Alterações no VCM e suas correlações com os valores de RDW-SD e RDW-CV em caninos e felinos / Variation in MCV and its correlation with RDW-SD and RDW-CV values in dogs and cats

A anemia é uma síndrome caracterizada pela diminuição do número de hemácias, hematócrito e/ou concentração de hemoglobina. Conforme o Volume Corpuscular Médio (VCM), as anemias podem ser classificadas em microcíticas, normocíticas ou macrocíticas. O RDW (Amplitude de Distribuição dos Eritrócitos) também é utilizado para ajudar na classificação das anemias, refletindo a anisocitose da população eritrocitária. Neste estudo retrospectivo objetivou-se determinar a correlação entre o RDW-SD (Desvio Padrão), RDW-CV (Coeficiente de Variação), macrocitose e microcitose em caninos e felinos atendidos na rotina clínica do Hospital Veterinário da Universidade Luterana do Brasil. Para a realização deste estudo, selecionou-se 662 laudos de hemogramas realizados (434 caninos e 228 felinos), com faixa etária de seis meses até 10 anos, foram divididos em dois grupos: Grupo 1 ­ Anemia microcítica (255 caninos e 61 felinos); Grupo 2 ­ Anemia macrocítica (179 caninos e 167 felinos). Posteriormente, correlacionou-se os grupos com os valores de RDW-SD e RDW-CV. As análises de correlação foram realizadas utilizando o teste Spearman, para a análise de significância foi utilizado o T Student, no programa IBM SPSS®Statistics. Na análise estatística do grupo canino, não houve correlação da microcitose com o RDW-SD, enquanto o RDW-CV apresentou uma correlação inversamente proporcional, razoável. No grupo macrocítico canino, a análise de correlação com o RDW-SD foi moderada e diretamente proporcional, e com o RDW-CV foi moderada e diretamente proporcional. No grupo felino, não houve correlação entre microcitose e RDW-SD, e com o RDW-CV houve uma correlação razoável e inversamente proporcional. Entre macrocitose em felinos e o RDW-SD houve uma correlação moderada e diretamente proporcional, já o RDW-CV apresentou uma correlação razoável e diretamente proporcional. Conclui-se que os caninos e felinos do grupo microcítico apresentam uma correlação com o RDW-CV. Contudo, os caninos com macrocitose apresentaram correlação tanto para o RDW-CV quanto para o RDW-SD, e os felinos apresentaram uma maior correlação com o RDW-SD.

Anemia is a syndrome characterized by a low red blood cell count, hematocrit and/or hemoglobin concentration. According to the Mean Corpuscular Volume (MCV), anemias can be classified as microcytic, normocytic or macrocytic. The RDW (Red Cell Distribution Width) is also used to help classify anemias, reflecting the anisocytosis of the erythrocyte population. This retrospective study aimed to determine the correlation between RDW-SD (Standard Deviation), RDW-CV (Coefficient of Variation), macrocytosis and microcytosis in canines and felines treated in the clinical routine of the Veterinary Hospital of Universidade Luterana do Brasil. To carry out this study, 662 blood count reports were selected (434 canines and 228 felines), aged between six months and 10 years, divided into two groups: Group 1 ­ Microcytic anemia (255 canines and 61 felines); Group 2 ­ Macrocytic anemia (179 canines and 167 felines). Subsequently, the groups were correlated with the values of RDW-SD and RDW-CV. Correlation analyzes were performed using the Spearman test, for the analysis of significance the T Student was used, in the IBM SPSS® Statistics program. In the statistical analysis of the canine group, there was no correlation between microcytosis and the RDW-SD, while the RDW-CV showed a reasonable, inversely proportional correlation. In the canine macrocytic group, correlation analysis with RDW-SD was moderate and directly proportional, and with RDW-CV it was moderate and directly proportional. In the feline group, there was no correlation between microcytosis and RDW-SD, and with RDW-CV there was a reasonable and inversely proportional correlation. There was a moderate and directly proportional correlation between macrocytosis in felines and RDW-SD, whereas RDW-CV presented a reasonable and directly proportional correlation. It is concluded that the canines and felines of the microcytic group present a correlation with the RDW-CV. However, canines with macrocytosis showed a correlation for both RDW-CV and RDW-SD, and felines showed a greater correlation with RDW-SD.

Red cell distribution width and its association with Neonatal Bacteremia: A case-control study

Background@#Bacteremia is a major cause of prolonged hospital stay and mortality in neonates and its early diagnosis remains a challenge to pediatricians. Red cell distribution width (RDW) is a component of a complete blood count test which is accessible and inexpensive and has been reported to be a possible diagnostic marker for neonatal bacteremia. This study determined the association of RDW with neonatal bacteremia in term and preterm neonates. @*Methodology@#This is a retrospective case-control study of 26 bacteremic neonates as cases and 104 non-bacteremic neonates, either symptomatic or with risk factors for bacteremia, as controls. Included newborns were seen between January 1, 2010 to September 30, 2021. Laboratory data obtained were CBC, C-reactive protein and blood culture. @*Results@#RDW values between bacteremic and non-bacteremic neonates were not significantly different. There was an association between RDW and neonatal bacteremia at an RDW level of > 16.1, where the likelihood of bacteremia was three times higher compared with lower RDW values. Significantly lower levels of hemoglobin, hematocrit, RBC count, WBC count, platelet count, MCH and MCHC, and a higher CRP level were seen among bacteremic neonates compared to those who were not. The median RDW for both term and preterm neonates was close to 16, with a narrow inter-quartile range at 1 and 2 for controls and cases, respectively. The range (minimum to maximum) of RDW values of bacteremic preterm neonates was more variable than those of term neonates. Using RDW to detect bacteremia, it had an equivocal discriminatory power or AUC of 0.6056. We found insufficient evidence to demonstrate a correlation between RDW and other CBC parameters, except for MCHC. For MCHC, the results suggest a very weak and indirect correlation. @*Conclusion@#RDW was not significantly different between bacteremic and non-bacteremic neonates, but there was a suggested association between RDW and bacteremia at an RDW level of > 16.1, at which level there was a 3-fold risk for bacteremia.

Influence of the Ratio of Peripheral Hemoglobin-to-Red Cell Distribution width on the Prognosis of Patients with Diffuse Large B-cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the influence of peripheral hemoglobin (Hb)-to-red cell distribution width (RDW) ratio (HRR) on the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).@*METHODS@#Data of 265 patients with diffuse large B-cell lymphoma (DLBCL) at the Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2019 were retrospectively analyzed. 132 healthy people in the same period were used as normal control group. The best cut-off points of HRR was determined by receiver operating characteristics (ROC) curve; the chi-square test was used to analyze the correlation of clinical characteristics with HRR; the Kaplan-Meier method was used to compare the overall survival (OS) and progression-free survival (PFS) of HRR patients in different groups; the Cox proportional risk model was used for univariate and multivariate analysis.@*RESULTS@#The best cut-off value of HRR was 0.936, which was divided into low HRR group and high HRR group. The low HRR group had a higher ECOG score, higher incidence of advanced Ann Arbor stage, higher NCCN-IPI score, and elevated LDH level. K-M survival analysis showed that OS (P<0.001) and PFS (P<0.001) in the low HRR group were significantly shorter than that in the higher HRR group. The multivariate analysis revealed that HRR was an independent predictor of OS（HR＝0.379，95％CI：0.237-0.605，P<0.001） and PFS （HR＝0.384，95％CI：0.241－0.614，P<0.001） in DLBCL patients.@*CONCLUSION@#Low HRR（<0.936） in patients with DLBCL indicates a poor prognosis, which is an independent prognosis risk factor.

The Relationship between Hematopoietic Scoring System Composed of HB，PLT and MCV and Prognosis and Curative Effect of Multiple Myeloma Patients / 中国实验血液学杂志

OBJECTIVE@#To investigate the prognostic value of hemopoietic scoring system composed of hemoglobin (HB), platelet count (PLT) and mean corpuscular volume (MCV) in MM patients and its correlation with curative effect.@*METHODS@#The clinical data of 172 newly diagnosed MM patients treated by bortezomib as the first-line regimen in our hospital from May 2014 to December 2019 were collected, three variables (HB≤100 g/L, PLT≤150×109/L, MCV≥96 fl) were introduced, each variable was distributed 1 score, the patients were divided into four groups (0, 1, 2 and 3 points in group 1, 2, 3 and 4, respectively), and the clinical characteristics and prognosis of the patients in the four groups were analyzed. The initial efficacy evaluation after 3-4 courses of treatment was carried out, and the curative effect of the patients in the different hematopoiesis score groups were compared.@*RESULTS@#The median OS time of the patients in group 1, 2, 3 and 4 was 27.0, 22.5, 20.7 and 18.1 months, while the median PFS time were 23.0, 19.0, 18.0 and 14.0 months, respectively. The OS and PFS of the patients in low score group were significantly better than those in high score group (P=0.045, P=0.048). There was no significant difference in the curative effect of the patients treated by bortezomib after 3-4 courses (P>0.05).@*CONCLUSION@#Hematopoiesis score can preliminarily predict the overall survival of newly diagnosed MM patients, but there is no significant difference between different scoring groups in the initial curative effect.

Hematological Characteristics of Different Genotypes of Thalassemia among Reproductive Population in Chongqing / 中国实验血液学杂志

OBJECTIVE@#To investigate the hematological characteristics and genotype distribution of thalassemia among people at reproductive age in Chongqing.@*METHODS@#Hematology analysis and capillary electrophoresis were performed in 29 145 participants at reproductive age. The patients with positive results were confirmed by thalassemia genotyping. Genotype distribution and characteristics of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and hba2 levels in thalassemia patients were analyzed.@*RESULTS@#--SEA/αα (45.10%), -α3.7/αα (39.31%) and -α4.2/αα (8.46%) were the most common genotypes of α-thalassemia, while CD17 (HBB: c. 52A>T) (31.67%), CD41-42 (HBB: c. 126-129 del TTCT) (26.87%) and IVS-Ⅱ-654 (HBB: c. 316-197 C>T) (24.21%) were the most common genotypes of β-thalassemia in Chongqing. In α-thalassemia ααCS/αα showed the lowest hba2 value (2.18±0.23)%, while --SEA/αα showed the lowest MCV (71.9±8.5) fl and MCH (22.7±3.3) pg value. The patients in βE (HBB: c. 79G>A) group showed comparatively higher values of MCV and MCH and significantly lower HbA and hba2 values than the other genotypes. There was no significant difference in HbA, hba2, MCV, MCH levels of the patients between pregnant group and non-pregnant group.@*CONCLUSIONS@#In Chongqing, there are differences in hematological characteristics among patients with different thalassemia genotypes. There is no significant effect of pregnancy on HbA, hba2, MCV and MCH has been found.

Índice PROFUND y mortalidad intrahospitalaria en pacientes pluripatológicos. Análisis post-hoc / PROFUND index and intrahospital mortality in plurypathological patients. A post-hoc analysis

Resumen El índice PROFUND se desarrolló y validó para predecir mortalidad a 12 meses en pacientes pluripatológicos. Sin embargo, su valor potencial para predecir mortalidad intrahospitalaria no ha sido suficientemente estudiado. Se evaluó la capacidad del índice PROFUND en comparación con la proteína C re activa (PCR), la albúmina, y el ancho de distribución eritrocitaria (ADE) para predecir mortalidad intrahospitalaria, mediante el análisis posterior de una cohorte prospectiva de 111 pacientes pluripatológicos internados en clínica médica. La edad promedio fue 75.8 ± 9.3 años. La mortalidad intrahospitalaria fue de 17% (19 pacientes). La mediana (RIQ) del índice PROFUND, albúmina, PCR y ADE en los fallecidos y sobrevivientes fue 12 (4) y 6 (7) p< 0.0001, 2.5 (0.4) y 2.6 (0.8) p 0.295, 58 (64) y 40 (60) p 0.176, 14.5 (2) y 14.6 (3) p 0.523, respectivamente. El análisis logístico multivariado mostró que el índice PROFUND se asocia con mortalidad intrahospitalaria (p 0.0003). El riesgo de fallecer durante la internación es 20% mayor por cada punto que se incrementa el índice PROFUND (OR 1.2, IC95% 1.1-1.4). El área bajo la curva de las características operativas del receptor (AUC-ROC) del índice PROFUND para predecir mortalidad durante la internación (0.760, IC95% 0.628-0.891) fue mayor a la del ADE, PCR y albúmina (0.494 IC95% 0.364-0.624 p 0.012; 0.583 IC95% 0.437-0.728 p 0.028; 0.621 0.494-0.748 p 0.109, respectivamente). El índice PROFUND se asocia a mortalidad intrahospitalaria, con una mayor capacidad predictiva que los biomarcadores estudiados, lo cual se sumaría a su valor pronóstico a largo plazo en pacientes pluripatológicos.

Abstract The PROFUND index was developed and valid to predict mortality at 12 months in polypathological patients (PP). However, its potential value for predicting in-hospital mortality has not been sufficiently studied. The ability of the PROFUND index in comparison with C-reactive protein (CRP), albumin, and red blood cell distribu tion width (RDW) to predict in-hospital mortality was evaluated through the subsequent analysis of a prospective cohort of 111 multiple pathological patients admitted to the clinic medical. The mean age was 75.8 ± 9.3 years. In-hospital mortality was 17% (19 patients). The median (IQR) of the PROFUND index, albumin, CRP and ADE in the deceased and survivors was 12 (4) and 6 (7) p < 0.0001, 2.5 (0.4) and 2.6 (0.8) p 0.295, 58 (64) and 40 (60) p 0.176, 14.5 (2) and 14.6 (3) p 0.523, respectively. The multivariate logistic analysis showed that the PROFUND index is associated with in-hospital mortality (p 0.0003). The risk of dying during hospitalization is 20% higher for each point that the PROFUND index increases (OR 1.2, 95% CI 1.1-1.4). The area under the curve the receiver operating characteristic (AUC-ROC) of the PROFUND index to predict mortality during hospitalization (0.760, 95% CI 0.628-0.891) was higher than that of the RDW, CRP and albumin (0.494 95% CI 0.364-0.624 p 0.012; 0.583 95% CI 0.437-0.728 p 0.028; 0.621 0.494-0.748 p 0.109, respectively). The PROFUND index is associated with in-hospital mortality, with a greater predictive capacity than the biomarkers studied, which would add to its long-term prognostic value in multiple pathological patients.

Valor prognóstico da amplitude de distribuição das hemácias em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST submetidos à intervenção coronariana percutânea / Prognostic value of red cell distribution width in ST-segment elevation myocardium infarction patients undergoing percutaneous coronary intervention

Objetivo: Determinar os valores da amplitude de distribuição das hemácias em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST submetidos à intervenção coronária percutânea primária e avaliar sua associação com resultados adversos. Métodos: Os níveis de amplitude de distribuição das hemácias foram medidos em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST antes da intervenção coronária percutânea primária e divididos conforme valor das amplitudes de distribuição das hemácias. Após a alta hospitalar, os pacientes foram acompanhados por até 3 anos para a ocorrência de eventos cardiovasculares adversos maiores e mortalidade a longo prazo. Resultados: Foram incluídos 893 pacientes com idade média de 60,7 (±12,5) anos, e 66,3% eram do sexo masculino. Na análise multivariada, a hemácia permaneceu como preditor independente de mortalidade a longo prazo. A área sob a curva para mortalidade a longo prazo foi de 0,64 (IC95% 0,61-0,67; p<0,0001). Amplitudes de distribuição das hemácias <13,3 tiveram valor preditivo negativo de 87,1% para mortalidade por todas as causas. Conclusão: Um valor elevado de amplitude de distribuição das hemácias é um preditor independente de mortalidade a longo prazo e eventos cardiovasculares adversos maiores em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST submetidos à intervenção coronária percutânea primária. Amplitudes de distribuição das hemácias baixas têm baixo tem um excelente valor preditivo negativo para mortalidade a longo prazo. (AU)

Objective: To determine red cell distribution width values in ST-elevation acute myocardial infarction patients undergoing primary percutaneous coronary intervention and to evaluate its association with adverse outcomes. Methods: Red cell distribution width levels were measured in ST-segment elevation myocardial infarction patients before primary percutaneous coronary intervention and divided into low and high red cell distribution width. After discharge, patients were followed for up to 3 years for the occurrence of long-term major adverse cardiovascular events and mortality. Results: A total of 893 patientes were with a mean age of 60.7 (±12.5) years, 66.3% were male. In multivariate analysis, the red cell distribution width remained as an independent predictor of long-term mortality. The area under the curve for long-term mortality was 0.64 (95%CI0.61-0.67; p<0.0001). Red cell distribution width<13.3 had a negative predictive value of 87.1% for all-cause mortality. Conclusion: High number of red cell distribution width is an independent predictor of long-term mortality and major adverse cardiovascular events in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. A low number of red cell distribution width has an excellent negative predictive value for long-term mortality. Patients with sustained elevated levels of red cell distribution width have worse outcomes at long-term follow-up. (AU)

Effectiveness of Using Mean Corpuscular Volume and Mean Corpuscular Hemoglobin for Beta-thalassemia Carrier Screening in the Guangdong Population of China / 生物医学与环境科学（英文）

Beta (β)-thalassemia is one of the most common hemoglobinopathies worldwide, creating major public health problems and social burdens in many regions. Screening for β-thalassemia carriers is crucial for controlling this condition. To investigate the effectiveness of mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) for screening β-thalassemia, retrospective data were analyzed for 6,779 β-thalassemia carriers subjected to genetic testing following thalassemia screening in Guangdong province between January 2018 and December 2019. Prevalent mutations observed included CD41/42 (-TTCT) (38.43%), IVS-II-654 (C > T) (25.71%), -28 (A > G) (15.78%), CD17 (AAG > TAG) (10.03%), and β

Iron deficiency and early childhood caries: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUNDS@#Previous surveys have found that children with iron deficiency (ID) were likely to suffer from early childhood caries (ECC). We aimed to assess the scientific evidence about whether ID is intrinsically related to ECC.@*METHODS@#The medical subject headings (MeSH) terms and free words were searched on PubMed, Web of Science, Cochrane, China National Knowledge Infrastructure, Wanfang, and the Database for Chinese Technical Periodicals from March 2020 to September 2020. Two researchers independently screened the articles. Data extraction and cross-checking were performed for the studies that met the inclusion criteria. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.3 software.@*RESULTS@#After excluding duplication and irrelevant literature, 12 case-control studies were included in the study. The meta-analysis demonstrated that children with ECC were more likely to have ID (odds ratio [OR] = 2.63, 95% confidence interval [CI]: [1.85, 3.73], P < 0.001). There was no statistically significant association found between the level of serum ferritin and ECC (weighted mean difference (WMD) = -5.80, 95% CI: [-11.97, 0.37], P = 0.07). Children with ECC were more likely to have iron-deficiency anemia (OR = 2.74, 95% CI: [2.41,3.11], P < 0.001). The hemoglobin (HGB) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -9.96, 95% CI: [-15.45, -4.46], P = 0.0004). The mean corpuscular volume (MCV) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -3.72, 95% CI: [-6.65, -0.79], P = 0.01).@*CONCLUSIONS@#ID was more prevalent in children with ECC, and the markers of iron status in the ECC group, such as serum ferritin, HGB, and MCV, were relatively lower than the ECC-free group.

Diagnostic Cut-Off Value of RDW for Screening Thalassemia and the Combined Determination of MCV, MCH, HBA / 中国实验血液学杂志

OBJECTIVE@#To explore the value of red cell distribution width (RDW), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin (Hb) A2 combined determination scheme for screening thalassemia.@*METHODS@#The RDW levels of thalassemia group and healthy control group were detected and compared. The efficiency of RDW for screening thalassemia was evaluated by receiver operating characteristic (ROC) curve. The diagnostic cut-off value of RDW was also acquired by Youden index. Then, 3 groups for thalassemia screening scheme were set, including MCV+MCH+HBA @*RESULTS@#The RDW level in thalassemia group was significantly higher than that in healthy control group (P15.15, when the Youden index was the biggest among all data. The sensitivity, specificity, positive predictive value, negative predictive value, false negative rate and consistency rate of MCV+MCH+RDW(>15.15)+HBA @*CONCLUSION@#The diagnostic cut-off value of RDW for thalassemia screening has been established. The group of MCV(<82.0 fl)+MCH(<27.0 pg)+HBA

The Clinical Value of Combined Detection of RBC, Ret-He and HbA2 for Thalassemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution of Ret-He and RBC in thalassemia and the value of combining HbA2 in the detection of thalassemia among patients with microcytic or hypochromic.@*METHODS@#145 patients with microcytic or hypochromic outpatient or hospitalization in our hospital from May 2018 to December 2019 were selected and were divided into the thalassemia group(68 cases) and the non-thalassemia group (77 cases), and at the same time, the patients were divided into four groups of the non-anemia, mild anemia, moderate anemia and severe anemia group according to the degree of anemia. The Ret-He, RBC, RDW-CV and HbA2 in patients were detected, and the distribution of these parameters were compared, and the joint detection of Ret-He, RBC and HbA2 about its sensitivity, specific and other indicators of auxiliary diagnosis of thalassemia were analyzed.@*RESULTS@#Among patients with microcytic or hypochromic, according to the anemia grade Ret-He gradually decreased from the non-anemia group to the severe anemia group (P<0.05); while RDW-CV was increased gradually from the mild anemia group to the severe anemia group (P<0.05); both RBC and Ret-He were increased in the thalassemia group as compared with the non- thalassemia group (P<0.05); while RDW-CV was decreased in the thalassemia group as compared with the non-thalassemia group (P<0.05); meanwhile Ret-He in the α-thalassemia group was higher than that in the β-thalassemia group. ROC curve analysis showed that combined with HbA2, the specificity was 93.51%, the sensitivity was 66.18%, the positive predictive value was 90% and the negative predictive value was 75.189% when Ret-He was truncated with 19.25 pg and RBC was truncated with 4.95×10@*CONCLUSION@#Among patients with microcytic or hypochromic, the distribution of RBC, Ret-He and RDW-CV was different in the thalassemia group and the non-thalassemia group, and was also affected by the degree of anemia. Combined Ret-He and RBC could improve the diagnostic specificity for thalassemia, which were screened by HbA2 in patients with microcytic or hypochromic.

The Value of Umbilical Cord Blood Erythrocyte Index in the Screening of Neonatal Thalassemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the relationship between umbilical cord blood erythrocyte index and thalasse-mia, and reveal its clinical value in the screening of thalassemia in neonates.@*METHODS@#2 919 cases of umbilical cord blood from neonatal who were born in Boai Hospital of Zhongshan Affiliated with Southern Medical University from July 2017 to December 2018 were collected, the routine blood tests were preformed to detect the umbilical cord blood. Thalassemia gene in peripheral blood of neonates was collected. The cut-off values of cord blood indexes were determined, and the sensitivity, specificity and other evaluation indexs were calculated.@*RESULTS@#Among the cord blood in 2 919 neonates, 314 cases were detected out as thalassemia(positive rate: 10.76%). The average level of RBC and RDW in 2 605 children with non-thalassemia was lower than those with 314 children with thalassemia. The levels of Hb, MCV, MCH, MCHC, HCT, Hb/RBC and MCV/RBC in children with non-thalassemia were higher than those with thalassemia, and there were significant differences in the neonates between the two groups. The RBC and RDW levels of neonates in the α-thalassemia group were higher than those in the non-thalassemia group, while the levels of Hb, MCV, MCH, MCHC, HCT, Hb/RBC and MCV/RBC of neonates were lower than those in the non-thalassemia group. The levels of MCV, MCH and Hb/RBC of neonates in the β-thalassaemia group were lower than those in the non-thalassaemia group. The levels of MCV, MCH, Hb/RBC, and MCV/RBC of neonates in the complex thalassemia group were lower than those in the non-thalassemia group. When the cut-off value of MCV was set to 106.05 fl, the sensitivity was 0.548, and the specificity was 0.907, the specificity was the highest among all indexes. The area under the ROC curve of the combined diagnosis of MCH+MCV/RBC was the largest(0.807), the sensitivity was 0.710, the specificity was 0.841, the positive predictive value was 0.348, and the negative predictive value was 0.960.@*CONCLUSION@#The single indicator of umbilical cord blood red blood cells has advantages and disadvantages for the screening of thalassemia, but the combination of MCH+MCV/RBC can improve the accuracy of the screening or diagnosis of thalassemia, it also has a positive effect to the reduction of the birth rate of children with thalassemia major, which showed a high popularization value in primary hospitals.

Sex disparities determined by biometric and hematological measurements in Astyanax bimaculatus / [Disparidades sexuais determinadas por medições biométricas e hematológicas em Astyanax bimaculatus]

This study aimed to compare the body indexes and hematological characteristics between Astyanax bimaculatus males and females. Four hundred fish were randomly distributed into four polyethylene tanks (100 fish/unit) in a recirculation system and fed four times a day (3% of biomass). After 90 days, ten fish (five ♀ and five ♂) were removed to perform blood tests and to measure weight, height, total length, height/length ratio, condition factor and index determination: vicerosomatic (VSI), hepatosomatic (HSI), and gonadosomatic (GSI). The results showed a higher average weight (g) in females (12.32±0.71) compared to males (6.98±0.75), the same happened to height (cm) = (3.01±0.07) and (2.40±0.05), total length (cm) = (3.01±0.07) and (2.40±0.05), VSI (%) = (11.43±0.81) and (3.55±1.05), HSI (%) = (0.72±0.08) and (0.30±0.04), respectively. Mean corpuscular hemoglobin (pg) was higher in females (3.72±1.20) than in males (2.99±1.51). Regarding the number of thrombocytes (103.µL-1), there was an increase in males (25.71±3.91) compared to females (17.40±6.40).(AU)

O objetivo deste trabalho foi comparar os índices corporais e as características hematológicas entre machos e fêmeas de Astyanax bimaculatus. Quatrocentos peixes foram distribuídos aleatoriamente em quatro caixas de polietileno (100 peixes/unidade), em sistema de recirculação, e alimentados quatro vezes ao dia (3% da biomassa). Após 90 dias, 10 peixes (cinco ♀ e cinco ♂) foram retirados para realização das análises sanguíneas e para mensuração do peso, da altura, do comprimento total, da relação altura/comprimento, do fator de condição e da determinação dos índices: viscerossomático (IVS), hepatossomático (IHS) e gonadossomático (IGS). Os resultados mostraram um maior peso médio (g) nas fêmeas (12,32±0,71) em relação aos machos (6,98±0,75); o mesmo aconteceu para altura (cm) = (3,01± 0,07) e (2,40± 0,05), comprimento total (cm) = (3,01±0,07) e (2,40±0,05), IVS (%) = (11,43±0,81) e (3,55±1,05), IHS (%) = (0,72±0,08) e (0,30±0,04), respectivamente. Hemoglobina corpuscular média (pg) foi maior nas fêmeas (3,72±1,20) que nos machos (2,99±1,51). Em relação ao número de trombócitos (103/µL), houve um aumento nos machos (25,71± 3,91) em relação às fêmeas (17,40±6,40).(AU)

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.

Discriminant indexes to simplify the differential diagnosis between iron deficiency anemia and thalassemia minor in individuals with microcytic anemia

SUMMARY INTRODUCTION: Microcytic anemias are very common in clinical practice, with iron deficiency anemia (IDA) and thalassemia minor (TT) being the most prevalent. Diagnostic confirmation of these clinical entities requires tests involving iron metabolism profile, hemoglobin electrophoresis, and molecular analysis. In this context, several discriminant indices have been proposed to simplify the differential diagnosis between IDA and TM. OBJECTIVE: The aim of this paper was to demonstrate the clinical relevance of the use of discriminant indices in individuals with microcytic anemia to simplify the differential diagnosis between iron deficiency anemia and minor thalassemia. METHODS: A bibliographic and cross-sectional search was performed in the PubMed, SciELO and LILACS databases, using the following descriptors: iron deficiency anemia, thalassemia minor, and differential diagnosis. RESULTS: More than 40 mathematical indices based on erythrocyte parameters have been proposed in the hematological literature in individuals with microcytosis. Green & King indexes (IGK), Ehsani index, and erythrocyte count (RBC) had excellent performances, especially when their efficacy was observed in adults and children. CONCLUSIONS: Confirmatory tests for differential diagnosis between IDA and TM require time-consuming and costly methods. Despite the excellent performances of IGK, Ehsani index, and RBC, none of them presented sufficient sensitivity and specificity to establish a diagnosis. However, they can provide a powerful additional tool for diagnostic simplification between IDA and TM.

RESUMO INTRODUÇÃO: Anemias microcíticas são muito comuns na prática clínica, sendo a anemia ferropriva (AF) e a talassemia menor (TM) as mais prevalentes. A confirmação diagnóstica dessas entidades clínicas requer testes que envolvem o perfil do metabolismo do ferro, eletroforese de hemoglobinas e análises moleculares. Nesse contexto, vários índices discriminantes têm sido propostos para simplificação do diagnóstico diferencial entre AF e TM. OBJETIVO: O objetivo deste artigo foi demonstrar a relevância clínica da utilização de índices discriminantes em indivíduos com anemia microcítica, para simplificação do diagnóstico diferencial entre anemia ferropriva e talassemia menor. MÉTODOS: Foi realizada uma pesquisa bibliográfica e transversal nas bases de dados PubMed, SciELO e Lilacs, utilizando-se os seguintes descritores: anemia ferropriva, talassemia menor e diagnóstico diferencial. RESULTADOS: Mais de 40 índices matemáticos baseados em parâmetros eritrocitários foram propostos na literatura hematológica em indivíduos com microcitose. Os índices de Green & King (IGK), o índice de Ehsani e a contagem de eritrócitos (RBC) obtiveram excelentes desempenhos, especialmente quando sua eficácia foi observada em adultos e crianças. CONCLUSÕES: Testes confirmatórios para o diagnóstico diferencial entre AF e TM demandam métodos que consomem bastante tempo e alto custo. Apesar dos excelentes desempenhos do IGK, do índice de Ehsani e do RBC, nenhum deles possui sensibilidade e especificidade suficientes para firmar diagnóstico. No entanto, podem fornecer uma poderosa ferramenta adicional para simplificação diagnóstica entre AF e TM.

Relação entre indicadores antropométricos, aptidão cardiorrespiratória e perfil hematológico de adolescentes no sul do Brasil / Relationship between anthropometric indicators, cardiorespiratory fitness and hematological profile of adolescents

A obesidade pode influenciar no baixo desempenho da aptidão cardiorrespiratória (APCR), bem como colaborar com alterações nos níveis de indicadores hematológicos. Objetivo: Verificar se existe associação entre indicadores antropométricos, APCR e perfil hematológico de adolescentes no sul do Brasil. Método: Estudo transversal, em que foram avaliados 1 6 98 ado lescentes (742 do sexo masculino) com idade entre 10 e 17 anos, de escolas da rede pública e particular de Santa Cruz do Sul-RS. A avaliação antropométrica foi realizada, utilizando-se os seguintes parâmetros: IMC e circunferência da cintura (CC). Para o teste de APCR, foi utilizado o test e de co rrida/cam inha do s 6 minutos. Para reconhecimento do perfil hematológico, foram avaliados os seguintes parâmetros: leucócitos (WBC), eritrócitos (RBC), hemoglobina (HBC), hematócrito (HCT) e amplitude de distribuição dos glóbulos vermelhos (RDW). A associação entre as variáveis contínuas foi testada por meio da correlação de Pearson. Foram considerados significativos os valores de p<0,05. Resultados: Nos meninos, identificou-se relação fraca entre IMC com RBC (r=0,293; p<0,001) e com HCT (r=0,271; p <0,001 ). A CC também demonstrou associação fraca com estas duas variáveis hematológicas (RBC: r=0,311; p<0,001; HCT: r=0,291; p<0,001). Os níveis de APCR estiveram associados, também de fo rma fraca e direta, com HBC (r=0,224; p<0,001) e HCT (r=0,258; p<0,001). Para o sexo feminino, os níveis de W BC associaram-se, de forma fraca, com IMC (r=0,208; p<0,001) e com CC (r=0,185; <0,001). Conclusão: Os resultados obtidos no presente estudo evidenciam correlação positiva, porém fraca, entre o perfil hematológico dos adolescentes com as variáveis antropométricas e APCR...(AU)

Obesity might cause cardiorespiratory fitness (CRF) to underperform, as well as collaborate with changes in hematological parameters. Aim: To investigate the asso ciation between anthropometric indicators, CRF, and the hematological profiles of adolescents in Southern Brazil. Method: A cross-sectional study of 1,698 adolescents (742 boys, 956 girls), aged between 10 and 17 from p ublic and private schools of Santa Cruz do Sul, State of Rio Grande do Sul, was conducted. Furt h ermore, an anthropometric evaluation of the following parameters was performed: body mass index (BMI) and waist circumference (WC). CRF was evaluated using the 6-minute run/walk test. Hematolo gical p rofile was evaluated based on the following parameters: leucocytes (WBC), erythrocytes (RBC), hemoglobin (HGB), hematocrit (HCT), and red cell distribution width (RDW). The association of continuo us v ariables was tested through Pearson's correlation; p values lower than 0.05 were considered significant. Result s: The boys' BMI presented a weak correlation with RBC (r = 0.293; p < 0.001) and HCT (r = 0.271; p < 0.001). Their WC also presented a weak correlation with both hematological variables (RBC: r = 0.311; p < 0.001; HCT: r = 0.291; p < 0.001). Their CRF levels exhibited a direct but weak asso ciatio n wit h HGB (r = 0.224; p < 0.001) and HCT (r = 0.258; p < 0.001). The WBC levels of girls were fo un d t o be weak ly associated with BMI (r = 0.208; p < 0.001) and WC (r = 0.185; p < 0 .0 01 ). Co nclusio n: Th e result s highlight a positively weak correlation of the hematological profile of adolescents with an throp ometric variables and CRF...(AU)

Impacto del volumen de sangre extraído por flebotomía sobre el requerimiento transfusional en prematuros menores de 1500 g. Estudio cuasiexperimental / Impact of the volume of blood collected by phlebotomy on transfusion requirements in preterm infants with birth weight of less than 1500 g. A quasi-experimental study

Introducción. La anemia es una complicación para los recién nacidos de muy bajo peso al nacer, y los exámenes de laboratorio son un factor de riesgo preponderante. Más del 50 % recibe, al menos, una transfusión de glóbulos rojos. Estas se han asociado a mayor riesgo de infecciones, hemorragia intracraneal, enterocolitis necrotizante y displasia broncopulmonar. En 2012, se implementó, en el Hospital Italiano de Buenos Aires, una estrategia de menor volumen de extracción de sangre por flebotomía. El objetivo del presente estudio fue evaluar su asociación con el número detransfusiones.Métodos. Estudio cuasiexperimental del tipo antes/después. Se comparó el número de transfusiones entre dos grupos de prematuros de muy bajo peso con diferente volumen de extracción. Se evaluó la correlación entre el volumen extraído y el número de transfusiones estimando el coeficiente de Spearman. Para ajustar por confundidores, se realizó un modelo de regresión logística.Resultados. Se incluyeron en el estudio 178 pacientes con edad gestacional media de 29,4 semanas (desvío estándar: 2,7) y peso al nacer de 1145 gramos (875-1345). El perfil de la serie roja inicial fue similar entre ambos grupos. El número de transfusiones (p = 0,017) y el volumen transfundido (p = 0,048) disminuyeron significativamente. El coeficiente de correlación resultó de 0,83. En el análisis multivariado, volumen de extracción y peso al nacer se asociaron a un requerimiento mayor de 3 transfusiones.Conclusión. Un menor volumen de extracción de sangre en prematuros de muy bajo peso está asociado de manera independiente a menor requerimiento transfusional.

Introduction. Anemia is a complication in very low birth weight (VLBW) infants, and lab tests are a predominant risk factor. At least one red blood cell transfusion is given in more than 50 % of cases. Transfusions are associated with a higher risk for infections, intracranial hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia. In 2012, Hospital Italiano de Buenos Aires implemented a strategy to collect a lower blood volume by phlebotomy. The objective of this study was to assess its association with the number of transfusions.Methods. Before-and-after, quasi-experimental study. The number of transfusions was compared between two groups of VLBW preterm infants with different blood collection volumes. The correlation between the collection volume and the number of transfusions was assessed estimating Spearman's coefficient. A logistic regression model was used to adjust for confounders.Results. The study included 178 patients with a mean gestational age of 29.4 weeks (standard deviation: 2.7) and a birth weight of 1145 g (875-1345). The baseline red series profile was similar between both groups. The number of transfusions (p = 0.017) and the transfusion volume (p = 0.048) decreased significantly. The correlation coefficient was 0.83. In the multivariate analysis, collection volume and birth weight were associated with a requirement of more than three transfusions.Conclusion. A lower blood collection volume in VLBW preterm infants is independently associated with fewer transfusion requirements.

Trichostrongylus colubriformis infection in Santa Inês lambs: impact on feed digestibility, blood markers, and nitrogen balance / Infecção por Trichostrongylus colubriformis em cordeiros Santa Inês: impacto na digestibilidade dos alimentos, marcadores sanguíneos e balanço de nitrogênio

Abstract This study aimed to evaluate the effects of Trichostrongylus colubriformis infection on the hemato-biochemical parameters, feed digestibility, and nitrogen balance in Santa Inês lambs. Eighteen three-month-old Santa Ines castrated male lambs (16.9 ± 1.43 kg of body weight) were randomly distributed in two experimental treatments: infected with T. colubriformis (I, n = 9) and uninfected (U, n = 9). The I group received a total of 45,000 L3 larvae of T. colubriformis (5,000 infective larvae, three times per week, for three weeks). During the experimental period, blood, feed digestibility, and nitrogen balance were evaluated. The I lambs showed a reduction in erythrocytes, hemoglobin, hematocrit, mean corpuscular volume, and total proteins, as well as an increase in platelets and eosinophils compared to those in the U group (p < 0.05). With the exception of total protein content, these values were within the normal range for the species. Furthermore, lower dry matter and organic matter digestibility were observed in the I lambs (p = 0.08). The present findings highlight that T. colubriformis infection has the potential to impair some hemato-biochemical parameters as well as feed digestibility in lambs, which could affect their productivity.

Resumo O objetivo deste estudo foi avaliar os efeitos da infecção por Trichostrongylus colubriformis nos parâmetros hemato-bioquímicos, digestibilidade aparente dos nutrientes e balanço de nitrogênio de cordeiros Santa Inês. Dezoito cordeiros Santa Inês, de três meses de idade e castrados (16,9 ± 1,43 kg de peso corporal), foram distribuídos aleatoriamente em dois tratamentos experimentais: infectados com T. colubriformis (I, n = 9) e não infectados (U, n = 9). O grupo I recebeu um total de 45.000 larvas L3 de T. colubriformis (5.000 larvas infectantes, três vezes por semana, durante três semanas). Durante o período experimental, foram avaliadas as variáveis sanguíneas, digestibilidade e balanço de nitrogênio. Os cordeiros I apresentaram redução de eritrócitos, hemoglobina, hematócrito, volume corpuscular médio e proteínas totais, além de aumento de plaquetas e eosinófilos, quando comparados ao grupo U (p< 0,05). Contudo, exceto para proteínas totais, os valores estavam dentro do intervalo normal para a espécie. Além disso, a digestibilidade da matéria seca e da matéria orgânica foi menor no grupo I de cordeiros (p = 0,08). Os presentes achados destacam que a infecção por T. colubriformis teve potencial para prejudicar alguns parâmetros hemato-bioquímicos, bem como a digestibilidade aparente da dieta, o que poderia afetar a produtividade dos cordeiros.

Gelatinasas como marcadores de consumo crónico de alcohol: un estudio piloto en Uruguay / Gelatinases as markers of chronic alcohol consumption: a pilot study in Uruguay / Gelatinasas como marcadores de consumo crônico de álcool: um estúdio piloto em Uruguai

El consumo crónico de alcohol en Uruguay es un problema creciente, sin embargo, las determinaciones de biomarcadores consensuados no se realizan sistemáticamente ni se investigan otros marcadores potenciales. Para validar la hipótesis de que las metaloproteinasas de matriz con actividad gelatinasa son biomarcadores de consumo crónico de alcohol, se evaluaron muestras de sangre de 100 alcohólicos que comenzaron a atenderse en la Unidad de Trastornos Relacionados con el Alcohol y de 50 donantes sanos no alcohólicos. Las muestras de alcohólicos presentaron actividad de gelatinasas que triplicaron la de los controles y aumentos pequeños pero significativos en los niveles de γ-glutamil transferasa, aspartato-aminotransferasa y volumen corpuscular medio. Los valores de transferrina deficiente en carbohidratos fueron menores en alcohólicos que en controles. Estos resultados permiten proponer a las gelatinasas como los indicadores más sensibles del consumo sostenido de alcohol en la población analizada, ya que las enzimas hepáticas y el volumen corpuscular medio muestran una tendencia acorde con la literatura pero no alcanzaron valores asociados a la patología. Dado que la transferrina deficiente en carbohidratos es considerada el biomarcador indirecto más sensible y específico de consumo crónico de alcohol, los valores menores obtenidos en alcohólicos respecto de controles sugieren problemas metodológicos que podrían subsanarse aplicando otras técnicas de medida o por la presencia de interferencias que deben ser identificadas. Finalmente, estos hallazgos justifican una extensión de este trabajo piloto, así como estudios adicionales centrados en la participación de las metaloproteinasas de matriz con actividad gelatinasa en las cascadas de daño asociadas al consumo crónico de alcohol.

Chronic alcohol consumption in Uruguay is a growing problem, however, determinations of consensual biomarker are not performed systematically neither potential markers are explored. To validate the hypothesis that matrix metalloproteinases with gelatinase activity are biomarkers of chronic alcohol consumption, blood samples of 100 alcoholics that began medical treatment at the Unidad de Trastornos Relacionados con el Alcohol and 50 healthy non-alcoholic donors were evaluated. Alcoholic samples showed gelatinase activity that tripled that of controls and small but significant increases in levels of γ-glutamyl transferase, aspartate-aminotransferase and mean cellular volume. Carbohydrate deficient transferrin values were lower in alcoholics than in controls. These results allow proposing gelatinases as the most sensitive indicators of sustained alcohol consumption in the population analyzed since hepatic enzymes and mean cellular volume showed a tendency consistent with the literature but did not reach values associated with the pathology. Since carbohydrate-deficient transferrin is considered the most sensitive and specific indirect biomarker of chronic alcohol consumption, lower values in alcoholics related to controls suggest methodological problems that could be solved by applying other measurement techniques or by the presence of yet unknown interferences. Finally, these findings justify an extension of this pilot work, as well as additional studies focused on the participation of matrix metalloproteinases with gelatinase activity in the cascades of damage associated with chronic alcohol consumption.

O consumo crônico de álcool no Uruguai é um problema crescente, no entanto, as determinações consensuais de biomarcadores não são realizadas sistematicamente ou os potenciais marcadores são explorados. Para validar a hipótese de que as metaloproteinases de matriz com atividade gelatinase são biomarcadores do consumo crônico de álcool, foram avaliadas amostras de sangue cd 100 alcoólatras que começaram a ser tratadas na Unidad de Trastornos Relacionados con el Alcohol e 50 doadores não-alcoólatras saudáveis. As amostras alcoólicas apresentaram atividade de gelatinase que triplicou a dos controles e pequenos más significativos aumentos nos níveis de γ-glutamil transferase, aspartato-aminotransferase e volume médio celular. Os valores de transferrina deficientes em carboidratos foram menores nos alcoolistas que nos controles. Esses resultados permitem que as gelatinases sejam propostas como os indicadores mais sensíveis do consumo sustentado de álcool na população analisada, uma vez que as enzimas hepáticas e o volume celular médio apresentam uma tendência consistente com a literatura, mas não alcançaram valores associados à patologia. Como a transferrina deficiente em carboidratos é considerada o biomarcador indireto mais sensível e específico do consumo crônico de álcool, os valores mais baixos em alcoólatras do que em controles sugerem problemas metodológicos que poderiam ser sanados pela aplicação de outras técnicas de mensuração pela presença de interferências que deben ser identificadas. Finalmente, esses achados justificam uma extensão deste trabalho piloto, bem como estudos adicionais voltados para a participação de metaloproteinases de matriz com atividade de gelatinase nas cascatas de danos associados ao consumo crônico de álcool.