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Platelet transfusions are commonly used to prevent bleeding in preterm infants with thrombocytopenia. Data are lacking to provide guidance regarding thresholds for prophylactic platelet transfusions in preterm neonates with severe thrombocytopenia.

This multicentre trial was designed to elucidate this issue. Six hundred and sixty infants with a median gestational age of 26.6 weeks were randomised to receive a platelet transfusion at platelet-count thresholds of 50,000 per cubic millimetre (high-threshold group) or 25,000 per cubic millimetre (low-threshold group). A major bleeding episode or death occurred in 26% of the high threshold group and in 19% of the low threshold group (p=0.02). There was no significant difference in the incidence of serious adverse events between the two groups.

The researchers concluded that those randomly assigned to receive platelet transfusions at a platelet-count threshold of 50,000 per cubic millimetre had a significantly higher rate of death or major bleeding within 28 days after randomisation than those who received platelet transfusions at a platelet-count threshold of 25,000 per cubic millimetre.

N Engl J Med 2019; 380:242–51

Impact of cardiac magnetic resonance imaging on heart failure patients referred to a tertiary advanced heart failure unit

The aim of this study which was carried out in Brisbane was to examine how cardiac magnetic resonance (CMR) imaging compared with routine echocardiography in the diagnosis and management of patients with heart failure (HF).

One hundred and fourteen new HF referrals were included. Evaluation of HF of uncertain aetiology (70%) was the commonest indication for CMR. In 20% of cases CMR led to a completely new diagnosis. Clinical decision-making was altered in 48%. Overall, CMR had a significant impact on 50% of patients.

This study clearly demonstrates that CMR makes a substantial contribution to both the diagnosis and management of HF patients over and above standard echocardiography.

Internal Medicine Journal 2019; 49:203–211

Prepregnancy and early pregnancy calcium supplementation among women at high risk of pre-eclampsia

Calcium supplementation in the second half of pregnancy is known to reduce the serious consequences of pre-eclampsia.

This double-blind randomised, placebo-controlled trial was devised to test whether calcium supplementation before and in early pregnancy (up to 20 weeks gestation) would prevent development of pre-eclampsia. Six hundred and fifty-one appropriate patients were randomised to receive either 500mg of calcium daily or placebo. All received 1.5g of calcium after 20 weeks gestation.

The results demonstrated that such a supplementation did not show a significant reduction in recurrent pre-eclampsia compared with placebo.

Lancet 2019; 393:330–39

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Platelet transfusions are commonly used to prevent bleeding in preterm infants with thrombocytopenia. Data are lacking to provide guidance regarding thresholds for prophylactic platelet transfusions in preterm neonates with severe thrombocytopenia.

This multicentre trial was designed to elucidate this issue. Six hundred and sixty infants with a median gestational age of 26.6 weeks were randomised to receive a platelet transfusion at platelet-count thresholds of 50,000 per cubic millimetre (high-threshold group) or 25,000 per cubic millimetre (low-threshold group). A major bleeding episode or death occurred in 26% of the high threshold group and in 19% of the low threshold group (p=0.02). There was no significant difference in the incidence of serious adverse events between the two groups.

The researchers concluded that those randomly assigned to receive platelet transfusions at a platelet-count threshold of 50,000 per cubic millimetre had a significantly higher rate of death or major bleeding within 28 days after randomisation than those who received platelet transfusions at a platelet-count threshold of 25,000 per cubic millimetre.

N Engl J Med 2019; 380:242–51

Impact of cardiac magnetic resonance imaging on heart failure patients referred to a tertiary advanced heart failure unit

The aim of this study which was carried out in Brisbane was to examine how cardiac magnetic resonance (CMR) imaging compared with routine echocardiography in the diagnosis and management of patients with heart failure (HF).

One hundred and fourteen new HF referrals were included. Evaluation of HF of uncertain aetiology (70%) was the commonest indication for CMR. In 20% of cases CMR led to a completely new diagnosis. Clinical decision-making was altered in 48%. Overall, CMR had a significant impact on 50% of patients.

This study clearly demonstrates that CMR makes a substantial contribution to both the diagnosis and management of HF patients over and above standard echocardiography.

Internal Medicine Journal 2019; 49:203–211

Prepregnancy and early pregnancy calcium supplementation among women at high risk of pre-eclampsia

Calcium supplementation in the second half of pregnancy is known to reduce the serious consequences of pre-eclampsia.

This double-blind randomised, placebo-controlled trial was devised to test whether calcium supplementation before and in early pregnancy (up to 20 weeks gestation) would prevent development of pre-eclampsia. Six hundred and fifty-one appropriate patients were randomised to receive either 500mg of calcium daily or placebo. All received 1.5g of calcium after 20 weeks gestation.

The results demonstrated that such a supplementation did not show a significant reduction in recurrent pre-eclampsia compared with placebo.

Lancet 2019; 393:330–39

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Platelet transfusions are commonly used to prevent bleeding in preterm infants with thrombocytopenia. Data are lacking to provide guidance regarding thresholds for prophylactic platelet transfusions in preterm neonates with severe thrombocytopenia.

This multicentre trial was designed to elucidate this issue. Six hundred and sixty infants with a median gestational age of 26.6 weeks were randomised to receive a platelet transfusion at platelet-count thresholds of 50,000 per cubic millimetre (high-threshold group) or 25,000 per cubic millimetre (low-threshold group). A major bleeding episode or death occurred in 26% of the high threshold group and in 19% of the low threshold group (p=0.02). There was no significant difference in the incidence of serious adverse events between the two groups.

The researchers concluded that those randomly assigned to receive platelet transfusions at a platelet-count threshold of 50,000 per cubic millimetre had a significantly higher rate of death or major bleeding within 28 days after randomisation than those who received platelet transfusions at a platelet-count threshold of 25,000 per cubic millimetre.

N Engl J Med 2019; 380:242–51

Impact of cardiac magnetic resonance imaging on heart failure patients referred to a tertiary advanced heart failure unit

The aim of this study which was carried out in Brisbane was to examine how cardiac magnetic resonance (CMR) imaging compared with routine echocardiography in the diagnosis and management of patients with heart failure (HF).

One hundred and fourteen new HF referrals were included. Evaluation of HF of uncertain aetiology (70%) was the commonest indication for CMR. In 20% of cases CMR led to a completely new diagnosis. Clinical decision-making was altered in 48%. Overall, CMR had a significant impact on 50% of patients.

This study clearly demonstrates that CMR makes a substantial contribution to both the diagnosis and management of HF patients over and above standard echocardiography.

Internal Medicine Journal 2019; 49:203–211

Prepregnancy and early pregnancy calcium supplementation among women at high risk of pre-eclampsia

Calcium supplementation in the second half of pregnancy is known to reduce the serious consequences of pre-eclampsia.

This double-blind randomised, placebo-controlled trial was devised to test whether calcium supplementation before and in early pregnancy (up to 20 weeks gestation) would prevent development of pre-eclampsia. Six hundred and fifty-one appropriate patients were randomised to receive either 500mg of calcium daily or placebo. All received 1.5g of calcium after 20 weeks gestation.

The results demonstrated that such a supplementation did not show a significant reduction in recurrent pre-eclampsia compared with placebo.

Lancet 2019; 393:330–39

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

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