An improved Vision Transformer model for the recognition of blood cells / 生物医学工程学杂志

Leukemia is a common, multiple and dangerous blood disease, whose early diagnosis and treatment are very important. At present, the diagnosis of leukemia heavily relies on morphological examination of blood cell images by pathologists, which is tedious and time-consuming. Meanwhile, the diagnostic results are highly subjective, which may lead to misdiagnosis and missed diagnosis. To address the gap above, we proposed an improved Vision Transformer model for blood cell recognition. First, a faster R-CNN network was used to locate and extract individual blood cell slices from original images. Then, we split the single-cell image into multiple image patches and put them into the encoder layer for feature extraction. Based on the self-attention mechanism of the Transformer, we proposed a sparse attention module which could focus on the discriminative parts of blood cell images and improve the fine-grained feature representation ability of the model. Finally, a contrastive loss function was adopted to further increase the inter-class difference and intra-class consistency of the extracted features. Experimental results showed that the proposed module outperformed the other approaches and significantly improved the accuracy to 91.96% on the Munich single-cell morphological dataset of leukocytes, which is expected to provide a reference for physicians' clinical diagnosis.

Blood cells and some hematological parameters of red drum (Linnaeus, 1766) in Vietnam / Células sanguíneas e alguns parâmetros hematológicos do tambor vermelho (Linnaeus, 1766) no Vietnã

This research focuses on hematological characteristics, erythrocyte morphology and some biochemical parameters of red drum Sciaenops ocellatus (Perciformes: Sciaenidae), cultured in natural water environment in areas near river mouth (L1), estuaries (L2) in Ha Tinh province and coastal areas (L3) in Nha Trang city, Khanh Hoa province of Vietnam. A total of 18 speciments were examined in research, six in each location. Blood was drawn from the tail vein, using a microscope to research morphology and automated gauges to determine blood biochemical parameters. Analysis of blood samples showed that the rate of red drum's erythrocyte morphology disorders in all three locations was quite high. The two main types of disorders were nuclear deformity and nuclear-matter distribution. Changes in erythrocyte size, shape and nuclear were related to salt concentration at culture locations. Blood hemoglobin content was stable in all three regions. Other hematological parameters such as the number of erythrocytes, blood biochemical parameters (glucose, SGOT, SGPT, urea, creatine, plasma iron, albumin, and protein) have differences among the locations, which showed the different reactions of the same species with different environmental conditions.

Esta pesquisa se concentra nas características hematológicas, na morfologia eritrocitária e em alguns parâmetros bioquímicos do tambor vermelho Sciaenops ocellatus (Perciformes: Sciaenidae), cultivado em ambiente aquático natural em áreas próximas à foz do rio (L1), em estuários (L2) na província de Ha Tinh e em áreas costeiras (L3) na cidade de Nha Trang, província de Khanh Hoa do Vietnã. Um total de 18 espécimes foi examinado na pesquisa, seis em cada local. O sangue foi coletado da veia da cauda, usando um microscópio para pesquisar a morfologia e medidores automatizados para determinar os parâmetros bioquímicos do sangue. A análise das amostras de sangue mostrou que a taxa de distúrbios morfológicos dos eritrócitos do tambor vermelho em todos os três locais era bastante alta. Os dois principais tipos de distúrbios eram deformidade nuclear e distribuição de matéria nuclear. Mudanças no tamanho, na forma e no núcleo dos eritrócitos foram relacionadas à concentração de sal nos locais de cultivo. O conteúdo de hemoglobina no sangue era estável em todas as três regiões. Outros parâmetros hematológicos, como número de eritrócitos, parâmetros bioquímicos sanguíneos (glicose, SGOT, SGPT, ureia, creatina, ferro plasmático, albumina e proteína), apresentam diferenças entre os locais, o que evidencia diferentes reações de uma mesma espécie em diferentes ambientes e condições.

Implementation of a customised antimicrobial resistance laboratory scorecard in Cameroon, Ethiopia and Keny

Background: In low-resource settings, antimicrobial resistance (AMR) is detected by traditional culture-based methods and ensuring the quality of such services is a challenge. The AMR Scorecard provides laboratories with a technical assessment tool for strengthening the quality of bacterial culture, identification, and antimicrobial testing procedures. Objective: To evaluate the performance of the AMR Scorecard in 11 pilot laboratory evaluations in three countries also assessed with the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.Methods: Pilot laboratory evaluations were conducted in Cameroon, Ethiopia and Kenya between February 2019 and March 2019. Assessors with previous SLIPTA and microbiology experience were trained. Assessors performed the laboratory assessments using the SLIPTA and AMR Scorecard tools.Results: Weaknesses in technical procedures and the quality management systems were identified in all areas and all laboratories. Safety had the highest mean performance score (SLIPTA: 68%; AMR Scorecard: 73%) while management review had the lowest (SLIPTA: 32%; AMR Scorecard: 8%) across all laboratories. The AMR Scorecard scores were generally consistent with SLIPTA scores. The AMR Scorecard identified technical weaknesses in AMR testing, and SLIPTA identified weaknesses in the quality management systems in the laboratories.Conclusion: Since the AMR Scorecard identified important gaps in AMR testing not detected by SLIPTA, it is recommended that microbiology laboratories use SLIPTA and the AMR Scorecard in parallel when preparing for accreditation. Expanding the use of the AMR Scorecard is a priority to address the need for quality clinical microbiology laboratory services in support of optimal patient care and AMR surveillance.

Avanços e perspectivas no diagnóstico molecular da leucemia mieloide aguda: revisão sistemática / Advances and perspectives in the molecular diagnosis of acute myeloid leukemia: systematic review

O câncer do colo do útero é o quarto tumor mais comum entre mulheres no mundo e o terceiro no Brasil. A detecção precoce e a identificação das lesões cervicais são essenciais no rastreamento do câncer cervical. Nos últimos anos, vários marcadores têm sido apresentados como possíveis candidatos para a triagem eficiente de exames citológicos com anormalidades das células epiteliais. O objetivo deste trabalho é analisar a correlação com a expressão imuno-histoquimica dos biomarcadores p16 e Ki-67 com lesão intraepitelial cervical de alto grau na detecção molecular DNA/HPV de alto risco. A metodologia de pesquisa empregada é uma revisão sistemática, realizada por meio de buscas nas bases de dados eletrônica Literatura Latino-Americana em Ciência e Saúde (LILACS), Scientific Electronic Library Online (SCIELO), National Library of Medicine (MEDLINE) de artigos publicados no período de 2005 a 2019 nos idiomas português, inglês e espanhol. Concluiu-se que o uso das proteínas p16 e Ki67 auxilia na identificação das mudanças que acontecem durante a progressão da lesão cervical, aprimorando os métodos de rastreio atuais. O gene p53, a pRb e ciclinas também têm um papel crítico na carcinogênese e, desta maneira, também têm sido indicados para entrar nos painéis de estudo.

Introduction: Acute myeloid leukemia (AML) is a genetically heterogeneous malignant clonal disorder of the hematopoietic system, characterized by the uncontrolled proliferation of abnormal and immature blast cells and impaired production of normal blood cells. Objective: to present the advances in diagnosis in Acute Myeloid Leukemia through the techniques of molecular biology. Methodology: The research was carried out in the electronic databases for scientific articles of the search portal PubMed, NCBI, BVSMS, also SciELO. Results: Molecular techniques, including real-time quantitative PCR (RT-qPCR), digital PCR and technologies based on new generation sequencing, can be standardized and used to detect AML-associated gene changes. Conclusion: The advance in molecular diagnosis can be promising in the ideal and personalized treatment.

Decreased levels of cathepsin Z mRNA expressed by immune blood cells: diagnostic and prognostic implications in prostate cancer

Cathepsin Z (CTSZ) is a cysteine protease responsible for the adhesion and migration of both immune and tumor cells. Due to its dual role, we hypothesized that the site of CTSZ expression could be determinant of the pro- or anti-tumorigenic effects of this enzyme. To test this hypothesis, we analyzed CTSZ expression data in healthy and tumor tissues by bioinformatics and evaluated the expression levels of CTSZ mRNA in the blood cells of prostate cancer (PCa) patients by qRT-PCR compared with healthy subjects, evaluating its diagnostic and prognostic implications for this type of cancer. Immune cells present in the blood of healthy patients overexpress CTSZ. In PCa, we found decreased CTSZ mRNA levels in blood cells, 75% lower than in healthy subjects, that diminished even more during biochemical relapse. CTSZ mRNA in the blood cells had an area under the curve for PCa diagnosis of 0.832, with a 93.3% specificity, and a positive likelihood ratio of 9.4. The site of CTSZ mRNA expression is fundamental to determine its final role as a protective determinant in PCa, such as CTSZ mRNA in the blood cells, or a malignant determinant, such as found for CTSZ expressed in high levels by different types of primary and metastatic tumors. Low CTSZ mRNA expression in the total blood is a possible PCa marker complementary to prostate-specific antigen (PSA) for biopsy decisions, with the potential to eliminate unnecessary biopsies.

Comparative study on erythrogram parameters of Cell-Dyn Ruby and Humacount 5l / Estudio comparativo de los parámetros del eritrograma de Cell-Dyn Ruby y Humacount 5l

SUMMARY: The use of hematological counts for the prevention, diagnosis and follow-up of hematological diseases has increased. Indeed, the correct operation of a clinical laboratory is essential to producing comparable results. However, there is a paucity of validation and reproducibility studies among the different existing methods for clinical analysis. Therefore, our aim was to assess the commutability of the results provided by analyzers with different measuring systems. Sixty venous blood samples were obtained from patients, without discriminating for age or sex. Then, an automated hematological analysis was performed using the Cell-Dyn Ruby and HumaCount 5L instruments. The variables measured were: RBC, Hb, HCT, MCV, MCH and MCHC. The data were compared by a one-way ANOVA and Pearson's correlation coefficient. Statistical significance was fixed at p < 0.05. There were no statistically significant differences for RBC, HCT, MCH or MCHC. In addition, with the exception of MCHC, all the analytes showed a good correlation coefficient between the two instruments. There is a variety of automated systems for the clinical laboratory and it is essential for the clinician to know the different methodologies used in hematological analyzers as well as their sensitivity and specificity. Therefore, our results are useful for demonstrating the importance of practical knowledge of the analyzers mentioned.

RESUMEN: El uso de recuentos de células sanguíneas para la prevención, diagnóstico y monitoreo de enfermedades hematológicas ha ido en aumento. Por ello, el funcionamiento correcto de un laboratorio clínico es indispensable para producir resultados comparables. Sin embargo, existen pocos estudios de validación y reproducibilidad de los diferentes métodos de análisis clínico existentes. Por lo tanto, nuestro objetivo fue evaluar la intercambiabilidad de los resultados entregados por los analizadores que utilizan diferentes sistemas de medición. Se obtuvieron sesenta muestras de sangre venosa de pacientes, sin discriminar por edad o sexo. Los eritrogramas fueron obtenidos utilizando los analizadores automatizados Cell-Dyn Ruby y HumaCount 5L. Las variables medidas fueron: RBC, Hb, HCT, MCV, MCH y MCHC. Los datos fueron comparados por ANOVA a una vía y la correlación de Pearson. La significación estadística se estableció en el nivel estándar p<0,05. No hubo diferencias estadísticamente sig- nificativas para RBC, HCT, MCH y MCHC. Con la excepción de la MCHC, todos los analitos presentaron un buen coeficiente de correlación entre los dos analizadores comparados. Existen varios sistemas de automatización para su uso en laboratorios clínicos. Por lo tanto, es primordial para el clínico estar familiarizado con las diferentes metodologías utilizadas en los analizadores de sangre, así como su sensibilidad y especificidad. Nuestros resultados son útiles para mostrar la importancia del conocimiento práctico de los diferentes sistemas de medidas comparados.

Comparación de parámetros hematológicos y morfología celular en muestras de sangre con EDTA K2 y EDTA K3 / Comparison of hematological parameters and cellular morphology in blood samples with EDTA K2 and EDTA K3

El EDTA es el anticoagulante de elección en los laboratorios de hematología para la conservación de la muestra de sangre total. Existen dos tipos, EDTA K2 y EDTA K3, y su diferencia radica en la cantidad de moléculas de potasio. Algunas guías sugieren que hay diferencias entre el anticoagulante EDTA K2 y el K3 para el proceso del hemograma; sin embargo, con las nuevas presentaciones de los tubos que traen las casas comerciales, no se tiene claro si en realidad aún hay diferencia entre los dos anticoagulantes, y si esto puede alterar el resultado del hemograma, tanto en el resultado cuantitativo, como en el cualitativo. Objetivo. Comparar los recuentos leucocitarios, la hemoglobina, el hematocrito, el volumen corpuscular medio, las plaquetas y la morfología celular en muestras de sangre periférica con EDTA K2 y EDTA K3, en diferentes tiempos (0, 1 y 2 horas). Materiales y métodos. Se realizó un estudio cuasi-experimental, multivariado, multifactorial, que tiene como unidad de análisis la sangre anticoagulada con EDTA K2 y EDTA K3, extraída de 53 individuos a través de un muestreo no probabilístico por conveniencia. Resultados. Al comparar los resultados del estudio morfológico por medio del extendido de sangre periférica y los datos cuantitativos del hemograma, se encontró que no hay diferencias estadísticamente significativas usando EDTA K2 o K3. Conclusión. Se evidenció que el uso del EDTA K2 o EDTA K3 como anticoagulante de elección, procesando las muestras en un tiempo adecuado después de su recolección, no afecta los parámetros cuantitativos del hemograma automatizado ni los morfológicos.

EDTA is the anticoagulant of choice in hematology laboratories for the conservation of whole blood samples. There are two types, K2 EDTA and K3 EDTA, and their difference lies in the amount of potassium molecules. Some guidelines suggest that there are differences between K2 and K3 EDTA for the blood analysis process. However, with the new collection tubes offered by the commercial suppliers, it is not clear if in fact there is a difference between the two anticoagulants that would result in changes in blood parameters and cell morphology. Objective. To compare leukocyte counts, hemoglobin, hematocrit, mean corpuscular volume, platelets and cell morphology in peripheral blood samples collected with K2 EDTA and K3 EDTA, at different times (0, 1 and 2 hours). Materials and methods. A quasi-experimental, multivariate, multifactorial study was carried out, with anticoagulated blood as the unit of analysis, either with K2 EDTA or K3 EDTA, extracted from 53 subjects through a non-probabilistic sampling for convenience. Results. There was no statistically significant difference when comparing results of the peripheral blood smear and the quantitative hematological parameters using K2 or K3 EDTA. Conclusion. The use of either K2 EDTA or K3 EDTA as the anticoagulant of choice, when processing samples within a suitable time after their collection, proved equally satisfactory for both quantitative and morphological parameters

Analysis of IgG Subclass in Blood Serum between Multiple Myeloma and Lymphoma Patients and Its Correlation with Blood Cell Parameters / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression of immunoglobulin G (IgG) and its subclasses in patients with multiple myeloma (MM) and lymphoma (LYM) and its correlation with blood cell parameters.@*METHODS@#129 patients with multiple myeloma and 113 patients with lymphoma diagnosed treated in Sichuan people's Hospital from January to December 2019 were selected and the total IgG and subclass IgG1, IgG2, IgG3 and IgG4, and some parameters of peripheral blood routine in patients were retrospective analyzed. Independent sample t test or nonparametric Mann Whitney U test were used for comparison between the groups. The relationship between IgG subclass and blood cell parameters was analyzed by correlation analysis. For the bivariate normal distribution data, Pearson correlation coefficient was calculated. For bivariate non normal distribution data, the Spearman correlation coefficient was calculated.@*RESULTS@#IgG1 and IgG2 were significantly higher in patients with multiple myeloma than in patients with lymphoma (P=0.001, 0.000, respectively), but IgG3 and IgG4 were significantly lower than in patients with lymphoma (P=0.000, 0.000, respectively), and there was no significant difference for total serum IgG between the two groups (P=0.717). The results showed that the IgG4 content of male patients with multiple myeloma and lymphoma was significantly higher than that of female patients (Z=-3.191, P=0.001); the age, M%, E% of the MM patients were significantly higher than those of the patients with lymphoma (P=0.000, 0.005, 0.019), but WBC, RBC, Hb were significantly lower than those of the patients with lymphoma (P=0.013, 0.000, respectively). The results of Spearman correlation analysis showed that RBC and Hb were decreased with the increasing of IgG and IgG1 in the MM patients(r=0.254, -0.272, -0.248 and -0.289, P=0.004, 0.002, 0.005 and 0.001). With the increasing of IgG4 in the serum of patients with lymphoma, RBC and Hb showed the trendy of decreased (r=-0.240 and, -0.251, respectively, P=0.010, 0.007).@*CONCLUSION@#The detection of IgG subclass and the correlation between IgG subclass and blood cell parameters are great value in the diagnosis and pathogenesis of multiple myeloma and lymphoma.

Enfermedad de Gaucher: caso clínico / Gaucher's disease: a clinical case

La enfermedad de Gaucher es una patología de depósito lisosomal, autosómica recesiva, con mutación en el gen GBA, que afecta principalmente al hígado, bazo, huesos y a la médula ósea. Es una enfermedad rara con baja incidencia mundial. Existen 3 tipos; el tipo I es el más frecuente en la población pediátrica, y el tipo III es el de peor pronóstico y presenta manifestaciones neurológicas. El diagnóstico se realiza con el tamizaje prenatal de enfermedades de depósito, más específicamente de mutaciones GBA. El diagnóstico definitivo se realiza al detectar ß-glucocerebrosidasa, y los estudios genéticos para la tipificación del gen afectado: en el tipo 1 mutación N370S y mutaciones L444P o D409H en tipo 2 y 3. El tratamiento se realiza con terapia de reemplazo enzimático o con la terapia de reducción de sustrato. Describimos en este artículo a un paciente preescolar del Hospital Enrique Garcés, con cuadro respiratorio, hepato-esplenomegalia y afectación de las tres líneas celulares sanguíneas.

Gaucher's disease is an autosomal recessive lysosomal storage pathology, with mutation in the GBA gene, which mostly affects the liver, spleen, bone and bone marrow. It is a rare disease with low global incidence. There are 3 types: type I is the most frequent in the pediatric population, and type III has the worst prognosis and presents neurological manifestations. Diagnosis is made with prenatal screening of storage diseases, and more specifically GBA1 mutations. The definitive diagnosis is made by detecting ß-glucocerebrosidase, and genetic studies for the detarmination of the affected gene, in type 1 mutation N370S and L444P mutations or D409H in type 2 and 3. The treatment is enzyme replacement therapy or substrate reduction therapy. This article describes a preschool patient of Enrique Garcés Hospital, with respiratory symptoms, hepato-splenomegaly and involvement of the three blood cell lines.

Blood cells profile in umbilical cord of late preterm and term newborns / Perfil de hemograma em sangue de cordão umbilical de recém-nascidos pré-termo tardio e a termo

ABSTRACT Objective: To describe the hematological profile in cord blood of late preterm and term newborns and compare blood indices according to sex, weight for gestational age and type of delivery. Methods: Cross-sectional study with late preterm and term newborns in a second-level maternity. Multiple gestation, chorioamnionitis, maternal or fetal hemorrhage, suspected congenital infection, 5-minute Apgar <6, congenital malformations, and Rh hemolytic disease were excluded. Percentiles 3, 5,10, 25, 50, 75, 90, 95 and 97 of blood indices were calculated for both groups. Results: 2,662 newborns were included in the sample, 51.1% males, 7.3% late preterms, 7.8% small for gestational age (SGA) and 81.2% adequate for gestational age (AGA). Mean gestational age was 35.6±1.9 and 39.3±1.0 weeks, respectively, for premature and term neonates. The erythrocytes indices and white blood cells increased from 34-36.9 to 37-41.9 weeks. Basophils and platelets remained constant during gestation. Premature neonates presented lower values ​​of all blood cells, except for lymphocytes and eosinophils. SGA neonates presented higher values ​​of hemoglobin, hematocrit and lower values of leukocytes, neutrophils, bands, segmented, eosinophils, monocytes and platelets. Male neonates presented similar values ​​of erythrocytes and hemoglobin and lower leukocytes, neutrophils, segmented and platelets. Neonates delivered by C-section had lower values ​​of red blood cells and platelets. Chronic or gestational hypertension induced lower number of platelets. Conclusions: Blood cells increased during gestation, except for platelets and basophils. SGA neonates had higher hemoglobin and hematocrit values and lower leukocytes. Number of platelets was smaller in male SGAs, born by C-section and whose mothers had hypertension.

RESUMO Objetivo: Descrever o perfil hematológico em sangue de cordão de recém-nascidos pré-termo tardio e a termo e comparar parâmetros hematimétricos segundo sexo, adequação peso idade gestacional e tipo de parto. Métodos: Estudo transversal com recém-nascidos pré-termo tardio e a termo, em maternidade de nível secundário. Excluíram-se gestação múltipla, corioamnionite, hemorragia materna ou fetal, suspeita de infecção congênita, Apgar no 5o minuto <6, malformações congênitas e doença hemolítica Rh. Calcularam-se os percentis 3, 5, 10, 25, 50, 75, 90, 95 e 97 dos parâmetros hematológicos. Resultados: Incluíram-se 2.662 recém-nascidos, 51,1% do sexo masculino, 7,3% prematuros tardios, 7,8% pequenos para a idade gestacional e 81,2% adequados. A idade gestacional foi 35,6±1,9 e 39,3±1,0 semanas, respectivamente, nos prematuros e termos. As séries vermelha e branca aumentaram de 34-36,9 para 37-41,9 semanas, exceto basófilos e plaquetas, que permaneceram constantes. Os prematuros apresentaram menores médias nas séries vermelha, plaquetária e branca, com exceção de linfócitos e eosinófilos. Recém-nascidos pequenos para a idade gestacional apresentaram maiores valores de hemoglobina e hematócrito e menores de leucócitos, neutrófilos, bastonetes segmentados, eosinófilos, monócitos e plaquetas. Recém-nascidos masculinos apresentaram taxas semelhantes de hemoglobina e hematócrito e menores de leucócitos, neutrófilos, segmentados e plaquetas. Na cesárea, as células vermelhas e as plaquetas foram menores que no parto vaginal. O número de plaquetas foi menor na hipertensão crônica ou gestacional. Conclusões: As células sanguíneas aumentaram durante a gestação, exceto plaquetas e basófilos. Recém-nascidos pequenos para a idade gestacional apresentaram maiores taxas de hemoglobina e hematócrito e menores de células brancas. O número de plaquetas foi menor no recém-nascido pequeno para a idade gestacional, masculino, nascido por cesárea e de mãe hipertensa.

Avaliação dos efeitos da fibrina rica em plaquetas (FRP) comparada a um anti-inflamatório não esteroidal (AINE) na resposta inflamatória e reparadora de defeitos críticos em calota de ratos / Evaluation of the effects of Platelet Rich Fibrin (PRF) compared to an Non-Steroidal (NSAID) in the inflammatory and repair of critical defects in rat's calvaria

O objetivo deste estudo foi avaliar a influência da Fibrina Rica em Plaqueta (FRP) no processo inflamatório em defeitos críticos em calotas de ratos e sua consequente reparação tecidual. Foram utilizados 128 (cento e vinte e oito) ratos (Rattus norvegicus, albinus, Wistar), adultos, com peso corporal entre 450 e 500g. Os animais foram divididos aleatoriamente em 4 grupos equitativos que compuseram a amostra do trabalho, onde no grupo coágulo (GC) foi realizado o defeito ósseo de tamanho crítico preenchido com coágulo sanguíneo; grupo anti-inflamatório não esteroidal (AINE) que teve os defeitos de tamanho crítico preenchidos com coágulo sanguíneo e administrado cetoprofeno (10mg/kg dia); o grupo fibrina rica em plaquetas (FRP) com defeitos de tamanho crítico preenchidos com preparado de fibrina rica em plaquetas autóloga; e o grupo fibrina rica em plaquetas mais AINE (FRP + AINE) com defeitos de tamanho crítico preenchidos com preparado de fibrina rica em plaquetas autóloga e administrado cetoprofeno (10mg/kg dia). Cada grupo foi avaliado nos períodos de 2, 7, 14 e 28 dias e os espécimes analisados através da histometria, micro-CT e teste ELISA para presença de TNFα. Os dados quantitativos foram submetidos aos testes estatísticos ANOVA 1/2 fatores ou Kruskal-Wallis e pos Tukey e Dunn (p<0,01). Os resultados histométricos e microtomográficos evidenciaram maior formação óssea para o grupo PRF em comparação aos demais grupos (p<0,05) e menor presença de TNF-alfa no período inicial no grupo PRF comparado ao grupo controle (p<0,05). Conclui-se que o PRF foi favorável desde os períodos iniciais até os mas tardios, auxiliando na resposta inflamatória e neoformação óssea(AU)

The objective of this study was to evaluate the influence of Platelet Rich Fibrin (PRF) on the inflammatory process in critical defects in rat calvaria and its consequent tissue repair. One hundred twenty-eight adult rats (Rattus norvegicus, albinus, Wistar) with body weight between 450 and 500g were used for the study. The animals were randomly divided into 4 equitable groups that composed the work sample. In the clot group (GC) the critical size defect was filled with blood clot; the non-steroidal anti-inflammatory group (NSAID) had the critical size defects filled with blood clot and ketoprofen was given pos-operatively (10mg / kg day); the platelet-rich fibrin group (FRP) had the critical-size defects filled with autologous platelet-rich fibrin preparation; and platelet-rich fibrina group plus NSAIDs (FRP + NSAID) had the critical-size defects filled with autologous platelet-rich fibrin preparation and administered ketoprofen post-operatively (10mg / kg day). Each group was evaluated at 2, 7, 14 and 28 days after the surgical procedures. The samples were evaluated through histometry, micro-CT and ELISA for the presence of TNFα. The quantitative data were submitted to the statistical test ANOVA 1/2 factors or Kruskal-Wallis and post Tukey and Dunn (p <0.01). The histometric and microtomographic results showed higher bone formation for the PRF group compared to the other groups (p <0.05) and lower TNF-alpha in the initial period in the PRF group compared to the control group (p <0.05). It was concluded that the PRF was favorable since the beginning through the later periods, aiding in the inflammatory response and bone neoformation(AU)

Use of Inert Gases for the Preservation of Nuclear Blood Cells

Abstract The subject of the study was the stability of human white blood cell membranes subject to noble gases (xenon ad krypton, 0.6 mPa) clathrate cryoanabiosis (‒80°C). A unique portable stainless steel low pressure container with a compartment for flexible plastic container was designed to ensure that the cells are saturated with gases. The samples were warmed after 1 and 30 days in a water bath (+38°C) for 35-50 sec, while the container was being tilted (2-3 times per second), until the temperature of the biological object reached +3±1°C. It was demonstrated that after 30 days of clathrate anabiosis (-80°C) over 95% (of the original number) of leukocytes remain viable, and cell membranes of 54.5±3.4% of them is resistant to trypan blue; granulocyte survival rate is 73.5±2.7%, original lipid peroxidation rate and antioxidant activity are retained. Biological object cryopreservation in noble gases environment is a promising trend in biology and medicine.

Recommendation for the Peripheral Blood Cell Morphology Report

There is considerable heterogeneity in the peripheral blood smear reports across different diagnostic laboratories, despite following the guidelines published by the International Council for Standardization in Haematology (ICSH). As standardization of reports can facilitate communication and consequently the diagnostic efficiency in both laboratories and clinics, the standardization committee of the Korean Society for Laboratory Hematology aimed to establish a detailed guideline for the standardization of peripheral blood smear reports. Based on the ICSH guidelines, additional issues on describing and grading the peripheral blood smear findings were discussed. In this report, the proposed guideline is briefly described.

Large Unstained Cell, Blast Suspect and Delta Neutrophil Index ll Analyzed with Automated Hematology Analyzer as Parameters for the Prediction of Acute Leukemia Relapse

BACKGROUND: Here we investigated the clinical utilities of blast suspect, large unstained cell (LUC), delta neutrophil index ll (DN ll), and delta neutrophil index l (DN l), analyzed in peripheral blood samples with automated hematology analyzers to predict the relapse of acute leukemia. METHODS: We retrospectively reviewed the medical records of 112 patients, including 56 patients with acute leukemia relapse and 56 controls. Blast suspect, LUC, DN ll, and DN l were compared between the control and leukemia relapse groups. RESULTS: Significant differences in blast suspect (P<0.001), LUC (P<0.001), DN ll (P<0.001), and DN l (P=0.002) were observed between the leukemia relapse and control groups. The areas under the curve (AUC) value was 0.927 for blast suspect (95% confidence interval [CI]: 0.8750.978, P<0.001), 0.868 for LUC (95% CI: 0.794–0.941, P<0.001), and 0.900 for DN ll (95% CI: 0.841–0.960, P<0.001). Logistic regression analysis for the prediction of leukemia relapse revealed odds ratio values of 1.52 (95% CI: 1.26–1.96, P=0.0002) for blast suspect, 1.66 (95% CI: 1.27–2.42, P=0.0019) for LUC, 1.16 (95% CI: 1.08–1.29, P=0.0014) for DN ll, and 1.05 (95% CI: 1.01–1.13, P=0.0845) for DN l. CONCLUSIONS: Multiple parameters provided by automated blood cell analyzers may serve as powerful ancillary tools for the prediction and diagnosis of leukemia relapse.

Correlation of IgG Subclass with Blood Cell Parameters in Patients with Autoimmune Hemolytic anemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the correlation of IgG subclasses with blood cell parameters in the patients with autoimmune hemolytic anemia (AIHA).@*METHODS@#Thirty-four patients with AIHA (except C3d types) of immune complex type (IgG+C3d) and single IgG type, including 26 cases of primary AIHA and 8 cases of secondary AIHA from December 2010 to August 2016 in our hospital were selected and enrolled in AIHA group; 30 healthy persons were selected and enrolled in healthy control group. The levels of IgG subclasses in blood plasma were detected by double antibody sandwich ELISA in healthy persons and AIHA patients, at the same time. The levels of IgG subclasses in of RBC diffuse fluid were detected as well. The relation of IgG subclass level with some parameters of blood cells was analyzed in the hight of partial parameters of blood cells in patients. The independent sample test was used for comparison of data in 2 groups, the Spearman method was used for correlation analyziz.@*RESULTS@#The average value of IgG1-4 in AIHA group was higher than that in healthy control group, there was statisticad difference between 2 groups (IgG1: t=-4.88, P0.01) the ratio pf IgG1, IgG2 and IgG3 all had the statistical differences (IgG1: t=4.03, P<0.01; IgG2: t=7.38, P<0.01; IgG3: t=3.03, P<0.01). The spearmen analysis of corrclation of IgG subclass in blood plasma of patients with partial parameters of blood cells showed that the IgG4 positivety correlated with Hb level, the RBC count and HCT (Hb: r=0.358, P<0.05; RBC: r=0.426, P<0.05; HCT: r=0.363, P<0.05); the IgG1 and IgG2 negatively correlated with WBC count (IgG1: r=0.437, P<0.05; IgG2: r=-0.487, P<0.01); the IgG2 negatively correlated with count (r=-0.436, P<0.05). The comparison of IgG subclass ratio in plasma and RBC diffuse fluid of patients showed that in addition to IgG2 (t=1.544, P＞0.05), the rest IgG1, 3 and 4 all had statistical differences (IgG1: t=6.528, P<0.01; IgG3: t=-9.488, P<0.05; IgG4: t=-9.434, P<0.05).@*CONCLUSIONS@#The AIHA relates with IgG1 and IgG3, the detection of IgG subclasses may have a certain significance for studying the diagnosis, treatment and pothogenesis of AIHA.

Delta Neutrophil Index as an Early Marker of Sepsis in Burn Patients

Prediction for serious bacterial infection in febrile children aged 3 years or younger: comparison of inflammatory markers, the Laboratory-score, and a new laboratory combined model

PURPOSE: To compare the efficacy of inflammatory markers, the Laboratory-score, and a new laboratory combined model for predicting serious bacterial infection (SBI) in young febrile children.METHODS: The presence of SBI was reviewed in previously healthy children aged 3 years or younger with fever (> 38℃) who visited the emergency department from 2017 through 2018. Areas under the curves (AUCs) of the receiver operating characteristic curve for SBI were compared with individual inflammatory markers (white blood cells [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], procalcitonin [PCT], and urine WBC count), the Laboratory-score, and a laboratory combined model. The latter model was developed using logistic regression analysis including ESR, CRP, and PCT.RESULTS: Of the 203 enrolled children, SBI was diagnosed in 58 (28.6%). For SBI prediction, the Laboratory-score showed 51.7% sensitivity (95% confidence interval [CI], 38.2%–65.0%) and 83.5% specificity (95% CI, 76.4%–89.1%). The AUC of the Laboratory-score (0.76) was significantly superior to the values of all individual inflammatory markers (WBC, 0.59 [P = 0.032]; ESR, 0.69; and CRP, 0.74 [P < 0.001]) except that of PCT (0.77, [P < 0.001]). The AUC of the laboratory combined model (0.80) was superior to that of the Laboratory-score (0.76) (P < 0.001).CONCLUSION: In this study, the new laboratory combined model showed good predictability for SBI. This finding suggests the usefulness of combining ESR, CRP, and PCT in predicting SBI.

Biological and Clinical Markers in Panic Disorder

OBJECTIVE: Classifying mental disorders on the basis of objective makers might clarify their aetiology, help in making the diagnosis, identify “at risk” individuals, determine the severity of mental illness, and predict the course of the disorder. This study aims to review biological and clinical markers of panic disorder (PD). METHODS: A computerized search was carried out in PubMed and Science Direct using the key words: “marker/biomarker/clinical marker/neurobiology/staging” combined using Boolean AND operator with “panic.” In addition, the reference lists from existing reviews and from the articles retrieved were inspected. Only English language papers published in peer-reviewed journals were included. RESULTS: Structural changes in the amygdala, hippocampus, cerebral blood level in the left occipital cortex, serotonin 5-TH and noradrenergic systems activation, aberrant respiratory regulation, hearth rate variability, blood cells and peripheral blood stem cells, hypothalamic–pituitary–adrenal axis dysregulation were identified as potential candidate biomarkers of PD. Staging was identified as clinical marker of PD. According to the staging model, PD is described as follows: prodromal phase (stage 1); acute phase (stage 2); panic attacks (stage 3); chronic phase (stage 4). CONCLUSION: The clinical utility, sensitivity, specificity, and the predictive value of biomarkers for PD is still questionable. The staging model of PD might be a valid susceptibility, diagnostic, prognostic, and predictive marker of PD. A possible longitudinal model of biological and clinical markers of PD is proposed.

Significance of Differential Characteristics in Infantile Kawasaki Disease

BACKGROUND AND OBJECTIVES: Immunological variability in Kawasaki disease (KD) shows age-specific differences; however, specific differences in laboratory values have not been compared between infants and non-infants with KD. We compared age-adjusted Z-values (Z) of white and red blood cells in infants with KD with those in non-infants with KD. METHODS: This study retrospectively investigated 192 infants and 667 non-infants recruited between 2003 and 2015 at the Korea University Hospital. Laboratory values for infants with KD and non-infants with KD were analyzed and age-unadjusted raw values (R) and age-adjusted Z for blood cells counts were determined. RESULTS: Z in infants with KD during pre-intravenous immunoglobulin (IVIG), post-IVIG, and chronic phases showed increased lymphopenia and eosinophilia, low neutrophil:lymphocyte and neutrophil:eosinophil ratios, worse anemia, increased thrombocytosis, and reduced erythrocyte sedimentation rates compared with those in non-infants with KD. The optimal cut-off value for pre-IVIG Z-hemoglobin for prediction of KD in all patients was 40 mg/L (AUC, 0.811; sensitivity/specificity, 0.712/0.700; p=0.04). CONCLUSIONS: Laboratory characteristics enable differentiation between infants and non-infants with KD and contribute to a better understanding of changes in blood cell counts. Infants with incomplete KD can be more easily differentiated from infants with simple febrile illness using pre-IVIG Z-hemoglobin and pre-IVIG CRP values.