During the fellowship year, Dr. Buckner will be mentored by UNC Hemophilia & Thrombosis Center Director Nigel Key, MD.

Adult Hemophilia Clinic is now held on Wednesday mornings.  We will no longer be seeing adult patients on Mondays.

You will continue to see the same Hemophilia Treatment Center staff at Carolina Pointe II.

You will continue to make, change, or cancel appointments by calling Tracy Griles at 919-966-4736 or 866-443-8096.

Pediatric patients will continue to be seen on Monday afternoons at the Cancer Hospital's first-floor pediatric clinic.

Please call us at 919-966-4736 or 866-443-8096 if you have questions about the change.

Hemophilia of North Carolina is a 501c3 non-profit organization dedicated to improving the quality of life of persons affected by bleeding disorders through advocacy, education, promotion of research and supportive programs and services.  The organization's vision is for all persons affected by bleeding disorders to achieve their full potential without barriers or limitations, until a cure if found.

Most biological products require specific storage conditions, as indicated in the product labeling, to maintain their safety, purity, and potency. These products include bacterial and viral vaccines, allergenic extracts, plasma derivatives, and other products requiring refrigeration or frozen storage, as well as products that can be stored at controlled room temperature (i.e., not exceptionally cold or hot). When there is an electrical power failure, whether due to accident, equipment failure, or disruption in the electrical power grid, the temperature control systems for product storage may not function. For example, on August 14, 2003, the northeast region of the country experienced a power outage lasting from one to several days, and some health professionals were uncertain what to do with products that they had in storage. Power failures are not only a concern regarding storage in a facility, as failure of the refrigeration or freezer unit on a carrier (e.g., truck) while the products are in transit may also occur. The information below may assist interested persons in determining what to do with their biological products in the event of a power failure.

During normal business hours, questions may be directed to 1-800-835-4709. After business hours parties may call the FDA emergency operations line at 301-796-8240. These questions will be forwarded to the appropriate Center or office for advice.

1. Vaccines Requiring Refrigeration or Frozen Storage

   Most refrigerated vaccines are relatively stable at room temperature for limited periods of time, although certain vaccines are temperature-sensitive. Products stored in a closed refrigerator (or freezer, if appropriate) during a power outage may maintain their potency unless the power outage is of such duration that the refrigerator's (or freezer's) internal temperature rises significantly. It is recommended that thermometers be located in the refrigerator and freezer section so that temperatures can be read when power resumes to see if excursions outside of recommended temperatures have occurred. The "How Supplied/Storage and Handling" section of the product label may also be consulted for information. Most vaccine manufacturers have filed data with CBER to support the stability of their products at somewhat elevated temperatures and related duration of storage; they may consult with CBER concerning the impact of temperature/time duration on product stability.

   1. If the Power Goes Out

      In the past, persons responsible for storing refrigerated or frozen biological products have taken the following actions to preserve cold storage conditions during a power outage:

      1. Note the time of the power outage and do not open freezers and refrigerators until power is restored. This will help keep the temperature low for a longer period of time.
      2. For refrigerator-stored vaccines, do not open the refrigerators to check temperatures during a power outage, as many products will maintain their potency for a few days in the relative cool of a closed refrigerator.
      3. For vaccines requiring freezer storage, consider removing them from the freezer after one day (if the power outage continues) and packing them in dry ice. If the vaccines are not cold to the touch, upon removal from the freezer, the vaccine should be discarded
   2. When Power is Restored
      1. Record the temperature in the refrigerator or freezer as soon as possible after power is restored and before the temperature has begun to drop again. Continue to record the temperature at periodic intervals until it reaches the temperature range indicated on the product labeling as appropriate for product storage.
      2. Record the duration of increased temperature exposure. For example, the temperature of the freezer was 0 degrees Fahrenheit at noon on day 1 when the power failed; 15 degrees Fahrenheit at 6 PM on day 2 when the power was restored; 10 degrees Fahrenheit at 10 PM on day 2; and 0 degrees Fahrenheit at 7 AM on day 3. This information about time/temperature duration can enable calculations to be made by the product manufacturer, in consultation with FDA as necessary, about the continued potency of the involved products.
   3. If a Flood is Expected

      When a flood is anticipated, storage facilities have taken steps to raise stored products out of range of anticipated flood waters. For example:

      1. Elevate biological products stored on warehouse floors off the ground (e.g., on pallets). For those items on shelves, it may be important to securely anchor the shelves to keep products dry.
      2. For products stored in refrigerators at floor level, elevate refrigerators on wheels or platforms to the extent possible.
   4. If Flooding Occurs

      Vials containing vaccine exposed to flood waters should be considered contaminated and also likely to have been exposed to temperatures outside of those recommended for cold chain storage, and should be discarded.

2. Other Non-Blood Biologicals Requiring Refrigeration or Frozen Storage

   The information above concerning the storage and recording of time/temperature conditions are applicable to other non-blood biologicals requiring refrigeration or frozen storage.

3. Blood Products and Plasma Derivatives

   Blood banks and plasma centers typically have back up generators and emergency procedures in place for storing products in the event of a power outage.

• Blood establishments collecting and storing blood and blood components generally have written procedures in place to address emergency circumstances. Problems or issues affecting the blood supply should be brought to the attention of the FDA.

  For health clinics, physician offices or in-home users that may not have emergency back up power, the following may be helpful:

• There is some evidence that lyophilized coagulation products such as Factor VIII and Factor IX may be stored at room temperature for a fairly long period of time without loss of factor potency. If you are concerned about the exposure or efficacy of a particular product, please call the supplier or the manufacturers' customer service department.
• Many immune globulin products are licensed for storage at 36 to 46 degrees Fahrenheit, and some products may be stored at room temperature for all or part of the time before expiration. Because storage temperatures and times are specific to each product, you should follow the package insert recommendations for Immune Globulin Intravenous (IGIV), intramuscular IG (IG), and subcutaneous IG (IGSC) products. Products requiring lower temperatures can be stored on wet ice. All of these products should not be frozen. If you have any questions about the storage of these products, you should consult the package inserts.

CHAPEL HILL, N.C. – Today HHT Foundation International announced that the University of North Carolina at Chapel Hill has been selected as the 12th HHT Center of Excellence in the United States.

Raj Kasthuri, MD, assistant professor of hematology and oncology in the UNC School of Medicine, is director of the new center for the treatment of hereditary hemorrhagic telangiectasia (HHT). HHT, also known as Osler-Weber-Rendu syndrome, is an inherited disorder of the blood vessels that can cause excessive bleeding. The most common symptom of HHT is bleeding from the nose, but HHT can also cause bleeding from the mouth, tongue, gastrointestinal tract, lungs, skin or other organs.

“Dr. Kasthuri has organized a team of specialists at UNC who are knowledgeable in the treatment and care of HHT and have been treating HHT patients for several years. We are really excited about this new collaboration,” said Marianne Clancy, executive director of HHT Foundation International.

HHT affects about 1 of every 5,000 people in the U.S. The number of people with HHT in the U.S. is estimated at 70,000. About 1,700 people in North Carolina have the disorder, which sometimes affects multiple members of the same family, Dr. Kasthuri said. It is estimated that there are about 2,800 additional people with HHT in the surrounding states of South Carolina, Tennessee, Virginia and West Virginia. None of those states have an HHT Center of Excellence.

“I am very excited to lead this multidisciplinary endeavor and look forward to providing care for a population that is underdiagnosed and underserved,” Dr. Kasthuri said.

The new HHT Center of Excellence at UNC is housed administratively within the Department of Radiology in the School of Medicine. Members of the center are:

• Drs. Charles Burke, Matt Mauro and Hortensia Alvarez – Interventional Radiology
• Dr. Mark Weissler – Otolaryngology/Head and Neck Surgery
• Dr. Jim Evans and Ofri Leitner – Genetics
• Dr. Douglas Morgan – Gastroenterology
• Dr. Jimmy Ford – Pulmonology
• Dr. Brian Jensen – Cardiology
• Dr. David Huang – Neurology
• Dr. Anand Germanwala – Neurosurgery
• Dr. George Blakey – Maxillofacial Surgery (UNC School of Dentistry)

The other 11 HHT Centers of Excellence in the U.S. are:

• Georgia Health Science University HHT Center (Augusta, Ga.)
• Johns Hopkins HHT Center (Baltimore, Md.)
• Mayo Clinic HHT Center (Rochester, Minn.)
• Oregon Health & Science University HHT Center (Portland, Ore.)
• University of California at Los Angeles HHT Center
• University of California at San Diego HHT Center
• University of Pennsylvania (Philadelphia)
• University of Texas – Southwestern (Dallas)
• University of Utah Medical Center (Salt Lake City)
• Washington University School of Medicine (St. Louis, Mo.)
• Yale University School of Medicine (New Haven, Conn.)

To request a screening at UNC’s HHT Center of Excellence, contact Karen Smith, RN, at 919-966-2790.

http://news.unchealthcare.org/news/2011/march/hht

Cancer is a risk factor for developing blood clots in the veins, known as venous thromboembolism (VTE).  Patients with cancer are four times more likely to develop VTE compared with the general population and 15% of patients with cancer will have an episode of VTE at some point during the course of their treatment.

The UNC Blood Clot Outreach Program will provide education to this high-risk population through its Clot Connect education project, online at www.ClotConnect.org.

Targeted education will include:

• The development of a patient education webinar series, to include both ‘Blood Clot Basics’ appropriate for all VTE patients and ‘Cancer and Clotting’ which will address more specifically cancer patients.
• Greater distribution of the Clot Connect bookmark, which lists the symptoms of VTE.
• Development of ‘Cancer and Clotting’ patient handout materials which will be available for widespread distribution on the website.

About the UNC Blood Clot Outreach Program:

The mission of the UNC Blood Clot Outreach Program (BCO), housed within the UNC Hemophilia and Thrombosis Center, is to increase knowledge of blood clots and clotting disorders through the development of educational programs for patients and health care professionals.  Clot Connect (clotconnect.org) is a collaborative outreach project led by the UNC BCO which engages community partners to develop and deliver innovative blood clot education programs.

The UNC Blood Clot Outreach Program utilizes the Clot Connect project constructs to develop and disseminate blood clot education targeted to:

a.       patients who have experienced venous thromboembolism (VTE)

b.      patients at high risk for  VTE and

c.       Health care professionals

The program is led by Stephan Moll, MD; Medical Director of the UNC Blood Clot Outreach Program and Clot Connect project; Associate Professor in the Department of Medicine and Division of Hematology-Oncology at the University of North Carolina at Chapel Hill.

For more information,  contact Beth Waldron, Program Director of the UNC Blood Clot Outreach Program and Clot Connect project.