Hematological Reference Values According to Geographical Region in Jujuy, Argentina.

Armella, Flavia Noelia, and Sandra Stella Lazarte. Hematological reference values according to geographical region in Jujuy, Argentina. High Alt Med Biol. 23:232-239, 2022. Background: Hematological values vary with altitude above sea level. The purpose of this work was to determine the ranges of hematological reference, and the prevalence of anemia and erythrocytosis in adult blood donors from Jujuy, discriminated according to the geographical region, who assisted at the Centro Regional de Hemoterapia from 2016 to 2018. Materials and Methods: A cross-sectional retrospective study was carried out. Men and women donors belonging to the regions of Valles, Yungas, Quebrada, and Puna were analyzed. The percentiles 2.5 and 97.5 were obtained for the hemoglobin (Hb), hematocrit (Ht), red blood cell count (RBCC), and hematimetric indices, according to sex and region. Results: A total of 4,707 men and 3,326 women, ranging from 18 to 65 years of age, who met with the expected clinical criteria in donors, were studied. The anemia prevalence was 2.5% (95% confidence interval [CI] = 2.2%-2.8%), while the erythrocytosis was 4.9% (95% CI = 4.4%-5.4%). The RBCC, Hb, and Ht increased with altitude above sea level. Conclusions: The Hb and Ht were similar to those observed in the Andean populations living at similar altitudes. The anemia prevalence was lower than the global prevalence reported by the World Health Organization, while that of erythrocytosis increased with the altitude above the sea level. The evidence indicates the necessity for laboratories to obtain reference values for their target population. Registro Nacional de Investigaciones (Renis, Ministerio de Salud de Argentina) IS002323.

Genetic Regulation of Redox Balance in ß-Thalassemia Trait.

ß-Thalassemia (ß-thal) trait is a heterogeneous group of genetic defects leading to decreased ß-globin production, ineffective erythropoiesis, and oxidative stress. The aim is to evaluate the cytoprotective response, at transcriptional and systemic levels, of the variations of global redox balance in ß-thal trait patients. Sixty-six subjects (40 healthy and 26 with ß-thal trait) were analyzed at the Universidad Nacional de Tucumán, Tucumán, Argentina, between 2016 and 2017. The following parameters were evaluated: complete blood count, iron status, hemoglobin (Hb) electrophoresis, Hb A2, thiobarbituric acid reactive species (TBARS), serum catalase (CAT), and superoxide dismutase (SOD) activity, FOXO3a, NRF2, SOD, PRDX2, CAT, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) gene expression. The ß-thal trait group showed a decrease in Hb levels, MCV, and MCH with higher TBARS levels. The SOD activity was significantly increased by 32.0% in ß-thal trait patients respect to the control group. Relative expression of NRF2 was 4.7-fold higher in ß-thal trait than in the control group, while FOXO3a expression was similar in both groups. The SOD, PRDX2, and proinflammatory cytokines transcriptional expression was significantly upregulated in ß-thal trait patients. This is the first study on the genetic regulation of redox balance in ß-thal trait patients in which interesting modifications were observed in the transcript levels of some redox regulators that could be associated with changes in the erythrocyte proteome in this disorder. A better understanding of the pathophysiological mechanisms present in these heterozygous patients would allow adequate therapy in situations such as growth, pregnancy, or high performance sports, favoring a personalized treatment.

Cryohemolysis, erythrocyte osmotic fragility, and supplementary hematimetric indices in the diagnosis of hereditary spherocytosis.

BACKGROUND: Hereditary spherocytosis (HS) is a chronic hemolytic anemia characterized by microspherocytes in the peripheral blood and increased erythrocyte osmotic fragility (EOF). This study evaluated the cryohemolysis test (CHT); initial hemolysis (IH); immediate and incubated hemolysis percentage in 5.5 g/L NaCl (H5.5); mean corpuscular hemoglobin concentration (MCHC); red blood cell distribution width (RDW); and Hb/MCHC, Hb/RDW, and MCHC/RDW ratios for the diagnosis of HS. METHODS: Data from 13 patients with HS were evaluated at the Instituto de Bioquímica Aplicada and compared with data from 14 unaffected individuals and 11 patients with anemia due to another etiology. Total blood and reticulocyte counts, CHT, and immediate and incubated EOF were performed in all subjects; sensitivity, specificity, efficiency, and Youden index (YI) were calculated. RESULTS: Eight patients with HS had MCHC ≥345 g/L, 10 had RDW ≥14.5%, 12 had IH >5.0 g/L, 11 had immediate H5.5 ≥5%, and 13 had incubated H5.5 ≥50% (the cut-off value to consider HS). The efficiency and YI were: immediate H5.5 (0.94-0.85), incubated H5.5 (0.89-0.82), IH (0.89-0.78), MCHC (0.87-0.62), CHT (0.84-0.54), and Hb/MCHC (0.71-0.56), respectively. The calculated ratios could distinguish subjects with HS from unaffected individuals (P<0.05), but not those with anemia of another etiology (P>0.05). CONCLUSION: Although the CHT and supplementary hematimetric indexes were useful to differentiate individuals with SH from healthy controls, they cannot distinguish from anemias of other etiology. CHT and MCHC, in addition to EOF, are recommended for diagnosing HS patients because of their low cost and efficiency.

Intervalos hematológicos de referencia en la provincia de Jujuy según región geográfica / Hematological reference intervals in the province of Jujuy according to geographic region

INTRODUCCIÓN Numerosos estudios han detectado que existen diferencias en los valores hematológicos obtenidos a distinta altura sobre el nivel del mar, y es importante que cada laboratorio establezca sus intervalos de referencia derivados de la población general saludable que atiende. Ello evitaría que en el acto de donación, cuando se trata de poblaciones de altura, pasen como normales donantes anémicos. OBJETIVO Determinar los intervalos hematológicos de referencia y la prevalencia de anemia en una población adulta, aparentemente sana, donante de sangre de la provincia de Jujuy discriminados según región geográfica, que fueron atendidos en el Centro Regional de Hemoterapia (CRH) durante los años 2016 y 2017. MATERIALES Y MÉTODOS Se realizó un estudio observacional descriptivo retrospectivo de corte transversal. La población estuvo compuesta por donantes del CRH de ambos sexos, pertenecientes a las regiones de Valles, Yungas, Quebrada y Puna. Se obtuvieron los percentiles 2,5 y 97,5 para hemoglobina (Hb), hematocrito (Hto), recuento de glóbulos rojos (RGR) e índices hematimétricos, según sexo y región. En Valles el sexo femenino se dividió en mujeres menores y mayores de 48 años. RESULTADOS Se estudiaron 5.397 varones y 3.693 mujeres, con un rango de edades de 18 a 65 años, que cumplieron con los criterios clínicos deseables en donantes. La prevalencia de anemia fue de 2,0% (IC 95%= 1,7-2,3%). Se comprobó que RGR, Hb y Hto aumentan con la altura sobre el nivel del mar, ya que los valores más bajos pertenecían a Yungas que se encuentra a unos 500 msnm, y los superiores a Puna, situada a más de 3500 msnm. DISCUSIÓN Los valores de Hb y Hto fueron semejantes a los observados en personas que residen en altitudes similares. La prevalencia de anemia obtenida fue inferior a la prevalencia global informada por la Organización Mundial de la Salud. La evidencia de este estudio indica la necesidad de que los laboratorios obtengan los valores de referencia de su población atendida

Prevalencia de sífilis en puérperas sin control serológico en el ultimo mes de gestación y estudio de su relación con factores de riesgo / Syphilis Prevalence in Postpartum Women without Serological Control in the Last Month of Pregnancy and Study of its Relationship with Risk Factors

INTRODUCCION: La transmisión vertical de sífilis puede ocurrir durante el embarazo, parto, puerperio y lactancia. En Argentina, el Sistema Nacional de Vigilancia de la Salud ha observado un aumento de notificaciones de infecciones congénitas, que revela un problema en Salud Pública. OBJETIVOS: Establecer la prevalencia de sífilis en puérperas sin serología en el último mes de gestación; detectar factores que influyeron en dicha prevalencia; e identificar causas de control prenatal (CPN) inadecuado de sífilis. METODOS: Se estudió a 278 puérperas en el Instituto de Maternidad y Ginecología Nuestra Señora de las Mercedes, mediante prueba de VDRL (Venereal Disease Research Laboratory test), TP-PA (Treponema pallidum particle agglutination assay) y una encuesta sobre factores socioeconómicos, conductas de riesgo y factores maternos, entre octubre de 2014 y marzo de 2015. RESULTADOS: La prevalencia fue de 2,9% (IC95%: 1,5-5,6%), con 3 casos de sífilis actual y 5 de sífilis pasada. Los factores de riesgo detectados fueron: ser adulta joven, no trabajar, tener menor número de hijos y haber tenido un mortinato. Un CPN adecuado se relacionó con ser adulta, tener mayor nivel de instrucción y estar casada. No tener hábitos tóxicos actuó como factor de protección, y la causa más frecuente de CPN inadecuado fue la falta de solicitud por el médico. CONCLUSIONES: Se detectó una prevalencia superior a la nacional (1,321%), y se identificaron algunos factores de riesgo. Para prevenir la transmisión de sífilis, sería esencial fortalecer los servicios de atención prenatal existentes.

Foxo3 gene expression and oxidative status in beta-thalassemia minor subjects.

BACKGROUND: Oxidative stress may aggravate symptoms of hemolytic anemias such as beta-thalassemia. FoxO3 activation results in resistance to oxidative stress in fibroblasts and neuronal cell cultures. OBJECTIVE: The purpose of this research was to study FoxO3 gene expression and oxidative status in beta-thalassemia minor individuals. METHODS: Sixty-three subjects (42 apparently healthy individuals and 21 with beta-thalassemia minor) were analyzed at the Universidad Nacional de Tucumán, Argentina, between September 2013 and June 2014. A complete blood count, hemoglobin electrophoresis in alkaline pH and hemoglobin A2 levels were quantified. Moreover, thiobarbituric acid reactive species, erythrocyte catalase activity and iron status were evaluated. Beta-thalassemia mutations were determined by real-time polymerase chain reaction. FoxO3 gene expression was investigated by real-time reverse transcription-polymerase chain reaction using mononuclear cells from peripheral blood. RESULTS: Subjects were grouped as children (≤12 years), and adult women and men. The analysis of erythrocyte catalase activity/hemoglobin ratio revealed a significant difference (p-value <0.05) between healthy and beta-thalassemia minor adults, but no significant difference was observed in the thiobarbituric acid reactive species levels and FoxO3 gene expression (p-value >0.05). Thiobarbituric acid reactive species and the erythrocyte catalase activity/hemoglobin ratio were not significantly different on comparing the type of beta-thalassemia mutation (ß0 or ß+) present in carriers. CONCLUSIONS: The lack of systemic oxidative imbalance demonstrated by thiobarbituric acid reactive species is correlated to the observation of normal FoxO3 gene expression in mononuclear cells of peripheral blood. However, an imbalanced antioxidant state was shown by the erythrocyte catalase activity/hemoglobin ratio in beta-thalassemia minor carriers. It would be necessary to study FoxO3 gene expression in reticulocytes to elucidate the role of FoxO3 in this pathology.

Foxo3 gene expression and oxidative status in beta-thalassemia minor subjects

ABSTRACT Background: Oxidative stress may aggravate symptoms of hemolytic anemias such as beta-thalassemia. FoxO3 activation results in resistance to oxidative stress in fibroblasts and neuronal cell cultures. Objective: The purpose of this research was to study FoxO3 gene expression and oxidative status in beta-thalassemia minor individuals. Methods: Sixty-three subjects (42 apparently healthy individuals and 21 with beta-thalassemia minor) were analyzed at the Universidad Nacional de Tucumán, Argentina, between September 2013 and June 2014. A complete blood count, hemoglobin electrophoresis in alkaline pH and hemoglobin A2 levels were quantified. Moreover, thiobarbituric acid reactive species, erythrocyte catalase activity and iron status were evaluated. Beta-thalassemia mutations were determined by real-time polymerase chain reaction. FoxO3 gene expression was investigated by real-time reverse transcription-polymerase chain reaction using mononuclear cells from peripheral blood. Results: Subjects were grouped as children (≤12 years), and adult women and men. The analysis of erythrocyte catalase activity/hemoglobin ratio revealed a significant difference (p-value <0.05) between healthy and beta-thalassemia minor adults, but no significant difference was observed in the thiobarbituric acid reactive species levels and FoxO3 gene expression (p-value >0.05). Thiobarbituric acid reactive species and the erythrocyte catalase activity/hemoglobin ratio were not significantly different on comparing the type of beta-thalassemia mutation (β0 or β+) present in carriers. Conclusions: The lack of systemic oxidative imbalance demonstrated by thiobarbituric acid reactive species is correlated to the observation of normal FoxO3 gene expression in mononuclear cells of peripheral blood. However, an imbalanced antioxidant state was shown by the erythrocyte catalase activity/hemoglobin ratio in beta-thalassemia minor carriers. It would be necessary to study FoxO3 gene expression in reticulocytes to elucidate the role of FoxO3 in this pathology.

Expresión de genes involucrados en el estrés oxidativo e inflamación en neoplasias hematológicas / Expression of genes involved in oxidative stress and inflammation in hematological neoplasms

INTRODUCCIÓN Varios estudios han encontrado evidencia de estrés oxidativo (EOx) crónico en las neoplasias hematológicas. Sin embargo, la importancia de la asociación entre el EOx y la malignidad actualmente no está clara. OBJETIVOS Analizar la expresión de los genes de las enzimas antioxidantes catalasa (CAT), superóxido dismutasa (SOD) y peroxiredoxina- 2 (PRX-2) y de los genes de IL-6 y TNF-α, y relacionarla con los niveles de expresión del gen Nrf2; establecer la prevalencia de las neoplasias hematológicas (NH) en Tucumán, describir las características demográficas y reconocer factores de riesgo de la población bajo estudio. MÉTODOS Se realizó un estudio descriptivo, entre junio de 2017 y mayo de 2018. Se estudiaron 33 pacientes con NH y 22 controles sanos en el Instituto de Bioquímica Aplicada de UNT. Los sujetos respondieron una encuesta sobre datos personales y factores de riesgo. Se realizó hemograma, técnicas citoquímicas, e inmunofenotipo mediante citometría de flujo. Se evaluó la expresión génica de CAT, SOD, PRX-2, IL-6, TNF-α y Nrf2 por RetroTranscripción-PCR tiempo real. RESULTADOS La prevalencia obtenida fue; leucemias agudas 70%, neoplasias linfoproliferativas (NLP) 12%, síndromes mielodisplásicos (SMD) 9% y neoplasias mieloproliferativas (NMP) 9%. Se detectó asociación significativa (p< 0,05) entre padecer NH con menor nivel educativo, no poseer obra social, tener hábitos tóxicos y no realizar actividad física. El análisis comparativo de los grupos NH mostró una disminución significativa (p<0,05) en la expresión de los genes de las enzimas y de TNF-α en los grupos SMD, NLP y NMP. El nivel de expresión del gen de Nrf2 demostró influencia significativa sobre los niveles de expresión del gen de la PRX-2 (R2= 0,73). DISCUSIÓN Estos hallazgos sentarían las bases de un potencial vínculo entre la disminución de los antioxidantes y el aumento de los niveles de EOx en las NH, además de señalar a Nrf2 como posible gen regulador del sistema antioxidante

Erythrocyte Catalase Activity in More Frequent Microcytic Hypochromic Anemia: Beta-Thalassemia Trait and Iron Deficiency Anemia.

Most common microcytic hypochromic anemias are iron deficiency anemia (IDA) and ß-thalassemia trait (BTT), in which oxidative stress (OxS) has an essential role. Catalase causes detoxification of H2O2 in cells, and it is an indispensable antioxidant enzyme. The study was designed to measure erythrocyte catalase activity (ECAT) in patients with IDA (10) or BTT (21), to relate it with thalassemia mutation type (ß (0) or ß (+)) and to compare it with normal subjects (67). Ninety-eight individuals were analyzed since September 2013 to June 2014 in Tucumán, Argentina. Total blood count, hemoglobin electrophoresis at alkaline pH, HbA2, catalase, and iron status were performed. ß-thalassemic mutations were determined by real-time PCR. Normal range for ECAT was 70,0-130,0 MU/L. ECAT was increased in 14% (3/21) of BTT subjects and decreased in 40% (4/10) of those with IDA. No significant difference (p = 0,245) was shown between normal and BTT groups, while between IDA and normal groups the difference was proved to be significant (p = 0,000). In ß (0) and ß (+) groups, no significant difference (p = 0,359) was observed. An altered ECAT was detected in IDA and BTT. These results will help to clarify how the catalase activity works in these anemia types.

Molecular characterization and phenotypical study of ß-thalassemia in Tucumán, Argentina.

The main hereditary hemoglobin (Hb) disorder in Argentina is ß-thalassemia (ß-thal). Molecular studies performed in the center of the country exhibited a marked prevalence of the codon 39 (C > T) and IVS-I-110 (G > A) mutations. The northwest region of Argentina has a different demographic history characterized by an important Spanish influx. Seventy-one ß-thal carriers attending the Instituto de Bioquímica Aplicada, Tucumán, Argentina, were investigated for ß-globin gene mutations by real-time polymerase chain reaction (RT-PCR). To examine the genotype-phenotype relationship, mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and Hb A2 were measured. In order to recognize ß-thal, Mentzer Index, Shine & Lal and Red Cell Distribution Width Index (RDWI), were calculated. The ethnic background of subjects revealed that 82.0% of the population was of Italian, Spanish and Arab origin. Seven mutations were detected: codon 39 (45.0%), IVS-I-1 (G > A) (22.5%), IVS-I-110 (16.3%), IVS-II-1 (G > A) (4.1%), IVS-I-1 (G > T) (2.0%), IVS-I-6 (T > C) (2.0%) and IVS-II-745 (G > C) (2.0%). In three families (6.1%), ß-thal mutations were not determined. These results differed from other Argentinian studies because at present codon 39 and IVS-I-1 are the most prevalent; MCV, MCH and Hb A2 did not correlate with the type of mutation (ß(0)/ß(+)). Values of MCV (67.0 fL) and Hb A2 (4.85%) were unable to discriminate between them. Significant differences (p < 0.05) in MCV, MCH and Shine & Lal were observed between the undetermined group and the three most common mutations. These data show different patterns of ß-thal mutations in the center and northwest regions of Argentina. Differences might represent the influence of Spanish immigration.

Prevalencia de anemia y deficiencia de hierro, ácido fólico y vitamina b12 en una comunidad wichí del noroeste argentino / Prevalence of anemia and iron, folic acid and vitamin b12 deficiencies in a wichí community from the argentine northwest region

La anemia y la malnutrición son prevalentes en comunidades de bajo nivel socioeconómico y con higiene inadecuada, como las aborígenes wichí que habitan en el noroeste argentino, región con alta prevalencia de enfermedad de Chagas. Objetivo: determinar la prevalencia de anemia y deficiencia de hierro (Fe), ácido fólico (AF) y vitamina B12 (B12) en una comunidad wichí de Salta, y evaluar la presencia de Chagas y talasemias como etiología de anemia. Material y métodos: se realizó un estudio observacional descriptivo en mayo de 2008. Se estudiaron 35 adultos wichí (21 mujeres, 14 hombres) de la comunidad La Unión. El grupo control consistió en 36 criollos adultos (21 mujeres, 15 hombres). Se realizó hemograma, Fe, transferrina, ferritina, AF, B12, electroforesis de hemoglobina (EHb) y serología para Chagas. Resultados: la prevalencia de anemia fue 76% (16/21; Intervalo de Confianza [IC] 95%=57-95%) en las mujeres wichí; en las criollas, 29% (6/21; IC95%=10-48%); en el grupo masculino criollo, 7% (1/15; IC95%=0-20%) y en los wichís, 29% (4/14; IC95%=16-42%). En las mujeres wichí, el 75% (12/16) de los casos fue por deficiencia de Fe. B12 y EHb fueron normales. El 15% (5/33) del grupo wichí y el 31% (11/35) del criollo presentó deficiencia de AF. La prevalencia de Chagas fue 31% (11/35; IC95%=16-46%) en wichís y 28% (10/36; IC95%=13-43%) en criollos, y no estuvo asociada a anemia. Conclusiones: la alta prevalencia de anemia y deficiencia de hierro indican un problema de salud y de nutrición importante en esta comunidad.

Anemia and malnutrition are prevalent in communities of low socioeconomic status and poor hygiene, including Aboriginal Wichí inhabiting the Argentine Northwest, a region with high prevalence of Chagas disease. Objetive: to investigate the prevalence of anemia and deficiencies of iron, folic acid (FA) and vitamin B12 in community wichí of Salta, and assess the presence of Chagas and thalas semia as etiology of anemia. Material and methods: a descriptive study was performed in May 2008. 35 wichí adults (21 women, 14 men) of La Union community were studied. The control group consisted of 36 adult creoles (21 women, 15 men), who shared environmental conditions. Complete blood count, iron, transferrin, ferritin, FA, vitamin B12, hemoglobin electrophoresis (HbE) and Chagas disease serology were performed. Results: the prevalence of anemia was 76% (16/21 Confidence Interval [CI] 95%=57-95%) in wichí women; in creole women, 29% (6/21, 95% CI=10-48%); in creole male group, 7% (1/15, 95% CI=0-20%) and wichí men group, 29% (4/14, 95% CI=16-42%). In anemic wichí women, 75% (12/16) of cases were produced by iron deficiency. Vitamin B12 levels and HbE were normal. FA deficiency was presented in 15% (5/33) of wichí group and 31% (11/35) of creole people. Chagasic infection prevalence was 31% (11/35, 95% CI=16-46%) in wichís and 28% (10/36, 95% CI=13-43%) in creoles, and was not associated with anemia. Conclusions: the high prevalence of anemia and iron deficiency indicates an important health and nutrition problem in this community.

Resistencia osmótica eritrocitaria en el diagnóstico de anemias hereditarias en Tucumán, Argentina / Red cell osmotic resistance in the hereditary anemias diagnosis in Tucumán, Argentina / ResistÛncia osmótica eritrocitária no diagnóstico de anemias hereditárias em Tucumán, Argentina

Las anemias hereditarias más frecuentes en Tucumán (Argentina) son el rasgo beta talasémico (RBT), las hemoglobinopatías estructurales (HBP) y la esferocitosis hereditaria (EH). La resistencia osmótica eritrocitaria inmediata y 24 horas post-incubación constituye el método diagnóstico de la EH, y como tubo único (ROETU) es usada para cribado de RBT. El propósito del trabajo fue determinar el comportamiento de ROETU (4,0 y 5,5 g/L de NaCl) en el diagnóstico de anemias hereditarias. Se estudiaron 125 pacientes: 34 normales (GN), 59 con RBT (GRBT), 21 con HBP (GHBP) y 11 con EH (GEH), que fueron agrupados en niños (≤12 años), mujeres y hombres (>12 años). Se realizaron hemograma (Coulter AcT10 y Sysmex KX-21N), índices de Mentzer y de Shine&Lal, ROETU, hierro, transferrina y saturación de transferrina (Wiener Lab), reticulocitos (azul brillante de cresilo), prueba de falciformación y electroforesis de hemoglobina a pH alcalino y ácido. GRBT presentó anemia microcítica hipocrómica, y GEH y GHBP, anemia normocítica normocrómica. El hierro fue normal. GRBT y GHBP fueron resistentes en ROETU 4,0 g/L, aunque GRBT mostró mayor resistencia (p<0,05). GEH fue menos resistente que GN en ROETU 5,5 g/L (p<0,05). ROETU 4,0 y 5,5 g/L serían recomendables en el diagnóstico presuntivo de RBT y EH, respectivamente.(AU)

Beta thalassaemia trait (BTT), structural hemoglobinopathies (SHB) and hereditary spherocytosis (HS) are the most frequent hereditary anaemias in Tucumán (Argentina). Immediately and 24 hours post-incubation red cell osmotic resistance is the diagnosis method of HS, and as a single tube (RORST), it is used for clínicamenBTT screening. The purpose of this study was to determine the RORST (NaCl 4.0 and 5.5 g/L) behaviour in the diagnosis of hereditary anemia. The study encompassed 125 patients : 34 normal patients (NG), 59 with BTT (BTTG), 21 with SHB (SHBG) and 11 with HS (HSG), who were divided into children (≤12 years), women and men (> 12 years). Blood count (Coulter AcT10 and Sysmex KX-21N), Mentzer and Shine&Lal indexes, RORST, iron, transferrin and transferrin saturation (Wiener Lab), reticulocytes (brilliant cresyl blue), sickling and hemoglobin electrophoresis at alkaline and acid pH were performed. BTTG showed hypochromic microcytic anemia, and SHBG and HSG, normochromic normocytic anemia. Iron was normal. BTTG and SHBG were resistant in RORST 4.0 g/L, but BTTG showed more resistance (p<0.05). SHG was less resistant than NG at RORST 5.5 g/L (p<0.05). RORST at values of 4.0 and 5.5 g/L would be recommended for the presumptive diagnosis of BTT and SH, respectively.(AU)

As anemias hereditárias mais comuns em Tucumán (Argentina) sÒo o traþo beta talassemia minor (BTM), as hemoglobinopatias estruturais (HBP) e esferocitose hereditária (EH). A resistÛncia osmótica dos eritrócitos imediata e 24 horas pós-incubaþÒo é o método de diagnóstico da EH, e como um único tubo (ROETU) é usado para a detecþÒo de BTM. O objectivo deste estudo foi determinar o comportamento de ROETU (4,0 e 5,5 g/L de NaCl) para o diagnóstico de anemias hereditárias. Foram estudados 125 pacientes: 34 normais (GN), 59 com BTM (GBTM), 21 com HBP (GHBP) e 11 com EH (GEH), que foram reunidos em crianþas (≤12 anos), mulheres e homens (>12 anos). Foi realizado hemograma (Coulter AcT10 e Sysmex KX-21N), índices de Mentzer e Shine&Lal, ROETU, ferro, transferrina e saturaþÒo de transferrina (Wiener Lab), reticulócitos (azul de cresil brilhante), teste de falcizaþÒo e eletroforese de hemoglobina em pH alcalino e ácido. GBTM mostrou anemia microcítica hipocr¶mica, e GEH e GHBP, anemia normocítica normocr¶mica. O ferro foi normal. GRBT e GHBP foram resistentes em ROETU 4,0 g/L, mas GBTM mostrou maior resistÛncia (p<0,05). GEH foi menos resistente que GN em ROETU 5,5 g/L (p<0,05). ROETU 4,0 e 5,5 g/L seria recomendado para o diagnóstico presuntivo da BTM e EH, respectivamente.(AU)

Resistencia osmótica eritrocitaria en el diagnóstico de anemias hereditarias en Tucumán, Argentina / Red cell osmotic resistance in the hereditary anemias diagnosis in Tucumán, Argentina / Resistência osmótica eritrocitária no diagnóstico de anemias hereditárias em Tucumán, Argentina

Las anemias hereditarias más frecuentes en Tucumán (Argentina) son el rasgo beta talasémico (RBT), las hemoglobinopatías estructurales (HBP) y la esferocitosis hereditaria (EH). La resistencia osmótica eritrocitaria inmediata y 24 horas post-incubación constituye el método diagnóstico de la EH, y como tubo único (ROETU) es usada para cribado de RBT. El propósito del trabajo fue determinar el comportamiento de ROETU (4,0 y 5,5 g/L de NaCl) en el diagnóstico de anemias hereditarias. Se estudiaron 125 pacientes: 34 normales (GN), 59 con RBT (GRBT), 21 con HBP (GHBP) y 11 con EH (GEH), que fueron agrupados en niños (≤12 años), mujeres y hombres (>12 años). Se realizaron hemograma (Coulter AcT10 y Sysmex KX-21N), índices de Mentzer y de Shine&Lal, ROETU, hierro, transferrina y saturación de transferrina (Wiener Lab), reticulocitos (azul brillante de cresilo), prueba de falciformación y electroforesis de hemoglobina a pH alcalino y ácido. GRBT presentó anemia microcítica hipocrómica, y GEH y GHBP, anemia normocítica normocrómica. El hierro fue normal. GRBT y GHBP fueron resistentes en ROETU 4,0 g/L, aunque GRBT mostró mayor resistencia (p<0,05). GEH fue menos resistente que GN en ROETU 5,5 g/L (p<0,05). ROETU 4,0 y 5,5 g/L serían recomendables en el diagnóstico presuntivo de RBT y EH, respectivamente.

Beta thalassaemia trait (BTT), structural hemoglobinopathies (SHB) and hereditary spherocytosis (HS) are the most frequent hereditary anaemias in Tucumán (Argentina). Immediately and 24 hours post-incubation red cell osmotic resistance is the diagnosis method of HS, and as a single tube (RORST), it is used for clínicamenBTT screening. The purpose of this study was to determine the RORST (NaCl 4.0 and 5.5 g/L) behaviour in the diagnosis of hereditary anemia. The study encompassed 125 patients : 34 normal patients (NG), 59 with BTT (BTTG), 21 with SHB (SHBG) and 11 with HS (HSG), who were divided into children (≤12 years), women and men (> 12 years). Blood count (Coulter AcT10 and Sysmex KX-21N), Mentzer and Shine&Lal indexes, RORST, iron, transferrin and transferrin saturation (Wiener Lab), reticulocytes (brilliant cresyl blue), sickling and hemoglobin electrophoresis at alkaline and acid pH were performed. BTTG showed hypochromic microcytic anemia, and SHBG and HSG, normochromic normocytic anemia. Iron was normal. BTTG and SHBG were resistant in RORST 4.0 g/L, but BTTG showed more resistance (p<0.05). SHG was less resistant than NG at RORST 5.5 g/L (p<0.05). RORST at values of 4.0 and 5.5 g/L would be recommended for the presumptive diagnosis of BTT and SH, respectively.

As anemias hereditárias mais comuns em Tucumán (Argentina) são o traço beta talassemia minor (BTM), as hemoglobinopatias estruturais (HBP) e esferocitose hereditária (EH). A resistência osmótica dos eritrócitos imediata e 24 horas pós-incubação é o método de diagnóstico da EH, e como um único tubo (ROETU) é usado para a detecção de BTM. O objectivo deste estudo foi determinar o comportamento de ROETU (4,0 e 5,5 g/L de NaCl) para o diagnóstico de anemias hereditárias. Foram estudados 125 pacientes: 34 normais (GN), 59 com BTM (GBTM), 21 com HBP (GHBP) e 11 com EH (GEH), que foram reunidos em crianças (≤12 anos), mulheres e homens (>12 anos). Foi realizado hemograma (Coulter AcT10 e Sysmex KX-21N), índices de Mentzer e Shine&Lal, ROETU, ferro, transferrina e saturação de transferrina (Wiener Lab), reticulócitos (azul de cresil brilhante), teste de falcização e eletroforese de hemoglobina em pH alcalino e ácido. GBTM mostrou anemia microcítica hipocrômica, e GEH e GHBP, anemia normocítica normocrômica. O ferro foi normal. GRBT e GHBP foram resistentes em ROETU 4,0 g/L, mas GBTM mostrou maior resistência (p<0,05). GEH foi menos resistente que GN em ROETU 5,5 g/L (p<0,05). ROETU 4,0 e 5,5 g/L seria recomendado para o diagnóstico presuntivo da BTM e EH, respectivamente.

Prevalencia y etiología de anemia en el embarazo: estudio observacional descriptivo en el Instituto de Maternidad de Tucumán / Prevalence and etiology of anemia in pregnancy: a descriptive observational study in the Maternity Institute of Tucumán

INTRODUCCIÓN: En Argentina, la anemia por deficiencia de hierro (ADH) constituye la patología de mayor prevalencia en el grupo materno-infantil. OBJETIVO: Determinar la prevalencia y etiología de anemia en embarazadas que efectuaron su control prenatal en el primer o segundo trimestre del embarazo en la Maternidad de Tucumán, entre octubre de 2009 y mayo de 2010. MÉTODOS: Se efectuó un estudio observacional descriptivo. Se realizó hemograma, análisis de ferremia,transferrina, ferritina, vitamina B12, ácido fólico y electroforesis de hemoglobina a 122 embarazadas. RESULTADOS: La prevalencia de anemia fue del 7,4% (9/122; intervalo de confianza [IC]95% = 2,8%-12%). De las gestantes, 4 tenían ADH y 5, anemia no ferropénica. El 29,5 % (IC 95% = 21-37%) de la población estaba en alguna etapa de ADH (manifiesta, latente o silente);un 4,4% tenía deficiencia de vitamina B12, mientras que el ácido fólico era normal. No se detectaron anemias hereditarias. CONCLUSIONES: El diagnóstico de ADH debería comprender la determinación de hemoglobina y ferritina para poder brindar a la gestante el tratamiento adecuado.

INTRODUCTION: In Argentina, iron deficiency anemia (IDA) is the most prevalent disease in the mother childgroup. OBJECTIVE: To determine the prevalence and etiology of anemia in pregnant women who made their prenatal control in the 1st or 2nd trimester of pregnancy at the Maternity Institute of Tucumán, between October 2009 and May 2010. METHODS: A descriptive observational study was conducted. The analysis included blood count, serum iron, transferrin, ferritin, vitamin B12, folic acid and hemoglobin electrophoresis in 122 pregnant women. RESULTS: The prevalence of anemia was 7,4% (9/122 ; confidence interval[CI] 95% = 2,8-12,0%). 4 pregnant women had IDA, and 5, non-IDA. 29,5% (CI 95% = 21-37%) of the population was in some stage of IDA (evident, latent, silent), 4,4% had vitaminB12 deficiency, and folic acid level was normal. Hereditary anemia was not found. CONCLUSIONS: The diagnosis of IDA should include the determination of hemoglobin and ferritin, in order to provide an appropriate treatment for pregnant women.

Lactobacillus casei: influence on the innate immune response and haemostatic alterations in a liver-injury model.

UNLABELLED: Lactobacilllus casei CRL 431 has the ability to modulate the local and systemic immune responses, which are significantly involved in liver injury caused by hepatotoxins. This work was conducted to determine whether L. casei has a preventive effect on the hepatic damage undergone during an acute liver injury (ALI). METHODS: ALI was induced by an intraperitoneal injection of d-galactosamine (D-Gal). Different groups of mice received 1x 109 L. casei cells/day/mouse for 2 days before D-Gal injection. Blood and liver samples were obtained 0, 6, 12, and 24 h after D-Gal administration. RESULTS: D-Gal induced increases in serum aminotransferases, reduced the number of blood leukocytes, enhanced neutrophil myeloperoxidase activity, increased dead cells, and altered prothrombin time and plasma fibrinogen levels. The preventive treatment with L. casei for 2 days modulated the innate immune response. This effect was shown by the earlier normalization of white blood cell counts, myeloperoxidase activity and aminotransferases levels. However, the haemostatic parameters were only partially recovered. The favourable effects obtained could be due to the capacity of L. casei to moderate the inflammatory response at the site of the injury with less damage to liver tissue.

Yogurt: effect on leukocytes and blood coagulation in an acute liver injury model.

This study determined whether cow or goat yogurt administration has a preventive effect on the hepatic damage undergone during an acute liver injury. Acute liver injury was induced by an intraperitoneal injection of d-galactosamine. Groups of mice were fed with cow or goat yogurt for 2 days or 7 days before the d-galactosamine injection. Blood and liver samples were obtained 12 hours after d-galactosamine inoculation. d-Galactosamine induced an increase in serum amino-transaminases, a reduction in the number of blood leukocytes, an enhancement in neutrophil myeloperoxidase activity, a recruitment of leukocytes toward the liver, an increase in cell death, and an alteration in prothrombin time, activated partial thromboplastin time, and fibrinogen levels. Treatment with cow or goat yogurt was effective at increasing leukocyte number and decrease myeloperoxidase activity. We also observed a decrease in leukocyte accumulation in the liver and a reduction in cell death. Activated partial thromboplastin time and fibrinogen were normalized, but prothrombin time only showed an improvement without reaching normal values. Cow or goat yogurts were effective at protecting against an experimental acute liver injury, especially when administered for 7 days.

Perfil hematológico de la beta-talasemia menor en Tucumán / Hematological profile of beta-thalassemia minor in Tucuman

La b-talasemia menor es uno de los desórdenes genéticos más comunes y constituye la principal causa de anemia hereditaria. Si se exceptúan las provincias de Buenos Aires y Santa Fe, es escasa la información bibliográfica acerca de la distribución de la talasemia en la Argentina. Dado que no existen registros sobre el perfil hematológico de la b-talasemia en la región noroeste de la Argentina, el propósito del presente trabajo fue realizar un estudio exploratorio descriptivo de las características hematológicas y electroforéticas de una población de la provincia de Tucumán portadora de b-talasemia. Se estudiaron 52 pacientes derivados para investigación de síndrome talasémico. Se realizó hemograma, reticulocitos, ferremia, electroforesis de hemoglobina, dosaje de hemoglobinas F y A2. En el 46% de los pacientes se confirmó el diagnóstico de rasgo b-talasémico, detectándose leve anemia con microcitosis y Hb A2 aumentada. El estudio del perfil hematológico no demostró diferencias significativas con respecto a edad y sexo y fue similar a lo ya publicado por otros autores. Según el origen étnico, la población estudiada estuvo constituida por un 58% de individuos de origen italiano, 34% de españoles y 8% de árabes, con predominio de la población italiana, similar a trabajos previos en la Argentina.

The b-thalassemia minor is one of the most common genetic blood disorder and it represents the main cause of hereditary anemia. There is scant information in the scientific literature about b-thalassemia minor distribution in Argentina, except for the provinces of Buenos Aires and Santa Fe. There is no published study of this disorder in the northwest of Argentina. The objective of this descriptive and explorative study is to determine the hematological and electrophoretic characteristics of a b-thalassemia minor population in the province of Tucumán. A total of 52 patients with suspected thalassemia syndrome were studied; haemogram, reticulocytes, serum iron, hemoglobin electrophoresis, hemoglobin F and hemoglobin A2 were performed. Forty-six percent of the patients presented a b-thalassemia minor diagnosis, with the following findings: mild anemia with microcytosis and elevated Hb A2. The hematological profile showed no significative differences with respect to age and sex, and it was similar to previous studies, published by different authors. The ethnic origins were as follow: Italians 58%, Spaniards 34% and Arabians 8%, with preponderance of the Italian population, similar to previous studies in Argentina.