Niveles plasmáticos de Vitamina D en adultos mayores de Lima Metropolitana, Perú

Objetivo. Determinar los niveles plasmáticos de vitamina D y su relación con la ocupación, procedencia y los valores de calcio, leucocitos, hemoglobina y plaquetas en adultos mayores de Lima Metropolitana. Método. Estudio observacional descriptivo de corte transversal, participaron 100 adultos mayores de uno u otro sexo de Lima Metropolitana, ellos fueron reclutados durante las estaciones de invierno-primavera del 2022, los niveles de vitamina D se categorizó como suficiente, insuficiente y deficiente, las concentraciones séricas de vitamina D se midieron por radioinmunoensayo. La relación de variables se realizó con el coeficiente de correlación de Spearman y regresión logística. Resultados. La edad media fue 69.6 años, el 71%, fueron del sexo femenino, la concentración media de vitamina D fue 36.56 ng/ml, el 13% tuvieron niveles de deficiente, y el 32% de insuficiente y el 53% suficientes. Según sexo, el 77,7% de los que tuvieron niveles de deficiente/insuficiente fueron mujeres. En el análisis bivariado no hubo correlación entre los valores de vitamina D con calcio, hemoglobina leucocitos y plaquetas, los que procedieron de distritos de menor temperatura tuvieron 2,25 veces más riesgo de tener niveles insuficientes/deficiente de vitamina D. Conclusiones. El 45% de los adultos mayores tuvieron niveles deficientes/insuficiente de vitamina D, siendo más frecuente en las mujeres y de los procedentes de distritos de menor promedio de temperatura.

Objective. To determine the plasmatic levels of vitamin D and its relationship with the occupation, origin and the values of calcium, leukocytes, hemoglobin and platelets in older adults of Metropolitan Lima. Methods Observational descriptive cross-sectional study, 100 older adults of either sex from Metropolitan Lima participated, they were recruited during the winter-spring seasons of 2022, vitamin D levels were categorised as sufficient, insufficient, and deficient, serum vitamin D concentrations were measured by radioimmunoassay. The relationship of variables was established with the Spearman correlation coefficient and logistic regression. Results. The mean age was 69.6 years, 71% were women, the mean vitamin D concentration was 36.56 ng/ml, 13% had deficient levels, 32% were insufficient and 53% sufficient. By sex, 77.7% of those with deficient/insufficient levels were women. In the bivariate analysis, there was no correlation between vitamin D values with calcium, hemoglobin, leukocytes and platelets; those who came from districts with lower temperatures had a 2.25 times greater risk of having insufficient/deficient levels of vitamin D. Conclusions. 45% of older adults had deficient/insufficient levels of vitamin D, more frequent in women and those coming from districts with lower average temperatures.

Caracterización del tratamiento con plasma rico en plaquetas y leucocitos en la fisura anal secundaria

Introducción: Las enfermedades benignas de recto son muy frecuentes en la práctica médica habitual en todos los niveles de atención de salud. Dentro de estos procesos se reconoce que la fisura anal es uno de los más comunes. Objetivo: Caracterizar a los pacientes tratados con plasma rico en plaquetas y leucocitos por fisura anal secundaria en la provincia Camagüey en el período comprendido entre septiembre del 2020 y septiembre del 2022. Métodos: Se realizó un estudio cuasiexperimental, cuyo universo lo conformaron los pacientes con el diagnóstico de fisura anal secundaria que asistieron a la consulta de Coloproctología del Hospital Provincial Docente Oncológico María Curie. Se estableció una muestra no probabilística a criterio de los autores conformada por 132 pacientes adultos, quienes recibieron tratamiento con plasma rico en plaquetas y leucocitos por fisura anal secundaria en la provincia Camagüey. Resultados: Con respecto al sexo y a la edad, se observó una mayor frecuencia del grupo de 40 a 49 años y predominó el sexo femenino. El síntoma de mayor frecuencia fue el dolor, mientras que en la etiología prevaleció la proctitis facticia. En la mayoría de los casos estudiados la fisura anal cicatrizó en menos de 15 días y en cuanto a la evaluación final del tratamiento solo la minoría empeoró. Conclusiones: La caracterización de la muestra en estudio permite afirmar que el tratamiento con plasma rico en plaquetas y leucocitos tiene beneficios para los pacientes con fistulas perianales y su calidad de vida.

Introduction: Benign rectal diseases are very frequent in routine medical practice at all levels of health care. Among these processes, anal fissure is recognized as one of the most common. Objective: To characterize patients treated with platelet-rich plasma and leukocytes for secondary anal fissure in Camagüey Province between September 2020 and September 2022. Methods: A quasiexperimental study was carried out, whose universe was made up of patients with the diagnosis of secondary anal fissure who attended the coloproctology office at Hospital Provincial Docente Oncológico María Curie. A nonprobabilistic sample was established according to the authors' criterions, made up of 132 adult patients who received treatment with platelet-rich plasma and leukocytes for secondary anal fissure in Camagüey Province. Results: Regarding sex and age, a higher frequency was observed in the group 40 to 49 years old and the female sex was predominant. The most frequent symptom was pain, while the prevailing etiology was factitious proctitis. In most of the cases under study, the anal fissure healed in less than 15 days and, regarding the final assessment of the treatment, only the minority worsened. Conclusions: The characterization of the sample under study allows to affirm that treatment with platelet-rich plasma and leukocytes has benefits for patients with perianal fistulas and their quality of life.

Ayudas diagnósticas y diagnóstico diferencial de la enfermedad de Pompe

Introducción: La enfermedad de Pompe (EP) o glucogenosis tipo II es una enfermedad autosómica recesiva causada por mutaciones en el gen GAA que codifica para la proteína alfa-1,4-glucosidasa. Su deficiencia lleva a un almacenamiento anormal de glucógeno en los lisosomas de varias células, a través de los diferentes tejidos, lo que causa un compromiso musculoesquelético predominante. Contenidos: Los fenotipos de la enfermedad dependen de las variantes genéticas y de los niveles de la actividad enzimática residual. La enfermedad se presenta como EP de inicio infantil, EP de inicio tardío y EP intermedio, por lo que es de suma importancia su diagnóstico temprano, por medio de estudios moleculares como la secuenciación de Sanger y la secuenciación de nueva generación. Conclusiones: Se ha demostrado, mediante diferentes estudios, que las variaciones genéticas pueden diferir entre etnias, y es importante su caracterización molecular para determinar el tratamiento más adecuado, de acuerdo con el estado del material inmunológico de reacción cruzada (CRIM).

Introduction: Pompe disease (PD) or Glycogenosis Type II is a rare autosomal recessive disease caused by mutations in the GAA gene that codes for the alpha-1,4-glucosidase protein. Its deficiency leads to abnormal glycogen storage in the lysosomes of various cells throughout the different tissues causing a predominant musculoskeletal compromise. Contents: The phenotypes of the disease depend on the genetic variants and the levels of residual enzyme activity, presenting as infantile-onset PD, late-onset PD, and intermediate PD; Therefore, early diagnosis of the disease through molecular studies such as Sanger sequencing and new generation sequencing is of utmost importance. Conclusions: It has been shown through different studies that genetic variations can vary between ethnic groups and the molecular characterization of the variants is important to determine the most appropriate treatment depending on the state of the cross-reactive immunological material (CRIM)

Articular mobilization promotes improvement in functional and inflammatory parameters in a gouty arthritis model

ABSTRACT Objective Gouty arthritis is characterized by painful inflammation due to the deposition of monosodium urate crystals in joint tissues. Despite available treatments, many patients experience ineffective management and adverse effects. This study evaluated a manual therapy protocol involving passive joint mobilization at the peak of inflammation in a gouty arthritis model using functional and inflammatory parameters. Methods Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10 each): Gouty Arthritis and Control Groups, which were further subdivided into treated and untreated groups (n=5 each). The Gouty Arthritis Group received intraarticular knee injection of 50µL of monosodium urate crystals, while the Control Group received 50µL of phosphate buffered saline. The treatment involved a 9-minutes session of grade III joint mobilization (according to Maitland). Nociception, grip strength, and edema were evaluated before induction (EV0), 7 hours after assessment (EV1), immediately after treatment (EV2), and 1 hour after treatment (EV3). The animals were euthanized, and synovial fluid was collected to analyze leukocyte migration. Results The model mimicked the signs of the Gouty Arthritis Group, with a decrease in the threshold of nociception and strength and an increase in edema and leukocyte count. The mobilization protocol significantly increased the nociceptive threshold and grip strength and reduced edema; however, it did not reverse the increase in leukocyte count. Conclusion Our results suggest that mobilization promotes analgesia and may modulate the inflammatory process owing to reduced edema and subtle attenuation of cell migration, which contributes to strength gain.

Blood count reference intervals for the Brazilian adult population: National Health Survey / Intervalos de referência de hemograma da população adulta brasileira: Pesquisa Nacional de Saúde

ABSTRACT Objective: To estimate the reference intervals (RIs) of complete blood count parameters in the Brazilian adult population. Methods: Cross-sectional study, with data from the National Health Survey (Pesquisa Nacional de Saúde - PNS), between 2014-2015. The final sample consisted of 2,803 adults. To establish the RIs, exclusion criteria were applied, outliers were removed and partitions were made by gender, age, and race/skin color. The non-parametric method was adopted. Differences were assessed using the Mann Whitney and Kruskal Wallis tests (p≤0.05). Results: There were statistically significant differences for the following hematological parameters based on gender, red blood cells, hemoglobin, hematocrit, MCH, MCHC, eosinophils and absolute monocytes, neutrophils and platelets (p≤0.05). When analyzed by age, the RIs were statistically different in females for hematocrit, MCV, white blood cells and RDW and in males for red blood cells, white blood cells, eosinophils, mean platelet volume, MCV, RDW, and MCH (p≤0.05). For race/color, there were differences in the RIs for parameters of hemoglobin, MCH, MCHC, white blood cells and mean platelet volume, neutrophils and absolute eosinophils (p≤0.05). Conclusion: The differences found in the RIs of some in blood count parameters in Brazilian adults reaffirm the importance of having their own laboratory reference standards. The results can support a more accurate interpretation of tests, adequate identification and disease prevention in Brazil.

RESUMO Objetivo: Estimar os intervalos de referência (IR) de parâmetros de hemograma completo na população adulta brasileira. Métodos: Estudo transversal, com dados da Pesquisa Nacional de Saúde (PNS), entre 2014-2015. A amostra final constitui-se de 2.803 adultos. Para estabelecer os IR, aplicou-se critérios de exclusão, removeram-se outliers e foram feitos particionamentos por sexo, idade e raça/cor da pele. Adotou-se o método não paramétrico. As diferenças foram avaliadas pelos testes Mann Withney e Kruskal Wallis (p≤0,05). Resultados: Houve diferenças estatisticamente significativas nos IR segundo sexo para glóbulos vermelhos, hemoglobina, hematócrito, HCM, CHCM, eosinófilos, monócitos, neutrófilos absolutos e plaquetas (p≤0,05). Quando analisados por idade, houve diferenças nos IR de mulheres para hematócrito, VCM, glóbulos brancos e RDW, e nos homens em glóbulos vermelhos, glóbulos brancos, eosinófilos, volume plaquetário médios, VCM, RDW e HCM (p≤0,05). Para raça/cor, houve diferenças nos IR de hemoglobina, HCM, CHMC, glóbulos brancos e volume plaquetário médio, neutrófilos e eosinófilos absolutos (p≤0,05). Conclusão: As diferenças encontradas nos IR de alguns parâmetros de hemograma nos adultos brasileiros, reafirmam a importância de se ter padrões laboratoriais próprios de referência. Os resultados podem subsidiar a interpretação mais precisa dos exames, identificação adequada e a prevenção de doenças no Brasil.

Preparation quality control and clinical application observation of pooled platelets with leukocytes reduced / 中国输血杂志

【Objective】 To investigate the preparation quality and clinical application effect of pooled platelets with leukocytes reduced. 【Methods】 The quality and clinical effect of the buffy-coated method prepared pooled platelets leukocytes reduced (experimental group, n=40) and apheresis platelets leukocytes reduced (control group, n=40) were compared. 【Results】 The platelet volume (mL), platelet count (×1011), red blood cell contamination (×108) and residual white blood cell (×106) of the experimental group and control group were 278.90±7.92 vs 276.52±8.01, 2.66±0.09 vs 2.66±0.83, 0.54±0.42 vs 0.83±0.84, 0.29±0.54 vs 0.27±0.51, respectively, with no significant difference. The results of bacterial culture were negative, all met the requirements of relevant national standards. In addition, the CCI (×103, 24 h) and PPR (%) were 15.11±9.86 vs 14.61±12.55 and 54.23±18.70 vs 61.41±19.09 respectively, with no significant difference, indicating a certain degree of therapeutic effect. 【Conclusion】 The quality and clinical therapeutic effect of pooled platelets leukocytes reduced were consistent with that of apheresis platelets leukocytes reduced.

Resultados estéticos en defectos nasales posquirúrgicos regenerados con fibrina autóloga rica en plaquetas y leucocitos / Aesthetic results in post-surgical nasal defects regenerated with autologous platelet- and leukocyte-rich fibrin

Introducción: En la reconstrucción de los defectos cutáneos nasales se han utilizado varias técnicas a nivel mundial. Novedosas prácticas utilizan los concentrados plaquetarios por sus propiedades moduladoras y favorecedoras de la regeneración tisular. Objetivo: Determinar los resultados estéticos asociados al uso de la membrana de fibrina autóloga rica en plaquetas y leucocitos, para la regeneración de defectos cutáneos nasales posquirúrgicos. Métodos: Se realizó un estudio cuasiexperimental, longitudinal y prospectivo en el Servicio de Cirugía Maxilofacial del Hospital Universitario "Arnaldo Milián Castro" de la ciudad de Santa Clara, Villa Clara, Cuba, desde septiembre de 2015 hasta junio de 2019. Se efectuó un muestreo intencional, no probabilístico, de 31 pacientes. A partir de una donación de sangre del paciente, se obtuvo una membrana de fibrina rica en plaquetas y leucocitos, la que fue suturada en el defecto nasal posquirúrgico. Se estudiaron variables como el resultado estético, evaluado sobre la base de parámetros como la elasticidad, el color, el volumen y la superficie. Resultados: La edad media fue 62,71 ± 11,09 años y el 61,29 por ciento de la muestra correspondió al sexo masculino. Mostraron un buen resultado estético el 90,32 por ciento de los pacientes, lo que se asoció de forma significativa al grado de epitelización. Conclusiones: Se obtuvo un buen resultado estético en los pacientes donde se utilizó la membrana de fibrina autóloga rica en plaquetas y leucocitos, con independencia de la presencia de diabetes mellitus y hábitos tóxicos. El resultado estético estuvo asociado significativamente al grado de epitelización y a la edad(AU)

Introduction: In the reconstruction of nasal skin defects, several techniques have been used worldwide. Innovative practices use platelet concentrates for their modulating properties and favoring tissue regeneration. Objective: Determine the aesthetic results associated with the use of autologous fibrin rich in platelets and leukocytes, for the regeneration of post-surgical nasal skin defects. Methods: A quasi-experimental, longitudinal and prospective study was conducted in the Maxillofacial Surgery Service of "Arnaldo Milián Castro" University Hospital in the city of Santa Clara, Villa Clara province, Cuba, from September 2015 to June 2019. An intentional, non-probabilistic sampling of 31 patients was carried out. From a blood donation from the patient, a fibrin membrane rich in platelets and leukocytes was obtained, which was sutured in the post-surgical nasal defect. Variables such as the aesthetic result were studied, evaluated on the basis of parameters such as elasticity, color, volume and surface. Results: The mean age was 62.71 ± 11.09 years and 61.29 percent of the sample corresponded to the male sex. A good aesthetic result was shown by 90.32 percent of the patients, which was significantly associated with the degree of epithelialization. Conclusions: A good aesthetic result was obtained in patients where the fibrin membrane rich in leukocytes and autologous platelets was used, regardless of the presence of diabetes mellitus and toxic habits. The aesthetic result was significantly associated with the degree of epithelialization and age(AU)

Quistes óseos aneurismáticos. Terapia celular con células mononucleares y seguimiento imagenológico en dos pacientes adolescentes / Aneurysmal bone cysts. Mononuclear cell therapy and imaging follow-up in two adolescent patients

RESUMEN Los quistes óseos aneurismáticos son frecuentes en la edad pediátrica. Para su determinación se cuenta con diversos estudios imagenológicos como la radiografía y la tomografía axial computarizada que pueden colaborar al diagnóstico diferencial con otras lesiones. Existen disímiles opciones terapéuticas, el uso de factores de crecimiento autólogos se ha considerado como alternativa eficaz. Se presentan dos pacientes consultados en el servicio de Ortopedia del Hospital Provincial Pediátrico Universitario «José Luis Miranda¼, de Villa Clara, con diagnóstico clínico e imagenológico de quiste óseo aneurismático que recibieron tratamiento mediante terapia celular con células mononucleares con buena evolución clínica y radiográfica. Esta técnica es aplicable en nuestro medio ya que no requiere de estimables recursos materiales lo que constituye una fortaleza para su implementación. Las radiografías permiten reconocer la evolución posterior al tratamiento.

ABSTRACT Aneurysmal bone cysts are common in children. For its determination, various imaging studies are available, such as radiography and computerized axial tomography, which can collaborate in the differential diagnosis with other lesions. There are dissimilar therapeutic options, the use of autologous growth factors has been considered as an effective alternative. We present two patients seen in the Orthopedics service at "José Luis Miranda" University Pediatric Hospital in Villa Clara, with a clinical and imaging diagnosis of aneurysmal bone cyst who received treatment with mononuclear cell therapy having a good clinical and radiographic evolution. This technique is applicable in our environment since it does not require considerable material resources, which constitutes a strength for its implementation. X-rays allow us to recognize the evolution after treatment.

Detección de Chlamydia spp. en leucocitos de sangre periférica de ovinos sin aborto previo / Detection of Chlamydia spp. In Peripheral Blood Leukocytes in Ewes without any Previous Abortion

Resumen El aborto enzootico ovino es una enfermedad causada por Chlamydia abortus. Es considerada una zoonosis y una de las principales causas de pérdidas económicas en estas explotaciones. Este trabajo se enfocó en utilizar el cultivo de leucocitos de animales sin signos de abortos y la detección de anticuerpos para determinar la posible presencia de C. abortus en explotaciones de traspatio. Se obtuvieron 42 muestras de sangre periférica de ovejas de diferentes poblaciones. La detección de Chlamydia abortus se realizó mediante la tinción de Giemsa y la técnica de PCR. La detección de anticuerpos anti-C. abortus se dio mediante una técnica de ELISA comercial. Los resultados mostraron 21 muestras positivas mediante la técnica de PCR, de las cuales solo 10 fueron positivas mediante la técnica de Giemsa, mientras que 22 sueros mostraron anticuerpos anti-C. abortus. En este estudio el 38,1 % de las muestras fueron positivas a la infección por C. abortus, como se confirmó mediante PCR y serología. En conclusión, los leucocitos de sangre periférica pueden ser útiles para detectar una infección por Chlamydia spp. en explotaciones sin historial de abortos, con lo que se puede conocer la prevalencia real del aborto enzootico ovino en México.

Abstract The Ewes Enzootic Abortion is a disease caused byChlamydia abortus. It is deemed a zoonosis and one of the leading causes of financial losses in this type of business. This article focuses on using the culture of leukocytes from animals without any abortion symptoms and antibody detection to determine the potential presence ofC. abortusin backyard exploitations. Forty-two samples of peripheral blood were obtained from ewes in different populations. The detection ofChlamydia abortuswas carried out by using the Giemsa dye and PCR technique. Anti-C. Abortusantibody detection was performed through a commercial ELISA technique. Results showed 21 positive samples using the PCR, and only ten were positive according to the Giemsa dye, while 22 serum samples showed anti-C. abortusantibody. In this study, 38.1% of the samples were positive for theC. abortusinfection, as verified with the PCR and serology. In conclusion, peripheral blood leukocytes can be helpful to detect an infection caused byChlamydiaspp. Animal exploitation without any previous abortion allows knowing the real prevalence of ewes' enzootic abortion in Mexico.

Contaje de leucocitos y relación neutrófilos/linfocitos en el segundo trimestre del embarazo como predictor de preeclampsia

Objetivo : Establecer la utilidad del contaje de leucocitos y relación neutrófilos/ linfocitos en el segundo trimestre del embarazo como predictor del desarrollo de preeclampsia. Diseño: Estudio de casos-controles. Institución. Hospital Central "Dr. Urquinaona", 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 de las gestantes, que fueron seguidas hasta el parto para establecer si desarrollaban preeclampsia. Principales medidas de resultado. Características generales de las pacientes, valores de leucocitos, neutrófilos, linfocitos, relación neutrófilos/linfocitos y eficacia pronóstica. Resultados : De las 504 pacientes seleccionadas, 41 embarazadas desarrollaron preeclampsia (grupo A) y 463 embarazadas fueron consideradas como controles (grupo B). No se encontraron diferencias estadísticamente significativas en las características generales al inicio del estudio (p = ns). La edad gestacional en el momento del diagnóstico de preeclampsia en el grupo A fue de 35,0 ± 3,2 semanas. Se encontró que las pacientes del grupo A presentaron valores significativamente más elevados de leucocitos, neutrófilos y relación neutrófilos/linfocitos junto a valores más bajos de linfocitos comparados con las pacientes del grupo B (p < 0,05). Solo los valores absolutos de neutrófilos (área bajo la curva 0,810) y de relación neutrófilos/linfocitos (área bajo la curva 0,963) tuvieron valores pronósticos útiles para discriminar entre los grupos de pacientes para el desarrollo de preeclampsia (p < 0,05). Conclusión: La relación neutrófilos/linfocitos y el contaje absoluto de neutrófilos en el segundo trimestre del embarazo son herramientas útiles en la predicción de preeclampsia.

Objective : To establish the usefulness of leukocyte count and neutrophil/lymphocyte ratio in the second trimester of pregnancy as a predictor of the development of preeclampsia. Design : Case-control study. Institution: Hospital Central "Dr. Urquinaona", Venezuela. Participants : Pregnant women between 17 and 20 weeks who attended prenatal consultation and were followed up to term. Methods: Blood samples were taken from the pregnant women who were followed until delivery to establish whether they developed preeclampsia. Main outcome measures: General characteristics of the patients, values of leukocytes, neutrophils, lymphocytes, neutrophil/lymphocyte ratio and prognostic efficacy. Results : Of the 504 patients selected, 41 pregnant women developed preeclampsia (group A) and 463 pregnant women were considered as controls (group B). No statistically significant differences were found in overall characteristics at baseline (p = ns). The gestational age at the time of diagnosis of preeclampsia in group A was 35.0 +/3.2 weeks. Patients in group A were found to have significantly higher values of leukocytes, neutrophils and neutrophil/lymphocyte ratio along with lower values of lymphocytes compared to patients in group B (p < 0.05). Only the absolute values of neutrophils (area under the curve 0.810) and neutrophil/lymphocyte ratio (area under the curve 0.963) had useful prognostic values for discriminating between patient groups for the development of preeclampsia (p < 0.05). Conclusion: The neutrophil/lymphocyte ratio and absolute neutrophil count in the second trimester of pregnancy are useful tools in the prediction of preeclampsia.

Analysis of different platelet-rich fibrin processing / Análise de diferentes processamentos da fibrina rica em plaquetas

Introduction: Platelet-rich fibrin (PRF) is formed by an autologous blood concentrate, with properties that promote cell proliferation and regenerationof bone, gingival and epithelial tissue. Objective: To compare four different procedures for processing as well as obtaining PRF, and analyzing their formation through laboratory techniques. The purpose of the study is to validate a method that produces higher quality PRF for oral surgery use in different branches of dentistry. Material and method: The experiment consisted of collecting blood from 12 volunteers, and processing each patient's sample in 4 different ways. In the following two-stage process analysis, the first, quantitative, step was to analyze the samples' platelet-poor plasma (PPP),with a Neubauer Hemocytometer to count blood components. In the second, qualitative step, the sample's PRF were analyzed under microscopy using histological slides. Result: The statistical analysis of the leukocyte, red blood cell and platelet count did not show any significant distinction when comparing different processes. Histological analysis of the PRF showed fibrin network with platelet aggregation, several leukocytes and presence of red blood cells, with double centrifuged samples presenting more white blood cells than the others. Conclusion: Among the analyzed procedures, the sample centrifuged once at 3000 RPM (1900 G) for 10 min showed the best quality PRF.

Introdução: A fibrina rica em plaquetas (FRP) é formada por um concentrado sanguíneo autólogo, com propriedades de promover a proliferação celular, regeneração de tecido, dentre eles tecido ósseo, gengival e epitelial. Objetivo: Comparar quatro tipos diferentes de processamento e obtenção de FRP, analisando a sua formação através de técnicas laboratoriais. A finalidade do estudo é validar um método que obtenha maior qualidade para o uso em cirurgias nas diversas áreas da odontologia. Material e método: O experimento foi constituído de uma coleta de sangue de 12 voluntários, onde a amostra de cada paciente foi processada de 4 formas. A análise dos processamentos se deu em duas etapas, onde na primeira, quantitativa, foi analisado o plasma pobre em plaquetas (PPP), através de contagem de constituintes sanguíneos em câmara de Neubauer. Na segunda etapa, qualitativa, foram analisadas as FRP em microscopia através de lâminas histológicas. Resultado: A análise estatística da contagem de leucócitos, hemácias e plaquetas não mostraram diferença significativa entre os distintos processamentos. As análises histológicas do FRP mostraram redes de fibrina com agregação plaquetária, inúmeros leucócitos e presença de hemácias, sendo que as amostras de dupla centrifugação apresentaram mais leucócitos que nas demais. Conclusão: Dos procedimentos analisados, a amostra centrifugada a 1 única vez a 3000 RPM (1900 G) por 10 min mostrou-se a melhor qualidade de FRP.

Tratamiento de heridas complejas mediante fibrina rica en plaquetas y leucocitos (L-PRF), experiencia inicial de un centro / Treatment of complex wounds using platelet rich fibrin and leukocytes (L-PRF), initial experience of a center

Resumen Introducción El uso de concentrados plaquetarios para el tratamiento de heridas complejas y regeneración tisular está siendo ampliamente utilizado a nivel mundial. Durante el último tiempo, la segunda generación de concentrados plaquetarios, particularmente el L-PRF, ha permitido tratar de manera efectiva a pacientes con esta patología. Debido a su bajo costo y versatilidad, ha sido posible aplicar esta técnica en variadas situaciones clínicas con buenos resultados. El objetivo de este trabajo es presentar nuestra experiencia utilizando L-PRF para la curación de heridas complejas (CHC) como una alternativa al uso de injertos de distinto grado de complejidad. Materiales y Método: Se realizó un análisis prospectivo de una serie de casos de pacientes que fueron sometidos a tratamiento quirúrgico de heridas complejas mediante el uso de L-PRF en el Hospital Santiago Oriente - Luis Tisné Brousse, entre los meses de enero de 2017 y diciembre de 2018. Mediante examen clínico y parámetros de inclusión, de éxito y de fracaso definidos previamente, se evaluó un total de 11 pacientes con heridas complejas a los cuales se les realizó un tratamiento local con injerto de L-PRF. Resultados: _La etiología de las heridas fue variada. 8 (72%) de los casos lograron una epitelización del 100% y 3 (28%) fracasaron. Se identificaron factores predisponentes para el fracaso de la técnica, y también fue posible establecer una relación de predicción de éxito en donde se relaciona una probabilidad alta de epitelización cuando la granulación de la herida ocurre durante los primeros 10 días sobre el injerto de L-PRF. Conclusión: El tratamiento de heridas complejas mediante L-PRF es una alternativa factible, de bajo costo y requerimientos (comparada con el uso de injertos, colgajos y sustitutos dérmicos), es segura en la resolución de heridas complejas, permitiendo disminuir la morbilidad, los costos asociados al tratamiento y estadía hospitalaria.

Introduction: The use of platelet concentrates for the treatment of complex wounds and tissue regenera-tion is being widely used worldwide. During the last time, the second generation of platelet concentrates, particularly L-PRF, has made it possible to effectively treat patients with this pathology. Due to its low cost and versatility, it has been possible to apply this technique in various clinical situations with good results. The objective of this work is to present our experience using L-PRF for the healing of complex wounds (HCC) as an alternative to the use of grafts of different degrees of complexity. Materials and Method: A prospective analysis was carried out with a series of cases who underwent surgical treatment of complex wounds using L-PRF at Santiago Oriente - Luis Tisné Brousse Hospital, between the months of January 2017 and December 2018. Through clinical examination and previously defined inclusion, success, and failure parameters, a total of 11 patients with complex wounds were evaluated who underwent local treatment with an L-PRF graft. Results: The etiology of the wounds was varied. 8 (72%) of the cases achieved 100% epithelialization and 3 (28%) failed. Predisposing factors for the failure of the technique were identified, and it was also possible to establish a predictive relationship of success where a high probability of epithelialization is related when the granulation of the wound occurs during the first 10 days on the L-PRF graft. Conclusion: The treatment of complex wounds using L-PRF is a feasible alternative, with low cost and requirements (compared to the use of grafts, flaps and dermal substitutes) and safe in the resolution of complex wounds, allowing to reduce morbidity, the costs associated with treatment and hospital stay.

Relação entre exercício físico e sistema imunológico / Relationship between exercise and the immune system

O corpo humano tende sempre a procurar um estado de homeostase, buscando o equilíbrio entre todos os sistemas. O exercício físico está presente na rotina diária de indivíduos, mesmo com objetivos diferentes, porém a influência no sistema imunológico não é muitas vezes abordada como fator relevante. O sistema imune é responsável por proteger o organismo contra infecções e doenças, podendo ser modulado perante a resposta de exercícios físicos regulares. Tendo em vista que, atualmente, existe uma preocupação maior em tornar e manter a imunidade eficiente, a prática regular e moderada do exercício pode contribuir para uma maior eficácia desse sistema, dessa forma, podendo ser considerada uma proteção ao corpo humano. O objetivo dessa revisão foi sintetizar os dados de estudos presentes na literatura que demonstram a influência do exercício físico na resposta do sistema imunológico, tornando possível compreender as alterações moleculares, fisiológicas, metabólicas e celulares que levam a um tipo específico de resposta do organismo humano.

The human body always tends to seek a homeostasis state, trying to balance all systems. Physical exercise is present in the routine of individuals even with different goals, but the influence in the immune system isnt a relevant factor. The immune system is responsible for protecting the human body against some infections and diseases, and could be modulated in response by some regular physical exercise. At the moment there is a greater concern to keep efficient immunity, a practice of regular and moderate exercise can contribute to a better effectiveness of this system, thus, it can be considered a form of protection to the human body. The objective of this review was to synthesize some data from any studies presented in the literature that demonstrate the influence of physical exercise on the immune system response. Making it possible to understand the molecular mechanisms, physiological, metabolic and cellular changes that turn to a specific type of response in the human body.

Leukocyte reduction filters as an alternative source of peripheral blood leukocytes for research

ABSTRACT Introduction: Peripheral blood leukocytes are a suitable cell model for science research. However, blood samples from healthy volunteers are limited in volume and difficult to obtain due to the complexity of volunteer recruitment. Objective: Therefore, it is urgent to find an alternative source of peripheral blood leukocytes. Method: One of the possibilities is the use of leukocyte reduction filters (LRFs) in blood banks that is used for preparation of leukoreduced blood products. More than 90% of the leukocytes are trapped in the leukofilters allowing the desired blood product to pass through. Results: It has been reported that the biological function of leukocytes collected from the filters are no different from those isolated from buffy coats, leukapheresis products and whole blood (WB) cells. Moreover, LRFs are waste products that are discarded after leukoreduction. Conclusion: Thus, leukofilters represent an economic source of human cell populations that can be used for a variety of investigative purposes, with no cost. In the present study, we reviewed the different usage of LRFs in the research, clinical and commercial applications.

Leucograma, proteínas totales y diferenciadas en mulares Equus mulus Jóvenes de la policía en Boyacá (Colombia) / Leukogram, total and differentiated proteins in young Equus mulus from the police in Boyacá (Colombia) / Leucograma, proteínas totais e diferenciadas em jovens mulares Equus mulus da policía de Boyacá (Colômbia)

Resumen Objetivo. Determinar los valores leucocitarios, proteínas totales, fibrinógeno, albúmina y globulina en mulares sanos jóvenes pertenecientes a la Policía Nacional de Colombia. Materiales y métodos. Se muestrearon 50 mulares sanos entre machos y hembras. Se obtuvieron muestras de sangre por venopunción yugular para el análisis de recuento total y diferencial de leucocitos, albúmina, globulina, y proteínas plasmáticas totales por medio de conteo en cámara de Neubauer, frotis sanguíneo y espectrofotometría. Los datos fueron analizados por estadística descriptiva, y se realizó un análisis comparativo con la media reportada para otros équidos utilizando la prueba de T-student (P<0,05) y la prueba de Wilcoxon. Se estableció una confiabilidad del 95% y un margen de error del 5%. Resultados. Los valores de leucocitos fueron: 11,32 ± 2,99 x 10⁹ células/μl Diferencial: Neutrófilos 5038,6 ± 2228,9 células/µl, Linfocitos: 5758 ± 1975,9 células/µl; monocitos 109,95 ± 156,9 células/µl, Relación N/L: 1,03 ± 0,66, Proteínas totales 7 ± 0,39 gr/dl, Albúmina 4,48 ± 0,18 gr/dl, globulina 2,51 ± 0,43 gr/dl, relación A/G 1,7 ± 0,71, fibrinógeno 206 ± 107,6. Conclusiones. Se encontraron diferencias de la media en el recuento de leucocitos totales, diferenciales y fibrinógeno, comparando con otros équidos; estos valores fueron más cercanos a los encontrados en burros catalanes jóvenes. Con otros mulares jóvenes no hubo diferencias en los valores de leucocitos, neutrófilos y linfocitos. Los valores medios de proteínas totales, albúmina y globulina, se encontraron muy cercanos a los valores reportados en equinos. Los resultados obtenidos muestran la importancia de investigar los parámetros hematológicos en mulares de acuerdo con la raza, la edad y el manejo.

Abstract Objective. To determine leukocyte, total protein, fibrinogen, albumin and globulin values in young mules belonging to the Colombian National Police. Matherials and Methods. 50 healthy male and female mules were sampled. Blood samples were obtained by jugular venipuncture for total and differential count analisis od leukocytes, albumin, globulin, and total plasma proteins by Neubauer counting chamber, blood smear and spectrophotometry. The data were analyzed by descriptive statistics, and a comparative analisis was performed with the mean reported for other equids using the T-student test (P<0.05) and the Wilcoxon test. A reliability of 95% with a margin of error 0f 5% were stablished. Results. Total White cell count: 11.32 ± 2.99 x 10⁹/L, differential count: neutrophils 5038.6 ± 2228 cells/µl, lymphocytes: 5758 ± 1975.9 cells/µl, monocytes: 109.95 ± 156.9 cells/µl, N/L ratio: 1.03 ± 0.66, total proteins 7 ± 0.39 gr/dl, albumin 4.48 ± 0.18 gr/dl, globulin 2.51 ± 0.43 gr/dl, A/G ratio 1.7 ± 0.71, fibrinogen 206 ± 107.6 gr /dl. Conclusions. Significant differences were established in the mean of total leukocytes, differentials and fibrinogen compared to other equids; these values were closer to those found in Catalans donkeys. In contrast, there were no differences in the values of leukocytes, neutrophils and lymphocytes with other young mules. The mean values of total proteins, albumin and globulin, were found to be closer to the values reported in horses. The results obtained show the importance of research on haematological parameters in mules according to breed, age, and management.

Resumo Objetivo. Determinar os valores de leucócitos, proteínas totais, fibrinogênio, albumina e globulina em mulas jovens saudáveis pertencentes à Policia Nacional da Colômbia. Materiais e métodos. Foram amostrados 50 machos e fêmeas. Amostras de sangue foram obtidas por punção venosa jugular para análise da contagem total e diferencial de leucócitos, albumina, globulina e proteínas plasmáticas totais por meio de contagem em câmara de Neubauer, esfregaço de sangue e espectrofotometria. Os dados foram analisados por estatística descritiva, e foi realizada uma análise comparativa com a média relatada para outros equídeos utilizando o teste T de Student (P<0,05) e o teste de Wilcoxon. Foi establecida uma confiabilidade de 95% e uma margem de erro de 5%. Resultados. Os valores de leucócitos foram: 11,32± 2,99 x 10 células/µl, Diferencial: Neutrófilos 5038.6 ± 2228.9 células/µl, Linfócitos: 5758 ± 1975,9 células/µl; monócitos 109,95 ± 156,9 células/µl, razão N/L: 1,03 ± 0,66, Proteins totais 7 ± 0,39 gr/dl, Albumina 4,48 ± 0,18 gr/dl, Globulina 2,51 ± 0,43 gr/dl, razão A/G: 1,7 ± 0,71, fibrinogênio 206 ± 107,6. Conclusões. Diferenças nas mëdias foram encontradas na contagem de leucócitos total, diferencial e fibrinogênio, quando comparados a outros equídeos; esses valores eram mais próximos dos encontrados em jovens burros catalães. Com outras mulas jovens não hove diferenças nos valores de leucócitos, neutrófilos e linfócitos. Os valores médios das proteínas totais, albumina e globulina, foram encontrados muito próximos aos valores relatados em cavalos. Os resultados obtidos mostram a importância da investigação dos parâmetros hematológicos em muares de acordo com a raça, idade e manejo.

Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting

Abstract Introduction: High leuko-glycaemic index (LGI) (> 2000) has been associated with poor prognosis in many critical care settings. However, there is no evidence of LGI's prognostic value in the postoperative period of coronary artery bypass grafting (CABG). This study aims to analyze the prognostic value of LGI in the postoperative period of CABG. Methods: Single-center retrospective analysis of prospectively collected data was performed. Consecutive adult patients undergoing CABG between 2007 and 2019 were included. Blood glucose levels and white blood cells count were evaluated in the immediate postoperative period. LGI was calculated by multiplying both values and dividing them by 1,000 and analyzed in quartiles. Receiver operating characteristic curve was used to determine the best cutoff value. The primary combined endpoint was in-hospital mortality, low cardiac output (LCO), or acute kidney injury (AKI). Secondary endpoints included in-hospital death, AKI, atrial fibrillation, and LCO. Results: The study evaluated 3,813 patients undergoing CABG (88.5% male, 89.8% off-pump surgery, aged 64.6 years [standard deviation 9.6]). The median of LGI was 2,035. Presence of primary endpoint significantly increased per LGI quartile (9.2%, 9.7%, 11.8%, and 15%; P<0.001). High LGI was associated with increased occurrence of in-hospital mortality, LCO, AKI, and atrial fibrillation. The best prognostic cutoff value for primary endpoint was 2,000. In a multivariate logistic regression model, high LGI was independently associated with in-hospital death, LCO, or AKI. Conclusion: High LGI was an independent predictor of in-hospital mortality, LCO, or AKI in postoperative period of CABG. It was also associated with higher in-hospital death.

Enhanced serum interferon-lambda 1/interleukin-29 levels in patients with psoriasis vulgaris

Abstract Background: Interferon (IFN)-λ1, also named Interleukin (IL)-29, is a new member of the Type III IFN or IFN-λ family. IL-29 plays an important role in the pathogenesis of many types of autoimmune and inflammatory diseases. Objective: To study the role of IL-29 in the pathogenesis of psoriasis vulgaris. Methods: The authors detected the serum levels of IL-29 in forty-one patients with psoriasis vulgaris, twenty-three patients with atopic dermatitis and thirty-eight age and gender-matched controls by sandwich Enzyme-Linked Immunosorbent Assay (ELISA). The effects of IL-29 on the expression of cytokines, such as IL-6, IL-17, IL-8, IL-4, IL10, Interferon (IFN-γ) and Tumor Necrosis Factor-α (TNF-α), in PBMCs and HaCat cells were determined by real-time quantitative PCR. Results: Our data indicated that serum IL-29 levels were significantly elevated in patients with psoriasis vulgaris when compared with atopic dermatitis patients and the control group. Moreover, Serum levels of IL-29 were closely associated with the severity of psoriasis vulgaris. Furthermore, IL-29 up-regulated the mRNA expression levels of IL-6, IL-17 and TNF-α in PBMCs from psoriasis vulgaris patients. In addition, IL-29 enhanced the IL-6 and IL-8 expression from the HaCat cells. Conclusion: This study provides the first observations on the association of IL-29 and psoriasis vulgaris and showed elevated IL-29 serum levels. The authors suggest that IL-29 may play a role in the pathogenesis of psoriasis vulgaris.

El agregado de aceite de Sacha inchi disminuye la relación granulocitos/linfocitos postprandial producida por una comida rica en grasas, en adultos saludables

RESUMEN La etapa postprandial se ha relacionado con cambios en marcadores inflamatorios, bioquímicos y celulares. El objetivo de este estudio fue evaluar los efectos postprandiales del agregado de aceite de Sacha inchi sobre la concentración y tamaño de leucocitos, eritrocitos y plaquetas, y en marcadores de inflamación, después de la ingesta de una comida rica en grasas. Una muestra de 42 individuos aparentemente sanos de sexo masculino consumió dos desayunos, uno de ellos adicionado con 15 mL de aceite rico en ácidos grasos poliinsaturados extraído de semillas de Sacha Inchi. Se tomaron muestras de sangre en ayunas y a las 4 horas postprandiales para determinar variables hematológicas (número y tamaño de leucocitos y plaquetas y distribución porcentual de leucocitos) y bioquímicas como interleukina 6 (IL6) y proteína C reactiva de alta sensibilidad (PCR-as). Con ambos desayunos aumentaron la concentración de PCR y los recuentos de leucocitos y plaquetas. El agregado de aceite de Sacha inchi aumentó el porcentaje de linfocitos (p= 0,005) y disminuyó el de granulocitos (p= 0,012), revirtiendo el aumento de la relación evidenciada luego de la ingesta grasa y las concentraciones de IL6. Los resultados permiten concluir que el agregado de 15 mL de aceite de Sacha inchi a un desayuno rico en grasas afecta la relación entre las diferentes poblaciones leucocitarias, lo que podría atenuar los efectos inflamatorios postprandiales y el riesgo cardiovascular. Registro: NCT02886169.

ABSTRACT The postprandial stage is related to an increase in biochemical and cellular inflammatory markers. The objective of this study was to evaluate the postprandial effects of the addition of Sacha inchi oil on the concentration and size of leukocytes, erythrocytes and platelets, and on inflammation markers, after the ingestion of a high-fat meal. A sample of 42 seemingly healthy male individuals consumed two high-fat breakfast meals, one with the addition of 15mL of oil rich in polyunsaturated fatty acids (omega 3 and 6 series), extracted from Sacha Inchi seeds. Fasting blood samples were taken at 4 hours postprandial to determine hematological variables (number and size of leukocytes and platelets and percentage distribution of leukocytes) and biochemical variables such as interleukin 6 (IL6) and high-sensitivity C-Reactive protein (hs-CRP). The concentration of CRP and leukocyte and platelet counts increased following ingestion of both types of breakfast. The addition of Sacha inchi oil increased the percentage of lymphocytes (p= 0.005) and decreased that of granulocytes (p= 0.012), reversing the increase in the granulocytes / lymphocytes ratio evidenced after fat intake. The percentage of intermediate-sized cells and postprandial concentrations of IL6 also decreased. In conclusion, the addition of 15.0 mL of Sacha inchi oil to a high-fat breakfast modulates the relationship between different leukocyte populations, which could mitigate postprandial inflammatory effects and cardiovascular risk. Registration: NCT02886169.

Cytometric blood phenotyping in free-living white-eyed parakeet (Psittacara leucophthalmus)

ABSTRACT: This study aimed at performing cytometric phenotyping of the blood samples from free-living, young white-eyed parakeets (Psittacara leucophthalmus), stained with 3,3-dihexyloxacarbocyanine [DiOC6(3)]. DiOC6(3)-stained whole blood samples from 19 free-living, young white-eyed parakeets were analyzed by flow cytometry and cell types were distinguished by their typical fluorescence in blue laser channel (FL-1) and SSC (side scatter). It was possible to differentiate erythrocytes (58.3±13.6) from leukocytes (32.4±13.1) and some of the leucocyte subpopulations: lymphocytes/thrombocytes (29.7±7.7), monocytes (30.6±8.5), and granulocytes (5.9-26). However, lymphocytes and thrombocytes could not be sorted in the plots. Our study determined that the predominant population in white-eyed parakeet (P. leucophthalmus) was lymphocytes, thrombocytes, and monocytes in the leucocytes gates in comparison to the granulocyte population. The cytometry method and use of DiOC6(3) stain was available for parakeets blood samples and can be studied and applied to other species of parrots.

RESUMO: Este estudo teve como objetivo realizar a fenotipagem citométrica com 3,3-di-hexiloxacarbocianina [DiOC6 (3)] de amostras de sangue de maritacas jovens de vida-livre (Psittacara leucophthalmus). As amostras de sangue total, coradas com DiOC6(3) de 19 maritacas de vida livre, foram analisadas por citometria de fluxo e os tipos de células foram distinguidos por sua fluorescência típica no canal laser azul (FL-1) e SSC (dispersão lateral). Foi possível diferenciar eritrócitos (58,3±13,6) de leucócitos (32,4±13,1) e algumas subpopulações de leucócitos: linfócitos/trombócitos (29,7±7,7), monócitos (30,6±8,5) e granulócitos (5,9-26), entretanto, linfócitos e trombócitos não puderam ser diferenciados em duas populações distintas. Nosso estudo determinou que a população predominante P. leucophthalmus foi mononuclear agranulocítica em comparação com a taxa de aquisição da população granulocítica. A metodologia de citometria de fluxo com uso da coloração de DiOC6(3) foi aplicável a amostras sanguíneas das maritacas e pode ser estudado e aplicado para outras espécies de psitacídeos.

Índice leucoglucémico como predictor de mortalidad intrahospitalaria en pacientes con infarto agudo del miocardio / Leukoglycemic index as a predictor of intrahospital mortality in patients with acute myocardial infarction

RESUMEN Introducción: el índice leucoglucémico relaciona el número de leucocitos con la glicemia, y guarda correlación con la inflamación generada por la magnitud de la noxa cardiaca. Objetivo: determinar el valor pronóstico del índice leucoglucémico para la mortalidad intrahospitalaria en pacientes con infarto agudo de miocardio. Métodos: se realizó un estudio observacional, analítico, de casos y controles en el periodo de dos años, con 155 pacientes. Se determinó la asociación mediante el test X2 para variables estudiadas, se consideró como significativo una p <0,05. Para evaluar discriminación se analizó el área bajo la curva con intervalos de confianza del 95%, además se calculo Odds Ratio (OR). Resultados: el 56,1 % de los pacientes tenían más de 70 años de edad, la mortalidad fue significativamente mayor en ellos, prevaleció el sexo masculino con el 53,5 %. Los pacientes con valores de glucemia por encima de 10 mmol/l fueron minoría (39,4 %) (p <0,01 OR 3,4). El 49 % de los pacientes presentaron valores del leucograma mayores a 10 mmol/l (p <0,01 OR 2,5); obtuvieron un índice leucoglucémico por encima del punto de corte el 49 % de los pacientes (p<0,01 OR 4,7). El índice leucoglucémico obtuvo el área bajo la curva mayor (0,71). Conclusiones: el índice leucoglucémico es una herramienta que puede ser de utilidad como predictor de mortalidad intrahospitalaria en el curso de un infarto agudo del miocardio.

ABSTRACT Introduction: leukoglycemic index relates the number of leukocytes and blood glucose, and it correlates with the inflammation generated by the degree of the cardiac noxa. Objective: to determine the prognostic value of the leukoglycemic index for the intrahospital mortality rate in patients with acute myocardial infarction. Methods: an observational, analytical study of cases and controls in a two-year period with 155 patients. The association by means of chi-squared test was determined by the variables studied, considering as significance p<0,05. To evaluate the differentiation, the area under the curve was analyzed with confidence intervals of 95 %, calculating the Odds Ratio as well (OR). Results: the 56,1 % of patients were 70 years old, the mortality rate was significantly higher in these patients, and male sex prevailed with 53,5 %. Patients with glycemic values above 10mmol/l represented the minority 39,4 % (p <0,01 OR 3,4). The 49 % of these patients presented values of leukocyte count higher than 10 mmol/l (p <0,01 OR 2,5); having a leukoglycemic index above the cut-off point and 49% of the patients (p<0,01 OR 4,7). Leukoglycemic index had a higher area under the curve (0,71). Conclusions: leukoglycemic index is an instrument that can be useful as a predictor of intrahospital mortality in an acute myocardial infarction.