(iv) Less need for orthopaedic surgery. Patients with severe HB needed joint arthroplasty (an indirect index of arthropathy severity) less frequently than those with HA, and this difference was maintained Talazoparib when various confounders were accounted for. In conclusion, these and other data give a hint that HB may be less clinically severe than HA. However, these data are not conclusive, because there are also fewer data in favour of a similar degree of severity of HA and HB. “
“X-linked and autosomally inherited bleeding disorders confer a risk of foetal intracranial haemorrhage during delivery. Conventional

prenatal diagnosis involving chorionic villus sampling or early amniocentesis is primarily aimed at offering the choice EPZ-6438 ic50 of pregnancy termination. Currently, non-invasive procedures, involving analysis of free foetal DNA in the maternal circulation, are restricted to gender determination, and are of limited value in women at risk of carrying a foetus with a bleeding

disorder. These limitations, together with the rising proportion of women shown to be carrying an affected foetus, who decide to continue the pregnancy, have led to the development of prenatal mutation identification via late amniocentesis after 34 weeks of gestation, with the sole aim of directing delivery management. Although this approach has been documented in some cases of potential foetal anomaly, there are no previous reports of its use

in women with heritable bleeding disorders. We report a single-centre experience of this technique in managing nine such deliveries. Of these, three showed an affected foetus, selleck inhibitor five showed an unaffected foetus and in one case no result could be obtained. In the three affected cases and the one with the inconclusive result restrictive birth plans were implemented, whereas the five unaffected cases underwent routine obstetric management; with one delivery necessitating interventions which would have been contraindicated if foetal status had not been determined. Late amniocentesis is a safe technique for guiding delivery management in women with bleeding disorders where the mutation is known. “
“Summary.  The use of emergency medical identification (EMI) such as MedicAlert® has been recommended for use in a variety of medical conditions; however, there is no consensus as to what form should be used and where they should be placed. There are also no uniform guidelines to direct first responders to where they should look for EMI in an emergency. The aim of this study was to identify current paediatric haemophilia nursing practice in educating families about EMI and their perceptions of patient/family adherence to using EMI. US haemophilia nurses listed on the Center for Disease Control’s website received an email invitation to participate in a 30-item questionnaire posted on SurveyMonkey.