Longitudinal hematological change in uncomplicated twin pregnancies: The white blood cell count decreases through pregnancy after the first trimester.

OBJECTIVE: Longitudinal hematological changes throughout twin pregnancies have not been reported. This study aimed to reveal longitudinal changes in hematological indices in twin pregnancies. MATERIALS AND METHODS: We conducted a retrospective chart review of hematological changes in uncomplicated twin pregnancies delivered at ≥37 weeks of gestation between 2010 and 2013 and randomly selected uncomplicated singletons during the same period. A complete blood count and hemogram were performed as blood examinations in the first trimester (9-13 weeks), late second trimester (22-27 weeks), mid-third trimester (33-35 weeks, only in twin pregnancies), and late third trimester (36-38 weeks). We evaluated inter-trimester differences in hematological indices and compared the values between twin and singleton pregnancies in each trimester. RESULTS: The final analysis group included 60 twin pregnancies and 63 singleton pregnancies. The white blood cell (WBC) count in twin pregnancies decreased throughout the pregnancy after the first trimester and became significantly lower than that in singletons in the late third trimester. The WBC count showed only a slight decrease in the third trimester in singleton pregnancies, whereas it showed a marked decrease throughout the pregnancy in twin pregnancies. The marked decrease in the total WBC count in twin pregnancies is mainly due to a decrease in neutrophils. The red blood cell count and hemoglobin and hematocrit values in twin pregnancies showed more marked decreases in the second trimester than in singletons. No decrease was observed after the second trimester of pregnancy. The platelet count decreased in the third trimester of twin pregnancies. CONCLUSION: We clarified the longitudinal hematological changes in twin pregnancies that showed augmentation of or differed from those of singleton pregnancies. It should be specifically mentioned that the WBC count markedly decreased through pregnancy after the first trimester, which is a characteristic change in twin pregnancies.

Changes in liver and kidney function, red blood cell count and hemoglobin levels 1 day after ultrasound-guided percutaneous microwave ablation for uterine fibroids.

OBJECTIVE: To investigate the changes in liver and kidney function, red blood cell (RBC) count and hemoglobin (HGB) levels in patients undergoing ultrasound-guided percutaneous microwave ablation (UPMWA) for uterine fibroids on postoperative day 1. METHODS: The changes in liver and kidney function, RBC count and HGB levels in 181 patients who underwent selective UPMWA in the Second Affiliated Hospital of Shantou University Medical College, China, between August 2017 and January 2023 were retrospectively analyzed. RESULTS: All patients underwent UPMWA for uterine fibroids; 179 patients had multiple uterine fibroids and 2 patients had single uterine fibroids. The maximum fibroid diameter ranged from 18 to 140 mm, with an average of 68.3 mm. Ultrasound imaging was used to confirm that the blood flow signal within the mass had disappeared in all patients, indicating that the ablation was effective. Within 24 h, compared with before UPMWA, levels of total bilirubin, direct bilirubin, indirect bilirubin and aspartate aminotransferase had significantly increased (p < 0.01), whereas levels of total protein, albumin, globulin, alanine aminotransferase, creatinine and urea had significantly decreased (p < 0.01). Acute kidney injury (AKI) occurred in 1 of the 181 patients. The RBC count and HGB levels decreased significantly after UPMWA (p < 0.01). CONCLUSION: Ultrasound-guided percutaneous microwave ablation for uterine fibroids can impose a higher detoxification load on the liver and cause thermal damage to and the destruction of RBCs within local circulation, potentially leading to AKI. Protein levels significantly decreased after UPMWA. Therefore, perioperative organ function protection measures and treatment should be actively integrated into clinical practice to improve prognosis and enhance recovery.

Correlations between the degree of infection by wild strain of Toxoplasma gondii in vitro and porcine hematological parameters.

The apicomplexa Toxoplasma gondii is capable of actively proliferating in numerous types of nucleated cells, and therefore has a high potential for dissemination and resistance. Thus, the present work aimed to correlate the inoculum concentrations and amount of post-infection parasites with porcine hematological parameters (including biochemistry) through in vitro culture. Porcine blood was incubated with different concentrations of parasites (1.2 × 107, 6/3/1.5 × 106 cells/mL), then the concentrations of red blood cells (RBC) and their morphology, total and differential leukocytes, and free peptides were evaluated. In addition, eight different blood samples analyzed before inoculation, where subsequent multivariate analysis was applied to correlate different variables with trophozoite concentration. The results showed no significant variation (p < 0.05) in the relative levels of free peptides, or the relative percentage of RBC at all the parasite concentrations tested. However, the normalized percentages of leukocytes and neutrophils showed a significant reduction, while those of lymphocytes, eosinophils and monocytes showed the opposite behavior. Semi-automatic processing of images exhibited significant microcytosis and hypochromia. The multivariate analysis revealed a positive correlation between the amount number of protozoa (AP) and the variables: "Red cells" and "Neutrophils", an indifference between the AP and the content of free peptides, and the concentration of monocytes in the samples; and a negative correlation for AP and the percentages of lymphocytes and eosinophils. Our results suggest that specific changes in hematological parameters may be associated with different degrees of parasitemia, demanding a thorough diagnostic process and adequate treatment.

Comparison Evaluation of Automated Nucleated Red Blood Cell Enumeration by Sysmex XN 1000 in Comparison With Microscopic Reference in Children Under 1 Year.

BACKGROUND: In newborns, elevated nucleated red blood cell (NRBC) levels can be associated with enhanced erythropoietic stress and might be predictive for adverse outcome. Also, the presence of NRBC in peripheral blood might lead to erroneous enumeration results of white blood cells in automated hematology analyzers. We aimed to assess the comparability of the Sysmex XN 1000 to manual slide reviews and correlation of NRBC with inflammation markers. METHODS: Specimens of 3397 children under 1 year were compared by automated and microscopic NRBC enumeration. Additionally, potential correlations between NRBC and age and inflammation markers were examined. RESULTS: Overall, there was good correlation (r = 0.97) between automated (range: 0%-3883%) and microscopic enumeration (range: 0%-3694%) of NRBC with high comparability up to a NRBC value of 200% and an increase in the variation between the two methods with increasing NRBC numbers. When 94 samples with ≤ 200% NRBC and ≥ 30% divergence between methods were separately reanalyzed with respect to overlapping cell populations in their scattergrams, Sysmex would have generated unrecognized incorrect automated results in 47 samples, corresponding to 1.4% of total study samples. NRBC counts were negatively correlated to age, but not to inflammation markers. CONCLUSION: Sysmex XN 1000 is highly precise in the enumeration of NRBC in children under 1 year up to counts of 200% and might replace time-intense manual counting in routine diagnostics. In the setting of neonatal and intensive care diagnostics, microscopic control and supervision of scattergrams are highly recommended for any automated NRBC enumeration processes.

The protective effects of BMSA1 and BMSA5-1-1 proteins against Babesia microti infection.

The intracellular parasite Babesia microti is among the most significant species causing human babesiosis and is an emerging threat to human health worldwide. Unravelling the pathogenic molecular mechanisms of babesiosis is crucial in developing new diagnostic and preventive methods. This study assessed how priming with B. microti surface antigen 1 (BHSA 1) and seroreactive antigen 5-1-1 (BHSA 5-1-1) mediate protection against B. microti infection. The results showed that 500 µg/ml rBMSA1 and rBMSA5-1-1 partially inhibited the invasion of B. microti in vitro by 42.0 ± 3.0%, and 48.0 ± 2.1%, respectively. Blood smears revealed that peak infection at 7 days post-infection (dpi) was 19.6%, 24.7%, and 46.7% in the rBMSA1, rBmSA5-1-1, compared to the control groups (healthy mice infected with B. microti only), respectively. Routine blood tests showed higher white blood cell, red blood cell counts, and haemoglobin levels in the 2 groups (BMSA1 and BMSA5 5-1-1) than in the infection control group at 0-28 dpi. Moreover, the 2 groups had higher serum interferon-γ, tumor necrosis factor-α and Interleukin-17A levels, and lower IL-10 levels than the infection control group throughout the study. These 2 potential vaccine candidate proteins partially inhibit in vitro and in vivo B. microti infection and enhance host immunological response against B. microti infection.

Comparison of atlantoaxial and lumbosacral cerebrospinal fluid centesis techniques in South American camelids.

BACKGROUND: Iatrogenic blood contamination during cerebrospinal fluid (CSF) centesis is common, which can limit the diagnostic usefulness of the sample. A novel ultrasound-guided CSF collection technique is described in horses, by which CSF is obtained from the atlantoaxial (AA) space. HYPOTHESIS/OBJECTIVES: To compare ultrasound-guided AA centesis with lumbosacral (LS) centesis in South American camelids (SAC). The hypotheses were that AA centesis would yield samples with less blood contamination although being technically more challenging than LS centesis. ANIMALS: Eight clinically healthy adult SAC from a university-owned teaching herd. METHODS: Single-blinded, randomized, 4-way, 4-period crossover study in which 2 veterinarians each performed both centesis techniques on each animal once. Cytological sample analysis was performed, and the technical difficulty of sample acquisition was assessed. RESULTS: The CSF was collected successfully and without complications by either technique during all collection attempts. Aspects of technical difficulty and concentrations of CSF analytes did not vary significantly between techniques. Median total nucleated cell and red blood cell counts were 1/µL and 0.5/µL and 167.5/µL and 155/µL for AA and LS techniques, respectively. The median total protein concentration was 32.9 mg/dL and 38 mg/dL for AA and LS centeses. A median of 1 attempt was necessary for both centesis techniques and the median number of needle repositioning events was 1 for AA and 0 for LS. CONCLUSION AND CLINICAL IMPORTANCE: Depending on clinical circumstances, ultrasound-guided AA centesis appears to be an acceptable alternative to other techniques for collection of CSF from SAC.

Nucleated Red Blood Cell Counts Differentiate Cardiac from Respiratory Causes of Cyanosis at Birth.

Tissue hypoxia increases erythropoietin production and release of immature erythrocytes that can be measured using nucleated red blood cell counts (nRBC). We hypothesized that hypoxia due to congenital heart disease (CHD) is chronic and is better tolerated than hypoxia due to respiratory disease (RD), which is an acute stress in newborns leading to higher nRBC. This study assesses the utility of nRBC as a marker to differentiate hypoxia due to CHD vs RD in term neonates. This was a single-center, retrospective study of term neonates with cyanosis from 2015 to 2022. Neonates < 37 weeks of gestation, with hypoxic-ischemic encephalopathy, and those with other causes of cyanosis were excluded. The patients were divided into 2 groups: cyanotic CHD and cyanotic RD. Clinical and laboratory data done within 12 h and 24-36 h after birth were collected. Data are represented as median and Interquartile range. Of 189 patients with cyanosis, 80 had CHD and 109 had RD. The absolute nRBC count at ≤ 12 h of age was lower in the CHD (360 cells/mm3) compared to RD group (2340 cells/mm3) despite the CHD group having significantly lower baseline saturations. A value of 1070 cells/mm3 was highly sensitive and specific for differentiating CHD from RD. The positive predictive value for this cut-off value of 1070 cells/mm3 was 0.94 and the negative predictive value was 0.89. The absolute nRBC is a simple screening test and is available worldwide. A nRBC < 1070 cells/mm3 in cyanotic newborns should hasten the search for CHD etiology with the possible need for prostaglandin therapy.

Development of a new staining protocol for the Kleihauer-Betke test to facilitate the reading of difficult cases.

BACKGROUND: The Kleihauer-Betke (KB) test allows the detection of fetal red blood cells (containing fetal hemoglobin, HbF) in the maternal blood to identify and quantify potential fetal-maternal hemorrhages. In certain cases, detecting fetal red blood cells with conventional staining is difficult. False-positive results or overestimation of the quantity of fetal red blood cells may occur in cases of maternal hemoglobinopathy. In this study, we developed a new staining protocol to facilitate the reading of difficult smears and improve the precision of the quantification of fetal red blood cells; we also analyzed the performance of this new method. This study assessed blood samples with and without hemoglobin abnormalities, which present difficulties when interpreting the KB test. METHODS: The new staining formula is based on an improved elution technique and the use of a different stain instead of hematoxylin. To test this staining method, 16 samples from patients with abnormal hemoglobin electrophoresis and 14 samples from patients with normal hemoglobin electrophoresis were analyzed using the KB test with the classical staining method and the new staining method. In addition, a second series was prepared using the same samples spiked with fetal red blood cells from newborn blood, to compare the accuracy of the two methods in identifying fetal red blood cells. RESULTS: In the 60 slides analyzed with both staining methods, we found that the new technique improved the accuracy from 78 to 85%; lowered the coefficient of variation between the operators, which decreased from 20.7% to 12.7%; increased the specificity in our population from 56 to 70%; and decreased the number of false-positive cases by 30%. CONCLUSIONS: We successfully developed a new staining technique that facilitates the reading of difficult slides and improves the specificity of the detection of fetal red blood cells. This technique is recommended as a secondary method to use before sending the sample for additional exploration.

Hematological parameters: is there a difference between those released by the hematological analyzer and to the customer?

OBJECTIVE: This study aimed to compare the hematological parameters released by hematological analyzers with those released in customer reports. METHODS: We conducted a descriptive study in the laboratories of a medium-sized municipality in the state of Minas Gerais registered in the National Register of Health Establishments. Interviews were conducted using a questionnaire to obtain information regarding the parameters released by the analyzers and those available in the customer's report. RESULTS: Sixteen laboratories were evaluated, and none of them released all the parameters obtained from the hematological analyzers to customers. The red blood cell distribution width was released in 88% of the laboratories, atypical lymphocytes in 70%, mean platelet volume in 50%, platelet distribution width and platelet count in 20%. No laboratory released information on reticulocytes, fraction of immature reticulocytes and immature granulocytes, nucleated erythrocyte count, immature platelet fraction and reticulocyte hemoglobin, and large platelet rate. CONCLUSION: All evaluated clinical analysis laboratories had at least one parameter that was not released in the customer's report despite being released by the hematological analyzers. The lack of knowledge on the part of professionals about the clinical importance of each parameter of the complete blood count results in a loss in patient assessment, and it is important to include these parameters in the complete blood count report.

Haematological reference intervals for pregnant Icelandic mares on pasture.

BACKGROUND: Few studies have been conducted on haematological reference intervals (RIs) in Icelandic horses. Reference intervals have been published for Icelandic horses in Austria and a preliminary study in Iceland compared haematological values in riding horses to published RIs for other breeds as well as Icelandic horses abroad. Haematological parameters can vary greatly due to factors such as breed, gender, age, reproductive status, and training, as well as feeding, prior exercise and management method. Icelandic broodmares are kept on pasture under supervision throughout the year, with haylage provided during the winter, and it is therefore of interest to establish haematological reference intervals for pregnant broodmares in Iceland. The purpose of this study was to establish haematological RIs specific to Icelandic broodmares in the first months of pregnancy, kept on pasture. Blood samples from 183 mares, stabilised in EDTA were analysed using IDEXX ProCyte Dx and total protein was analysed in serum samples from 157 of the 183 mares, using IDEXX Catalyst One analyser. The RIs were established using the guidelines of the American Society for Veterinary Clinical Pathology. RESULTS: The RIs for red blood cell count, haematocrit and haemoglobin were higher in pasture-kept Icelandic mares in early pregnancy, most of which were lactating, than in pregnant mares of other breeds. This was also true for white blood cell count, as well as numbers of monocytes, eosinophils, and basophils, which in some instances might illustrate problems in the automated categorisation of some leukocytes. CONCLUSIONS: As no RIs have been published for other pasture-kept Icelandic horses, future investigations should include other groups of pasture-kept Icelandic horses. Such an analysis might elucidate the effect of breed, management, and pregnancy on haematological values in pasture-kept Icelandic horses.

Determination of hematobiochemical and fore stomach fluid constituents of llama (Lama glama) living in Egypt.

There are no available data regarding the hematology, serum biochemistry, and fore stomach fluid constituents of llama (Lama glama) in Egypt. This study aimed to establish normal reference values for blood and fore stomach fluid constituents of llama and determine the influence of sex and season on these parameters under Egyptian conditions. The study was performed on (n = 38; 22 female, 16 male; 1-7 years) apparently healthy llamas located in the Giza Zoo and private zoo in the Ismailia Governorate. Samples were collected in two seasons and divided into summer and winter samples. Differences in the mean and range values of packed cell volume, serum minerals, fore stomach fluid pH, and total protozoal count in Egypt were recorded. Sex and season had minimal effects on hematology and only erythrocyte count showed a significant (p < 0.05) increase in males compared with females. Regarding serum biochemistry, males showed significant (p < 0.05) increases in alanine transaminase and calcium levels, while globulin significantly (p < 0.05) increased in females. The influence of season on serum biochemistry was evident in alanine transaminase, total protein, albumin, and chloride which increased significantly (p < 0.05) in summer, while urea, bilirubin, and magnesium increased significantly (p < 0.05) in winter. Fore stomach fluid pH and ammonia showed significant (p < 0.05) increases in winter, while the total protozoal count increased significantly (p < 0.05) in summer and in males compared with females. The results obtained in this study can serve as reference values for the hematobiochemical and fore stomach fluid constituents of llama in Egypt.

INFLUENCE OF SEASON, ENVIRONMENT, AND SEX ON SELECTED BLOOD PARAMETERS OF GEOFFROY'S SIDE-NECKED TURTLES, PHRYNOPS GEOFFROANUS (SCHWEIGGER, 1812).

Laboratory tests help to determine a diagnosis, to plan treatment, and to indicate prognosis of diseases. However, the interpretation of test results in reptiles is challenging, because they are influenced by environmental and individual factors. Therefore, the objective of this study was to establish hematologic parameters of Geoffroy's side-necked turtle (Phrynops geoffroanus), including variables such as season, environment, sex, and straight carapace length (SCL). Blood samples were analyzed from 38 P. geoffroanus (23 males and 15 females) collected during the rainy and dry seasons. Some of the animals were from captivity and others from an urban stream. To verify the influence of the variables on blood parameters, the general linear model was performed. The Pearson correlation coefficient was also used to verify the association between SCL and hematologic parameters. Among these parameters, hemoglobin (P = 0.008) and mean corpuscular hemoglobin concentration (P = 0.001) were statistically higher during the rainy season. On the other hand, WBC (P = 0.011), heterophils (P = 0.045), eosinophils (P < 0.001), lymphocytes (P = 0.014), and monocytes (P = 0.039) were higher in the dry season. The RBC count (P = 0.035), PCV (P = 0.029), basophils (P = 0.013), and monocytes (P = 0,013) were significantly higher in individuals from captivity, but lymphocytes (P = 0.033) were higher in the urban turtles. Only eosinophils (P = 0.025) were higher in females than in males. There was no influence of the variables season, environment, and sex on the mean corpuscular volume (P = 0.071; P = 0.458; P = 0.052), total solids (P = 0.773; P = 0.121; P = 0.131), and heterophil:lymphocyte ratio (P = 0.992; P = 0.58; P = 0.119). No influence of the size on hematologic parameters was observed. Season, environment, and sex may influence the blood parameters of P. geoffroanus, and these factors should be routinely considered in the interpretation of laboratory results.

Assessing total erythrocyte count as a potential attribute for estimating hemoglobin in Cholistani cattle.

The main objective of the study was to confirm whether a specific and constant interrelationship exists between total erythrocyte count (TEC) and hemoglobin (Hb) concentration in Cholistani cattle blood and to navigate the potential of TEC for estimating Hb level in Cholistani cattle (n = 264) grouped as per gender (males, n = 122; females, n = 142) and age (young, n = 140; adults, n = 124). The TEC and Hb (HbD) estimation was carried out through veterinary hematology analyzer. The Hb was also calculated as TEC × 3 and was termed as HbC. Linear regression was implied, and accordingly, scatterplots were drawn between TEC, HbD, HbC, and corrected Hb (CHB). The regression prediction equation hence attained was used to deduce corrected hemoglobin (CHb). A significant (P ≤ 0.05) difference was noticed between HbD and HbC. A non-significant (P ≥ 0.05) difference was noticed, however, between HbD and CHb. Tests of level of agreement indicated a higher Cronbach's alpha and intraclass correlation coefficient (0.682 for average measures) for HbD and CHb as compared to that for HbD and HbC (0.559 for average measures). A convention of Hb concentration as three times of TEC (× 3) is not valid for Cholistani cattle. A different pen-side hematological formula, i.e., Hb (g/dL) = 0.66(TEC) + 6.1, however, provides a better estimate of Hb from the TEC in cattle blood. Using hemocytometry for TEC in the field, all the stakeholders associated with veterinary research, academics, and practice may benefit from this formula in resource-poor countries.

Analysis of risk factors and construction of nomograph model for critical condition of patients with hypertension during pregnancy.

OBJECTIVE: This study aims to construct the risk prediction nomogram model of critical condition in patients with hypertension during pregnancy and to verify its evaluation effect. METHODS: A total of 531 patients with hypertension during pregnancy were randomly grouped into 427 model group and 104 validation group. The model group patients included 59 cases of critical group and 368 cases of non-critical group according to the occurrence of critical situation. Multivariate Logistic regression analysis was conducted to determine the risk factors of critical condition in patients with hypertension during pregnancy, and R software was used to construct the nomogram model. Moreover, the prediction efficiency of the model was evaluated. RESULTS: The proportions of patients aged over 30 years, with an educational background of junior high school or below, a family history of hypertension, anemia during pregnancy, and a lower erythrocyte count were significantly higher in the critical group compared to the non-critical group (P < 0.05). Age > 30 years old, educational background of junior high school and below, family history of hypertension, anemia during pregnancy, and red blood cell count were independent risk factors for the occurrence of critical condition in patients with hypertension during pregnancy (P < 0.05). The prediction model formula Z = 1.857×Age + 1.167×Education + 1.601×Family history of hypertension + 1.815×Pregnancy anemia + 3.524×Red blood cell count+(-19.769). The area under the curve (AUC) of the nomogram in the modeling group for predicting the risk of critical situations was 0.926 (95% CI = 0.887 ~ 0.964), indicating excellent discrimination. The calibration curve closely resembled the ideal curve, demonstrating good agreement between the predicted and actual values. The AUC of the validation group's nomogram to predict the risk of critical situation was 0.942 (95% CI = 0.872 ~ 0.998), with good discrimination. The calibration curve was close to the ideal curve, and the actual value was in good agreement with the predicted value. CONCLUSION: The nomograph model can predict the risk of critical condition in patients with hypertension during pregnancy and screen high-risk population.

Red blood cell count and risk of adverse outcomes in patients with mildly reduced left ventricular ejection fraction.

BACKGROUND: Anemia is associated with increased rates of heart failure (HF)-related mortality and hospitalization. No studies have focused on the association between the red blood cell (RBC) count and the prognosis of patients with HF with mildly reduced left ventricular ejection fraction (HFmrEF). We retrospectively analyzed the effect of the RBC count on outcome events in patients with HFmrEF. METHODS: We investigated the association of the RBC count with outcome events in 1691 patients with HFmrEF (mean age: 68 years; 35% female) in Xiangtan Central Hospital. Using Cox proportional hazards models, the RBC count was assessed as both a continuous and categorical variable. RESULTS: During follow-up (median: 33 months), cardiovascular death occurred in 168 patients (114 men and 54 women). After adjusting for established risk factors, each 1.0 × 1012 cell/L increase in the RBC count was associated with a 28% lower risk of cardiovascular death in men and a 43% lower risk in women. Patients with low RBC counts had a 0.5-fold higher risk of cardiovascular death than those with normal RBC counts. The hazard ratio for men was 1.42 (95% confidence interval [CI]: 1.07-1.89), and the hazard ratio for women was 1.79 (95% CI: 1.20-2.67). The RBC count was not significantly associated with the composite endpoint of cardiovascular death and HF readmission (cardiovascular events) (p > .05). CONCLUSIONS: A decreased RBC count is associated with increased cardiovascular mortality in patients with HFmrEF. Correcting a low RBC count might potentially reduce the risk of cardiovascular death in patients with HFmrEF.

Haematological values in cattle reared in humid and subhumid tropics of Mexico.

The objective of this study was to determine some factors that influence the haematological values of cattle reared in the humid and subhumid tropics of Mexico. Whole blood samples were taken from 1355 crossbred cattle in the years 2017 to 2019. Haematocrit (HTC, %), total plasma protein (TPP, g/dL) and peripheral eosinophils count (PEOS, × 103/µL) were determined manually, and the main haematological variables were recorded with an automatic analyser. The statistical analysis considered as classification variables age, sex, season (cold, dry and rainy), year (2017, 2018 and 2019) and origin of the cattle. The mean of the haematological parameters was determined along with the confidence limits (CL) of the different categories of animals according to age. Calves younger than 1-year-old presented higher levels of HTC, red blood cell count (RBC), haemoglobin (HGB), red blood cell distribution width (RDW), platelet number (PLT), white blood cell count (WBC) and lymphocyte count (LYMF) than animals older than 2 years of age. However, they showed the lowest mean cell volume (MCV) and TPP values. In cows, the highest levels of PEOS, granulocytes (GRAN), MCV and medium cells (MID) were observed and the lowest HTC, RBC, RDW and WBC levels. Intervals were determined with the 1st quartile (Q1) or lower confidence interval (90% CI) as the minimum values and the 3rd quartile (Q3) or upper confidence interval (90% CI) as the maximum values. The haematological parameters of cattle reared in the Southeast of Mexico are significantly affected by age, sex and environmental conditions.

Lower initial red blood cell count in cerebrospinal fluid predicts good functional outcome in patients with spontaneous subarachnoid haemorrhage.

BACKGROUND AND PURPOSE: Red blood cell (RBC) degradation after subarachnoid haemorrhage (SAH) negatively affects functional outcome. Although the detection of RBCs in the cerebrospinal fluid (CSF) is a widely available part of neurological routine diagnostics, the prognostic value as a biomarker remains unclear. This study was undertaken to investigate whether CSF RBC count correlates with established radiological markers of SAH volume and whether the CSF RBC count can predict functional outcome in SAH patients. METHODS: A total of 121 consecutive spontaneous SAH patients were retrospectively analyzed. CSF was collected from external ventricular drain as part of routine diagnostic procedures. We used multivariable binary logistic regression to investigate associations between CSF RBC counts and functional outcome 3 months after SAH or hospital survival. Good functional outcome was defined as modified Rankin Scale ≤ 2. RESULTS: Patients' age was 60 ± 14 years, and the median admission Hunt & Hess grade (H&H) was 4. CSF samples were collected 2 days after intensive care unit admission. High CSF RBC counts positively correlated with radiological measurements for SAH volume, for example, modified Fisher score (p = 0.002) and Hijdra ventricle score (p = 0.016). Multivariable regression analysis adjusted for age, H&H grade, modified Fisher and Hijdra scores showed that low CSF RBC counts predicted hospital survival (per 100,000 CSF RBCs: adjusted odds ratio [adjOR] = 0.74, 95% confidence interval [CI] = 0.61-0.89, p = 0.001) and good functional outcome after 3 months (per 100,000 CSF RBC: adjOR = 0.76, 95% CI = 0.60-0.96, p = 0.020). CONCLUSIONS: CSF RBC counts correlate with radiographic scores quantifying SAH volume and may serve as an early independent biomarker for hospital survival and good functional 3-month outcome in patients requiring ventriculostomy after SAH.

Gut microbiota were altered with platelet count and red blood cell count in immune thrombocytopenia patients with different treatments.

The gut microbiome is clearly linked to the development of various autoimmune diseases, however, its association with immune thrombocytopenia (ITP) is less well understood. The current study collected 73 samples, including 36 from healthy individuals and 37 from ITP patients. The gut microbial community was assessed using 16s rRNA sequencing. Findings illustrated that the abundance of key microbiota was significantly higher in the ITP group. This group was further divided into three subgroups that received different treatments for ITP. A random forest model was used to predict the key microbiota and the identified bacteria were shown to easily distinguish between the healthy and the ITP treatment groups. Microbial function annotation and difference analysis showed that drug treatment changed the gut microbiota and may play a role in inducing host autoimmune responses by changing microbial metabolism pathways. Clinical indices also correlated negatively with changes in the microbiota after treatment. In summary, ITP patients who received drug treatment had significant differences in their microbiota along with a high abundance of bacteria. Thus, the microbiome could be used as a biomarker to distinguish between healthy and ITB groups. The key differential bacteria could help to regulate the number of platelets in ITP patients and provide a red blood cell overstock.