The most common inadequacies in red blood cell requests at a reference center in Western Paraná state

Abstract Introduction In the current scenario, in which evidence-based medicine is almost obligatory, therapeutic approaches are increasingly being restricted to measures that are proven to bring benefits to the patient. Transfusion therapy follows the same concept. Even though it can be an essential support procedure in some situations, it must be carefully used, exclusively in situations in which the literature assures scientific support for its usage. Transfusion exposes patients to risks and complications, so it is necessary that we, as doctors, continue working to reduce possible mistakes involving the practice of this type of therapy. Objective To analyze if the red blood cell requests are properly made, analyzing the indication written on them (by the doctor, comparing them to the references in the actual literature. Method In this research, we have analyzed and reviewed the requests for red blood cell concentrates between August and September of 2018 received at the Hematology and Hemotherapy Center studied to find the most common mistakes made by requesters/doctors. Results A total of 397 of the 754 analyzed requests were evaluated as inadequate. Therefore, 1 out of every 2 transfusions performed did not have their requests properly completed in the city of Cascavel, Paraná. Conclusions The number of inappropriate requests was high during the studied period, especially when compared to studies available in the literature. The number of inadequacies suggests that the blood component requests and the subsequent evaluation by the transfusion agency needs to be better addressed in clinical practice.

Efectos a corto plazo del tratamiento con insulina, sobre los índices hematimétricos en diabéticos / Short-term effects of insulin treatment on hematimetricindices in diabetic subjects

Evaluar el efecto a corto plazo del tratamiento con insulina, sobre los índices hematimétricos en sujetos adultos diabéticos tipo 2. Metodología: Estudio retrospectivo, donde se registraron los índices hematimétricos y la glicemia de 44 pacientes hospitalizados (24 masculinos),de 58,7 ± 4,4 años de edad, diabéticos tipo 2, antes y después de 6 ± 2 horas del tratamiento con insulina. Resultados: No se encontraron diferencias estadísticamente significativas entre los índices hematimétricos antes y después del tratamiento y tampoco entre los sexos. La glicemia basal se correlacionó con el contaje de glóbulos rojos (r = 0,417; p = 0,03), el volumen corpuscular medio (r = 0,424; p= 0,04), la hemoglobina (r =0,626; p = 0,001), el hematocrito (r = 0,574; p = 0,005) y la hemoglobina corpuscular media (r = 0,537; p = 0,01). Al dividir a la muestra en dos grupos (G1 y G2), tomando en cuenta el valor de la mediana de la diferencia de la glicemia antes y después del tratamiento (G1:<139 mg/dL y G2 ≥ 139 mg/dL), se encontró diferencia estadísticamente significativa en el volumen corpuscular medio del G2 antes y después del tratamiento; en la hemoglobina entre G1 y G2, tanto antes como después del tratamiento y en el volumen corpuscular medio entre G1 y G2,después del tratamiento (p < 0,05). Conclusión: La insulina pareciera provocar a corto plazo, un aumento del volumen corpuscular medio en sujetos que disminuyen significativamente su glicemia(AU)

To evaluate the short-term effect of insulintreatment on hematimetric indices in type 2 diabetic adultsubjects. Methodology: It was a retrospective study, wherehematimetric indices and glycemia of 44 hospitalized patients(24 male), 58.7 ± 4.4 years old, type 2 diabetics, were recordedbefore and ather 6 ± 2 hours of insulin treatment. Results:no statistically significant differences were found between thehematimetric indices before and aer treatment and neitherbetween the sexes. Basal glycemia correlated with red blood cellcount (r = 0,417; . = 0,03), mean corpuscular volume (r =0,424; . = 0,04), hemoglobin (r = 0,626; . = 0,001), hematocrit(r = 0,574; . = 0,005), and mean corpuscular hemoglobin(r=0,537; .=0,01). When dividing the sample into two groups,taking into account the median value of the difference inglycemia before and aer treatment (G1: < 139 mg/dL and G2 ≥ 139 mg/dL), a statistically significant difference was found inthe mean corpuscular volume of G2 before and after treatment;in hemoglobin between G1 and G2, both before and aertreatment and in mean corpuscular volume between G1 and G2,after treatment (. <0.05). Conclusion: Insulin seems to cause,in the short term, an increase in mean corpuscular volume insubjects who significantly lower their glycemia(AU)

Utilidad de la fórmula HUGE para el diagnóstico de enfermedad renal crónica en el anciano / Usefulness of the HUGE formula for the diagnosis of chronic kidney disease in the elderly

INTRODUCCIÓN: La enfermedad renal crónica se encuentra en ascenso.Prevenir o retardar su progresión mediante la aplicación de estrategias dirigidas al diagnóstico precoz es esencial. OBJETIVO: Evaluar la utilidad de la fórmula HUGE para el diagnóstico de Enfermedad Renal Crónica en el anciano. MATERIAL Y MÉTODO: Se realizó un estudio observacional descriptivo prospectivo y de corte longitudinal en 260 adultos mayores que ingresaron en los servicios de Geriatría y Medicina Interna del Hospital Clínico Quirúrgico "Hermanos Ameijeiras" en el período enero de 2019 y junio de 2020. RESULTADOS: El 58,5% de la muestra de estudio fueron mujeres. La edad promedio fue de 77,1 ± 7,3 años. La enfermedad renal crónica estuvo presente en el 64,2% de los pacientes. Se observó mayor frecuencia de pacientes con daño renal (32,7%) al emplear la formula CKD­ EPI en comparación con los identificados al emplear la fórmula HUGE (25,0%). Al estimar la concordancia entre ambas fórmulas se observó un estadístico kappa (k) de 0,814 (IC de 95%:0,7370 - 0,8909; p < 0,001). La sensibilidad de la fórmula de HUGE fue de un 76,5% (IC de 95%: 66,9% - 86,1%) y la especificidad de un 100% (99,7% - 100%). El valor predictivo positivo fue de 100 % (IC de 95%: 99,2% - 100%) y el negativo de 89,7% (85,2% - 94,2%). CONCLUSIONES: La fórmula CKD-EPI identifica daño renal en mayor porcentaje, en estadios precoces. Por el contrario, la fórmula de HUGE, detecta el daño renal en un porcentaje mayor en estadios más avanzados.La concordancia para diagnosticar daño renal entre la fórmula CKD-EPI y HUGE fue muy buena. La fórmula HUGE es útil, sensible y específica para evaluar la enfermedad renal crónica en los adultos mayores.

INTRODUCTION: Chronic kidney disease is on the rise. Preventing or delaying its progression through the application of strategies aimed at early diagnosis is essential. OBJECTIVE: To evaluate the usefulness of the HUGE formula for the diagnosis of Chronic Kidney Disease in the elderly. MATERIAL AND METHOD: A prospective, descriptive and longitudinal observational study was carried out in 260 older adults who were admitted to the Geriatrics and Internal Medicine services of the "Hermanos Ameijeiras" Surgical Clinical Hospital between January 2019 and June 2020. RESULTS: 58.5% of the study sample was women. The mean age was 77.1 ± 7.3 years. CKD was present in 64.2% of the patients. A higher frequency of patients with kidney damage (32.7%) was observed when using the CKD ­ EPI formula compared to those identified when using the HUGE (25.0%). When estimating the concordance between both formulas, a kappa statistic (k) of 0.814 (95% CI: 0.7370 - 0.8909; p < 0.001) was observed. The sensitivity of the HUGE formula was 76.5% (95% CI: 66.9% - 86.1%) and the specificity was 100% (99.7% - 100%). The positive predictive value was 100% (95% CI: 99.2% - 100%) and the negative predictive value was 89.7% (85.2% - 94.2%). CONCLUSIONS: The CKD-EPI formula identifies kidney damage in a higher percentage, in early stages. On the contrary, the HUGE formula detects kidney damage in a higher percentage in more advanced stages. The concordance to diagnose kidney damage between the CKD-EPI and HUGE formula was very good. The HUGE formula is useful, sensitive, and specific for evaluating chronic kidney disease in older adults.

Anemia, estado nutricional y parasitosis intestinales en niños de hogares de Guayas / Anemia, nutritional status and intestinal parasites in children from homes in Guayas

Las parasitosis intestinales afectan principalmente a países subdesarrollados, donde se presentan condiciones socioeconómicas y geográficas propicias para desarrollarse, con mayor prevalencia en la población infantil. Dichas infecciones se han asociado a desnutrición y anemia, consideradas las alteraciones nutricionales más graves a nivel global. Se realizó un estudio descriptivo en 87 niños de la provincia de Guayas, Ecuador, con edades entre 24 y 59 meses, para determinar anemia, evaluar el estado nutricional y parasitosis intestinal. Se determinaron parámetros antropométricos, valores de hemoglobina y hematocrito, y se identificó las especies parasitarias. Se obtuvo mayor proporción de infantes eutróficos para talla e IMC según el género y grupo etáreo; los niños presentaron mayor prevalencia de sobrepeso, obesidad, retardo en la talla y delgadez, respecto las niñas; además el grupo etáreo entre 4 -5 años presentó mayor retardo en crecimiento y delgadez. Asimismo, 24,14% de niños presentaron anemia y los individuos parasitados significativamente presentaron anemia, mayor retardo en la talla y delgadez, frente a los no parasitados; siendo los protozoarios Entamoeba histolytica, Entamoeba coli y Giardia intestinalis los más frecuentes, mientras que, Enterobius vermicularis y Ascaris lumbricoides fueron los helmintos predominantes. El presente estudio evidencia deficiencias nutricionales asociadas a anemia e infección por parásitos intestinales en niños menores de 5 años de la provincia de Guayas; cuya población requiere adecuados servicios de salud y saneamiento, acceso a los alimentos, apropiadas prácticas de higiene y educación sanitaria, que contribuyan a aminorar los efectos de estas patologías y sus complicaciones(AU)

Intestinal parasites mainly affect underdeveloped countries, where socioeconomic and geographical conditions are conducive to development, with a higher prevalence in the child population. These infections have been associated with malnutrition and anemia, considered the most serious nutritional disorders globally. A descriptive study was carried out in 87 children from the province of Guayas, Ecuador, aged between 24 and 59 months, to determine anemia, evaluate nutritional status and intestinal parasitosis. A higher proportion of eutrophic infants was obtained for height and BMI according to gender and age group; boys had a higher prevalence of overweight, obesity, delayed height and thinness, compared to girls; In addition, the age group between 4 -5 years presented greater retardation in growth and thinness. Likewise, 24.14% of children presented anemia and significantly parasitized individuals presented anemia, greater delay in height and thinness, compared to those without parasitization; being the protozoa Entamoeba histolytica, Entamoeba coli and Giardia intestinalis the most frequent, while Enterobius vermicularis and Ascaris lumbricoides were the predominant helminths. The present study shows nutritional deficiencies associated with anemia and infection by intestinal parasites in children under 5 years of age in the province of Guayas; whose population requires adequate health and sanitation services, access to food, appropriate hygiene practices and health education, which contribute to lessen the effects of these pathologies and their complications(AU)

Economic impact of gastrointestinal nematodes in Morada Nova sheep in Brazil / Impacto econômico de nematódeos gastrintestinais em ovinos Morada Nova no Brasil

Abstract This study evaluated the economic impact of gastrointestinal nematode (GIN) infection in Morada Nova lambs under different parasite chemical control conditions. For this, 246 lambs, in the rainy and dry season, were randomized into groups according to their anthelmintic treatment with levamisole: control (CT: no treatment); routine treatment (RT: treated every 42 days); and targeted selective treatment (TST: treated according to the average daily weight gain, DWG). From 63 days of age (D63) to D210, the lambs were weighed and monitored for GIN infection parameters. Spending on anthelmintics in the production system was 1.3% of the total economic result. The economic result per animal (R$ 5.00 = US$ 1.00) was higher in the RT group, amounting to US$ 6.60 in the rainy and US$ 5.69 in the dry season, due to higher DWG. Thus, RT presented economic results 14.4% and 10.9% higher than CT, and 7.2% and 1.9% higher than TST, in the rainy and dry season, respectively. However, fast development of resistance made RT unfeasible. Here, the economic impact of GIN infection on a national scale is discussed, demonstrating its importance and the impossibility of profitable and sustainable sheep production without adequate control.

Resumo Este estudo avaliou o impacto econômico da infecção por nematoides gastrintestinais (NGI), em cordeiros Morada Nova, sob diferentes condições de controle químico dos parasitas. Para isso, 246 cordeiros, na estação chuvosa e seca, foram randomizados em grupos de acordo com o tratamento com levamisol: controle (TC: sem tratamento); tratamento rotineiro (TR: tratado a cada 42 dias); e tratamento seletivo direcionado (TST: tratado de acordo com o ganho de peso médio diário, GMD). Dos 63 dias de idade (D63) ao D210, os cordeiros foram pesados ​​e monitorados quanto aos parâmetros de infecção por NGI. O gasto com anti-helmínticos no sistema produtivo foi de 1,3% do resultado econômico total. O resultado econômico por animal (R$ 5,00 = US$ 1,00) foi maior no grupo RT, totalizando US$ 6,60 na estação chuvosa e US$ 5,69 na seca, devido ao maior GMD. Assim, o RT apresentou resultados econômicos 14,4% e 10,9% superiores ao TC, e 7,2% e 1,9% superiores ao TST, no período chuvoso e seco, respectivamente. Entretanto o rápido desenvolvimento de resistência inviabiliza o TR. O impacto econômico da infecção por NGI em escala nacional são aqui discutidos, demonstrando sua importância e a impossibilidade de uma ovinocultura lucrativa e sustentável sem o controle adequado.

Avaliação da anemia e outros biomarcadores em pacientes alcoolistas / Evaluation of anemia and other biomarkers in alcoholic patients

Introdução: os transtornos por uso de álcool afetam milhões de pessoas em todo o mundo e podem comprometer vários órgãos e sistemas, em muitos casos devido à deficiência de micronutrientes. O objetivo deste artigo é avaliar a frequência e caracterizar a anemia e os biomarcadores metabólicos e hepáticos em pacientes alcoolistas. Metodologia: trata-se de um estudo transversal, no qual foram incluídos 65 pacientes alcoolistas, do sexo masculino, internados no Centro de Acolhimento e Tratamento de Alcoolistas, das Obras Sociais Irmã Dulce. Resultados: a maioria dos indivíduos avaliados apresentou contagem de hemácias, teor de hemoglobina e hematócrito abaixo dos valores de referência, com uma frequência de 61,5% (40/65) para todos os parâmetros e uma média de 4,1x106/uL, 13,0 g/dL e 38,6%, respectivamente. Entre os 40 indivíduos que apresentaram anemia, prevaleceu um padrão normocítico (25/40) e normocrômico (32/40) e uma frequência de anisocitose de 35,0% (14/40). Observou-se elevada frequência de indivíduos com altos níveis de AST e GGT, 64,6 (42/65) e 76,9% (50/61), respectivamente, enquanto apenas 13,8 (9/65) e 3,1% (2/63) apresentaram alterações na concentração plasmática de albumina e no tempo de protrombina, respectivamente. Conclusão: neste trabalho, foi possível observar uma elevada frequência de anemia normocítica e normocrômica, bem como altos níveis de AST e GGT, enquanto os biomarcadores da função hepática estavam dentro do valor de referência. Estes resultados contribuem para o entendimento da saúde do indivíduo alcoolista, podendo auxiliar na elaboração de medidas públicas que atuem na prevenção e promoção da saúde desses pacientes.

Introduction: alcohol use disorders affect millions of people around the world and can compromise many organs and systems. The aim of the essay is to evaluate frequency and characterize anemia and metabolic and hepatic biomarkers in alcoholic patients. Methods: it is a cross-sectional study in which 65 male alcoholic patients admitted to treatment at Center for Reception and Treatment for Alcoholics at Sister Dulce Social Works. Results: most evaluated individuals had red blood cell count, hemoglobin content and hematocrit below reference values, with frequency of 61.5% (40/65) for all parameters and a mean of 4.1x106/uL, 13.0 g/dL and 38.6%, respectively. Among 40 individuals who presented anemia, a normocytic (25/40) and normochromic (32/40) pattern prevailed, and anisocytosis frequency of 35.0% (14/40). A high frequency of individuals with increased AST and GGT levels was observed, 64.6 (42/65) and 76.9% (50/61), respectively, while only 13.8 (9/65) and 3.1% (2/63) presented alterations in albumin levels and prothrombin time, respectively. Conclusion: study shows that it was possible to observe a high frequency of normocytic and normochromic anemia, as well as high levels of AST and GGT, while liver function biomarkers were within reference value. Results contribute to the understanding of alcoholic individuals' health, and may help with elaboration of public measures to prevention and promotion of health for these patients

Nelore females along a new Brazilian agricultural frontier: hematological and clinical-biochemical approaches / [Abordagens hematológicas e bioquímicas clínicas de fêmeas Nelore na nova fronteira agrícola brasileira]

The Nelore breed is the second largest bovine breed in the world and has actively participated in the expansion of new Brazilian agricultural frontiers. In this context, the purpose of this study was to determine the hematological and biochemical reference intervals of healthy Nelore matrices raised under an extensive regime without supplementation along southwest of Piauí state. Blood samples were collected from fifty-five multiparous female of the Nelore breed. Biochemical and hematological parameters were analyzed using a parametric statistical method with 95% CI of reference limits. The average values of red blood cells, hemoglobin as well as hematimetric indices showed reference ranges similar to reference standards. The hematocrit as well as granulocytes and agranulocytes presented alterations typical of animals raised in environments with higher temperatures. Mineral, enzymatic, protein and metabolic profiles were similar to other bovine breeds but with a narrower range of values. However, lower mean values were observed for levels of ionized calcium, total protein and urea. Nelore females present slightly different biochemical and hematological profiles from other breeds, which might result from the environmental and nutritional management applied and the natural deficiency of nitrogen, phosphorus and calcium in the region's pastures.(AU)

Nelore é a segunda maior raça bovina do mundo e tem participado ativamente da expansão das novas fronteiras agrícolas brasileiras. Nesse contexto, o objetivo do presente estudo foi determinar os intervalos de referência hematológicos e bioquímicos de matrizes Nelore criadas em regime extensivo sem suplementação, ao longo do sudoeste do estado do Piauí. Amostras de sangue foram coletadas de 55 fêmeas multíparas da raça Nelore. Os parâmetros bioquímicos e hematológicos foram analisados por método estatístico paramétrico com IC 95% para os limites de referência. Os valores médios de hemácias, hemoglobina e índices hematimétricos apresentaram intervalos de referência semelhantes aos padrões de referência. Tanto o hematócrito quanto os granulócitos e os agranulócitos apresentaram alterações típicas de animais criados em ambientes com temperaturas mais elevadas. Os perfis mineral, enzimático, proteico e metabólico foram semelhantes aos de outras raças bovinas, mas com uma faixa de valores mais estreita. No entanto, valores médios mais baixos foram observados para os níveis de cálcio ionizado, proteína total e ureia. Fêmeas Nelore apresentam perfis bioquímicos e hematológicos ligeiramente diferentes de outras raças, o que pode resultar dos manejos ambiental e nutricional aplicados e da deficiência natural de nitrogênio, fósforo e cálcio nas pastagens da região.(AU)

Impact of the novel coronavirus disease and lockdown on the packed red blood cells inventory management: An experience from a tertiary care oncology center in Western India

ABSTRACT Introduction The novel coronavirus disease has disrupted blood transfusion services worldwide. Despite blood transfusion services taking several precautionary measures to minimize the risks of COVID-19 during blood donations, donors became anxious regarding the risk of the COVID-19 infection during the donation and the blood transfusion services was facing the inevitable hazard of blood shortage. Methods The study was conducted at a tertiary care oncology hospital-based blood transfusion services and included analysis of blood donations, packed red blood cell units requirements, and packed red blood cell inventory in the pre lockdown and lockdown phase. New COVID-19 standard operating procedures with enhanced safety guidelines and donor confidence-building measures were implemented at the blood transfusion services. Results The total number of average monthly blood donations decreased in lockdown but the decrease was not statistically significant (238.5 vs. 197.8, P = 0.391). The requisitions for the packed red blood cell cross-matches (722.5 vs. 329.0, P = 0.001) and the packed red blood cell utilization (176.5 vs. 103.3, P = 0.028) for the hospital patients also decreased significantly due to the lockdown. In the lockdown phase, an expressive number of packed red blood cell units were outdated due to the unprecedented fall in the number of patients. In the post-lockdown phase, the packed red blood cell inventory was optimized with decreased outdating via a comprehensive approach. A special emphasis was given to the in-house donations. A second partial lockdown also decreased the blood donations. Conclusion Confidence-building in blood donors and the resolution of logistical issues were crucial for the efficient packed red blood cell inventory management in the lockdown. Implementation of COVID-19 preventive measures helped in the blood donor and blood transfusion services staff safety.

The effect of dialectic behavioral counseling on depression, anxiety, and postpartum hematocrit levelprotocolo 20210073553284 prefeitura

Abstract Objective Childbirth is a biological, psychological, and sociological event that can be a positive or negative experience, and, without support, this period may be potentially damaging. Parturition may distort maternal emotions and lead to short- or long-term disorders such as postpartum depression and anxiety. The present research aims to study the effects of dialectic behavioral therapy-based counseling on depression, anxiety symptoms, and postpartum hematocrit level. Methods The current research is a clinical trial study, and the sample was selected using parturients who were referred to the Health General Center with a diagnosis of postpartum depression and anxiety. The sample size consisted of 116 subjects who agreed to participate in the study. The patients in intervention group underwent group dialectic behavioral counseling (10 sessions/one session per week) and the control group did not receive any type of intervention. The patients were assessed in the first and last sessions as well as 2 months after the end of the sessions, using the Beck depression scale and Spielberg anxiety scale as well as the results of hematocrit tests. Data were analyzed using the IBMSPSS Statistics for Windows, Version 21.0 (IBMCorp., Armonk, NY, USA) Results The results implied the effectiveness of dialectic behavioral therapy on reduction of the depression score, anxiety symptoms (p-value ≤ 0.0001), and hematocrit level (p-value=0.04). The participants' depression, anxiety, and hematocrit levels decreased in the experiment group compared to the control group, and this decrease has remained until the 2-month follow-up. Conclusion It seems that dialectic behavioral counseling reduces the levels of postpartum depression, anxiety, and hematocrits.

Parâmetros sanguíneos de potros da raça Crioula / Blood parameters of crioulo breed horse

Com o propósito de estabelecer valores de hematócrito, proteínas plasmáticas totais, fibrinogênio, creatina quinase , aspartato transferase e lactato em potros da raça Crioula, do nascimento até os dois anos, utilizaram-se amostras sanguíneas de 85 animais, divididos pela estratificação etária: Grupo 1 (G1) Até 15 dias de vida (n=70); grupo 2 (G2), entre 16 dias até um mês (n=67); grupo 3 (G3), entre 1 e 3 meses (n=75); grupo 4 (G4), entre 3 e 6 meses (n=64); grupo 5 (G5), entre 6 e 9 meses (n=59); grupo 6 (G6), entre 9 e 18 meses (n=39); e grupo 7 (G7), entre 18 meses até 2 anos (n=17). Foi realizado estudo estatístico entre os grupos pela análise de variância unidirecional (one-wayANOVA), complementada pelo teste de Tukey. Para comparação das médias entre os sexos utilizou-se o teste t de Student. O hematócrito foi significativamente mais elevado até os 90 dias e nas fêmeas do G7. Para proteínas plasmáticas totais, notou-se aumento significativo nos grupos 3, 4, 6 e 7. Os valores de fibrinogênio foram maiores no G1. A CK apresentou maior concentração no G5 e a AST no G7. A AST assumiu valores semelhantes dos 30 dias até os 2 anos. A concentração de lactato foi mais elevada no G3. Conclui-se que na interpretação dos exames laboratoriais de potros da raça crioula, o gênero não interfere significativamente nos resultados, porém a idade deve ser considerada devido à ocorrência de variações relevantes. Recomenda-se que para interpretação sejam consultadas tabelas específicas para cada análise.

Plasma levels of hematocrit, total plasma protein, fibrinogen, creatine phosphokinase, aspartate transferase, and lactate were analyzed in blood samples of 85 Crioula breed foals, from birth to two years of age. The animals were divided into age groups: G1 (up to 15 days of age; n=70), G2 (from 16 days to one month of age; n=67), G3 (between one and three months of age; n=75), G4 (between three and six months of age; n=64), G5 (between six and nine months of age; n=59), G6 (between nine and 18 months of age; n=39), and G7 (between 18 months and two years of age; n=17). These groups were statistically analyzed by one-way variance analysis (ANOVA) and Tukey’s test. Male and female means were compared by Student’s t-test. Hematocrit levels were significantly higher up to 90 days of age and in G7 females. Total plasma proteins increased significantly in groups 3, 4, 6, and 7. The highest fibrinogen levels were found in G1. Yet for creatine phosphokinase, the highest concentrations were detected in G5, whereas those of aspartate aminotransferase in G7. The levels of this enzyme remained similar from 30 days to two years of age. Lactate concentrations were higher in G3. We concluded that the sex of the animal had no significant effect on laboratory test interpretations. By contrast, the age of the animal should be considered since relevant variations were observed with time. Nevertheless, specific tables for each analysis should be consulted for interpretation of results.

Blood parameters of crioulo breed horse / Parâmetros sanguíneos de potros da raça Crioula

Plasma levels of hematocrit, total plasma protein, fibrinogen, creatine phosphokinase, aspartate transferase, and lactate were analyzed in blood samples of 85 Crioula breed foals, from birth to two years of age. The animals were divided into age groups: G1 (up to 15 days of age; n=70), G2 (from 16 days to one month of age; n=67), G3 (between one and three months of age; n=75), G4 (between three and six months of age; n=64), G5 (between six and nine months of age; n=59), G6 (between nine and 18 months of age; n=39), and G7 (between 18 months and two years of age; n=17). These groups were statistically analyzed by one-way variance analysis (ANOVA) and Tukey's test. Male and female means were compared by Student's t-test. Hematocrit levels were significantly higher up to 90 days of age and in G7 females. Total plasma proteins increased significantly in groups 3, 4, 6, and 7. The highest fibrinogen levels were found in G1. Yet for creatine phosphokinase, the highest concentrations were detected in G5, whereas those of aspartate aminotransferase in G7. The levels of this enzyme remained similar from 30 days to two years of age. Lactate concentrations were higher in G3. We concluded that the sex of the animal had no significant effect on laboratory test interpretations. By contrast, the age of the animal should be considered since relevant variations were observed with time. Nevertheless, specific tables for each analysis should be consulted for interpretation of results.

Com o propósito de estabelecer valores de hematócrito, proteínas plasmáticas totais, fibrinogênio, creatina quinase , aspartato transferase e lactato em potros da raça Crioula, do nascimento até os dois anos, utilizaram-se amostras sanguíneas de 85 animais, divididos pela estratificação etária: Grupo 1 (G1) Até 15 dias de vida (n=70); grupo 2 (G2), entre 16 dias até um mês (n=67); grupo 3 (G3), entre 1 e 3 meses (n=75); grupo 4 (G4), entre 3 e 6 meses (n=64); grupo 5 (G5), entre 6 e 9 meses (n=59); grupo 6 (G6), entre 9 e 18 meses (n=39); e grupo 7 (G7), entre 18 meses até 2 anos (n=17). Foi realizado estudo estatístico entre os grupos pela análise de variância unidirecional (one-wayANOVA), complementada pelo teste de Tukey. Para comparação das médias entre os sexos utilizou-se o teste t de Student. O hematócrito foi significativamente mais elevado até os 90 dias e nas fêmeas do G7. Para proteínas plasmáticas totais, notou-se aumento significativo nos grupos 3, 4, 6 e 7. Os valores de fibrinogênio foram maiores no G1. A CK apresentou maior concentração no G5 e a AST no G7. A AST assumiu valores semelhantes dos 30 dias até os 2 anos. A concentração de lactato foi mais elevada no G3. Conclui-se que na interpretação dos exames laboratoriais de potros da raça crioula, o gênero não interfere significativamente nos resultados, porém a idade deve ser considerada devido à ocorrência de variações relevantes. Recomenda-se que para interpretação sejam consultadas tabelas específicas para cada análise.

Densidad escanográfica de los senos venosos en pacientes sanos a 2600 metros sobre el nivel del mar / Computed Tomography Density of the Venous Sinuses in Healthy Patients at 2600 Meters Above Sea Level

Introducción: Existe relación entre la densidad escanográfica de las estructuras vasculares medida en unidades Hounsfield (UH) y el hematocrito, el cual se incrementa en las personas que viven a mayor altitud sobre el nivel del mar. Se ha descrito que una densidad de 70 UH es el valor límite superior de normalidad de densidad de los senos venosos en personas sin trombosis venosa que habitan a una altitud de 1.000 m s. n. m.; sin embargo, no se ha establecido esta medida en personas que habitan en altitudes geográficas mayores. En este estudio se determinó dicho valor para personas sin trombosis de senos venosos que viven a 2.600 m s. n. m. Objetivo: Este estudio tiene como propósito caracterizar la densidad normal de los senos venosos en pacientes que habitan en altitudes geográficas de 2.600 m s. n. m. Metodología: Se analizaron las densidades escanográficas de los senos venosos longitudinal superior y de los sitios de unión entre los senos transversos y senos sigmoides de 240 sujetos que habitan a 2.600 m s. n. m., quienes asistieron a la institución entre enero de 2008 y junio de 2016. Estas personas consultaron por cefalea, convulsiones, alteración del estado de conciencia o focalización neurológica. A estos pacientes se les realizó inicialmente un estudio escanográfico de cráneo simple, hemoglobina y hematocrito con diferencia no mayor a 3 días entre el estudio escanográfico y el hemograma, así como estudios confirmatorios de positividad o ausencia de trombosis de senos intracraneales mediante resonancia magnética simple o angiorresonancia. Resultados: La media de UH fue de 59,8 con un rango entre 43,2 y 74,9, para pacientes normales. Se encontró una correlación positiva de 0,49 entre el hematocrito y las UH como es ampliamente conocido en la literatura. Conclusión: El rango en UH de los pacientes sin trombosis de senos venosos es amplio y supera por 4 puntos el informado en la literatura. Esto puede ser atribuible al aumento del hematocrito en individuos que viven a 2.600 m s. n. m. Para establecer normalidad en los pacientes con valores superiores a 70 UH se sugiere tomar en cuenta la simetría de la densidad escanográfica con respecto al seno venoso contralateral, así como evaluar la morfología del borde anterior del seno venoso y la adecuada localización del ROI (Region of Interest) para medir la densidad venosa.

Introduction: There is a relationship between the intravascular density measured in Hounsfield units (HU) in computed tomography (CT) and the hematocrit levels, which increases in people who live above sea level. The expected density in venous sinuses is lower than 70 HU in healthy people living at 1000 meters above sea level. However, this measure has not been established in people living at higher geographic altitudes. In this study, this value was determined for normal people living at 2,600 meters above sea level. Objective: The purpose of this study is to characterize the normal density of the venous sinuses in patients who live at geographical altitudes of 2,600 m above sea level. Methodology: We measured the density on CT at the superior longitudinal venous sinus and at the junction between the transverse sinus and sigmoid sinus of 240 subjects living at 2600 meters above sea level from January 2008 to June 2016. These patients consulted for headache, seizures, altered state of consciousness or neurological focus. Initially, all participants had a non-enhanced CT brain, hemoglobin and hematocrit levels with a difference of no more than 3 days between the CT study and the hemogram, as well as confirmatory studies of positivity or absence of intracranial sinus thrombosis by non-enhanced MR or MRA. Results: The mean HU was 59.8 with a range between 43.2 and 74.9, for normal patients. A positive correlation of 0.49 was found between hematocrit and HU, as is widely known in the literature. Conclusion: We obtained a wide range in the HU of healthy patients compared to the values reported in other papers, and exceeds the highest value by 4 points. This may be attributable to the increased hematocrit in healthy patients living at 2,600 meters above sea level. In order to establish whether patients with venous sinus densities greater than 70 HU have venous thrombosis, our suggestion is to evaluate the symmetry of the density compared to the contralateral venous sinus, as well as to evaluate the morphology and the location of the ROI used to measure venous density.

Em busca do melhor aproveitamento de bolsas de concentrado de hemácia de baixo volume / In search of the best use of bags low-volume red blood cells concentrate

RESUMO: Introdução: A produção de bolsas de sangue total com volume inferior ao esperado é prevista na Portaria de Consolidação no 05/2017, porém, a sua dispensação hoje leva em consideração apenas o teor de hemoglobinas e hematócrito da bolsa. Objetivo: Determinar, a partir dos parâmetros técnicos brasileiros existentes, os critérios para o melhor aproveitamento para bolsas de concentrados de hemácias de baixo volume (CHBV) produzidas na Fundação HEMOPA. Material e métodos: Foram analisados volume, teor de hemoglobina e hematócrito de 525 bolsas de CHBV provenientes de bolsas duplas sem adição de conservante; triplas convencional com adição de SAG-M (soro fisiológico, adenina, glicose e manitol); triplas top and bottom (TAB) com adição de SAG-M; e quádruplas TAB com filtro "in line" e adição de SAG-M. Resultados: Foi observado que 71,43% (375/525) das bolsas de CHBV, independente do tipo da bolsa, apresentavam-se em conformidade para hematócrito e teor de hemoglobina em relação à legislação. As bolsas duplas e triplas convencionais apresentaram os maiores valores de teor de hemoglobina. Observou-se ainda que as bolsas de sangue total coletadas com volumes entre 350 e 404 ml geraram bolsas de CHBV com os menores índices de descarte. O maior descarte das bolsas de CHBV ocorreu quando o volume final ≤250 mL e hemoglobina ≤ 16 g/dL. Conclusão: Observou-se que o melhor aproveitamento das bolsas de CHBV ocorreu quando as bolsas de sangue total se encontravam com volumes entre 350 e 404 mL e as bolsas de CHBV apresentavam volume final ≥ 250 mL e hemoglobina ≥ 16g/dL.(AU)

ABSTRACT: Introduction: The production of whole blood bags with a lower volume than expected is approved in the Consolidation Ordinance number 05/2017; however, its dispensation today takes into account only the hemoglobin and hematocrit content of the bag. Objective: From the existing Brazilian technical parameters, determine the criteria for the best clinical use for low-volume red cell concentrate (LVRCC) bags produced at the HEMOPA Foundation. Material and methods: We analyzed volume, hemoglobin content, and hematocrit of 525 LVRCC bags from double bags without addition of preservative; conventional triple bags with the addition of SAG-M (saline, adenine, glucose, and mannitol); triples bags top and bottom (TAB) with the addition of SAG-M, and quadruple bags TAB with "in line" filter and the addition of SAG-M. Results: It was observed that 71.43% (375/525) of bags of LVRCC, regardless of bag type, were in conformance with hematocrit and hemoglobin content concerning Brazilian legislation. With the double and conventional triple bags, they had the highest values of hemoglobin content. It was also observed that the bags of whole blood collected with volumes between 350 and 404 mL generated LVRCC bags with the lowest rate of discard. The greatest discard of LVRCC bags occurred when the final volume ≤ 250 mL and hemoglobin ≤ 16 g/dL. Conclusion: It was observed that the best use of LVRCC bags occurred when the whole blood bags were between 350 and 404 mL and the LVRCC bags had a final volume ≥ 250 mL and hemoglobin ≥ 16 g/dL. (AU)

Early hematological parameters as predictors for outcomes in children with dengue in northern India: A retrospective analysis

Abstract INTRODUCTION: Dengue presents with a variable clinical course, ranging from mild illness to potentially fatal hemorrhage and shock. We aimed to evaluate the capabilities of various hematological parameters observed early in the course of illness for predicting the clinical outcomes of illness. METHODS: We retrospectively analyzed the records of children admitted in the pediatric inpatient services of the institute with dengue between 2017 and 2019. We determined the relationships between the hematological parameters observed during the first evaluation and the various clinical outcomes. RESULTS: We evaluated data from 613 patients (age range, 26 days to 17 years). Of these, 29.85% exhibited fever with warning signs, and 8.97% had severe dengue. Lower values of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, and higher values of total leukocyte count (TLC), hematocrit, and red cell distribution width variably correlated with numerous clinical outcomes-duration of hospital stay, development of complications, requirement of blood component transfusion, inotropic support, and mortality. Among the parameters, TLC ≥20,000/mL and initial platelet count ≤20,000/mL significantly associated with mortality, with odds ratios (95% confidence interval) of 11.81 (4.21-33.80) and 5.53 (1.90-16.09), respectively. CONCLUSIONS: Hematological parameters observed early during dengue infection may predict its clinical outcomes in infected children. Initial high TLC and low platelet count are potential predictors of fatal outcomes in the course of disease.

Comparative study on erythrogram parameters of Cell-Dyn Ruby and Humacount 5l / Estudio comparativo de los parámetros del eritrograma de Cell-Dyn Ruby y Humacount 5l

SUMMARY: The use of hematological counts for the prevention, diagnosis and follow-up of hematological diseases has increased. Indeed, the correct operation of a clinical laboratory is essential to producing comparable results. However, there is a paucity of validation and reproducibility studies among the different existing methods for clinical analysis. Therefore, our aim was to assess the commutability of the results provided by analyzers with different measuring systems. Sixty venous blood samples were obtained from patients, without discriminating for age or sex. Then, an automated hematological analysis was performed using the Cell-Dyn Ruby and HumaCount 5L instruments. The variables measured were: RBC, Hb, HCT, MCV, MCH and MCHC. The data were compared by a one-way ANOVA and Pearson's correlation coefficient. Statistical significance was fixed at p < 0.05. There were no statistically significant differences for RBC, HCT, MCH or MCHC. In addition, with the exception of MCHC, all the analytes showed a good correlation coefficient between the two instruments. There is a variety of automated systems for the clinical laboratory and it is essential for the clinician to know the different methodologies used in hematological analyzers as well as their sensitivity and specificity. Therefore, our results are useful for demonstrating the importance of practical knowledge of the analyzers mentioned.

RESUMEN: El uso de recuentos de células sanguíneas para la prevención, diagnóstico y monitoreo de enfermedades hematológicas ha ido en aumento. Por ello, el funcionamiento correcto de un laboratorio clínico es indispensable para producir resultados comparables. Sin embargo, existen pocos estudios de validación y reproducibilidad de los diferentes métodos de análisis clínico existentes. Por lo tanto, nuestro objetivo fue evaluar la intercambiabilidad de los resultados entregados por los analizadores que utilizan diferentes sistemas de medición. Se obtuvieron sesenta muestras de sangre venosa de pacientes, sin discriminar por edad o sexo. Los eritrogramas fueron obtenidos utilizando los analizadores automatizados Cell-Dyn Ruby y HumaCount 5L. Las variables medidas fueron: RBC, Hb, HCT, MCV, MCH y MCHC. Los datos fueron comparados por ANOVA a una vía y la correlación de Pearson. La significación estadística se estableció en el nivel estándar p<0,05. No hubo diferencias estadísticamente sig- nificativas para RBC, HCT, MCH y MCHC. Con la excepción de la MCHC, todos los analitos presentaron un buen coeficiente de correlación entre los dos analizadores comparados. Existen varios sistemas de automatización para su uso en laboratorios clínicos. Por lo tanto, es primordial para el clínico estar familiarizado con las diferentes metodologías utilizadas en los analizadores de sangre, así como su sensibilidad y especificidad. Nuestros resultados son útiles para mostrar la importancia del conocimiento práctico de los diferentes sistemas de medidas comparados.

Effect of density of fingerling and juvenile pirarucu during transportation on water quality and physiological parameters

We assessed the effect of stocking density on physiological parameters (blood lactate, glucose, cortisol, hematocrit), water quality (temperature, dissolved oxygen, pH, unionized ammonia, carbon dioxide), and survival during the transportation of fingerling (24.5 ± 4.7 g) and juvenile (615.8 ± 122.2 g) pirarucu (Arapaima gigas) for six hours in plastic bags. The tested densities were 65, 80, 95, 110 and 125 g L-1 for fingerlings, and 50, 80, 110, 140 and 170 g L-1 for juveniles (three replicates each). Parameters were measured prior to and immediately after transportation, and at 24 and 96 hours recovery after transportation. No mortality was observed, except for fingerlings (< 3%) at densities of 110 and 125 g L-1 during recovery. All the water quality parameters were significantly altered after the transportation of fingerlings and juveniles. Water temperature, dissolved oxygen, carbon dioxide and unionized ammonia increased, but pH decreased. Only carbon dioxide and unionized ammonia differed among densities. Cortisol levels did not increase over time, except for the juveniles at 170 g L-1, which still had high cortisol after 96 hours. Glucose significantly increased after transportation for all the treatments and returned to the initial values during the recovery period. Conversely, the lactate values were still high after 96 hours. Hematocrit was assessed only for juveniles and was significantly lower after transportation. We conclude that fingerling and juvenile pirarucu can be safely transported at densities up to 95 g L-1 and 140 g L-1, respectively. (AU)

Comparison of two doses of intra-articular tranexamic acid on postoperative bleeding in total knee arthroplasty: a randomized clinical trial / Comparação entre duas doses de ácido tranexâmico intra-articular no sangramento pós-operatório de artroplastia total do joelho: estudo clínico randomizado

Abstract Introduction: Tranexamic Acid (TXA), an antifibrinolytic that inhibits the fibrinolytic activity of plasmin is used to decrease perioperative blood loss and transfusion requirements in orthopedic surgery. The aim of our study was to compare postoperative bleeding in two intra-articular doses (1 g and 2 g) of tranexamic acid in adult patients undergoing unilateral total knee replacement. Method: We conducted a single-operator, randomized, and controlled, double-blind study in two groups. The G1 group received 1 g of intra-articular TXA and the G2 group 2 g of intra-articular TXA. Both groups received 15 mg kg-1 IV before the surgical incision (TXA induction dose) and then 10 mg kg-1, orally, 6 and 12 hours after the induction dose of TXA.The primary endpoint was bleeding measured by blood loss in postoperative drainage. Secondary outcomes were change in hemoglobin and hematocrit levels on the first and third postoperative days, and the need for transfusion during hospitalization. Results: In total, 100 patients were randomized, and 100 were included in the analysis. Blood loss in postoperative drainage was similar in both groups (200 ± 50 vs. 250 ± 50 mL, G1 and G2 groups respectively). Change in hematocrit and hemoglobin values (% of change) between preoperative and day 3 were not statically significant between groups G1 and G2 (18 ± 5 vs. 21 ± 4; 21 ± 7 vs. 22 ± 5 respectively). No patients received blood transfusion. Conclusions: Our study did not show superiority of 2 g of intra-articular tranexamic acid compared to 1 g.ClinicalTrials.gov Identifier NCT04085575

Resumo Introdução: O Ácido Tranexâmico (TXA), agente antifibrinolítico que inibe a atividade fibrinolítica da plasmina, é usado para reduzir a perda sanguínea perioperatória e a necessidade de transfusão em cirurgia ortopédica. O objetivo do estudo foi comparar o efeito de duas doses intra-articulares (1 g e 2 g) de ácido tranexâmico no sangramento pós-operatório de pacientes adultos submetidos a prótese total unilateral de joelho. Método: Realizamos estudo com operador único, randomizado, controlado e duplo-cego em dois grupos. O grupo G1 recebeu 1 g de TXA intra-articular e o grupo G2, 2 g de TXA intra-articular. Os dois grupos receberam 15 mg.kg-1 IV antes da incisão cirúrgica (dose de indução de TXA) e 10 mg.kg-1 por via oral, 6 e 12 horas após a dose de indução de TXA. O desfecho primário foi o sangramento medido pela perda sanguínea na drenagem pós-operatória. Os desfechos secundários foram alteração nos níveis de hemoglobina e hematócrito no primeiro e terceiro dias de pós-operatório e necessidade de transfusão durante a hospitalização. Resultados: Cem pacientes foram randomizados e 100 foram incluídos na análise. A perda sanguínea pela drenagem pós-operatória foi semelhante nos dois grupos (200 ± 50 mL vs. 250 ± 50 mL, grupos G1 e G2, respectivamente). A variação nos valores de hematócrito e hemoglobina (% de variação) entre o pré-operatório e o dia 3 não foi estatisticamente significante entre os grupos G1 e G2 (18 ± 5 vs. 21 ± 4; 21 ± 7 vs. 22 ± 5, respectivamente). Nenhum paciente recebeu transfusão de sangue. Conclusões: O estudo não mostrou superioridade na dose de 2 g de ácido tranexâmico intra-articular em comparação à dose de 1 g. ClinicalTrials.gov Identifier NCT04085575.

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

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

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

Eritrocitosis excesiva y mal de montaña crónico en mujeres residentes a extrema altura (la Rinconada 5200 msnm, Perú) / Excessive erythrocytosis and acute mountain sickness in women living at extreme altitude (La Rinconada, 5200 msnm, Perú)

El objetivo del trabajo fue determinar la prevalencia y el impacto de la eritrocitosis excesiva (EE) y mal de montaña crónico (MMC) en mujeres, y factores asociados en el desarrollo de estas alteraciones, principalmente la edad e índice de masa corporal (IMC). Los resultados mostraron una prevalencia de EE y MMC, de 19,72% y 25,35%, respectivamente. La edad promedio es de 39,79 ± 10,87; el hematocrito promedio fue 51,95 ± 6,85; la saturación de oxígeno fue 79,88 ± 5,24 y el IMC promedio de la participantes es 28,08 ± 3,87. La prevalencia de EE en el sexo femenino es mayor en las mujeres posmenopáusicas, en comparación a las premenopáusicas. Por otro lado, se determinó que un mayor índice de masa corporal se asocia fuertemente a menores valores de saturación de oxígeno. Entonces, así el incremento de la edad y del índice de masa corporal, favorecen el presencia de eritrocitosis excesiva más marcada condicionando un desarrollo de mal de montaña crónico de mayor severidad.

The aim of the work was to determine the prevalence and impact of excessive erytrochytes (EE) and chronic mountain sickness (MMC) in women, and related factors of the development of these alterations, mainly age and body max index (IMC). Results displayed incidence of EE and MMC, by 19.72% and 25.35%, respectively. The average age was 39.79 ± 10.87; the average hematocrit was 51.95 ± 6.85; the oxygen saturation was 79.88 ± 5.24 and the average IMC of the participants was 28.08 ± 3.87. The prevalence of EE on females is greater in postmenopausal women, in comparison to pre menopausals. On the other hand, it was determined that a greater body mass index is strongly associated to lesser oxygen saturation values. Hence, the increase of age and body max index, favor the most marked excesive erytrochytes presence conditioning the most serious acute mountain sickness.

Avaliação dos parâmetros hematológicos em ratos Wistar descendentes de mães obesas / Evaluation of hematological parameters in Wistar rats descending from obese mothers

O modelo de obesidade em ratos por meio de uma dieta hiperlipídica têm se consolidado, sendo relevante compreender os componentes da hereditariedade nesta enfermidade. Por meio do hemograma é possível avaliar os elementos sanguíneos e as células responsáveis pela defesa do organismo, incluindo sua morfologia, bem como interpretando-as. Compreender esses fatores em ratos descendentes de mães obesas poderia contribuir na compreensão dos mecanismos imuno-hematológicos envolvidos na obesidade e na hereditariedade. Com isso, o objetivo deste estudo é avaliar os parâmetros hematológicos e leucocitários de ratos alimentados com dieta hiperlipídica descendentes de mães obesas. Foram utilizadas 20 ratas Wistar (peso inicial 200g) alimentadas com dieta padrão (CT) ou com dieta hiperlipídica (HL). Posteriormente, alocou-se 3 fêmeas com 1 macho por 4 dias, certificando o cruzamento. Após 23 dias do nascimento da ninhada, foi feita a separação da prole em 4 grupos com 5 animais cada, e submetidos à dieta HL ou CT. Ficando então os grupos CT, CT+ HL, HL, HL + CT. Após 20 semanas de dieta, os animais foram anestesiados e tiveram peritônio exposto para coleta de sangue, que serviu para a realização e análise do hemograma, por diferenciação celular. Todos os procedimentos foram realizados de acordo com as diretrizes da utilização de animais para fins científicos (Lei 11.794/08), e protocolada no CEUA sob o n° 9062310117. As ratas HL tiveram um ganho de peso significativamente maior a partir da 10ª semana, comparando as ratas CT. Já em relação à prole, após 13 semanas, o grupo HL obteve um ganho de peso maior em relação aos demais grupos: CT: 144,8 ± 12,15 g; CT+HL (ratos descendentes de mães CT alimentados com ração HL): 138,6 ± 5,34 g; HL+CT (ratos descendentes de mães HL alimentados com ração CT): 152,2 ± 5,23 g; HL 161 ± 10,75 g. Nos parâmetros hematológicos da prole, foi observada diferença entre o grupo CT e experimental, os monócitos apresentaram uma redução significativa de 1,6± 0,89, hemoglobina 13,8 ± 1,07, hematócrito 37,9 ± 5,51 nos grupos que receberam dieta CT comparado à CT+HL, VCM apresentou aumento de 50,4 ± 0,55 no grupo CT e 53,5 ± 0,58 na dieta HL. Dentro das condições experimentais deste trabalho e com base nos resultados obtidos, conclui-se que a dieta hiperlipídica é capaz de induzir a obesidade, com capacidade de influenciar a proliferação e a diferenciação hematopoiética, porém a prole alimentada com ração padrão (CT) consegue adaptar a dieta independente do fator hereditário em relação à obesidade.

The obesity model in rats maintained by a hyper-lipidic diet is well known, and thus, there is a need to understand the components of heredity in this disease. Using HEM, it is possible to study the blood elements and cells involved in the defense of the organism, including cell morphology and its interpretation. Understanding these factors in rats descending from obese mothers may contribute to the comprehension of the immunity and hematologic mechanisms involved in both obesity and heredity. The purpose of this study is to evaluate the hematologic and leukocyte parameters of rats fed with a hyper-lipidic diet descending from obese mothers. A total of twenty Wistar female rats (initial weight 200g) fed standard diet (SD) or hyperlipidic diet (HD) were used. Subsequently, 3 females were housed with a male for 4 days in order to get inseminated. Twenty-three days after born, the animals were separated into 4 groups, with 5 animals in each group. The groups were organized as follows: SD, SD+HD, HD, SD+HD. The animals were kept on a diet for 20 weeks. In the end of that period, animals were anesthetized and had their peritoneum exposed for the collection of blood, which was used for performing the erythrogram and leukogram analysis via cellular differentiation. All procedures were performed according the animal welfare guidelines (Law No. 11.794/08) and approved by CEUA (number 9062310117). After 10 weeks, HL mothers presented an increased body weight when compared with SD mothers. In relation to the offspring, after 13 weeks, the HD group presented greater weight gain when compared to the other groups, as follows: SD: 144.8 ± 12.15 g; SD+HD (rats from SD mothers fed with HD feed): 138.6 ± 5.34 g; HD + SD (offspring from HL mothers fed with SD feed): 152.2 ± 5.23 g; HD 161 ± 10.75 g. The offspring hematological parameters presented differences between the SD and the experimental group, where the monocytes presented a significant reduction (1.6 ± 0.89), hemoglobin (13.8 ± 1.07), hematocrit (37.9 ± 5.51) in the groups that received a SD diet compared with the SD + HD; the MCV presented an increase of 50.4 ± 0.55 in the SD group and 53.5 ± 0.58 in the group on HD diet. Conclusion: Based on the results, it can be concluded that a hyper-lipidic diet is capable of inducing obesity and may also influence hematopoietic proliferation and differentiation. However, the offspring fed with standard diet (SD) is able to adapt the diet regardless of the hereditary factor in relation to obesity.