the knowledge part of the questionnaire indicated that 39 % of patients had poor information about thalassemia 32.5% had little information and 28.5% had satisfying information. Fifty eight percent of patients had a positive attitude towards their appearance, quality of life and social relations. Positive attitude was significantly correlated with good knowledge (p=0.009). Low knowledge about the disease had caused treatment to be irregular and improper. Based on our questionnaire 144 patients (75.8%) were depressed which was significantly higher among females (P=0.002). Conclusion: Increasing knowledge, attitude and practice awareness among thalassemic patients considering their disease and treatment methods has a positive influence in their quality of life. This will improve their performance to deal with their lifelong disease and its challenges during the course of treatment. 502 Pediatric Hematology & Oncology Knowledge of Breast Cancer Risk Factors among a Cohort of Nurses in Iran F Ghahremanfard R Ghorbani S Hemmati 1 7 2014 6 4 183 187 22 08 2014 22 08 2014 Background: Improving the knowledge of healthcare providers towards different aspects of breast cancer leads to appropriate management and screening of disease. This study aimed to investigate the knowledge of breast cancer risk factors among a cohort of nurses in Iran. Materials and Methods: The target group of the present study was 243 consecutive nurses (27 males and 216 females) at two referral hospitals in Semnan province, Iran, between March 2012 and February 2013. The data concerning the nurses’ knowledge of breast cancer risk factors was collected using a predesigned questionnaire. Results: In total, 9.9% of nurses had poor, 71.2% had intermediate and only 18.9% had good level of knowledge towards breast cancer risk factors. The level of knowledge towards risk factors was not affected by nurses’ gender, age, level of education, years of experience, marital status, presence of a history of breast problem, or history of caring for a breast cancer patient. However, those nurses with a family history of breast cancer especially those with a patient as a first degree relative had significantly higher level of knowledge about the disease risk factors. The highest level of knowledge on breast cancer risk factors was observed among nurses working in CCU wards, while the lowest level of knowledge was found in pediatrics and psychiatry wards. Among nurses working in obstetrics and gynecology wards, 15.8% had a poor level, 68.4% had an intermediate level, and only 15.8% had an acceptable level of knowledge on breast cancer risk factors. Conclusion: This study revealed a relatively low awareness of breast cancer risk factors among nurses emphasizing the need for adding proper education programs aimed at improving the knowledge of breast cancer risk factors among our nurses. 503 Pediatric Hematology & Oncology Conversion from Platelet-Rich Plasma Platelet Production to Buffy Coat Platelet Component Production: Benefits and Limitations S Nasiri 1 7 2014 6 4 189 202 22 08 2014 22 08 2014 Blood transfusion centers are under considerable pressure to produce platelet concentrates with high quality and safety due to the short shelf life of 3-5 days as well as possible bacterial and viral contaminations. For a variety of reasons, many Europeans have changed their methods of component production from whole blood using the North American standard platelet-rich plasma method to the buffy coat method of platelet production. Many advantages and some limitations during conversion from platelet-rich plasma method to buffy coat method have been observed. It seems that decisions to switch from platelet-rich plasma method to buffy coat method with whole blood component production should be considered the benefits from increased platelet yield, improved platelet quality, increased plasma recovery, reduced blood transfusion adverse reactions and lower pathogen transmission rates compared to the platelet-rich plasma method outweigh any transient difference in red cell parameters or inconsiderable reduction of factor VIII activity. The purpose of this review is to discuss the quality, safety and economic aspects of blood components production during conversion from platelet-rich plasma to buffy coat method in preparing blood components which may benefit developing countries. 508 Pediatric Hematology & Oncology Study of Blood Products Utilization in Major Departments of Imam Reza Hospital, Kermanshah, Iran Golpayegani MR Akramipour R Zanganeh S Rezayi M Yousefi H Faranoush M 1 7 2014 6 4 203 208 24 10 2014 24 10 2014 Background: In the present study the amount of requested blood products in major departments of Imam Reza Medical Center, Kermanshah, Iran has been studied to evaluate the necessity of these requests and also the amount of blood products wastage because of unnecessary requests. Materials and Methods: In the present study the information related to 4832 unit of requested blood products from Iranian Blood Transfusion organization from January 2011 to July 2012 in major (internal medicine, obstetrics and gynecology, pediatrics , general surgery) departments of Imam Reza Medical Center, Kermanshah, Iran were evaluated. All data related to these requested blood products were analyzed using SPSS version 16 software. Results: The internal medicine department had the highest amount of blood products requests and also the highest percentage of unnecessary requests causing the waste of products (60% of requested blood products were wasted in this department). The lowest rate of waste was observed in pediatrics department (38.3%). Conclusion: At the present a high percentage of blood products requests were found to be unnecessary. An education program to improve the awareness and knowledge of health personnel about the transfusion medicine and also preparation of local guidelines for blood ordering system is essential for appropriate use of blood products. The reduced amount of wastage will also be an essential step in improving the safety of blood transfusion. Keywords: Blood, indication, wastage, Iran. 509 Pediatric Hematology & Oncology The Prevalence of Blood-Borne Viral Infection (HBV, HCV, HIV) among Hemophilia Patients in Hamedan Province of Iran H Esfahani H Bazmamoun 1 7 2014 6 4 209 211 24 10 2014 24 10 2014 Background: Hemophilia A and B are the most frequent congenital coagulation disorders. This study was conducted to determine the prevalence of hepatitis B, C and human immunodeficiency viruses among hemophilic patients in Hamadan, Iran. Patients and Methods: In this study, patients with hemophilia A and B treated in Hamedan Hemophilia Center, Hamedan, Iran, were screened for hepatitis B, C and human immunodeficiency viruses (HIV) during the year 2012. Results: The prevalence of hemophilia A and B were 86.5 % and 13.5% respectively, and 57.3% of patients had severe hemophilia. HBS antigen, HCV antibody, HCV PCR and HIV antibody were positive in 1.1%, 49.4%, 16.7% and 1.1% of patients respectively. The prevalence of HCV antibody was higher in those patients receiving cryoprecipitates more frequently. Conclusion: Hepatitis C infection has a high prevalence in Hamedan Hemophilia Center, Hamedan, Iran, among hemophilic patients. It seems reasonable to use more accurate virus deactivation techniques during blood products preparation or use other safer treatment methods for hemophilia patients. Keywords: Hepatitis, human immunodeficiency virus, hemophilia. 504 Pediatric Hematology & Oncology Fungal Infections in Pediatric Patients with Hematologic Malignancies Ansari S Kiumarsi A Rostami T Shirzadi E 1 7 2014 6 4 213 214 22 08 2014 22 08 2014 As the data on the epidemiology and outcome of fungal infections in children with hematologic cancer are limited especially in Iran, this study was aimed to delineate the epidemiologic features and outcome of fungal infections in this population. The medical records of all children with hematologic malignancies diagnosed with a fungal infection from 2005 to 2010 at a tertiary pediatric hospital (Ali Asghar Children’s Hospital, Tehran, Iran) were reviewed. The results indicated that out of 617 children hospitalized in the hematology/oncology department during the study period, 115 (18.6%) were diagnosed with a fungal infection. Between 87 patients with fungal infection whose records were complete, Candida species caused the majority (73.6%) of fungal infections. Aspergillus species were found in 14.9% and Mucor species in 11.5% of patients. The mortality rate significantly correlated with the organism causing the infection (P< 0.0001) and was especially high in patients with Aspergillus infections (61.5%). Improved prevention, early detection, and advanced treatment strategies are needed to improve the outcome. 510 Pediatric Hematology & Oncology Analgesic Effect of a Single Dose of Adenosine for Neuropathic Pain Reduction in a Patient with Primitive Neuroechtodermal Tumor F Abolhasan Gharehdaghi M Tashvighi A Mehrvar 1 7 2014 6 4 215 219 24 10 2014 24 10 2014 Background: We report the analgesic efficacy of lumbar epidural adenosine injection in reducing the chronic neuropathic pain in a patient with primitive neuroectodermal tumor. Report of the Case: In this case report a 13-year-old male with primary neuroectodermal tumor (PNET) was administered in epidural space with adenosine to reduce his pain. The patient received 10ml of 0.25% ropivacaine and 2mg adenosine in the epidural space using the L4-L5 interspinous approach. The neuropathic characteristics were assessed using Douleur Neuropathic 4 (DN4) neuropathic pain diagnostic questionnaire. We also evaluated the pain intensity using the visual analogue scale (VAS). The sedation score, patient’s satisfaction, nausea and vomiting and the use of additional analgesia at 1, 3, 7, 15 and 21 days after the procedure were recorded. Result: The DN4 neuropathic questionnaire and VAS pain intensity scores before intervention were 8/10 and 9/10 respectively. After 3 and 7 days, they both decreased to 3/10. Level of sedation as well as nausea and vomiting were satisfactory. Conclusion: The bolus epidural administration of adenosine might improve the cancer related chronic neuropathic pain. Keywords: Adenosine, primitive neuroectodermal tumor, cancer, pain. 511 Pediatric Hematology & Oncology Rhabdomyosarcoma of Eyelid: A picture presentation Shakibazad Karimi 1 7 2014 6 4 221 222 24 10 2014 24 10 2014 This is a picture review of a case of orbital rhabdomyosarcoma. The course of patients diagnosis, treatment and outcome is briefly presented.