Basics to Brilliance: Haematology Podcast

Lab Diagnostic Techniques for Haemoglobinpathies and Thalassemias (with Dr. Noemi Roy)

Feedback [https://www.buzzsprout.com/2344561/fan_mail/new] We are delighted to have Dr. Noémi Roy Consultant Haematologist at Oxford University Hospitals NHS Foundation Trust join us for this very special episode! 'Basics to Brilliance: Haematology Podcast' has been accredited for CPD credit by the Royal College of Pathologists UK.  Medical professionals and clinical scientists holding career-grade positions, who are registered with any of the Royal Colleges for CPD, will be eligible to earn 1 credit for every hour of learning.  Email: basicstobrilliancehaem@gmail.com Insta: BasicstoBrilliance X: @basics_2_brill Send us your feedback!

Red Cell Basics

Feedback [https://www.buzzsprout.com/2344561/fan_mail/new] Welcome to the Red Cell Series! Timestamps and notes to follow... 'Basics to Brilliance: Haematology Podcast' has been accredited for CPD credit by the Royal College of Pathologists UK.  Medical professionals and clinical scientists holding career-grade positions, who are registered with any of the Royal Colleges for CPD, will be eligible to earn 1 credit for every hour of learning.  Email: basicstobrilliancehaem@gmail.com Insta: BasicstoBrilliance X: @basics_2_brill Send us your feedback!

Haemophilia B, Gene Therapy

Feedback [https://www.buzzsprout.com/2344561/fan_mail/new] Timestamps to follow! 'Basics to Brilliance: Haematology Podcast' has been accredited for CPD credit by the Royal College of Pathologists UK.  Medical professionals and clinical scientists holding career-grade positions, who are registered with any of the Royal Colleges for CPD, will be eligible to earn 1 credit for every hour of learning.  Email: basicstobrilliancehaem@gmail.com Insta: BasicstoBrilliance X: @basics_2_brill Send us your feedback!

Dilemmas in Haemophilia

Feedback [https://www.buzzsprout.com/2344561/fan_mail/new] This is a discussion about possible factors and strategies to consider and should not be used as a guideline for clinical practice. Always discuss complicated cases with the attending H&T consultant. 00:52 Intro 01:30 Case 1: 41M Severe Haemophilia A, acute MI needing PCI Try the 4 steps! 1. Bleeding Risk 2. Anticoagulant characteristics 3. Intensity of anticoagulant (prophylactic vs therapeutic) 4. Duration of anticoagulant therapy 11:20 Cardiac Disease in Haemophilia: thoughts and considerations  20:40 Case 1: a potential algorithm in action 24:15 Case 2: 60M Moderate Haemophilia A, positive cardiac Hx, AF on ECG 33:30 Case 3: Moderate Haemophilia A, lobectomy, DVT on USS doppler of leg 40:00 Golden nuggets with a side of ffries 'Basics to Brilliance: Haematology Podcast' has been accredited for CPD credit by the Royal College of Pathologists UK.  Medical professionals and clinical scientists holding career-grade positions, who are registered with any of the Royal Colleges for CPD, will be eligible to earn 1 credit for every hour of learning.  Email: basicstobrilliancehaem@gmail.com Insta: BasicstoBrilliance X: @basics_2_brill Send us your feedback!

Acquired Haemophilia A

Feedback [https://www.buzzsprout.com/2344561/fan_mail/new] 00:52 Intro and chuckles 01:40 Case study: 75M, left calf swelling, put on DOAC, 24 hrs later haematoma and deep bleed on CT 06:00 General information * Elderly (>65), Mortality 8-40% * Common presentations: GI and UG bleeding, Retroperitoneal and muscle bleeds (compartment syndrome) * Ptegnancy, TTP, Malignancy (15%), Autoimmune disease (17%) 08:56 Pathogenesis and diagnosis: AutoAb against F8 * *Bethesda units do not correlate with bleeding phenotype in Acquired HA- second orfer kinetics* * History * APTT, PT (isolated raised APTT) * Mixing studies: 50/50 or 80/20 mix * Factor Assays (**Intrinsic**) * Decreased Factor VIII + Non-paralellism -> Bethesday Assay 20:20 Non-clotting investigations 22:05 Treatment * MDT + Comprehensive Care Center escalation * RICE., TXA, Bypassing agents * Limit iatrogenic bleeding * Review medications * Pregnancy: birth plan!!!  inhibitor can cross palcenta * Steroid +/- Cyclophosphamide 27:10 Bypassing Agents in Acquired Haemophilia A * FENOC + EACH2 study: FEIBA vs NovoSeven = No difference in bleeding/thrombosis rates- more info at 33:25 for EACH2 * Obizor can be titrated according to response whereas FEIBA and NovoSeven cannot * Emicizimab +/- Immunosuppression  = Not currently licesnsed in the UK  32:25 Inhibitor eradication * Mean time to remission: 5 weeks * Good prognostic markers: FVIII 1 or more, Inhibitor titre < 20 * EACH 2 Study: Steroids -> Steroids + Cyclophosphamide -> Steroids + Cyclo + Rituximab * Biggest cause of death: infection 36:45 Follow up  * Weekly FVIII levels and inhibitor monitoring till remission then monthly for 6 months then 2-3 monthly for a year * Planned procedure; FVIII level 38:45 Golden Nuggets 'Basics to Brilliance: Haematology Podcast' has been accredited for CPD credit by the Royal College of Pathologists UK.  Medical professionals and clinical scientists holding career-grade positions, who are registered with any of the Royal Colleges for CPD, will be eligible to earn 1 credit for every hour of learning.  Email: basicstobrilliancehaem@gmail.com Insta: BasicstoBrilliance X: @basics_2_brill Send us your feedback!