In recent years, data have been repeatedly published stating that most errors in the process of obtaining a laboratory result occur in the pre-analytical phase (46 % to 68.2 %). This is an area that is usually out of direct control of the laboratory, involving venous blood collection (phlebotomy). The detection of these errors is considered to be quite difficult and can therefore easily lead to a misinterpretation of laboratory results with a consequent adverse effect for the patient and even in unintended injury. The most effective way to prevent them is to have a good knowledge of the current blood collection recommendations, which were recently (2018) revised by the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) and are offered in this review.

• Klíčová slova
• closed blood collection system, guidelines, patient preparation, recommendations, venous blood collection,
• MeSH
• flebotomie metody   MeSH
• klinická chemie * MeSH
• lidé MeSH
• odběr vzorku krve * metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Most myelodysplastic syndromes (MDS)-patients receive multiple red blood cell transfusions (RBCT). Transfusions may cause iron-related toxicity and mortality, influencing outcome after allogeneic HSCT. This prospective non-interventional study evaluated 222 MDS and CMML patients undergoing HSCT. Overall survival (OS), relapse-free survival (RFS), non-relapse mortality (NRM), and relapse incidence (RI) at 36 months were 52%, 44%, 25%, and 31%, respectively. Age, percentage of marrow blasts and severe comorbidities impacted OS. RFS was significantly associated with RBCT burden prior to HSCT (HR: 1.7; p = .02). High ferritin levels had a significant negative impact on OS and RI, but no impact on NRM. Administration of iron chelation therapy prior to HSCT did not influence the outcome, but early iron reduction after HSCT (started before 6 months) improved RFS significantly after transplantation (56% in the control group vs. 90% in the treated group, respectively; p = .04). This study illustrates the impact of RBCT and related parameters on HSCT-outcome. Patients with an expected prolonged survival after transplantation may benefit from early iron reduction therapy after transplantation.

• Klíčová slova
• MDS, allogeneic stem cell transplantation, chelation therapy, phlebotomies, transfusions,
• MeSH
• chelátová terapie MeSH
• dospělí MeSH
• flebotomie MeSH
• homologní transplantace MeSH
• incidence MeSH
• krevní transfuze * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• myelodysplastické syndromy komplikace   epidemiologie   mortalita   terapie   MeSH
• nemoc štěpu proti hostiteli diagnóza   etiologie   MeSH
• přetížení železem diagnóza   etiologie   terapie   MeSH
• proporcionální rizikové modely MeSH
• senioři MeSH
• transplantace hematopoetických kmenových buněk * škodlivé účinky   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The common opinion is that in Europe acupuncture was introduced in China at the end of the XVII century. However there are some publications, which describe the similar treatment method in the Stone Age Europe. From ancient to late middle century theoretical and practical aspects of medieval medicine in Europe were very similar to the Tradition Chinese medicine. So it is possible that historical phlebotomy in Europe (bloodletting) played the same role as the acupuncture in the Chinese therapy and they had one scientific source. In this article we are comparing the modern acupuncture with some Bohemian medical tractates (Practica medicinalis by Sigismundus Albicus from 1408-1424, De sanguinis minucione by Cristannus de Prachaticz from 1430). We can see the close relationship between localizations and indications of medieval phlebotomy and modern acupuncture points. 40% of the bloodletting points have close localization with the modern acupuncture points and 57% of their indications are common or very similar. The similarity of two methods may be explained in two ways. First is a common scientific source and intensive interaction and crosscultural transmission of knowledge during medical development in China and Europe up to the beginning of the XV century. This possibility indicates also some linguistic coincidences. On the other hand, both methods could have been developed separately based on common clinical empire and objective neuro-physiological patterns of human body.

• MeSH
• akupunkturní body MeSH
• akupunkturní terapie dějiny   MeSH
• dějiny 20. století MeSH
• dějiny středověku MeSH
• flebotomie dějiny   MeSH
• kultura MeSH
• lidé MeSH
• pouštění žilou dějiny   MeSH
• tradiční čínská medicína dějiny   MeSH
• Check Tag
• dějiny 20. století MeSH
• dějiny středověku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• historické články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Čína MeSH
• Evropa MeSH

Wet cupping was used in the nineteenth century for treatment of patients in the United Kingdom (UK) by a few experienced practitioners. Revival Hijama use by practitioners in the UK in recent years has been observed as well as interest from the public, with developments of specific certified training programmes, established businesses providing tailored Hijama therapy Clinical Waste disposal services, provisions of insurance cover, involvement of medical professionals and membership with the General Regulatory Council for Complementary Therapies (GRCCT). However, there has also been noted that there is not much in the way of guidance or regulation. Therefore, we would like to initiate some communication and understanding of Hijama (wet cupping) to benefit medical professionals, discussing recent research undertaken as a basis for potentially more in the future (evidence-based practice), in the likely event that a patient might request to be referred for this therapy during a consultation.

• Klíčová slova
• Clinical practice, Complementary medicine, Evidence, Hijama, Regulation, Wet cupping,
• MeSH
• komplementární terapie * MeSH
• lidé MeSH
• medicína založená na důkazech MeSH
• pouštění žilou * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Spojené království MeSH

AIMS: The main objective of the study was to determine the effect of structured psychological intervention on the level of perceived pain in children undergoing venipuncture. A second goal was to investigate how pain behavior during venipuncture is affected by age, sex, previous number of venipunctures, the presence of parents during the procedure and reason for the venipuncture. METHODS: Children with indications for venipuncture aged 5-10 years, were randomly divided into a control group and an intervention group. The control group was prepared for the venipuncture routinely. Children in the intervention group were prepared according to prior structured psychological consultation. Perceived pain levels were assessed by the CHEOPS scale and the self report Wong and Baker faces pain rating scale. RESULTS: A significant difference in evaluated pain between the intervention group and the control group was found. The psychological intervention carried out by a nurse proved to lower pain levels from venipuncture as measured by the CHEOPS scale and evaluated using the self-report scale. A greater level of pain was found in children in the age group 5-7 years, in children where peripheral venous catheter was introduced and in children where the parents were present. Special consultation with the child one day before venipuncture reduced pain levels, especially in children below the age-category mentioned. Consultation should be part of the standard of care for children with indications for venipuncture.

• MeSH
• bolest psychologie   MeSH
• dětská psychologie * MeSH
• dítě MeSH
• flebotomie škodlivé účinky   psychologie   MeSH
• lidé MeSH
• percepce * MeSH
• předškolní dítě MeSH
• vzdělávání pacientů jako téma * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH

Hepcidin is a key regulator of iron homeostasis, while hemojuvelin is an important component of the hepcidin regulation pathway. It has been recently proposed that soluble hemojuvelin, produced from hemojuvelin by the protease furin, decreases hepcidin expression. The aim of the presented study was to examine the downregulation of hepcidin by chronic bleeding in hemojuvelin-mutant mice. Male mice with targeted disruption of the hemojuvelin gene (Hjv-/- mice) and wild-type littermates were maintained on an iron-deficient diet and subjected to weekly phlebotomies for 7 weeks. Gene expression was examined by real-time PCR. In wild type mice, repeated bleeding decreased hepcidin mRNA by two orders of magnitude. In Hjv-/- mice, basal hepcidin expression was low; however, repeated bleeding also decreased hepcidin mRNA content by an order of magnitude. Phlebotomies reduced hepatic iron overload in Hjv-/- mice by 80 %. Liver and muscle furin mRNA content was not significantly changed. No effect on hepatic Tmprss6 mRNA content was observed. Results from the study indicate that soluble hemojuvelin is not the sole factor responsible for hepcidin downregulation. In addition, the presented data suggest that, under in vivo conditions, tissue hypoxia does not transcriptionally regulate the activity of furin or TMPRSS6 proteases.

• MeSH
• časové faktory MeSH
• deficit železa MeSH
• dietní železo aplikace a dávkování   MeSH
• down regulace MeSH
• erytropoéza * MeSH
• flebotomie MeSH
• furin metabolismus   MeSH
• GPI-vázané proteiny MeSH
• hepcidiny MeSH
• hypoxie buňky MeSH
• játra metabolismus   MeSH
• kationické antimikrobiální peptidy genetika   metabolismus   MeSH
• kosterní svaly metabolismus   MeSH
• krvácení etiologie   genetika   metabolismus   MeSH
• membránové proteiny nedostatek   genetika   metabolismus   MeSH
• messenger RNA metabolismus   MeSH
• modely nemocí na zvířatech MeSH
• myši knockoutované MeSH
• myši MeSH
• přetížení železem metabolismus   prevence a kontrola   MeSH
• protein hemochromatózy MeSH
• serinové endopeptidasy metabolismus   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• dietní železo MeSH
• furin MeSH
• GPI-vázané proteiny MeSH
• Hamp protein, mouse MeSH Prohlížeč
• hepcidiny MeSH
• HJV protein, mouse MeSH Prohlížeč
• kationické antimikrobiální peptidy MeSH
• matriptase 2 MeSH Prohlížeč
• membránové proteiny MeSH
• messenger RNA MeSH
• protein hemochromatózy MeSH
• serinové endopeptidasy MeSH

OBJECTIVE: In primary aldosteronism, adrenal venous sampling (AVS) is essential for subtype differentiation as it evaluates aldosterone secretion from both adrenals. Selectivity of adrenal sampling is assessed by the ratio of cortisol concentrations in adrenal venous blood and inferior vena cava blood (C(adrenal)/C(ivc)). Since the criteria for selective adrenal sampling differ among the reported literature, we performed a study to evaluate the influence of different selectivity criteria on AVS results. DESIGN AND METHODS: Reports of AVS were screened retrospectively. All AVS were performed with cosyntrophin infusion. Reports containing samples with C(adrenal)/C(ivc)>or=10 taken from both adrenals and at least one other adrenal sample characterised by C(adrenal)/C(ivc)>or=1.1 were enrolled. For each individual, we chose reference samples that were defined by the highest C(adrenal)/C(ivc) achieved from each adrenal. The significance of the remaining samples with C(adrenal)/C(ivc)>or=1.1 was analysed in regard to their respective reference samples. We assessed the impact of analysed samples on identification of lateralisation of aldosterone secretion that is crucial for decisions concerning adrenalectomy. RESULTS: AVS reports of 87 patients were enrolled. A total of 225 adrenal samples were analysed and divided into five groups according to C(adrenal)/C(ivc):1.1-1.99, 2-2.99, 3-4.99, 5-9.99 and >or=10. By comparing reference with analysed samples, a concordant assessment with respect to lateralisation of aldosterone secretion was observed in 39, 52, 72, 85 and 94% of the respective groups of analysed samples. CONCLUSION: AVS provides consistent information when adrenal samples with high cortisol concentrations are used.

• MeSH
• časové faktory MeSH
• dospělí MeSH
• flebotomie metody   normy   statistika a číselné údaje   MeSH
• hyperaldosteronismus krev   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nadledviny krevní zásobení   MeSH
• odběr vzorku krve metody   normy   statistika a číselné údaje   MeSH
• retrospektivní studie MeSH
• vény MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

Hemojuvelin (Hjv) is an essential component of the pathway regulating hepcidin (Hamp1) gene expression. Mice with targeted disruption of the Hjv gene (Hjv-/- mice) fail to upregulate hepatic Hamp1 expression following iron overload. The main aim of the study was to determine whether the Hjv protein is also necessary for Hamp1 downregulation. In addition, sex differences in Hamp1 expression in Hjv-/- mice were also examined. Male and female Hjv-/- mice (129SvJ background) were used for the experiments, tissue Hamp1 and Hamp2 mRNA content was determined by real-time PCR. Hepatic Hamp1 mRNA content in male Hjv-/- mice was low (0.6% of Hjv+/+ males), however, female Hjv-/- mice displayed only moderately reduced (to 17%) Hamp1 mRNA levels. Hepatic non-heme iron concentration was similar in Hjv-/- mice of both sexes. Disruption of the Hjv gene did not affect Hamp1 mRNA content in the myocardium or Hamp2 mRNA content in the pancreas. Single phlebotomy resulted in significant reduction of Hamp1 mRNA in both male and female Hjv+/+ mice (to 17% and 27% of controls respectively), measured 20 h after treatment. In Hjv-/- mice, phlebotomy decreased Hamp1 mRNA content to 46% in males and to 11% in females. Bleeding also significantly decreased (to 16%) hepatic Hamp2 mRNA levels in Hjv-/- females. The obtained results indicate that the pathway mediating hepcidin downregulation by phlebotomy does not require functional hemojuvelin protein. In addition, they confirm a significant effect of sex on hepcidin gene expression.

• MeSH
• flebotomie MeSH
• GPI-vázané proteiny MeSH
• hepcidiny MeSH
• kationické antimikrobiální peptidy biosyntéza   MeSH
• krvácení metabolismus   MeSH
• lidé MeSH
• membránové proteiny nedostatek   MeSH
• mutace MeSH
• myši knockoutované MeSH
• myši MeSH
• orgánová specificita genetika   MeSH
• pohlavní dimorfismus * MeSH
• protein hemochromatózy MeSH
• regulace genové exprese * genetika   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• GPI-vázané proteiny MeSH
• HAMP protein, human MeSH Prohlížeč
• Hamp protein, mouse MeSH Prohlížeč
• Hamp2 protein, mouse MeSH Prohlížeč
• hepcidiny MeSH
• HJV protein, mouse MeSH Prohlížeč
• kationické antimikrobiální peptidy MeSH
• membránové proteiny MeSH
• protein hemochromatózy MeSH

Successful treatment of iron overload by phlebotomies has been reported in two splenectomized siblings with congenital dyserythropoietic anemia--type II (CDA-II). In both patients 400 ml of blood were withdrawn every month. During three years 12 200 ml of blood were removed. The serum ferritin levels decreased from 1450,4 microg/L and 1131,7 microg/L to 447 microg/L and 457 microg/l, respectively. The transferrin saturation dropped from 0,99 at the start of the therapy to 0,64 and 0,86, respectively. The values of Hb, Hct, erythrocyte counts and MCV did not change as well as did not change reticulocyte counts, reticulocyte index, and RDW. Both patients tolerated repeated phlebotomies well. The decrease of bilirubin and normal values of haptoglobin might be the concequence of diminished destruction of erythrocytes and their precursors. Our observation confirms that phlebotomies can be used with success in CDA patients with mild anemia as treatment modality of iron overload.

• MeSH
• dospělí MeSH
• flebotomie * MeSH
• kongenitální dyserytropoetická anemie krev   genetika   terapie   MeSH
• lidé MeSH
• mladiství MeSH
• přetížení železem terapie   MeSH
• splenektomie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The results of a study of effects of stress on serum prolactin (PRL) levels in patients with SLE reveal statistically significant differences in serum PRL level readings in samples taken over a short period of time, thus corroborating the need to take into account PRL stress induction during sample withdrawals and to interpret the values obtained, especially where moderate idiopathic hyperprolactinemia was detected. To eliminate any external stress factors, it is advisable to take PRL samples repeatedly and in perfectly resting patients.

• MeSH
• adenohypofýza metabolismus   MeSH
• autoimunitní nemoci krev   komplikace   patofyziologie   MeSH
• bolest etiologie   patofyziologie   MeSH
• časové faktory MeSH
• dospělí MeSH
• flebotomie škodlivé účinky   psychologie   MeSH
• fyziologický stres etiologie   patofyziologie   MeSH
• hyperprolaktinemie etiologie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• periferní katetrizace škodlivé účinky   psychologie   MeSH
• prolaktin krev   metabolismus   MeSH
• psychický stres etiologie   patofyziologie   MeSH
• rychlost sekrece MeSH
• systémový lupus erythematodes krev   komplikace   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• prolaktin MeSH