Circulation profile of respiratory viruses in symptomatic and asymptomatic children from Midwest Brazil.

Acute respiratory infection (ARI) is a major cause of morbidity and mortality worldwide. Most of these infections are caused by viruses. Infections pose as important triggers of acute episodes of chronic respiratory diseases (CRD). This study sought to evaluate the frequency and circulation profile of respiratory viruses among ARI symptomatic patients and completely asymptomatic children in Midwest Brazil. The study enrolled symptomatic children with and without ARI symptoms. During 1 year, 225 nasal respiratory samples were obtained from patients aged 4-14 years old. The samples were screened by multiplex nested-PCR for 16 common respiratory viruses. From 225 samples, 42 had at least one virus detected. Samples from four different patients had multiple viruses detected. The viral detection rate in symptomatic (20.1%) and asymptomatic patients (14.8%) showed no significant difference. The most frequent viruses detected were rhinovirus (28.6%), FLUA (11.9%), adenovirus (11.9%), human bocavirus (HBoV) (11.9%), and respiratory syncytial virus (RSV) antigenic group A (9.5%). Monthly detection rate was higher during the rainy season. RSVs were detected during the months with higher rainfall indexes and higher air humidity, while FLU and HBoV were detected during the winter months. The obtained results reinforce the importance of viral pathogens in pediatric population, emphasizing similar viral occurrence in symptomatic and asymptomatic children.

Comparison of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in normoglycemic and hyperglycemic subjects.

OBJECTIVE: To compare the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as possible parameters of systemic inflammation in hyperglycemic and normoglycemic subjects. METHODS: A retrospective, cross-sectional study of data collected from patients tested for fasting blood glucose, glycated hemoglobin (HbA1c) and blood count on the same day, between July and December 2016. Patients were divided into hyperglycemic and normoglycemic, and matched by age and sex. The data were analyzed using Epi Info™, version 7.2.1.0, for the Windows® platform. RESULTS: We enrolled 278 subjects, 139 hyperglycemic and 139 normoglycemic. The absolute number of leukocytes and neutrophils was higher in the Hyperglycemic Group (p=0.006 and p=0.004, respectively). There was no difference in the neutrophil-to-lymphocyte ratio between the Hyperglycemic Group and the Normoglycemic Group (2.1 versus 2.0; p=0.264), and both neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios showed no differences between those with HbA1c ≥7% (n=127, p=0.778) and those with HbA1c <7% (n=12, p=0.490). In contrast, the platelet-to-lymphocyte ratio was lower in the Hyperglycemic Group (117.8 versus 129.6; p=0.007). CONCLUSION: Hyperglycemic subjects had a neutrophil-to-lymphocyte ratio similar to that of normoglycemic subjects, but had a lower platelet-to-lymphocyte ratio. Future prospective studies will be useful to determine the importance and prognostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in the hyperglycemic state.

Comparison of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in normoglycemic and hyperglycemic subjects / Comparação das razões neutrófilo-linfócito e plaqueta-linfócito de indivíduos normoglicêmicos e hiperglicêmicos

ABSTRACT Objective: To compare the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as possible parameters of systemic inflammation in hyperglycemic and normoglycemic subjects. Methods: A retrospective, cross-sectional study of data collected from patients tested for fasting blood glucose, glycated hemoglobin (HbA1c) and blood count on the same day, between July and December 2016. Patients were divided into hyperglycemic and normoglycemic, and matched by age and sex. The data were analyzed using Epi Info™, version 7.2.1.0, for the Windows® platform. Results: We enrolled 278 subjects, 139 hyperglycemic and 139 normoglycemic. The absolute number of leukocytes and neutrophils was higher in the Hyperglycemic Group (p=0.006 and p=0.004, respectively). There was no difference in the neutrophil-to-lymphocyte ratio between the Hyperglycemic Group and the Normoglycemic Group (2.1 versus 2.0; p=0.264), and both neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios showed no differences between those with HbA1c ≥7% (n=127, p=0.778) and those with HbA1c <7% (n=12, p=0.490). In contrast, the platelet-to-lymphocyte ratio was lower in the Hyperglycemic Group (117.8 versus 129.6; p=0.007). Conclusion: Hyperglycemic subjects had a neutrophil-to-lymphocyte ratio similar to that of normoglycemic subjects, but had a lower platelet-to-lymphocyte ratio. Future prospective studies will be useful to determine the importance and prognostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in the hyperglycemic state.

RESUMO Objetivo: Comparar a razão neutrófilo-linfócito e a razão plaqueta-linfócito como possíveis parâmetros de inflamação sistêmica em indivíduos hiperglicêmicos e normoglicêmicos. Métodos: Estudo transversal retrospectivo, em que foram coletados dados dos pacientes que realizaram glicemia em jejum, hemoglobina glicada (HbA1c) e hemograma na mesma data, entre julho e dezembro de 2016. Os pacientes foram divididos em um Grupo Hiperglicêmico e um Grupo Normoglicêmico, pareados por idade e sexo. Os dados foram analisados no Epi Info™, versão 7.2.1.0, em plataforma Windows®. Resultados: Foram incluídos 278 indivíduos, sendo 139 hiperglicêmicos e 139 normoglicêmicos. O número absoluto de leucócitos e neutrófilos foi maior no Grupo Hiperglicêmico (p=0,006 e p=0,004, respectivamente). Não houve diferença da razão neutrófilo-linfócito entre o Grupo Hiperglicêmico e o Grupo Normoglicêmico (2,1 versus 2,0; p=0,264), assim como a razão neutrófilo-linfócito e razão plaqueta-linfócito não apresentou diferença entre aqueles com HbA1c ≥7% (n=127) e com HbA1c <7% (n=12; p=0,778 e p=0,490). Contrariamente, a razão plaqueta-linfócito mostrou-se menor no Grupo Hiperglicêmico (117,8 versus 129,6; p=0,007). Conclusão: Indivíduos hiperglicêmicos apresentaram razão neutrófilo-linfócito semelhante a dos normoglicêmicos, mas tiveram razão plaqueta-linfócito menor. Pesquisas futuras, de modo prospectivo, seriam úteis para analisar a importância e o valor prognóstico da razão neutrófilo-linfócito e da razão plaqueta-linfócito no estado hiperglicêmico.

Razões neutrófilos/linfócitos e plaquetas/linfócitos em pacientes diabéticos com ou sem disfunção renal / Neutrophil/lymphocyte and platelet/lymphocyte ratios in diabetic patients with or without renal dysfunction

OBJETIVOS: Comparar a razão neutrófilos/linfócitos (RNL) e a razão plaquetas/linfócitos (RPL) entre pacientes com e sem diabetes mellitus tipo 2 e entre pacientes diabéticos com e sem disfunção renal. MÉTODOS: Estudo transversal retrospectivo realizado no Laboratório de Análises Clínicas do Hospital das Clínicas da Universidade Federal de Goiás entre janeiro e dezembro de 2016. Foram incluídos no estudo os dados dos pacientes com idade maior ou igual a 40 anos. Aqueles com glicemia casual ≥200mg/dL e/ou hemoglobina glicada ≥6,5% formaram o grupo diabético, e aqueles que não apresentavam esses critérios para diabetes formaram o grupo controle, sendo pareados por idade e sexo. O grupo diabético foi classificado em um grupo com dano renal e outro sem dano renal, de acordo com a microalbuminúria de 24 horas. Os cálculos para RNL e RPL foram realizados a partir do número absoluto de neutrófilos, linfócitos e plaquetas, e foram comparadas as medianas. RESULTADOS: Um total de 122 indivíduos foi incluído no estudo, entre os quais 52,5% tinham entre 40 e 64 anos de idade e 63,9% eram do sexo masculino. A mediana da RNL foi de 2,1 (mín. 0,8 -máx. 5,3) no grupo diabético e de 1,9 (mín. 0,6 -máx. 6,2) no grupo controle (p=0,16). A mediana da RPL foi de 120,5 (mín. 63,5 -máx. 206,6) no grupo diabético e de 119,7 (mín. 40,4 -máx. 215,1) no grupo controle (p=0,19). Considerando a faixa etária, não houve diferença das medianas de RNL e RPL entre o grupo de diabéticos e o grupo controle, entretanto a da RNL foi maior para indivíduos com 65 anos ou mais, independentemente de serem diabéticos (mediana 2,2; mín. 1,0 -máx. 3,8; p=0,0144) ou não (mediana 2,4; mín. 0,9 -máx. 3,6; p=0,0019). Dentre os participantes, 38 pacientes apresentavam dano renal, sendo 24 (63,1%) do grupo diabético e 14 (36,9%) do grupo controle. As medianas da RNL e da RPL foram semelhantes entre os pacientes diabéticos com dano renal, diabéticos sem dano renal e grupo controle. CONCLUSÕES: A RNL e a RPL foram semelhantes entre o grupo diabético e o grupo controle, assim como entre diabéticos com ou sem dano renal. A RNL foi maior para indivíduos com 65 anos ou mais, independentemente de serem diabéticos ou não.

AIMS: To compare the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) between patients with and without type 2 diabetes mellitus and between diabetic patients with and without renal dysfunction. METHODS: A cross-sectional retrospective study was performed at the Laboratory of Clinical Analyzes of the Hospital das Clínicas of the Federal University of Goiás between January and December 2016. Data from patients aged 40 years or older were included in the study. Those with a blood glucose ≥200mg / dL and/or glycated hemoglobin ≥6.5% formed the diabetic group, and those who did not present these criteria for diabetes formed the control group, being matched by age and sex. The diabetic group was classified in one group with renal damage and another without renal damage, according to the 24-hour microalbuminuria. Calculations for NLR and PLR were performed from the absolute number of neutrophils, lymphocytes and platelets, and the medians were compared. RESULTS: A total of 122 subjects were included in the study, among which 52.5% were between 40 and 64 years of age and 63.9% were male. The median NLR was 2.1 (min 0.8-max 5.3) in the diabetic group and 1.9 (min 0.6-max 6.2) in the control group (p=0.16). The median PLR was 120.5 (min 63.5-max 206.6) in the diabetic group and 119.7 (min 40.4-max 215.1) in the control group (p=0.19). Considering the age group, there was no difference in the median NLR or PLR among the diabetic group and the control group; however, the NLR was higher for individuals 65 years of age or older, regardless of whether they were diabetic (median 2.2, min 1.0-max 3.8, p=0.01) or not (median 2.4, min 0.9-max 3.6, p=0.001). Among the participants, 38 patients presented renal damage, 24 (63.1%) of the diabetic group and 14 (36.9%) of the control group. The median NLR and PLR were similar among diabetic patients with renal damage, diabetics without renal damage and control group. CONCLUSIONS: NLR and PLR were similar between the diabetic group and the control group, as well as among diabetics with or without renal damage. RNL was higher for individuals 65 years of age or older, regardless of whether they were diabetic or not.