Hidronefrosis como causa de poliglobulia secundaria / Hydronephrosis as a cause of secondary polyglobulia

La policitemia primaria es producida por una mutación adquirida o heredada en las células progenitoras de los glóbulos rojos, mientras que la poliglobulia secundaria está relacionada con un aumento de la eritropoyetina sérica como respuesta a la hipoxia tisular o a la producción autónoma tumoral. Hace más de medio siglo que se conoce que la hidronefrosis puede actuar como una rara causa de eritrocitosis debido al aumento de producción de eritropoyetina por un riñón que censa una disminución de oxígeno, mecanismo también observado en la estenosis de la arteria renal y en los quistes renales. Se describe a continuación el caso de un paciente de 38 años con poliglobulia atendido en el Hospital Italiano de San Justo (Argentina), que presenta como hallazgo una hidronefrosis unilateral severa y cuya resolución quirúrgica a través de una nefrectomía revierte el cuadro hematológico de base. (AU)

Primary polycythemia is produced by an acquired or inherited mutation in progenitor cells of red blood cells, while secondary polyglobulia is related to an increase in serum erythropoietin in response to tissue hypoxia or autonomous tumor production. Since the middle of the twentieth century, the hydronephrosis is known to be a rare etiology of secondary polycythemia, with increased erythropoietin production caused by diminished oxygen sensing by the kidney, also seen in renal artery stenosis and kidney cysts. We describe a case of a 38 year old patient with polycythemia studied in the "Hospital Italiano de San Justo" (Argentina) that presented an incidental severe unilateral hydronephrosis, and nephrectomy was carried out as a final resolution of the hematological disorder. (AU)

Anemia among pregnant women attending primary healthcare units in the municipality of São Paulo, Brazil: evaluations after the mandatory fortification of wheat and maize flours with iron

BACKGROUND: Improvements in the iron status of a population as result of food fortification are expected at the long term. In Brazil, the effectiveness of mandatory flour fortification with iron has been evidenced mostly from surveys on gestational anemia after 1 or 2 years from its implementation, in 2004. Our aim was to assess hemoglobin (Hb) concentrations and the prevalences of anemia and linked erythrocyte morphology patterns among pregnant women in 2006 and 2008.METHODS: The study design was retrospective and cross-sectional. The analysis was based on secondary data in 546medical records from women at the times of their first prenatal attendance in 13 public primary healthcare units of the Butantan Administrative Region from São Paulo (SP), Brazil. Anemia was evaluated from Hb concentration (cut-off <11.0 g/dL) and erythrocyte morphology patterns from mean corpuscular volume (MCV), mean corpuscular Hb concentration (MHC), and red cell distribution widths (RDW). Recorded sociodemographic and obstetric data included maternal age, gestational age, ethnoracial self-classification, and residence type. Student's t tests, analysis of variance, Chi-squared tests, and multiple linear and logistic regressions were employed in the statistical analysis using a significance level of 5 %.RESULTS:The prevalence of anemia was 9.7 % in 2006 and 9.4 % in 2008 (P= 0.922), with no significant difference in mean Hb concentrations (P= 0.159). Normocytosis (normal MVC), normochromia (normal MHC), and anisocytosis (high RDW) were found in most anemia cases, suggesting that the low Hb concentrations resulted from mixed causes. In multiple regression analysis, gestational age at the first prenatal attendance was an independent predictor of low Hb and of having anemia. Moreover, black ethnoracial self-classification was associated with lower Hb. CONCLUSIONS: The prevalence of gestational anemia was low among women in both of the studied periods, representing a mild public health problem. Our results highlight the importance of early prenatal care as a means of reducing gestation-associated risks. The erythrocyte morphology pattern found in most cases of low Hb levels suggests that, besides iron deficiency, hemoglobin pathies and nutritional deficiencies of folate and vitamin B12 are common complicating factors of gestational anemia in our setting.

Foreign Bodies in the Ear, Nose and Throat: An Experience in a Tertiary Care Hospital in Central Nepal

Introduction A foreign body (FB) is an object or substance foreign to the location where it is found. FBs in the ear, nose, and throat are a common problem frequently encountered in both children and adults. Objective To analyze FBs in terms of type, site, age, and gender distribution and method of removal. Methods A retrospective study was performed in a tertiary care hospital in the central part of Nepal. The study period was from June 2013 to May 2014. The information was obtained from hospital record books. Results A total of 134 patients had FBs in the ear, nose, or throat; 94 were males and 40 were females. Of the 134 patients, 70 (52.23% ) had FB in the ear, 28 (20.89% ) in the nose, and 36 (26.86% ) in the throat. The FB was animate (living) in 28 (40% ) patients with FB in the ear and 1 (3.5% ) patient with FB in the nose, but the FB was inanimate (nonliving) in any patient with FB in the throat, in 42 (60% ) patients with FB in the ear FB, and in 27 (96.4% ) patients with FB of the nose. The FB was removed with or without local anaesthesia (LA) in 98 (73.13% ) patients, and only 36 patients (26.86% ) required general anaesthesia (GA). The most common age group affected was <10 years. Conclusion FBs in the ear and nose were found more frequently in children, and the throat was the most common site of FB in adults and elderly people. Most of the FBs can be easily removed in emergency room or outpatient department. .

Alteraciones hematológicas en la diabetes mellitus / Blood disorders in diabetes mellitus

Although it has been treated in a limited way the relationship between diabetes and hematopoietic system, there is evidence demonstrating thedeleterious effect of hyperglycemia on the three cell lines: red blood cells, white cells and platelets. Different forms of anemia associated with hyperglycemia are analyzed and erythrocyte alterations observed in diabetes. In chronic decompensated patients have been demonstrated alterationsof monocytes, lymphocytes and polymorphonuclear particularly, with decreased chemotaxis, adherence, phagocytosis and opsonization. Hyperglycemia determines a prothrombotic state by platelet hyperreactivity, which is a marker of inflammation...

Apoptosis of non-parasitised red blood cells in Plasmodium yoelii malaria

Recently, while studying erythrocytic apoptosis during Plasmodium yoelii infection, we observed an increase in the levels of non-parasitised red blood cell (nRBC) apoptosis, which could be related to malarial anaemia. Therefore, in the present study, we attempted to investigate whether nRBC apoptosis is associated with the peripheral RBC count, parasite load or immune response. To this end, BALB/c mice were infected with P. yoelii 17XL and nRBC apoptosis, number of peripheral RBCs, parasitaemia and plasmatic levels of cytokines, nitric oxide and anti-RBC antibodies were evaluated at the early and late stages of anaemia. The apoptosis of nRBCs increased at the late stage and was associated with parasitaemia, but not with the intensity of the immune response. The increased percentage of nRBC apoptosis that was observed when anaemia was accentuated was not related to a reduction in peripheral RBCs. We conclude that nRBC apoptosis in P. yoelii malaria appears to be induced in response to a high parasite load. Further studies on malaria models in which acute anaemia develops during low parasitaemia are needed to identify the potential pathogenic role of nRBC apoptosis.

A Case of Hereditary Spherocytosis Coexisting with Gilbert's Syndrome / 대한소화기학회지

We recently encountered a case of hereditary spherocytosis coexisting with Gilbert's syndrome. Patient was initially diagnosed with Gilbert's syndrome and observed, but other findings suggestive of concurrent hemolysis, such as splenomegaly and gallstones were noted during the follow-up period. Therefore, further evaluations, including a peripheral blood smear, osmotic fragility test, autohemolysis test, and red blood cell membrane protein test were performed, and coexisting hereditary spherocytosis was diagnosed. Genotyping of the conjugation enzyme uridine diphosphate-glucuronosyltransferase was used to confirm Gilbert's syndrome. Because of the high prevalence rates and similar symptoms of these 2 diseases, hereditary spherocytosis can be masked in patients with Gilbert's syndrome. In review of a case and other article, the possibility of the coexistence of these 2 diseases should be considered, especially in patients with unconjugated hyperbilirubinemia who also have splenomegaly and gallstones.

Detection and quantification of Duffy antigen on bovine red blood cell membranes using a polyclonal antibody / Detecção e quantificação do antigeno Duffy nos eritrócitos de bovinos empregando um anticorpo policlonal

Babesiosis is one of the most important diseases affecting livestock agriculture worldwide. Animals from the subspecies Bos taurus indicus are more resistant to babesiosis than those from Bos taurus taurus. The genera Babesia and Plasmodium are Apicomplexa hemoparasites and share features such as invasion of red blood cells (RBC). The glycoprotein Duffy is the only human erythrocyte receptor for Pasmodium vivax and a mutation which abolishes expression of this glycoprotein on erythrocyte surfaces is responsible for making the majority of people originating from the indigenous populations of West Africa resistant to P. vivax. The current work detected and quantified the Duffy antigen on Bos taurus indicus and Bos taurus taurus erythrocyte surfaces using a polyclonal antibody in order to investigate if differences in susceptibility to Babesia are due to different levels of Duffy antigen expression on the RBCs of these animals, as is known to be the case in human beings for interactions of Plasmodium vivax-Duffy antigen. ELISA tests showed that the antibody that was raised against Duffy antigens detected the presence of Duffy antigen in both subspecies and that the amount of this antigen on those erythrocyte membranes was similar. These results indicate that the greater resistance of B. taurus indicus to babesiosis cannot be explained by the absence or lower expression of Duffy antigen on RBC surfaces.

As doenças infecciosas e parasitárias causam perdas importantes em vários setores da produção da pecuária mundial. Estima-se que mais de 600 milhões de bovinos de países tropicais e subtropicais estejam expostos à infecção por Babesia sp. gerando grande prejuízo econômico. Os gêneros Babesia e Plasmodium são hemoparasitas pertencentes ao filo Apicomplexa e apresentam características comuns no processo de invasão eritrocitária. A babesiose bovina causada por Babesia bigemina e Babesia bovis apresenta sinais clínicos similares a malária humana causada por Plasmodium vivax e Plasmodium falciparum. A glicoproteína Duffy é a única receptora para o P. vivax em humanos. A maioria dos indivíduos negros africanos é resistente a este parasita devido a uma mutação que provoca a ausência de expressão desta glicoproteína na superfície das hemácias. Tendo em vista este fato, e que animais da subespécie Bos taurus taurus são mais susceptíveis à babesiose quando comparados à animais Bos taurus indicus, objetivou-se neste trabalho a detecção e quantificação do antígeno Duffy na superfície dos eritrócitos de bovinos empregando para tal, anticorpo policlonal que permitisse investigar se as diferenças na susceptibilidade são devido a diferentes níveis de expressão do antígeno Duffy nas hemácias. Ensaios de ELISA mostraram que o anticorpo produzido foi capaz de reconhecer o antígeno Duffy presente nas hemácias bovinas e a análise quantitativa não demonstrou diferença significativa na presença do mesmo. Estes resultados sugerem que a resistência maior dos zebuínos à babesiose não se deve à ausência de expressão, ou à presença em menor quantidade do antígeno Duffy na superfície de suas hemácias.

Acute aerocistitis induced by thioglycolate, lipopolysaccharide and inactivated Aeromonas hydrophila in Piaractus mesopotamicus: hematological effects / Aerocistite aguda induzida por tioglicolato, lipolisacarídeo e Aeromona hydrophila inativada em Piaractus mesopotamicus: efeitos hematológicos

The effects of swim bladder injection with thioglycolate, Escherichia coli lipopolysaccharide (LPS) and heat-inactivat ed Aeromonas hydrophila were assessed on hematological responses in pacu, Piaractus mesopotamicus (Characidae). A quantitative assessment was done on erythrocytes, thrombocytes e leucocytes at 6, 24, and 48 h pos-injection of the inflammatory agents and compared with fish injected with saline solution (control). Fish injected with inactivated A. hydrophila showed a reduction of erythrocytes and hemoglobin, whereas the hematocrit increased 6 h pos-injection. The results show that thioglycolate and LPS also induced a reduction on hemoglobin and an increase on the hematocrit. The thrombocytes count decreased 6 h post A. hydrophila injection, whereas increased 48 hours post LPS injection. The leukocytes count increased after 6 h post A. hydrophila injection, while the lymphocytes and PAS-positive granularleukocytes (PAS-LG) count decreased after 24 h post injection. In fish injected with thioglycolate or with LPS showed an increase in the LG-PAS counts when compared to A. hydrophila or control groups. The monocytes count was not affected by the different inflammatory agents.

Os efeitos da injeção de tioglicolato, lipolissacarídio de Escherichia coli e Aeromonas hydrophila inativada na bexiga natatória de pacus, Piaractus mesopotamicus (Characidae) foram avaliados quanto às respostas de células vermelhas, leucócitos e trombócitos do sangue. Ensaios quantitativos de eritrócitos, leucócitos e trombócitos foram realizados 6, 24 e 48 h após os estímulos e comparados com peixes que receberam solução salina 0,65% pela mesma via. Peixes inoculados com A. hydrophila apresentaram redução do número de eritrócitos e da taxa de hemoglobina enquanto o hematócrito aumentou 6 h após o estímulo. Os resultados mostraram que o tioglicolato e o LPS também induziram redução da hemoglobina e aumento do hematócrito. A contagem de trombócitos diminuiu 6 h após a inoculação de A. hydrophila inativada e aumentou 48 horas após a injeção de LPS. A contagem de leucócitos aumentou 6 h após a inoculação de A. hydrophila enquanto a de linfócitos a leucócitos granulares PAS positivos (PAS_LG) diminuiu 24 h depois. Peixes injetados com tioglicolato o LPS apresentaram aumento do número de LG_PAS em relação aos inoculados com A. hydrophila inativada ou grupo controle. A contagem de monócitos não foi afetada pelos diferentes agentes.

Alteración de la carga eritrocitaria utilizando el método de azul Alcian en extractos de Ascaris lumbricoides / Change of erythrocyte charge with the use of Alcian blue method in Ascaris lumbricoides extracts

Introducción: el estudio de las interacciones hospedador-parásito es un nuevo desafío para comprender aspectos del metabolismo parasitario, los mecanismos de invasión, escape inmunológico y daño. Ascaris lumbricoides puede provocar anemia y trombosis. Previamente se demostró que este parásito altera la carga superficial eritrocitaria, lo cual indica que puede captar ácido siálico del glóbulo rojo. Objetivo: estudiar el efecto producido por extractos del parásito adulto sobre la carga eritrocitaria, utilizando el método de azul Alcian y comparar su sensibilidad con el método de Polibrene. Métodos: se trabajó con 55 extractos parasitarios [EA] y con suspensiones de eritrocitos grupo O. Se realizó el tratamiento de los glóbulos incubando el sedimento con igual volumen de [EA] a 37 ºC durante 1 h. El Control (eritrocitos sin contacto con [EA]) fue incubado con tampón fosfato pH 7,4. Se aplicó el método de azul Alcian y se determinó la carga aniónica eritrocitaria porcentual (CAE por ciento) en el Control y en los glóbulos tratados. Se definió el coeficiente experimental de carga aniónica eritrocitaria (Cexp CAE), como el cociente entre CAE por ciento final e inicial. Resultados: se observó que 27 de los 55 [EA] (49,1 por ciento) modificaron la carga de los glóbulos rojos, el Cexp CAE para estos eritrocitos resultó 0,75 ± 0,1144 y para los que no mostraron variación de carga de 0,94 ± 0,04450. El análisis estadístico concluyó que los métodos de Polibrene y de azul Alcian tienen sensibilidades comparables (p> 0,20). Conclusiones: Ascaris lumbricoides es capaz de captar ácido siálico del eritrocito, lo que contribuiría a explicar la trombosis atribuida al parásito, pero también sugeriría que el nematodo lo podría utilizar en sus rutas metabólicas o en sus estrategias de evasión inmunológica.

Introduction: the study of the host-parasite interactions is a new challenge to understanding some aspects of the parasitic metabolism and the mechanisms of invasion, immunological evasion and damage. Ascaris lumbricoides may cause anemia and thrombosis. It was previously shown that Ascaris lumbricoides modified the superficial charge of erythrocytes, which means that the parasite can capture sialic acid from the red blood cell. Objective: to study the effect of adult parasite extracts on the erythrocyte charge using the Alcian Blue method and to compare its sensitivity with the Polybrene method. Methods: fifty five adult parasite extracts and Group O erythrocyte suspensions were used. The erythrocytes were treated by incubating the sediment with an equal volume of parasite extracts for one hour at 37 ºC. The control group (erythrocytes without any contact with the parasite extracts) was incubated with pH 7.4phosphate buffer solution. Alcian Blue method was applied and the percentage erythrocyte anionic charge was determined in the control group and in the treated red cells. The experimental coefficient of erythrocyte anionic charge was defined as the quotient between the initial and the final percentage erythrocyte anionic charge. Results: it was shown that 27 out of 55 parasite extracts (49.1 percent) modified the charge of the red blood cells, being their experimental coefficient of the erythrocyte anionic charge 0.75 ± 0.1144 whereas the same coefficient amounted to 0,94 ± 0.0445 for those which did not show any charge variation. The statistical analysis concluded that the Polybrene and Alcian Blue Methods had comparable sensitivities (p>0.20). Conclusions: A. lumbricoides is able to capture sialic acid from the erythrocyte, which would not only explain the thrombosis attributed to the parasite, but also suggest that the nematode could use this acid either in its metabolic routes or for its strategies of immunological evasion.

Pregnancy malaria: cryptic disease, apparent solution

Malaria during pregnancy can be severe in non-immune women, but in areas of stable transmission, where women are semi-immune and often asymptomatic during infection, malaria is an insidious cause of disease and death for mothers and their offspring. Sequelae, such as severe anaemia and hypertension in the mother and low birth weight and infant mortality in the offspring, are often not recognised as consequences of infection. Pregnancy malaria, caused by Plasmodium falciparum, is mediated by infected erythrocytes (IEs) that bind to chondroitin sulphate A and are sequestered in the placenta. These parasites have a unique adhesion phenotype and distinct antigenicity, which indicates that novel targets may be required for development of an effective vaccine. Women become resistant to malaria as they acquire antibodies against placental IE, which leads to higher haemoglobin levels and heavier babies. Proteins exported from the placental parasites have been identified, including both variant and conserved antigens, and some of these are in preclinical development for vaccines. A vaccine that prevents P. falciparum malaria in pregnant mothers is feasible and would potentially save hundreds of thousands of lives each year.

On cytoadhesion of Plasmodium vivax: raison d'être?

It is generally accepted that Plasmodium vivax, the most widely distributed human malaria parasite, causes mild disease and that this species does not sequester in the deep capillaries of internal organs. Recent evidence, however, has demonstrated that there is severe disease, sometimes resulting in death, exclusively associated with P. vivax and that P. vivax-infected reticulocytes are able to cytoadhere in vitro to different endothelial cells and placental cryosections. Here, we review the scarce and preliminary data on cytoadherence in P. vivax, reinforcing the importance of this phenomenon in this species and highlighting the avenues that it opens for our understanding of the pathology of this neglected human malaria parasite.

Alteración de la carga aniónica superficial de glóbulos rojos y glóbulos rojos desializados por Ascaris lumbricoides / Alteration in superficial anionic charge of erythrocytes and desialated erythrocytes caused by Ascaris lumbricoides

INTRODUCCIÓN: eL ácido siálico del eritrocito tiene importancia hemorreológica y hemodinámica. Su disminución promueve la agregación eritrocitaria y la reducción del flujo sanguíneo. OBJETIVO: estudiar el efecto producido por A. lumbricoides sobre la carga aniónica de eritrocitos y eritrocitos desializados, en función del tiempo de contacto de los glóbulos rojos con extractos del parásito. MÉTODOS: se trabajó con 20 extractos parasitarios ([EA]) y con suspensiones de eritrocitos Grupo O en medio salino (GR) y en medio enzimático de bromelina (GR B). Se realizó el tratamiento de los glóbulos incubando el sedimento globular con igual volumen de extractos parasitarios a 37 ºC durante 15, 30, 45, 60, 90 y 120 min. Para cada tiempo de tratamiento hubo un control (eritrocitos sin contacto con extractos parasitarios). Se aplicó simultáneamente el método de Polibrene en el control, GR y GR B. Se asignó una puntuación a cada agregación obtenida. Se calculó CexpCAS[EA] como el cociente entre la puntuación del control y de los eritrocitos tratados. RESULTADOS: los análisis estadísticos permitieron concluir que el tiempo de tratamiento de GR y GR B tuvo un efecto altamente significativo sobre el valor del CexpCAS[EA]; la mediana de CexpCAS[EA] fue significativamente mayor para GR respecto de GR B; la captación de ácido siálico en GR fue mayor a partir de los 90 min, mientras que en GR B fue menor a los 15 min, sin diferencias significativas entre los demás tiempos de tratamiento. Los resultados mostraron que la captación de ácido siálico por el parásito dependió del tiempo de tratamiento y que el extracto parasitario provocó mayor alteración en la carga superficial de GR B. CONCLUSIONES: la disminución de ácido siálico podría relacionarse con la trombosis y la anemia comunicadas en ascariosis. La experiencia permite suponer que el efecto del parásito puede tener mayor relevancia en individuos con diabetes e hipertensión.

INTRODUCTION: sialic acid of the erythrocytes has hemorreologic and hemodynamic importance, so its reduction causes erythrocyte aggregation and low blood flow. OBJECTIVE: to study the effect of A. lumbricoides on the anionic charge of erythrocytes and of desialated erythrocytes, taking the time of contact of the erythrocytes with parasite extracts into account. METHODS: twenty parasite extracts and Group O erythrocyte suspensions in saline medium (GR) and in bromelin enzymatic medium (GRb) were used. The erythrocytes were treated by incubating the globular sediment with the same volume of parasite extracts, at 37 ºC for 15, 30, 45, 60 , 90 and 120 min. There was a control for each treatment interval (erythrocytes without contact with parasite extracts). The polybrene´s method was simultaneously applied to the controls, the GR ad the GRb. Each obtained aggregation was given a scoring. CexpCAS[EA] was calculated as the quotient between the treated erythrocytes scoring and the control scoring. RESULTS: the statistical analysis allowed arriving to the conclusion that the time of GR and GR B treatment had a highly significant effect on the value of CexpCAS[EA]; the median of CexpCAS[EA]; was significantly higher for GR than for GR B; the sialic acid uptake in GR was higher from 90 minutes on, whereas this parameter was lower in GR B at 15 min; no significant differences were observed for the rest of the treatment times. The results showed that the sialic acid uptake by the parasite depended on the time of treatment and that the parasite extract caused more alteration in the superficial charge of GR B. CONCLUSIONS: the reduction of sialic acid could be related to thrombosis and anemia in ascariosis. The experience gained allows us to consider that the effect of the parasite may be more significant in diabetic and hypertensive individuals.

Ascaris lumbricoides: alteration of the erythrocyte superficial charge using the Partition Method in aqueous two-phase system / Ascaris lumbricoides: alteración de la carga superficial eritrocitaria usando el Método de Partición en sistemas bifásicos acuosos

Sialic acid is responsible for the negative charge of the erythrocyte. The decrease of sialic acid has hemodynamical and hemorheological importance. The aim was to study the effect of A. lumbricoides on the erythrocyte superficial charge using the Partition Method in aqueous two-phase system in order to indirectly evaluate the alteration of sialic acid in the red cells. We worked with five parasite extracts (AE) and larvae concentrate (LC). Erythrocyte superficial charge was studied by working with non-treated (Controls) and treated erythrocytes. The treatment consisted of incubating the erythrocytes with AE or LC for 30 minutes at 4 ºC, 20 ºC and 37 ºC. The red cells were separated in a sensitive charge two-phase system (Dx/ PEG). The partition coefficient (P) of treated and untreated erythrocytes were calculated. The results showed a P decrease at the three temperatures for red cells treated with four of the AE. The remaining extract did change P values at any of the temperatures studied. The erythrocytes treated with LC showed a decrease in the P value at 37 ºC and 4 ºC but no change was observed at 25 ºC. Statistical analysis concluded that P values were significantly lower in treated erythrocytes than in their corresponding untreated ones (p < 0.05). The Partition Method showed that this parasite alters the erythrocyte superficial charge which may indicate that it can catch sialic acid.

La disminución de ácido sialico, responsable de la carga negativa del eritrocito, tiene importancia hemodinámica y hemorreológica. El objetivo fue estudiar el efecto de A. lumbricoides sobre la carga superficial eritrocitaria aplicando el método de partición en sistemas bifásicos acuosos, a los fines de evaluar de manera indirecta la alteración de acido sialico de los eritrocitos. Se trabajó con 5 extractos del parásito adulto (EA) y con un concentrado de larvas (500-600 larvas/mL) (CL). Se estudió la carga superficial eritrocitaria, trabajando con eritrocitos no tratados y tratados. El tratamiento consistió en la incubación de los eritrocitos con EA o CL durante 30 minutos a 4 ºC, 25 ºC y 37 ºC. Los eritrocitos fueron sometidos a la separación en un sistema bifásico carga sensible constituido por Dx / PEG. Se calculó el coeficiente de reparto (P), de los eritrocitos sin tratar y tratados. Los resultados mostraron disminución de P a las 3 temperaturas, en hematíes tratados con 4 de los EA. El EA restante no modificó los valores de P a ninguna de las temperaturas estudiadas. CL produjo la disminución de P a 37 ºC y 4 ºC, pero no se observó modificación a 25 ºC. Los análisis estadísticos concluyeron que los valores de P son significativamente menores en los eritrocitos tratados que en los respectivos eritrocitos sin tratar (p < 0.05). El método de partición demostró que A. lumbricoides altera la carga superficial eritrocitaria lo que indicaría que el parásito, tanto en su estado adulto como en sus fases larvales, puede captar acido sialico.

Antioxidant potential of the root of Vetiveria zizanioides (L.) Nash.

Vetiveria zizanioides, an aromatic plant commonly known as vetiver has been used for various ailments. The essential oil of vetiver root has been shown to possess antioxidant activity. However, antioxidant potential of spent root extract has not been reported. Hence, in the present study, ferric reducing, free radical scavenging and antioxidant activity of two genotypes namely KS1 and gulabi of V. zizanioides L. Nash root were investigated using in vitro assays - the ferric reducing antioxidant power (FRAP), 1,1-diphenyl-2-picrylhydrazyl (DPPH), total phenolic content (TPC), total antioxidant capacity (TAC) and reducing power (RP). KS1 genotype showed higher FRAP values, DPPH inhibition, TPC and RP potential compared to gulabi and the antioxidant activity increased with the concentration of the extract (10-1000 microg/mL). A significant protective effect of cv KS1 (100 microg/mL) extract was also observed in reduced glutathione (GSH) and malondialdehyde (MDA) concentrations of erythrocytes subjected to oxidative stress by tert-butyl hydroperoxide (t-BHP) and hydrogen peroxide (H202). The cv KS1 showed better antioxidant activity, compared to cv gulabi indicating the possibility of exploring the presence of different phytoconstituents in the two varieties.

Caracterização das áreas hemófagas da placenta bovina / Characterization of hemophagous areas of the bovine placenta

A região específica da interface materno-fetal corresponde à zona arcada do placentônio ovino e caprino. Em pequenos ruminantes esta área é também caracterizada por sangue materno extravasado (áreas hemófagas). É possível que o ferro seja transferido para o feto por eritrofagocitose trofoblástica nestas áreas. Para investigar as áreas hemófagas na placenta bovina, foram analisados placentônios de 34 vacas zebuínas gestantes (dois a três, quatro a seis, sete a oito, e nove meses de prenhez). O material foi fixado com solução aquosa de formaldeído a 10 por cento e paraformaldeído a 4 por cento, em tampão fosfato, pH 7,4, 0,1M, sendo processado e corado para microscopia de luz e histoquímica. Os hematomas placentários foram observados entre o epitélio uterino e trofoblástico, a partir de três meses de prenhez. A presença de eritrócitos nas células trofoblásticas elucidou a eritrofago-citose. A reação histoquímica de Perl's permitiu provar a existência de ferro férrico no trofoblasto. A reação de PAS foi po-sitiva, marcando substância mucóide nas células epiteliais e, principalmente, nas células binucleadas do epitélio fetal. Baseando-se nas características histológicas e histoquímicas, inferimos que as áreas hemófagas são sítios importantes para a transferência de ferro na placenta bovina.

The specific region of maternal fetal interface needs to be clarified and corresponds to the "arcade zone" of sheep and goat placentomes. In small ruminants that area is also characterized by macroscopic blood extravasation (hemophagous areas). This occurs possibly because the iron is transferred to the embryo by trophoblastic erytrophagocytosis in these hemophagous placental areas. In order to investigate the hemophagous placental areas in cattle, placentomes of 34 pregnant Bos indicus cows (2-3, 4-6, 7-8 and 9 months of gestation) were analyzed. They were fixed by perfusion with 10 percent formaldehyde aqueous solution and 4 percent paraformoldehyde in PBS, pH 7.4, 0.1M, processed and stained for light microscopy and histochemistry. The methodology used allowed to observe placental haematomes between the uterine and trophoblastic epithelium since 3 months of pregnancy. Erythrocytes had been found in the trophoblastic cells, elucidating the erytrophagocytosis. Through Perl's histochemical reaction it was possible to prove the existence of ferric iron in the trophoblastic cells. The PAS reaction was positive staining mucoid substance in the epithelial cells, especially in the binucleate cells of the fetal epithelium. Based on histology and histochemistry, it can be inferred that the hemophagous areas are important sites for iron transfer in the bovine placenta.

RBC aggregation: laboratory data and models.

The reversible aggregation of red blood cells (RBC) into linear and three-dimensional structures continues to be of basic science and clinical interest: RBC aggregation affects low shear blood viscosity and microvascular flow dynamics, and can be markedly enhanced in several clinical states. Until fairly recently, most research efforts were focused on relations between suspending medium composition (i.e., protein levels, polymer type and concentration) and aggregate formation. However, there is now an increasing amount of experimental evidence indicating that RBC cellular properties can markedly affect aggregation, with the term "RBC aggregability" coined to describe the cell's intrinsic tendency to aggregate. Variations of aggregability can be large, with some changes of aggregation substantially greater than those resulting from pathologic states. The present review provides a brief overview of this topic, and includes such areas as donor-to-donor variations, polymer-plasma correlations, effects of RBC age, effects of enzymatic treatment, and current developments related to the mechanisms involved in RBC aggregation.

Defectos eritrocíticos y densidad de la parasitemia en pacientes con malaria por Plasmodium falciparum en Buenaventura, Colombia / Erythrocyte defects and parasitemia density in patients with Plasmodium falciparum malaria in Buenaventura, Colombia

OBJETIVOS: Determinar la prevalencia de algunos defectos eritrocíticos y evaluar su relación con la densidad de la parasitemia en personas con diagnóstico de malaria (paludismo) por Plasmodium falciparum en una población del Pacífico colombiano. MÉTODOS: Se realizó un estudio de prevalencia en 242 personas con malaria por P. falciparum que consultaron al Programa de Enfermedades Tropicales en la ciudad de Buenaventura, Colombia. Se midieron los niveles de parasitemia y se determinó la presencia de defectos eritrocíticos congénitos (deficiencia de glucosa-6-fosfato deshidrogenasa [G6PD] y presencia de hemoglobinas anormales y de talasemias) y de otros factores potencialmente relacionados con los niveles de parasitemia. RESULTADOS: La prevalencia obtenida de defectos eritrocíticos fue de 26,4 por ciento (IC95 por ciento 21,0 a 32,5), similar a la hallada en estudios realizados antes en la misma zona. En los modelos de regresión múltiple, las personas con drepanocitosis o deficiencia total de la G6PD presentaron una menor densidad de parasitemia que las personas sin defecto, y el riesgo de parasitemias altas fue menor en estas personas después de ajustes respecto a otras variables de interés (razón de posibilidades [odds ratio, RP]: 0,30 y 0,72, respectivamente). CONCLUSIONES: Los resultados confirman una alta prevalencia de defectos eritrocíticos en el Pacífico colombiano, en una población con características étnicas similares a las de algunas poblaciones del Africa Occidental, y aportan información en favor de la existencia de resistencia innata a la malaria en personas portadoras de hemoglobina AS o con deficiencia de la G6PD.

Red cell distribution width in the diagnosis of iron deficiency anemia.

OBJECTIVE: 1. To compare peripheral smear (PS) and Red cell distribution width (RDW) in diagnosis of Iron deficiency anemia (IDA) in various grades. 2. To study the changes in RDW and PS after therapy. METHODS: Children in the age group of six months to five years with microcytic (MCV<80fl) anemia (Hemoglobin <11 g%) were evaluated. Those who had received blood transfusion and /or were already on iron therapy were excluded. Evaluation included clinical examination, complete blood count (CBC), RDW estimation microscopic examination of peripheral smear, measurement of serum iron and transferrin saturation. Children with IDA were treated with oral iron for 8 weeks and PS, CBC including RDW were repeated. RESULT: Of the 100 children evaluated, 89 had IDA. 48% had mild, 42% had moderate and 10% had severe anemia. Transferrin saturation correlated with severity of anemia. Peripheral smear showed microcytosis and hypochromia in all cases with severe anemia, 61.5% and 22.5% of those with moderate and mild anemia respectively. RDW was suggestive of iron deficiency in 100%, 82.05% and 100% of patient with mild, moderate and severe anemia respectively. CONCLUSION: In the diagnosis of mild and moderate iron deficiency anemia, RDW had a higher sensitivity than PS. Red cell morphology, Hb, PCV and RDW showed significant improvement after iron-therapy.

Erythrophagocytosis assay in patients with autoimmune hemolytic anemia

The aim of this paper is to evaluate the erythrophagocytosis assay (EA) in patients with autoimmune hemolytic anemia (AIHA). Direct antiglobulin test (DAT), indirect antiglobulin test (ITA) and EA were performed in blood samples from 46 patients with presumed AIHA. The EA was carried out incubating patients'erythocytes and peripheral blood monocyte. A total of 200 monocytes were analysed to determine the percentage of active phagocytic cells (porcentage APC). In 9 of these patients the applied treatment was evaluated by DAT,IAT and EA. In 14 transfusion requirements, the compatibility tets and EA were performed. For EA, patients'monocyte were incubated with erytrocytes from previously selected units sensitized with patients'sera. The porcentage of APC was 32.1 +/- 1.7 in 35 patients with positive DAT and 17.8 +/- 1.3 in 11 patients with negative DAT. This last value was significantly higher than that with negative controls (3.7 +/- 0.3) (p

Microesferocitosis: perfil eritroide y su relación con distintas pruebas de laboratorio / Microspherocytosis: erythroid profile and its relation with different laboratory tests

La esferocitosis hereditaria (EH) es una anemia hemolítica congénita con microesferocitos en sangre periférica y Coombs negativa. Hay heterogeneidad en la clínica, herencia y defectos moleculares (alteración de proteínas de la membrana), pero la EH típica es autosómica dominante, con anemia, ictericia y esplenomegalia. El objetivo de este estudio fue presentar nuestra experiencia y establecer relación entre parámetros hematológicos y bioquímicos, y pruebas de fragilidad osmótica y autohemólisis tradicionalmente diagnósticas. En nuestro medio, la EH ocupa el segundo lugar dentro de las anemias hemolíticas hereditarias, después de la b talasemia menor. El diagnóstico lo basamos en la microesferocitosis, el análisis de RGO y la autohemólisis. Se estudiaron 47 pacientes (45 de origen latino y 2, sajón). Doce pacientes no tenían antecedentes familiares. Valores promedios: hematíes (x1012/L) / hemoglobina (g/dL): niños (22): 3.84/10.5; adultos (25): mujeres (13): 3.54/10.59; hombres (12): 4.65/13.15. La autohemólisis (promedio %) estuvo muy aumentada (15.54) y corrigió con el agregado de glucosa (4.07). La fragilidad corpuscular media (promedio g/dL) estuvo incrementada tanto en sangre fresca (0.48) e incubada (0.65). Haptoglobina ausente se encontró en 76.5% de los niños y 26.7% de los adultos Reticulocitos, bilirrubina indirecta y LDH estuvieron aumentadas (medias 336.35 x109/L, 36.25 mmol/L, 236.48 UI/L, respectivamente). Microcitosis, esferocitosis, policromatofilia, acantocitosis, punteado basófilo, "células pinzadas" fueron observados en 43, 41, 41, 12, 11, 1 pacientes respectivamente. Las alteraciones morfológicas estuvieron más marcadas en los niños. Los resultados del laboratorio podrían ser consecuencia de la microcitosis más que de la esferocitosis