Evaluation of Cytotoxic effect of Moringa peregrina seeds on Oral Cancer, CAL 27, Cell Line and Red Blood Cells Hemolysis / Evaluación del efecto citotóxico de las semillas de Moringa peregrina en el cáncer oral, CAL 27, líneas celulares y hemólisis de glóbulos rojos

Background: Moringa peregrina Forssk is a well-known plant in ethnomedicine due to its widespread uses in various diseases like cough, wound healing, rhinitis, fever, and detoxification. The plant seeds contain compounds that are cytotoxic to many cancer cells. During the therapeutic use of plants via the oral route, some compounds present in the plants may be cytotoxic to normal cell lines and red blood cells. Objective: This study was the first report of investigation of the cytotoxic profile on oral cancer, CAL 27, cell line, and hemolytic activities on human erythrocytes of Moringa peregrina seeds ethanolic extract (MPSE). Methods: MPSE was screened for its cytotoxic effect against oral cancer, CAL 27, cell line using 3-(4, 5-dimethylthiazol-2-yl)-2, 5,-diphenyltetrazolium bromide (MTT) assay. The toxicity of MPSE on human erythrocytes was determined by in vitro hemolytic assay. Results: MPSE showed significant anti-proliferative activity against oral cancer, CAL 27 cell line at lower concentrations with half maximal inhibitory concentration (IC50) value of 21.03 µg/mL. At 1,000 µg/ml of MPSE, the maximum hemolysis was found to be 14.3% which is within safer limit. Conclusions: This study revealed a potential anti-oral cancer of MPSE and provided a baseline for its potential use in oral cancer treatment with minimum hemolytic effect on human RBCs.

La Moringa peregrina Forssk es una planta muy conocida en etnomedicina debido a sus usos generalizados en diversas enfermedades como la tos, la cicatrización de heridas, la rinitis, la fiebre y la desintoxicación. Las semillas de la planta contienen compuestos citotóxicos para muchas células cancerosas. Durante el uso terapéutico de las plantas por vía oral, algunos compuestos presentes en ellas pueden ser citotóxicos para las líneas celulares normales y los glóbulos rojos. Objetivo: Este estudio fue el primer informe de investigación del perfil citotóxico sobre el cáncer oral, CAL 27, línea celular, y las actividades hemolíticas en eritrocitos humanos del extracto etanólico de semillas de Moringa peregrina (MPSE). Métodos: Se examinó el efecto citotóxico del MPSE contra la línea celular de cáncer oral CAL 27 mediante el ensayo con bromuro de 3-(4, 5-dimetiltiazol-2-il)-2, 5,-difeniltetrazolio (MTT). La toxicidad del MPSE sobre los eritrocitos humanos se determinó mediante un ensayo hemolítico in vitro. Resultados: MPSE mostró una actividad antiproliferativa significativa contra el cáncer oral, línea celular CAL 27 a concentraciones más bajas con un valor de concentración inhibitoria media máxima (IC50) de 21,03 µg/mL. A 1.000 µg/ml de MPSE, la hemólisis máxima fue del 14,3%, lo que está dentro del límite de seguridad. Conclusiones: Este estudio reveló un potencial anticancerígeno oral de MPSE y proporcionó una base para su uso potencial en el tratamiento del cáncer oral con un efecto hemolítico mínimo en los glóbulos rojos humanos.

Transfusion of packed red blood cells in adults with sickle cell anemia treated at an emergency hospital

SUMMARY OBJECTIVE: The aim of this study was to analyze the prescription of packed red blood cells performed by emergency physicians for adults with sickle cell anemia. METHODS: Transfusions performed in adults with sickle cell anemia treated at an emergency service in São Bernardo do Campo, São Paulo Brazil, between January 2018 and January 2022 were evaluated. For data comparison, the chi-square2 test was used. The significance level adopted was 5%. RESULTS: A total of 114 transfusions were performed. The mean age was 41.8±16.4 years, and pretransfusion hemoglobin was 6.1±1.23 g/dL. Regarding the indication, the adequacy of transfusions performed in symptomatic individuals was significantly higher compared to asymptomatic individuals (100% vs. 3.9%, p<0.001). Symptomatic individuals received excessive volumes of packed red blood cells less frequently than asymptomatic individuals (17.5% vs. 56.9%, p<0.001). The filtered subtype, indicated for sickle cell anemia, was prescribed in only a quarter of the patients. However, non-indicated subtypes were frequently prescribed. CONCLUSION: This study found low adequacy in the indication and calculation of the transfusion volume of packed red blood cells in asymptomatic individuals. Few patients received filtered red blood cells, resulting in increased risks of transfusion reactions. On the contrary, non-indicated subtypes were prescribed in a quarter of transfusions, which resulted in higher costs and delay in receiving packed red blood cells.

El ancho de distribución eritrocitaria en el pronóstico de corrección quirúrgica de cardiopatías congénitas / Red cell distribution width in the prognosis of surgical correction of congenital heart diseases

Resumen Objetivo: Evaluar la capacidad del ancho de distribución eritrocitaria (ADE) para predecir la mortalidad en niños sometidos a cirugía cardiovascular en la Fundación Hospital Infantil Napoleón Franco Pareja, en Colombia. Método: Estudio analítico de corte transversal retrospectivo que incluyó 45 individuos de 0 a 17 años operados de cardiopatía congénita. Se aplicaron la escala RACHS-1 (Risk Adjustment in Congenital Heart Surgery) y variables de laboratorio, incluyendo el ADE. La asociación entre el ADE y la mortalidad se determinó mediante análisis por curva ROC y correlación rho de Spearman. Resultados: Un ADE superior al 15.52% representó 1.6 veces más riesgo, comparado con los individuos por debajo de ese valor (intervalo de confianza del 95%: 1.01-2.6; p = 0.034). Los valores del ADE no se correlacionaron con los días de estancia hospitalaria ni con las complicaciones. El ADE prequirúrgico y el puntaje RACHS-1 fueron significativamente mayores en el grupo de mortalidad. La relación entre el ADE prequirúrgico y el puntaje RACHS-1 fue significativa. Conclusiones: En nuestro estudio, el ADE prequirúrgico presentó un poder moderado para discriminar la mortalidad perioperatoria en la corrección quirúrgica de cardiopatías congénitas. Se precisan más estudios con mayor tamaño de muestra.

Abstract Objective: To evaluate the capacity of red cell distribution width (RDW) to predict mortality in children undergoing cardiovascular surgery at the Fundación Hospital Infantil Napoleón Franco Pareja, in Colombia. Method: Retrospective cross-sectional analytical study that included 45 individuals aged 0 to 17 years operated for congenital heart disease. The RACHS-1 (Risk Adjustment in Congenital Heart Surgery) scale and laboratory variables including the RDW were applied. The association between RDW and mortality was determined by ROC curve analysis and Spearman's rho correlation. Results: An RDW greater than 15.52% represented 1.6 times more risk, compared to individuals below that value (95% confidence interval: 1.01-2.6; p = 0.034). The RDW values did not correlate with days of hospital stay or complications. The preoperative RDW and RACHS-1 score were significantly higher in the mortality group. The relationship between presurgical RDW and the RACHS-1 score was significant. Conclusions: In our study, the preoperative RDW had moderate power to discriminate perioperative mortality in the surgical correction of congenital heart disease. More studies with a larger sample size are required.

Neutrophil-Lymphocyte Ratio for Predicting Coronary Artery Lesions in Children With Kawasaki Disease

Background: Coronary artery lesions (CAL) are a specific feature of Kawasaki disease (KD), and develop during the second week of illness. This study was conducted to determine whether Neutrophil: Lymphocyte Ratio (NLR), assessed between the fourth and sixth day of fever onset in children with KD, can predict coronary artery lesion (CAL) development. Methods: In this review of hospital records, data of patients with KD admitted at our center between January, 2016 and January, 2020 was retrieved. The patients were divided into two groups based on the presence of CAL, and clinical characteristics of patients were compared between the two groups. Results: Out of the 79 patients enrolled, CAL was found in 40 (50.6%) patients and intravenous immunoglobulin (IVIg) resistance was seen in 13 (16.5%) patients. Multivariate logistic regression revealed NLR as an independent predictor of CAL [OR (95% CI) 2.0 (1.2-3.1); P<0.001], and erythrocyte sedimentation rate (ESR) [OR (95% CI) 1.03 (1.001-1.1) P=0.04], as an independent predictor of IVIg resistance. NLR ?2.08 was 82% sensitive and 80% specific in predicting CAL. ESR ?88 mm/h was 85% sensitive and 64% specific in predicting IVIg resistance. Conclusions: NLR is an independent predictor of CAL in KD. NLR ?2.08 done between the fourth and sixth day of fever onset may identify children with KD at risk of CAL.

Diagnosis of acute appendicitis and appendicular perforation: evaluation of platelet indices and red cell distribution width as emerging biomarkers / Diagnóstico de apendicite aguda e perfuração apendicular: avaliação dos índices de plaquetas e distribuição de glóbulos vermelhos como biomarcadores emergentes

ABSTRACT BACKGROUND: Acute appendicitis is a common surgical emergency worldwide. Recent studies on hematological inflammatory markers concerning acute appendicitis have shown variable results. AIMS: The aim of this study was to evaluate pre-operative values of platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW), and red cell distribution width (RDW) in relation to the diagnosis of acute appendicitis and their efficacy as predictors of appendicular perforation. METHODS: A prospective observational study of 190 patients diagnosed with appendicitis and who underwent an appendectomy was undertaken and confirmed histopathologically. Preoperatively, blood samples of white blood cells (WBCs), platelet count, MPV, PDW, and RDW were analyzed using a Sysmex XN1000 analyzer machine. RESULTS: Of 190 patients, 169 had acute appendicitis, and 21 had perforated appendicitis. The mean age of patients was 28.04 ± 14.2 years. The male-to-female ratio was 1.5:1. The WBC (p<0.05), MPV (p<0.05), and PDW (p<0.05) were found to have higher statistically significant values in acute appendicitis and perforated appendicitis compared to the RDW (p>0.05). However, perforated appendicitis had a higher RDW value compared to acute appendicitis, which can be a predictive factor. CONCLUSIONS: The elevated value of MPV and PDW associated with leukocytosis can be used as supportive evidence for the clinical and radiological diagnosis of acute appendicitis and appendicular perforation. Thus, these values can be used as diagnostic cost-effective inflammatory biomarkers.

RESUMO RACIONAL: A apendicite aguda é uma emergência cirúrgica comum em todo o mundo. Estudos recentes sobre marcadores inflamatórios hematológicos relacionados à apendicite aguda mostraram resultados variáveis. OBJETIVOS: Avaliar valores pré-operatórios de índices plaquetários como volume médio de plaquetas (VPM) e largura de distribuição de plaquetas (PDW), largura de distribuição de hemácias (RDW) em relação ao diagnóstico de apendicite aguda e sua eficácia como preditores de apendicite perfuração. MÉTODOS: Estudo observacional prospectivo de 190 pacientes diagnosticados com apendicite e submetidos a apendicectomia confirmados histopatologicamente. Amostras de sangue pré-operatórias de glóbulos brancos (WBC), contagem de plaquetas, volume plaquetário médio (MPV), distribuição das plaquetas (PDW) e distribuição dos glóbulos vermelhos (RDW) foram analisadas usando uma máquina analisadora Sysmex XN1000. RESULTADOS: Foram incluídos 190 pacientes, sendo que 169 tiveram apendicite aguda e 21 tiveram apendicite perfurada. A média de idade dos pacientes foi de 28,04 ± 14,2. A proporção homem-mulher foi de 1,5:1. Verificou-se que WBC (p<0,05), MPV (p<0,05) e PDW (p<;0,05) têm valores estatisticamente significativos mais altos na apendicite aguda e na apendicite perfurada em comparação com o RDW (p> 0,05). No entanto, a apendicite perfurada apresentou um valor de RDW maior em comparação com a apendicite aguda, o que pode ser um fator preditivo. CONCLUSÕES: O valor elevado de MPV e PDW associado à leucocitose pode ser usado como evidência de suporte para o diagnóstico clínico e radiológico de apendicite aguda e perfuração apendicular. Assim, esses valors podem ser usado como biomarcadores inflamatórios diagnósticos de baixo custo.

Hematological parameters: is there a difference between those released by the hematological analyzer and to the customer?

ABSTRACT Objective This study aimed to compare the hematological parameters released by hematological analyzers with those released in customer reports. Methods We conducted a descriptive study in the laboratories of a medium-sized municipality in the state of Minas Gerais registered in the National Register of Health Establishments. Interviews were conducted using a questionnaire to obtain information regarding the parameters released by the analyzers and those available in the customer's report. Results Sixteen laboratories were evaluated, and none of them released all the parameters obtained from the hematological analyzers to customers. The red blood cell distribution width was released in 88% of the laboratories, atypical lymphocytes in 70%, mean platelet volume in 50%, platelet distribution width and platelet count in 20%. No laboratory released information on reticulocytes, fraction of immature reticulocytes and immature granulocytes, nucleated erythrocyte count, immature platelet fraction and reticulocyte hemoglobin, and large platelet rate. Conclusion All evaluated clinical analysis laboratories had at least one parameter that was not released in the customer's report despite being released by the hematological analyzers. The lack of knowledge on the part of professionals about the clinical importance of each parameter of the complete blood count results in a loss in patient assessment, and it is important to include these parameters in the complete blood count report.

Investigation of the relationship between red blood cell distribution width and mortality in patients with hemophagocytic lymphohistiocytosis: a retrospective study

ABSTRACT BACKGROUND: Red blood cell distribution width (RDW) is related to sepsis-related mortality. Hemophagocytic lymphohistiocytosis (HLH) is a syndrome caused by severe infection, tumors, or autoimmunity without a specific diagnosis. OBJECTIVE: To explore the correlation between RDW and mortality in patients with HLH. DESIGN AND SETTING: A retrospective study conducted in a hospital in China. METHODS: A total of 101 inpatients with HLH from January 1, 2017 to December 31, 2021 were divided into non-survivor (n = 52) and survivor (n = 49) groups. A non-parametric test was used to analyze demographic, clinical, and laboratory data between groups. Independent variables with P < 0.05 were analyzed using binary logistic regression to screen out mortality-related variables. Selected variables were subjected to multivariate logistic regression analysis, and those with strong correlations were screened. Receiver operating characteristic (ROC) curves of strongly correlated variables and area under curve (AUC) values were obtained. RESULTS: The APACHE II score, RDW, and platelet (PLT) and fibrinogen (FIB) levels (P < 0.05) different significantly. RDW, PLT, FIB were correlated with mortality. The AUC values of RDW, PLT, and FIB were 0.857, 0.797, and 0.726, respectively. RDW was associated with mortality in patients with HLH (P < 0.01, cut-off value: 16.9). The sensitivity and specificity of predicting mortality were 97.96% and 96.1%, respectively. CONCLUSION: Logistic regression analysis showed a correlation between RDW and patients' mortality. Therefore, RDW can be used to predict mortality in patients with HLH.

Clinical and gene mutation characteristics of patients with hereditary ellipsocytosis: nine cases report and literature review / 中华血液学杂志

Objective: To report gene mutations in nine patients with hereditary elliptocytosis (HE) and analyze the characteristics of pathogenic gene mutations in HE. Methods: The clinical and gene mutations of nine patients clinically diagnosed with HE at Institute of Hematology & Blood Diseases Hospital from June 2018 to February 2022 were reported and verified by next-generation sequencing to analyze the relationship between gene mutations and clinical phenotypes. Results: Erythrocyte membrane protein gene mutations were detected among nine patients with HE, including six with SPTA1 mutation, one with SPTB mutation, one with EPB41 mutation, and one with chromosome 20 copy deletion. A total of 11 gene mutation sites were involved, including 6 known mutations and 5 novel mutations. The five novel mutations included SPTA1: c.1247A>C (p. K416T) in exon 9, c.1891delG (p. A631fs*17) in exon 15, E6-E12 Del; SPTB: c.154C>T (p. R52W) ; and EPB41: c.1636A>G (p. I546V) . Three of the six patients with the SPTA1 mutation were SPTA1 exon 9 mutation. Conclusion: SPTA1 is the most common mutant gene in patients with HE.

The value of red cell distribution width, procalcitonin, C-reactive protein, and mean platelet volume/platelet count in predicting the prognosis of patients with acute exacerbations of chronic obstructive pulmonary disease / 中国基层医药

Objective:To investigate the value of red cell distribution width (RDW), procalcitonin (PCT), C-reactive protein (CRP), mean platelet volume (MPV)/platelet count (PLT) in predicting the prognosis of patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods:The clinical data of 137 patients with AECOPD admitted to the Department of Laboratory Medicine of Haiyang People's Hospital from March 2020 to March 2021 were retrospectively analyzed. According to their prognosis, these patients were divided into the survival group ( n = 99) and the death group ( n = 38). RDW, MPV, and PLT were measured using a blood cell analyzer (mindray ABC5390) in all patients. PCT and CRP levels were measured using the ETHealthcare instrument in all patients. RDW, PCT, CRP, and MPV/PLT were compared between the two groups. The value of RDW, PCT, CRP and MPV/PLT in predicting the prognosis of patients with AECOPD was analyzed using receiver operating characteristic curves. Results:The length of hospital stay and hospitalization expenses in the survival group were (10.75 ± 2.51) days and (1.49 ± 0.46) ten thousand yuan, respectively, which were significantly shorter and lower than (12.81 ± 3.36) days and (2.18 ± 0.57) ten thousand yuan in the death group ( t = 6.11, 14.45, both P < 0.05). The level of PLT in the survival group was significantly higher than that in the death group [(214.01± 63.97) × 10 9/L vs. (189.04 ± 61.75) × 10 9/L, t = 2.07, P < 0.05]. RDW, PCT, CRP, MPV, and MPV/PLT in the survival group were (13.18 ± 2.30)%, (4.30 ± 1.82) ng/L, (31.06 ± 10.38) mg/L, (11.39 ± 2.16) fL, and (0.05 ± 0.01), respectively, which were significantly lower than (16.65 ± 1.78)%, (9.55 ± 2.11) ng/L, (68.21 ± 20.94) mg/L, (12.28 ± 2.09) fL, (0.06 ± 0.02) in the death group ( t = 8.38, 14.45, 13.82, 2.18, 3.88, all P < 0.05). The receiver operating characteristic curve analysis results showed that the area under the curves depicting the value of RDW, PCT, CRP, MPV/PLT and their combination in predicting AECOPD was 0.831, 0.978, 0.966, 0.713, 0.988, with the predictive sensitivity of 62.6%, 89.9%, 91.9%, 59.6%, 98.0%, respectively, and the predictive specificity of 97.4%, 97.4%, 100.0%, 65.8%, 92.1%, respectively. Conclusion:Combined detection of RDW, PCT, CRP and MPV/PLT has a high value for the prediction of AECOPD. Corresponding indicators should be selected according to the actual situation of patients to guide clinical diagnosis and treatment.

Determination of suspended erythrocyte volume range and establishment of its internal control standard / 中国输血杂志

【Objective】 To determine the volume range of suspended erythrocyte and establish its internal control standard. 【Methods】 The theoretical value of suspended erythrocyte volume was calculated according to the screening criteria of healthy blood donors and Quality Requirements for Whole Blood and Blood Components. A total of 2 410 bags of 1 U and 2 U suspended erythrocyte were randomly selected and weighed, and the volume range were formulated by ±2S and ±10% respectively and then compared to determine the volume range in line with the actual situation of our center. 【Results】 The theoretical volume range of 1 U and 2 U suspended erythrocyte were 117-160 mL vs 234-320 mL, and the actual volume range were 142-180 mL vs 276-393 mL. The volume range of 1 U and 2 U suspended erythrocyte formulated by ±2S were 145-181 mL vs 298-358 mL, and by ±10% were 147-179 mL vs 295-361 mL. The hematocrit and hemoglobin content of suspended erythrocyte within the actual volume range met the quality requirements. There were fluctuations in the volume of suspended erythrocyte from different regions. 【Conclusion】 Based on the actual situation of our center and the sampling results of suspended erythrocytes in recent two years, 163 mL±10% and 328 mL±10% were determined as the internal control standards of 1 U and 2 U suspended erythrocyte, respectively. Blood centers should establish accurate and feasible standard of suspended erythrocyte according to the actual situation.

Study on fecal calprotectin in predicting disease activity and mucosal healing in patients with small intestinal Crohn′s disease / 中华消化杂志

Objective:To explore the differences of fecal calprotectin (FC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) between colon and small intestinal Crohn′s disease, and their predictive values for disease activity and mucosal healing in patients with small intestinal Crohn′s disease.Methods:From January 2017 to January 2023, 64 patients with Crohn′s disease who underwent capsule endoscopy in the First Affiliated Hospital of Zhejiang Chinese Medical University were enrolled, among them 28 patients had only small intestinal lesions (small intestine group) and 36 patients had lesions involving both small intestine and colon or only colon involvement (ileocolon group). The FC, CRP, and ESR levels of the two groups were detected and compared 15 days before capsule endoscopy examination. Wilcoxon rank-sum test was used for statistical analysis. Receiver operating characteristic curve analysis was used to evaluate the predictive value of FC, CRP, and ESR for disease activity and mucosal healing in patients with small intestinal Crohn′s disease.Results:The FC, CRP, and ESR levels of the small intestine group during the active phase of the disease were 1 689.00 μg/g (727.75 μg/g, 1 800.00 μg/g), 5.67 mg/L (1.00 mg/L, 17.01 mg/L), and 4.50 mm/1 h (2.00 mm/1 h, 11.00 mm/1 h), respectively; while FC, CRP, and ESR levels during the mucosal healing phase were 112.00 μg/g (46.50 μg/g, 130.50 μg/g), 1.00 mg/L (1.00 mg/L, 1.62 mg/L), and 2.00 mm/1 h (2.00 mm/1 h, 5.50 mm/1 h), respectively. The FC, CRP, and ESR levels of the ileocolon group during the active phase of the disease were 1 800.00 μg/g (895.50 μg/g, 1 800.00 μg/g), 4.94 mg/L (3.10 mg/L, 14.80 mg/L), and 10.00 mm/1 h (2.00 mm/1 h, 27.75 mm/1 h), respectively, while FC, CRP, and ESR levels during the mucosal healing phase were 66.00 μg/g (32.50 μg/g, 97.50 μg/g), 1.00 mg/L (1.00 mg/L, 1.55 mg/L), and 2.00 mm/1 h (2.00 mm/1 h, 4.50 mm/1 h), respectively. There were no statistically significant differences in FC, CRP, and ESR between the small intestine group and the ileocolon group during the active phase of the disease and mucosal healing phase (all P> 0.05). In the small intestine group, the levels of FC and CRP of patients during the active phase of the disease were 1 173.00 μg/g (312.00 μg/g, 1 800.00 μg/g) and 2.10 mg/1 L (1.00 mg/L, 16.00 mg/L), which were both higher than those of patients during the mucosal healing phase (112.00 μg/g (46.50 μg/g, 130.50 μg/g) and 1.00 mg/L (1.00 mg/L, 1.62 mg/L)), and the differences were statistically significant ( Z=-4.35 and-2.67, P<0.001 and =0.008). In the small intestine group, the level of ESR of patients during the active phase of the disease was 4.00 mm/1 h (2.00 mm/1 h, 16.00 mm/1 h), and there was no significant difference compared with that of patients during the mucosal healing phase (2.00 mm/1 h (2.00 mm/1 h, 5.50 mm/1 h)) ( P>0.05). When the cut-off level of FC was 188.50 μg/g, the sensitivity, specificity, and area under the curve for predicting disease activity in patients with small intestinal Crohn′s disease was 93.3%, 100.0%, and 0.964, respectively. When the cut-off value of CRP was 3.12 mg/L, the sensitivity, specificity, and area under the curve for predicting disease activity in patients with small intestinal Crohn′s disease was 46.7%, 92.3%, and 0.744, respectively. When the cut-off level of ESR was 10.00 mm/1 h, the sensitivity, specificity, and area under the curve for predicting disease activity in patients with small intestinal Crohn′s disease was 33.3%, 100.0%, and 0.654, respectively. There were no statistically significant differences in the area under the curve between the combinations of FC and CRP, FC and ESR, FC, CRP and ESR, and FC alone for predicting disease activity in patients with small intestinal Crohn′s disease (0.964, 0.959, and 0.959 vs. 0.964, all P> 0.05). There was a statistically significant difference in the area under the curve between the combination of CRP and ESR and FC alone in predicting disease activity in patients with small intestinal Crohn′s disease (0.708 vs. 0.964, Z=-2.57, P=0.010). Conclusions:There are no statistically significant differences in FC, CRP, and ESR between colon and small intestinal Crohn′s disease. FC has a high predictive value for disease activity and mucosal healing in patients with small intestinal Crohn′s disease and has certain clinical application value.

Effects of flurochloridone on apoptosis and Nrf2/HO-1 and NFκB signaling pathways in mouse testis and TM4 cells / 环境与职业医学

Background Flurochloridone (FLC) is toxic to male reproduction and can induce apoptosis of testicular tissue and supporting cells under oxidative stress. Of particular concern is whether nuclear factor-erythrocyte 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) signaling pathway and nuclear factor kappa B (NFκB) signaling pathway participate this process. Objective To observe apoptosis of testicular tissue and sertoli TM4 cells and alterations of Nrf2/HO-1 and NFκB signaling pathways in mice treated with FLC in vivo/in vitro. Methods (1) Animal experiment. Testis samples were harvested from male C57BL/6 mice after 28-day FLC (0, 3, 15, 75, and 375 mg·kg−1 per day) exposure via oral route. Malondialdehyde (MDA) and superoxide dismutase (SOD) in homogenate of testicular tissue were measured by colorimetry. Apoptosis of testicular tissue was evaluated by TUNEL staining. Expression and distribution of Nrf2 and NFκB were detected by immunohistochemistry. Protein expression levels of Nrf2, HO-1, NAD(P)H: quinone oxidoreductase 1 (NQO1), NFκB, inhibitor of nuclear factor kappa-B kinase subunit beta (IKKβ), and phosphorylated recombinant inhibitory subunit of nuclear factor kappa-B alpha (P-IκBα) in testicular tissue homogenate were determined by Western blotting. (2) Cell experiment. TM4 cell lines were treated with 40, 80, 120, 160, and 200 μmol·L−1 FLC for 6 h, and cell viability was detected by CCK-8. After 6 h exposure to 40, 80, and 160 μmol·L−1 FLC, the apoptosis rate was detected by flow cytometry, and the protein expression levels of Nrf2, HO-1, NQO1, NFκB, IKKβ, and IκBα were detected by Western blotting. Results (1) Animal experiment. Apoptosis occurred in the interstitial and basal parts of spermatogenic tubules in male C57BL/6 mice after 28 days of oral FLC exposure. Compared with the control group, the MDA level in testicular tissue of the 375 mg·kg−1 FLC-treated group was significantly increased (P<0.05), and the SOD activity was significantly decreased (P<0.05). After 375 mg·kg−1 FLC exposure, apoptosis occurred in the interstitial and basal parts of spermatogenic tubules. The results of immunohistochemistry showed the expression of Nrf2 and NFκB in the interstitium and basal part of spermatogenic tubules of the treated groups. Compared with the control group, the protein levels of Nrf2, NQO1, P-IκBα, NFκB, and IKKβ in the 15, 75, and 375 mg·kg-1 groups were significantly increased (P<0.001), and the HO-1 protein level was significantly increased in the 375 mg·kg−1 group (P<0.001). (2) Cell experiment. Compared with the control group, the TM4 cell viabilities in the 40, 80, 120, 160, and 200 μmol·L−1 FLC-treated groups significantly decreased (P<0.01). The apoptosis rates were significantly increased (P<0.05), and the apoptosis rates increased from 5.7% in the control group to 7.4%, 9.4%, and 11.7% in the 40, 80, and 160 μmol·L−1, respectively. The Nrf2 protein level in the 40 μmol·L−1 group was significantly increased (P<0.01), while the levels significantly decreased in the 80 and 160 μmol·L−1 groups (P<0.01). The HO-1 protein levels in the 40, 80, and 160 μmol·L−1 groups were significantly increased (P<0.01). The level of NQO1 protein in the 40 μmol·L−1 group was significantly increased (P<0.01). The NFκB protein levels were significantly increased in the 80 and 160 μmol·L−1 groups (P<0.001). The IκBα protein levels were significantly decreased in all treated groups (P<0.001). The IKKβ protein had no significant change. Conclusion FLC induces testicular tissue apoptosis, and the process affects Nrf2/HO-1 signaling pathway and NFκB signaling pathway. The in vitro study confirms that FLC could induce apoptosis of TM4 cells and activate Nrf2/HO-1 and NFκB signaling pathways.

Red blood cell distribution width and white matter hyperintensities / 国际脑血管病杂志

Dementia is one of the age-related diseases with the fastest increase in incidence. With the increasingly severe aging problem of the population, it further exacerbates the demand and burden of the healthcare system. Red blood cell distribution width (RDW) is an easily obtainable blood routine indicator that reflects the variability of red blood cell size. As an early marker of dementia risk, researches have shown an association between white matter hyperintensities (WMHs) and RDW. This article reviews the relationship between RDW and WMHs.

Short-Term Results of Ivabradine versus Metoprolol: The Effects on Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

ABSTRACT Introduction: Classic coronary artery bypass grafting (CABG) surgery involves diastolic cardiac arrest under cardiopulmonary bypass, while off-pump CABG (OPCABG) has become widespread in recent years. Methods: 174 patients who underwent OPCABG were included in the study. Patients were divided into two groups. Group I (n=90) received ivabradine and Group M (n=84) received metoprolol before surgery until postoperative day 10. Intraoperative arrhythmias and hypotension were recorded. Postoperative atrial fibrillation (AF) and arrhythmia, mortality and morbidity rates were assessed based on the 30-day postoperative follow-up. Results: There were no significant differences in the intraoperative amount of inotropic support and red blood cell transfusion between groups (P=0.87 and P=0.31). However, the rates of intraoperative arrhythmias and hypotension were not significantly higher in Group M (P=0.317 and P=0.47). Ventricular tachycardia/ventricular fibrillation (VT/VF) was observed in 2 patients in both groups. Postoperative AF occurred in 7 patients (7.7%) in Group I and in 10 patients (11.9%) in Group M. Although there was a trend towards a higher prevalence of AF in Group M patients, this did not reach statistical significance. In addition, mortality and morbidity rates were comparable between groups.

Anemia hemolítica autoinmune: mecanismos de inducción de autoinmunidad e inmunobiología / Autoimmune hemolytic anemia: mechanisms of autoimmunity induction and immunobiology

Introducción: La patogénesis de la anemia hemolítica autoinmune es un proceso complejo en el que muchos elementos tienen una función esencial que repercuten en la gran heterogeneidad clínica de la enfermedad, pero los mecanismos involucrados en su inducción se desconocen en gran medida. Objetivo: Explicar los principales mecanismos propuestos en el inicio y aparición de la anemia hemolítica autoinmune y su contribución a la fisiopatología de la enfermedad. Métodos: Se realizó una revisión de la literatura en los idiomas inglés y español, de artículos publicados en los últimos 10 años sobre mecanismos propuestos en el inicio de la anemia hemolítica autoinmune. Análisis y síntesis de la información: Los mecanismos propuestos en la inducción de la autoinmunidad contra los eritrocitos incluyen el mimetismo molecular entre antígenos endógenos y antígenos exógenos, el procesamiento desregulado de autoantígenos influenciado por factores adquiridos y la disfunción de los linfocitos B y T. Conclusiones: Los mecanismos propuestos en la aparición de la anemia hemolítica autoinmune brindan información valiosa para mejorar la comprensión de los mecanismos moleculares involucrados y subrayan la complejidad de los fenómenos involucrados en la perdida de la tolerancia hacia los eritrocitos autólogos y el delicado equilibrio entre factores genéticos y ambientales(AU)

Introduction: The pathogenesis of autoimmune hemolytic anemia is a complex process in which many elements play an essential role and have an impact on the great clinical heterogeneity of the disease, but the mechanisms involved in its induction are largely unknown. Objective: To explain the main mechanisms proposed in the initiation and occurrence of autoimmune hemolytic anemia and its contribution to the pathophysiology of the disease. Methods: A review of the literature, in English and Spanish languages, of articles published in the last 10 years on proposed mechanisms in the initiation of autoimmune hemolytic anemia was carried out. Analysis and synthesis of information: Proposed mechanisms for the induction of autoimmunity against erythrocytes include molecular mimicry between endogenous and exogenous antigens, deregulated processing of autoantigens influenced by acquired factors, and B and T cells dysfunction. Conclusions: The proposed mechanisms in the occurrence of autoimmune hemolytic anemia provide valuable information to improve the understanding of the mechanisms involved and underline the complexity of the phenomena involved in the loss of tolerance towards autologous erythrocytes and the delicate balance between genetic and environmental factors(AU)

Parámetros hemocitarios y química de la hemolinfa en reproductores de la concha prieta Anadara tuberculosa (Arcoida: Arcidae)

Con motivo de conocer el estado de salud de poblaciones silvestres de la concha prieta Anadara tuberculosa se estudiaron los parámetros hemocitarios (viabilidad, conteo total y diferencial, estabilidad lisosomal, fragilidad osmótica) y la química sanguínea (hemoglobina-Hb, proteínas, triglicéridos, glucosa, lactato deshidrogenasa-LDH y catalasa-CAT). Se extrajo hemolinfa en reproductores salvajes aparentemente sanos colectados en la isla Corazón, río Chone, Ecuador. La viabilidad celular fue elevada, con presencia de 5 morfotipos: eritrocitos (74%), granulocitos traslucidos (6%), amebocitos (3%), hialinocitos (12%), blastocitos (5%). Los hemocitos presentaron membranas lisosomales estables al rojo neutro durante 240 min y una fragilidad osmótica media (FO50) de 4.8‰. Las concentraciones de Hb, proteínas, lípidos y glucosa denotan la función respiratoria y reservas energéticas durante los cambios de marea. La actividad de LDH está vinculada al metabolismo anaeróbico y CAT a la capacidad de mantener el equilibrio redox del sistema inmunitario. Los parámetros hemocitarios y química de la hemolinfa pueden servir como índices fisiológicos normales de referencia en reproductores de A. tuberculosa.

In this work we studied the health status of wild populations of the black shell Anadara tuberculosa, haemocyte parameters (viability, total and differential count, lysosomal stability, osmotic fragility) and blood chemistry (haemoglobin-Hb, proteins, triglycerides, glucose, lactate dehydrogenase-LDH and catalase-CAT). Haemolymph was extracted from apparently healthy wild broodstock collected from Corazón Island, Chone River, Ecuador. Cell viability was high, with 5 morphotypes present: erythrocytes (74%), colorless granulocytes (6%), amebocytes (3%), hyalinocytes (12%), blastocytes (5%). Haemocytes showed stable lysosomal membranes to neutral red for 240 min and a mean osmotic fragility (OF50) was 4.8‰. Hb, protein, lipid and glucose concentrations denote respiratory function and energy reserves during tidal changes. LDH activity is linked to anaerobic metabolism and CAT denotes the ability to maintain the redox balance of the immune system. The haemocitary parameters and haemolymph chemistry can serve as normal physiological reference indices in A. tuberculosa broodstock.

The relationship between red cell distribution width and prognostic scores in myelodysplastic syndrome

ABSTRACT Introduction: The myelodysplastic syndrome (MDS) represents a group of hematopoietic neoplasms that is characterized by clonal hematopoiesis, cytopenia and abnormal cellular maturation. Red cell distribution width (RDW) refers to the variation degree of erythrocyte size and it is a reflection of anisocytosis. Higher values have been linked to adverse outcomes, such as increased mortality, vascular events, kidney and liver disease and demonstrated to harbor poor prognosis in solid and hematological malignancies. The RDW value can be used as a contributing parameter for MDS diagnosis, as well as its prognosis. In this study, we essentially aimed to demonstrate the correlation between the RDW and MDS prognostic indexes. Materials and methods: Ninety-four MDS patients at the Aydın Adnan Menderes University Hematology Division were included in the study. The correlations between the RDW and laboratory values (either lactate dehydrogenase, albumin, globulin or ferritin) and the RDW prognostic scoring indexes (IPSS, WPSS, IPSS-R and LR-PSS) were investigated. The PASW for Windows, version 21.0 (SPSS Inc., Chicago, IL, USA), was used for statistical assessment. A p-value below 0.05 was the cut-off for the statistical significance. Results: The mean age of all the patients was 73 ±10 years. Patients were observed for 41.88 ± 25 months. The mean RDW value for all cases was 15.5 ± 2.39. We found a statistically significant difference of survival between RDW values below and above 15.5% (p = 0.016). A significant difference was also observed according to the prognostic scoring indexes (see below). Conclusion: An increase in RDW is probably related to dysplasia in the MDS and this constitutes a possible explanation for the poor outcome. Prognostic indexes might incorporate the RDW as a parameter in the future.

Evaluación del perfil férrico en donantes regulares de plasma / Evaluation of the iron profile in regular plasma donors

RESUMEN Fundamento un aspecto poco relacionado de la plasmaféresis productiva, es el efecto que puede causar sobre el hierro corporal en donantes regulares de plasma. Objetivo caracterizar el comportamiento del perfil férrico en donantes regulares de plasmaféresis. Métodos estudio descriptivo transversal, realizado con 115 donantes de plasma, registrados en el Banco Provincial de Sangre de Cienfuegos. En un periodo de dos años, se estudiaron las variables: sexo, edad, tiempo en el programa, intensidad de donaciones, sideremia, transferrina, capacidad e índice de saturación, mediciones básicas del hemograma y parámetros eritrocitarios. La información se extrajo de las historias clínicas y los informes de laboratorio. Resultados las mediciones del mineral prevalecieron dentro del rango normal. El 27,0 % de los donantes mostraron ferropenia, más frecuente entre las mujeres, los mayores de edad, aquellos que llevaban mayor tiempo en el programa y habían donado mayor número de veces. Más de la mitad de los individuos presentaron capacidad e índice de saturación patológicos, sugerente de hematopoyesis ferropénica. Los parámetros eritrocitarios fueron más sensibles al relacionar ferropenia latente, con predominio de mediciones patológicas de volumen corpuscular medio, hemoglobina corpuscular media e índice de distribución eritrocitario. Conclusión la deficiencia de hierro subclínica resultó más frecuente de lo esperado entre los donantes de plasmaféresis incluidos en el estudio.

ABSTRACT Background a little related aspect of productive plasmapheresis is the effect it can have on body iron in regular plasma donors. Objective to characterize the behavior of the iron profile in regular plasmapheresis donors. Methods cross-sectional descriptive study, carried out with 115 plasma donors, registered in the Provincial Blood Bank of Cienfuegos. In a period of two years, the studied variables were: sex, age, time in the program, intensity of donations, serum iron, transferrin, capacity and saturation index, basic measurements of the blood count and erythrocyte parameters. Information was extracted from medical records and laboratory reports. Results the mineral measurements prevailed within the normal range. 27.0% of the donors showed iron deficiency, more frequent among women, the elderly, those who had been in the program for a longer time and had donated more times. More than half of the individuals presented pathological capacity and saturation index, suggestive of iron deficiency hematopoiesis. The erythrocyte parameters were more sensitive when relating latent iron deficiency, with a predominance of pathological measurements of mean corpuscular volume, mean corpuscular hemoglobin and erythrocyte distribution index. Conclusion subclinical iron deficiency was more frequent than expected among the plasmapheresis donors included in the study.

O impacto da automação da fenotipagem eritrocitária estendida na rotina de um serviço de hemoterapia / The impact of automation of extended erythrocyte phenotyping in the routine of a blood transfusion center

Objetivos. Avaliar o impacto da automação na fenotipagem eritrocitária expandida e o nível de concordância dessa com a metodologia manual em amostras de doadores de sangue atendidos no hemocentro coordenador da Fundação HEMOPA no período de janeiro a dezembro de 2019. Material e Métodos. Foram analisadas 2.700 fenotipagens eritrocitárias realizadas por metodologia manual e automatizada através do equipamento IH500 da BioRad®. Os resultados foram testados quanto ao nível de concordância através do teste de Coeficiente Kappa. Resultados. Das amostras fenotipadas 98,6% (2.662/2.700) foram concordantes em ambas as metodologias e apenas 1,4% (38/2700) foram discordantes. Das 38 amostras discordantes 31,6% referiram-se ao fenótipo Lu(b); 15,8% ao fenótipo Lu(a); 13,1% ao fenótipo Fy(b); 7,9% aos fenótipos Le(b), E, c; 5,3% aos fenótipos N, S, s, Kp(a), P1; e 2,6% aos fenótipos M, Jk(a), Jk(b), Fy(a). Conclusões. O nível de concordância entre os dados obtidos através das técnicas de fenotipagem eritrocitária manual e automatizada foi de 98,6%. Já a implantação dessa metodologia teve um impacto positivo com o aumento em 1.649 amostras processadas a mais em relação ao mesmo período do ano anterior. [au]

Objective. Evaluate the impact of automation on expanded erythrocyte phenotyping and the level of agreement between it and the manual methodology in samples from blood donors treated at the blood center coordinating the Fundação HEMOPA from january to december 2019. Material and Methods. 2,700 erythrocyte phenotyping performed by manual and automated methodology using BioRad® IH500 equipment was analyzed. The results were tested for the level of agreement using the Kappa Coefficient test. Results. Of the phenotyped samples, 98,6% (2,662 / 2,700) were in agreement in both methodologies and only 1,4% (38/2700) were in disagreement. Of the 38 discordant samples, 31,6% referred to the Lu(b) phenotype; 15,8% to the Lu(a) phenotype; 13,1% to the Fy phenotype (b); 7,9% to Le(b), E, c phenotypes; 5,3% to N, S, s, Kp (a), P1 phenotypes; and 2,6% for phenotypes M, Jk(a), Jk(b), Fy(a). Conclusions. The level of agreement between data obtained through manual and automated erythrocyte phenotyping techniques was 98.6%. The implementation of this methodology had a positive impact, with an increase of 1,649 more processed samples compared to the same period of the previous year. [au]

Amplitud de la distribución eritrocitaria en el segundo trimestre del embarazo como predictor de preeclampsia

Objetivo. Establecer la utilidad de la amplitud de distribución eritrocitaria en el segundo trimestre del embarazo como predictor del desarrollo de preeclampsia. Diseño. Estudio de casos-controles. Institución. Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Participantes. Embarazadas entre 17 y 20 semanas que acudieron a la consulta prenatal y fueron seguidas hasta el término del embarazo. Métodos. Se tomaron muestras de sangre y fueron seguidas hasta el parto para establecer si desarrollaban preeclampsia. Principales medidas de resultado. Características generales, valores de la amplitud de la distribución eritrocitaria y eficacia pronóstica. Resultados. Los casos fueron 41 embarazadas que desarrollaron preeclampsia (grupo A) y 463 embarazadas fueron consideradas como controles (grupo B). No se encontraron diferencias estadísticamente significativas en la edad materna, edad gestacional y presión arterial sistólica y diastólica al momento de la realización de la ecografía (p = ns). La edad gestacional al momento del diagnóstico de preeclampsia en el grupo A fue de 35,0 +/- 3,2 semanas. Se encontraron diferencias significativas en los valores de amplitud de la distribución eritrocitaria entre las pacientes del grupo A (14,5 +/- 2,3%) y las pacientes del grupo B (13,8 +/- 1,8%; p = 0,039). Un valor de corte de 14% presentó un valor por debajo de la curva de 0,576 con sensibilidad del 63,4%, especificidad del 49,7%, valor predictivo positivo del 10,0% y valor predictivo negativo del 93,9%. Conclusión. Los valores de valores de la amplitud de la distribución eritrocitaria en el segundo trimestre no son útiles en la predicción de preeclampsia.

Objective: To establish the usefulness of red cell distribution width in the second trimester of pregnancy as a predictor of the development of preeclampsia. Design: Case-control study. Institution: Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Participants: Pregnant women between 17 and 20 weeks who attended prenatal consultation and were followed up until to term. Methods: Blood samples were taken and followed up until delivery to establish if they developed preeclampsia. Main outcome measures: General characteristics, values of red cell distribution width and prognostic efficacy. Results: Cases were 41 pregnant women who developed preeclampsia (group A) and 463 pregnant women were considered as controls (group B). No statistically significant differences were found in maternal age, gestational age, and systolic and diastolic blood pressure at the time of ultrasound (p = ns). Gestational age at the time of diagnosis of preeclampsia in group A was 35.0 +/- 3.2 weeks. Significant differences were found in red cell distribution width values between patients in group A (14.5 +/- 2.3%) and patients in group B (13.8 +/- 1.8%; p = 0.039). A cut-off value of 14% presented a value under the curve of 0.576 with sensitivity of 63.4%, specificity of 49.7%, positive predictive value of 10.0% and negative predictive value of 93.9%. Conclusion: The values of red cell distribution width values in the second trimester are not useful in the prediction of preeclampsia.