Evolución de los parámetros hematológicos y óbito en internados con COVID-19 en un hospital de Paraguay, 2021

Introducción: Los parámetros hematológicos proporcionan al equipo médico marcadores pronósticos útiles en la evolución clínica de la enfermedad de COVID-19. El objetivo fue analizar la relación entre la evolución desfavorable de los valores hematológicos y el óbito de los pacientes internados con COVID-19. Metodologia: El estudio es observacional, correlacional y longitudinal. Se realizó la revisión de fichas clínicas de los pacientes mayores a 18 años internados entre enero y marzo del 2021. Se registró en una planilla Excel el resultado de los parámetros hematológicos al ingreso, a las 48 horas, a los 8 días y al egreso. Los datos fueron analizados con Epi Info 7.1 (CDC, Atlanta) según estadística descriptiva. Resultados: De 144 pacientes, se observaron 68 (47,2%) muertes, con predominio del sexo masculino (63,2%) y, mayores a 60 años (47,1%). Los factores asociados a mortalidad fueron la hipertensión (52,9% vs 31,6%; p=0,009), la diabetes (50% vs 26,3%; p=0,003) y, la obesidad (41,2% vs 25%; p=0,039). Los parámetros hematológicos desfavorables asociados a la mortalidad se presentaron a partir de los 8 días de internación con leucocitosis (64,1% vs 33,3%; p=0,003), linfopenia (96,8% vs 79%; p=0,008), neutrofilia (98,5% vs 87,7%; p=0,029) y, un elevado índice neutrófilo/linfocito (INL) (96,9% vs 75,4%; p=0,001). Discusión: Los parámetros hematológicos que se asociaron con la mortalidad fueron leucocitosis con neutrofilia, linfopenia e INL elevado. Estos parámetros podrían tener valor pronóstico en el seguimiento para contribuir en el manejo de estos pacientes.

Introduction: Hematological parameters provide the medical team with useful prognostic markers in the clinical evolution of COVID-19 disease. The objective was to analyze the relationship between the unfavorable evolution of hematological values and the death of patients hospitalized with COVID-19. Methodology: The study is observational, correlational, and longitudinal. A review of the clinical records of patients over 18 years of age hospitalized between January and March 2021 was carried out. The results of the hematological parameters at admission, at 48 hours, at 8 days and at discharge were recorded in an Excel spreadsheet. The data were analyzed with Epi Info 7.1 (CDC, Atlanta) according to descriptive statistics. Results: Of 144 patients, 68 (47.2%) deaths were observed, with a predominance of males (63.2%) and those over 60 years of age (47.1%). The factors associated with mortality were hypertension (52.9% vs 31.6%; p=0.009), diabetes (50% vs 26.3%; p=0.003) and obesity (41.2% vs 25 %; p=0.039). The unfavorable hematological parameters associated with mortality occurred after 8 days of hospitalization with leukocytosis (64.1% vs 33.3%; p=0.003), lymphopenia (96.8% vs 79%; p=0.008), neutrophilia (98.5% vs 87.7%; p=0.029) and a high neutrophil/lymphocyte ratio (NLR) (96.9% vs 75.4%; p=0.001). Discussion: The hematological parameters that were associated with mortality were leukocytosis with neutrophilia, lymphopenia, and elevated NLR. These parameters could have prognostic value in follow-up to contribute to the management of these patients.

Evaluación de la estabilidad de parámetros hematológicos en muestras pediátricas bajo diferentes condiciones de almacenamiento determinados en un analizador Sysmex XN / Stability of hematological parameters in pediatric samples under different storage conditions using the Sysmex XN analyser / Avaliação de estabilidade de parâmetros hematológicos em amostras pediátricas sob diferentes condições de armazenamento determinados em um analisador Sysmex XN

Resumen Conocer la estabilidad de las muestras biológicas es esencial para obtener resultados confiables en el laboratorio de análisis clínicos. La Norma IRAM-ISO 15189:2023 establece que cada laboratorio debe estandarizar las condiciones de almacenamiento de las muestras. El objetivo de este trabajo fue determinar el tiempo y la temperatura óptimos para conservar muestras sanguíneas para la determinación de parámetros hematológicos en un analizador Sysmex XN 1000. Se procesaron muestras de sangre entera conservadas hasta 48 horas a temperatura ambiente y hasta 72 horas en heladera. De acuerdo a los resultados, para la determinación del hemograma, las muestras almacenadas a temperatura ambiente deben procesarse dentro de las 6-8 horas posextracción; los parámetros limitantes son aquellos influenciados por cambios en el volumen eritrocitario. En las muestras conservadas en heladera el análisis puede retrasarse hasta 48 horas y el recuento de plaquetas es el parámetro menos estable.

Abstract Knowing sample stability is essential to obtain reliable results in the clinical laboratory. The IRAM-ISO 15189:2023 Standard establishes that each laboratory must standardise the storage conditions of biological samples. This study was conducted to investigate the stability of haematological parameters using a Sysmex XN 1000 in samples stored for up to 48-72 hours at different temperatures. According to these results, the hematologic analytes should be processed in this laboratory within 6-8 hours after extraction if they are stored at room temperature. The limiting parameters are those influenced by changes in the erythrocyte volume. If storage is in a refrigerator, the analysis can be delayed up to 48 hours, being platelet count the limiting parameter.

Resumo Conhecer a estabilidade das amostras biológicas é essencial para obter resultados confiáveis no laboratório de exames clínicas. A Norma IRAM-ISO 15189:2023 estabelece que cada laboratório deve padronizar as condições de armazenamento das amostras. O objetivo deste trabalho foi determinar o tempo e a temperatura ideais para preservar amostras de sangue para a determinação de parâmetros hematológicos em um analisador em um Sysmex XN 1000. Para isso, foram processadas amostras de sangue total armazenadas por até 48 horas em temperatura ambiente e por até 72 horas em geladeira. De acordo com os resultados obtidos, para a determinação do hemograma, as amostras armazenadas em temperatura ambiente devem ser processadas dentro de 6-8 horas após a extração, sendo os parâmetros limitantes aqueles influenciados por alterações no volume eritrocitário. Nas amostras armazenadas em geladeira, a análise pode demorar até 48 horas, sendo a contagem de plaquetas o parâmetro menos estável.

Effect of thyroid dysfunction on hematological parameters-retrospective study

Background: Thyroid gland is an important endocrine gland in the human body. Thyroid hormones are required for the appropriate development, metabolic balance, differentiation and physiological function of almost all tissues. The thyroid gland produces hormones such as triiodothyronine (T3) and tetraiodothyronine or thyroxine (T4). Under physiological settings, thyroid hormone influences hematological parameters. This study was done to evaluate the effect of various types of thyroid function abnormalities on different haematological parameters. Methods: This was a retrospective study which included 323 subjects who were grouped as hypothyroidism, hyperthyroidism, subclinical hypothyroidism and euthyroid groups. Two blood samples were collected from patients in EDTA tubes and plain tubes for estimation of hematological parameters and thyroid hormonal assay respectively. The results were analysed using SPSS software. Results: The mean age of patients is 34.50 years with females comprising about 89.16% of cases and males comprising 10.84% of cases. Analysis of data obtained showed that there was a significant statistical difference in TLC, MCHC, RDW, TSH, FT4 and euthyroid, hypothyroid, hyperthyroid and subclinical hypothyroid (p value <0.05) respectively. However, there was no significant correlation in Hb, PLT, RBC, PCV, MCV, MCH (p value >0.05) thyroid groups. Conclusions: The study found that thyroid diseases impacted female more frequently than males. Thyroid diseases were more common in age group of 18-28 years. Study also revealed a strong link between haematological parameters and thyroid dysfunction in patients.

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as markers of early sepsis and mortality in pediatric burns: a prospective evaluation

Background: Delay in the diagnosis of sepsis in pediatric burns results in advertently high mortality and morbidity. Our study aimed at evaluating the role of two upcoming biomarkers- neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR)- as predictors of early sepsis and mortality in this group of patients. Methods: This was a prospective study conducted at a tertiary care burn centre of northern India over 18 months. 90 pediatric burn cases, aged 1-16 years, presenting within 24 hours of burns, with >10% body surface area of thermal burns/scalds were included in the study. Cell counts were measured on day 1, 3, 5 and 7 of burns. Patients were followed up till discharge, 30th post burn day or death, whichever was earlier. Results: Sepsis was clinically present in 49 cases out of 90 (54.44%) with 30% median total body surface area (TBSA) of burns. Mortality was seen in 31cases out of 90 (34.44%) with 35% median TBSA burns. Higher PLR levels were seen in the sepsis group. NLR and PLR were also elevated in the survival group. Both parameters were found to be reliable markers of sepsis as well as mortality, particularly on days 5 and 7, in this cohort of patients. Conclusions: Indices like NLR and PLR, which can easily be derived from complete blood count, have potential utility as determinants of both sepsis and mortality in children afflicted with thermal injuries.

Sub-Chronic Safety Assessment on the Use of Solanum aethiopicum (L.) Leaf Extract as Blood Booster in Male Wistar Rats

Aim: The effect of Solanum aethiopicum (SA) on the haematological indices of Wistar rats was investigated in this study. Methodology: A total of 20 male Wistar rats with an average 172.45±0.15 g were distributed into four groups (A – D) and allowed to acclimatize for two weeks. Group A served as the control, while groups B, C, and D were given aqueous extracts of SA at doses of 75 mg/kg, 150 mg/kg, and 225 mg/kg per body weight, respectively, every 48 hours for 30 days. After the exposure period, a final evaluation and sacrifice of the rats was performed. Blood sample collection was carried for full blood count and blood film preparation. Results: The result of this study showed that leaf extract of Solanum aethiopicum caused a significant increase in white blood cells (18.18±0.78 - 27.08±2.68 x 103/?l), especially lymphocytes (13.58±2.48 - 30.95±4.65 x 103/?l) in group of rats when compared to control. On the contrary, there was a non-significant reduction in red blood cells (7.78±0.04 - 7.19±0.45 x 106/?l), hemoglobin (16.92±0.62 - 14.55±0.95 g/dl), haematocrit (41.49±0.29 - 38.38±1.68 %), mean corpuscular hemoglobin (21.71±0.91 - 20.30±0.10 ?g) when compared to the control. Platelet (451.25±87.25 - 724.75±249.25 x 103/?l) and Plateletcrit (0.36±0.07 - 0.50±0.17 %) was significantly higher in treated group, while mean platelet volume (8.21±0.31 - 6.98±0.07 ?m3) and platelet distribution width (18.68±1.38 - 15.93±0.73 %) was low when compared with control. Conclusion: The current study has demonstrated that the leaves of Solanum aethiopicum may be safe to consume in regulated amount, as it has been shown to boost blood indices. These plant extracts may be utilized as a blood promoting potentials as it has been shown to strengthens the body's immune system particularly cell-mediated immunity, have no hemotoxic impact on the red blood cell and its indices and improve the ability for the body to repair itself as seen from the platelet count and its indices.

Risk factors, etiology and prognostic markers in patients of young stroke: a prospective observational study

Background: The rate of stroke at a young age has accelerated over the years and is a matter of true concern. Young stroke causes devastating consequences leading to loss of productive years and life time disability. Methods: We performed an observational prospective study to identify the risk factors, etiology and prognostic markers in patients of young stroke. Results: The study was conducted on 50 patients who were less than or equal to 50 years and have suffered ischemic stroke during the time period of 6 months i.e. from April, 2022 to September, 2022 and visited Department of Neurology, at SSB heart and multispecialty hospital, Faridabad. We found the prevalence of young stroke was significantly more in males (81%) compared to same aged female participants. Conclusions: Maximum patients suffered young stroke were at an age group 35-45 years. We could identify that the traditional risk factors including diabetes, hypertension and dyslipidemia were the major risk factors compared to the lifestyle based risk factors like smoking or alcohol consumption. The young patients showed similar response to thrombolysis treatment like old stroke patients. All the patients enrolled in the study were cured. Further research is required to understand the risk factors and prognosis of young stroke.

Risk factors, etiology and prognostic markers in patients of young stroke: a prospective observational study

Background: The rate of stroke at a young age has accelerated over the years and is a matter of true concern. Young stroke causes devastating consequences leading to loss of productive years and life time disability. Methods: We performed an observational prospective study to identify the risk factors, etiology and prognostic markers in patients of young stroke. Results: The study was conducted on 50 patients who were less than or equal to 50 years and have suffered ischemic stroke during the time period of 6 months i.e. from April, 2022 to September, 2022 and visited Department of Neurology, at SSB heart and multispecialty hospital, Faridabad. We found the prevalence of young stroke was significantly more in males (81%) compared to same aged female participants. Conclusions: Maximum patients suffered young stroke were at an age group 35-45 years. We could identify that the traditional risk factors including diabetes, hypertension and dyslipidemia were the major risk factors compared to the lifestyle based risk factors like smoking or alcohol consumption. The young patients showed similar response to thrombolysis treatment like old stroke patients. All the patients enrolled in the study were cured. Further research is required to understand the risk factors and prognosis of young stroke.

Predictive Value of Complete Blood Count and Inflammation Marker on Risk of Recurrence in Children with Henoch-Schönlein Purpura / 中国实验血液学杂志

OBJECTIVE@#To investigate the predictive value of complete blood count (CBC) and inflammation marker on the recurrence risk in children with Henoch-Schönlein purpura (HSP).@*METHODS@#One hundred and thirty-three children with HSP admitted to Cangzhou Central Hospital from February 2017 to March 2019 were enrolled. The clinical data of the children were collected, at the time of admission CBC and C-reactive protein (CRP) were detected. After discharge, the children were followed up for 1 year, the clinical data of children with and without recurrence were compared, and multivariate logistic regression was used to analyze the risk factors affecting HSP recurrence. Receiver operating characteristic (ROC) curve should be drawn and the predictive value of CBC and CRP on HSP recurrence should be analyzed.@*RESULTS@#In the follow-up of 133 children, 8 cases were lost and 39 cases recurred, with a recurrence rate of 31.20% (39/125). The age, skin rash duration, proportion of renal damage at the initial onset, percentage of neutrophils, percentage of lymphocytes, platelet count (PLT), mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), MPV/PLT ratio (MPR), and CRP level of patients with recurrence were statistically different from those without recurrence (P <0.05). Multivariate logistic regression analysis showed that long skin rash duration, renal damage at the initial onset, increased PLR, high PLT, increased MPV and elevated CRP level were independent risk factors for recurrence in children with HSP (P <0.05). The ROC curve analysis showed that the area under the curve (AUC) of the combination of the four blood and inflammation marker (PLT, MPV, PLR and CPR) in the early prediction of HSP recurrence was 0.898, which was higher than the initial renal damage (AUC=0.687) and persistent skin rash time (AUC=0.708), with a sensitivity of 84.62% and a specificity of 83.72%.@*CONCLUSION@#Observation of CBC and CPR can predict the risk of HSP recurrence early and guide early clinical intervention.

Development and Validation of a Predictive Model for Neonatal Sepsis / 实用医学杂志

Objective To establish a Nomogram predictive model for Neonatal Sepsis(NS)based on the general characteristics and initial complete blood count of neonates.Methods Retrospective analysis was conducted on the clinical data of newborns who were admitted for the first time to NICU and completed blood routine examination after admission in the MIMIC Ⅲ database.The LASSO-Logistic regression was used to investigate the prediction factors of NS,and then Nomogram prediction model was established.Internal validation was performed using boot-strap resampling with 1000 iterations.External validation of the model was performed using the data from newborns admitted to the First Affiliated Hospital of Zhengzhou University.We evaluated the predictive performance by Area Under the Receiver Operating Characteristic Curve(AUROC),C-index,calibration curve,and decision curve analysis(DCA).Results Among the 3,001 neonates,185 were diagnosed with NS.The Nomogram model was con-structed based on indicators such as respiratory distress syndrome,gestational age,birthweight,and initial hemato-logical parameters(red blood cell count,white blood cell count,lymphocyte percentage,neutrophil percentage),exhibiting good predictive performance with an AUROC of 0.860.Satisfactory predictive abilities were confirmed through both internal and external validation.Conclusion This study developed and validated a well-performing Nomogram prediction model.With simple parameters,it can help clinicians identify newborns at high risk early.

Rapid identification and correction of the interference of cold agglutinins by using RET channel red blood cell parameters / 中华检验医学杂志

Objective:To assess the role of Delta-RBC parameters in the automated hematocrit analyzer RET channel for the recognition of cold agglutinins (CA) and to explore the value of RET channel optical method parameters in correcting interference with CA.Methods:This is a retrospective study. The Cas group included 68 samples with Cas interference and the control group included 45 samples without CA interference. All specimens were collected from Zhongshan Hospital Fudan University Outpatient Department from January 2022 to January 2023. Specimens in both the CA and Control group were examined using the CBC+RET channel at room temperature. Recorded and calculated the Impedance method test parameters RBC-I, HGB, HCT-I, MCH-I, MCV-I, MCHC-I and the Optical method test parameters RBC-O, HCT-O, MCH-O, R-MFV, MCHC-O, Delta-RBC. Examined the specimens in the CA group using the CBC channel after prewarmed at 37 ℃ for 2 h, and Impedance method parameters RBC-I 37 ℃ 2 h, HGB 37 ℃ 2 h, HCT-I 37 ℃ 2 h, MCH-I 37 ℃ 2 h, MCV-I 37 ℃ 2 h, MCHC-I 37 ℃ 2 h were recorded. The ROC curves were used to analyze the discrimination efficacy of Delta-RBC in identifying CA interference, and the Bland-Altman method was used to analyze the consistency between the results of the optical method RBC parameters at room temperature and the results of the impedance method after prewarming. The correlation analysis was performed using Pearson and Spearman correlation analysis to analyze the results of the RBC parameters before and after prewarming in the CA group. Result:If Delta-RBC was used as diagnostic indicators for the identification of CA interference, the best cut-off value was 1.065, with AUCs of 0.998. In the CA group, the correlation coefficients between RBC-O, HCT-O, R-MFV, MCH-O, MCHC-O, and RBC-I 37 ℃ 2 h, HCT-I 37 ℃ 2 h, MCV-I 37 ℃ 2 h, MCH-I 37 ℃ 2 h, MCHC-I 37 ℃ 2 h were 0.985, 0.981, 0.729, 0.870, and 0.649, respectively. The percentages within the limits of agreement of the percentage differences between the results of the two methods were 95.6%, 92.6%, 95.6%, 94.1%, and 95.6%, respectively. Conclusions:The RBC parameter Delta-RBC from RET channel optical method can be used as an indicator to effectively assist in the clinical determination of the presence of CA. Reporting results using the optical method RBC parameters of the RET channel can correct the interference of CA without specimen pre-treatment and obtain more correct results of complete blood counts.

Study on changes in complete blood cell count parameters of patients with occupational silicosis / 中国职业医学

{L-End}Objective To study the changes of complete blood cell count parameters and its influencing factors in patients with occupational silicosis (hereinafter referred to as "silicosis"). {L-End}Methods A total of 354 silicosis patients were selected as the research subjects using judgment sampling method. The patients were divided into stage Ⅰ, stage Ⅱ and stage Ⅲ groups according to the stage of silicosis. Based on the course of the disease, they were divided into groups of ≤3, >3-≤6, >6-≤9 and >9-≤12 years. The peripheral blood of the patients was collected for complete blood cell count analysis, and the influencing factors of complete blood cell count were analyzed by multiple linear regression model. {L-End}Results The levels of hemoglobin and the average red blood cell hemoglobin in patients with silicosis at stage Ⅱ and Ⅲ groups were lower than those at stageⅠgroup (all P<0.05). The percentage and counts of neutrophils increased in patients at stage Ⅲ group (all P<0.05), while the percentage and counts of lymphocytes decreased (all P<0.05) compared with those in stage Ⅰand Ⅱ groups. The percentage of eosinophils in patients at stage Ⅲ was lower than those at stage Ⅰ group (P<0.05). The red blood cell count in the courses of silicosis >6-􀰤9 years group was lower (P<0.05), and the percentage of neutrophils was higher, while the percentage of lymphocyte was lower in the courses of silicosis >6-􀰤9 years group and >9-􀰤12 years group (all P<0.05) compared with the courses of silicosis ≤3 years and >3-􀰤6 years groups. The mean corpuscular volume of the courses of silicosis >6-􀰤9 years group and the neutrophil count of the courses of silicosis >9-􀰤12 years group increased (all P<0.05) compared with the courses of silicosis ≤3 years group. The results of multiple linear regression analysis showed that the silicosis stage and course of silicosis were influencing factors of erythrocyte count (all P<0.05), gender and age of first dust-exposure were influencing factors of hemoglobin level (all P<0.05), while age at diagnosis, duration of dust-exposure, age of first dust-exposure and comorbidities were influencing factors of neutrophil count (all P<0.05). Gender, comorbidities, smoking and silicosis stage were influencing factors of lymphocyte count (all P<0.05). {L-End}Conclusion There are differences in complete blood cell count parameters in patients with silicosis at different stages and courses of the disease. Silicosis stage, course of disease, gender, age, smoking,comorbidities, duration of dust-exposure and age of first dust-exposure were influencing factors affecting complete blood cell count in silicosis patients.

Profil lipidique associé à l'obésité chez les adolescents à Brazzaville, Congo / Lipid profile among obese adolescents in Brazzaville, Congo

Contexte & objectif. Les modifications lipidiques chez les enfants obèses en Afrique noire sont peu documentées. Les objectifs de la présente étude étaient de déterminer chez les adolescents obèses le profil lipidique, et analyser les associations entre quelques paramètres anthropométriques et lipidiques. Méthodes. L'étude transversale a été réalisée à Brazzaville auprès de 82 adolescents âgés de 11 à 18 ans, répartis en 45 sujets obèses, 17 en état de surpoids et 20 poids normal. Des mesures de la taille, du poids, du tour de taille, des plis cutanés sous-scapulaire et tricipital ont été effectuées. Des prélèvements sanguins ont permis de déterminer les concentrations en cholestérol total, cholestérol-LDL, cholestérol-HDL et triglycérides. Résultats. Les concentrations lipidiques notées chez les adolescents obèses étaient significativement supérieures à celles des sujets de poids normal : cholestérol total, 1,70 vs 1,59g/L ; cholestérol-LDL, 1,03 vs 0,88g/L ; triglycérides, 1,18 vs 0,86. Par contre, celles du cholestérol-HDL étaient significativement inférieures : 0,42 vs 0,51g/L. Une corrélation positive a été retrouvée entre le rapport tour de taille/taille et le cholestérol-HDL (r=0,75 ; p=0,031). Conclusion. Nos résultats soulignent la nécessité de renforcer la prise en charge des enfants obèses afin de prévenir les facteurs de risque potentiels des maladies cardiovasculaires à l'âge adulte

Perfil hematológico de idoso com dengue internado em unidade de terapia intensiva / Hematological profile of elderly people with dengue hospitalized in an intensive care unit / Perfil hematológico de ancianos con dengue hospitalizados en una unidad de cuidados intensivos

Introdução: A dengue é considerada a arbovirose mais comum no mundo, sendo hoje um problema crescente de saúde pública. Objetivo: Por ser considerada de alta prevalência, foi realizada a avaliação hematológica de um paciente hospitalizado na Unidade de Terapia Intensiva na cidade de Umuarama-PR. Metodologia: Tratou-se de um estudo descritivo retrospectivo, do qual foram analisados os resultados de hemogramas obtidos por um laboratório local, considerando que o paciente constava como sorologia positiva para NS1. Foram avaliados 09 laudos de hemograma emitidos durantes 5 dias de internamento do paciente. Os resultados foram comparados entre os laudos e com os valores de referência disponibilizados pelo próprio laudo. Resultados: Com base na análise dos hemogramas pode-se verificar a redução do hematócrito em 33,33%, macrocitose em 88,9%, leucopenia em 27,3%, trombocitopenia em 27,3%. Conclusão: Conclui-se que através dos laudos avaliados foram encontrados plaquetopenia, leucopenia, linfocitopenia, eosinopenia, neutropenia, monocitopenia. Evidenciando o hemograma como uma ferramenta laboratorial de grande auxílio na avaliação do paciente.

Introduction: Dengue is considered the most common arbovirus in the world, and is now a growing public health problem. Objective: Due to its high prevalence, a hematological evaluation of a patient hospitalized in the Intensive Care Unit in the city of Umuarama-PR was carried out. Methodology: This was a retrospective descriptive study, in which the results of blood counts obtained by a local laboratory were analyzed, considering that the patient had positive serology for NS1. 09 blood count reports issued during the 5 days of the patient's hospitalization were evaluated. The results were compared between the reports and with the reference values provided by the report itself. Results: Based on the analysis of blood counts, it was possible to verify a reduction in hematocrit in 33.33%, macrocytosis in 88.9%, leukopenia in 27.3%, thrombocytopenia in 27.3%. Conclusion: It is concluded that through the evaluated reports, thrombocytopenia, leukopenia, lymphocytopenia, eosinopenia, neutropenia, monocytopenia were found. Evidencing the blood count as a laboratory tool of great help in the evaluation of the patient.

Introducción: El dengue es considerado el arbovirus más común en el mundo, y actualmente es un problema creciente de salud pública. Objetivo: Debido a su alta prevalencia, se realizó una evaluación hematológica de un paciente hospitalizado en la Unidad de Cuidados Intensivos de la ciudad de Umuarama-PR. Metodología: Se trató de un estudio descriptivo retrospectivo, en el cual fueron analizados los resultados de los hemogramas obtenidos por un laboratorio local, considerando que el paciente tenía serología positiva para NS1. Fueron evaluados 09 informes de hemogramas emitidos durante los 5 días de internación del paciente. Los resultados se compararon entre los informes y con los valores de referencia proporcionados por el propio informe. Resultados: A partir del análisis de los hemogramas, fue posible verificar reducción del hematocrito en 33,33%, macrocitosis en 88,9%, leucopenia en 27,3%, trombocitopenia en 27,3%. Conclusiones: Se concluye que a través de los reportes evaluados se encontró trombocitopenia, leucopenia, linfocitopenia, eosinopenia, neutropenia, monocitopenia. Evidenciando el hemograma como una herramienta de laboratorio de gran ayuda en la evaluación del paciente.

Alteraciones hematológicas en sangre periférica de pacientes con COVID-19 / Molecular study of leukemias: essential tool for the hematologist

Introducción: Los primeros casos con neumonía atípica de etiología desconocida fueron reportados en Wuhan, China en diciembre de 2019. En enero 2020 se describió como agente causal un nuevo tipo de virus de la familia Coronaviridae, denominado SARS-CoV-2. Objetivo: Evaluar la significación clínica de los cambios hematológicos y morfológicos en la sangre periférica de pacientes con COVID-19. Métodos: Se realizó un estudio descriptivo, observacional, transversal que incluyó a los pacientes con COVID-19 que ingresaron en el Hospital Clínico Quirúrgico Docente Freyre de Andrade desde el 1ro de junio hasta 31 de septiembre de 2021. Los pacientes fueron asignados a dos grupos según fueron admitidos, en las unidades de vigilancia intensiva o en la unidad de cuidados intensivos. Se les realizó hemograma completo y lámina periférica el día del ingreso para evaluar la significación clínica de estas variables en la evolución de estos pacientes. Resultados: El sexo femenino predominó en los pacientes ingresados en unidades de vigilancia intensiva (67,36 %) y el masculino en los ingresados en unidades de cuidados intensivos (63,26 %). La media de edad fue mayor en el grupo de pacientes en cuidados intensivos (65,83 años). La leucocitosis y el menor recuento de plaquetas predominaron en los pacientes ingresados en cuidados intensivos, seguido de linfopenia. Las macroplaquetas, las vacuolas citoplasmáticas y las granulaciones tóxicas fueron más frecuentes en el grupo de cuidados intensivos. Conclusiones: El hemograma y el frotis de sangre periférica son útiles para diagnosticar y predecir la evolución de los pacientes y permiten un mejor manejo de la infección.

Introduction: The first cases of atypical pneumonia of unknown etiology were reported in Wuhan, China in December 2019. In January 2020 a new virus from Coronaviridae family was described as causal agent and was named SARS-COV-2. Objectives: To evaluate the clinical significance of numerical values of complete blood count (CBC) and morphologic changes on peripheral blood on patients with COVID-19. Methods: A descriptive, observational, transversal study included patients with diagnosis of COVID-19 admitted in Freyre de Andrade Hospital in Havana, between June 1st and September 31st of 2022 was carried out. Patients were assigned to two groups according to their admission in intensive vigilance ward or intensive care unit. CBC test and peripheral blood smear were performed on admission day to evaluate the significance on clinical evolution. Results: Female sex predominated on intensive vigilance group (67,36 %) and male in intensive care group (63,26 %). Media of age was superior in intensive care group (67,83 years). Leukocytosis and low level of platelets count were significantly more common in more severe group followed by lymphopenia. The presence of big platelets, cytoplasmic vacuoles and toxic granules were more common in intensive care unit group. Conclusions: The CBC and peripheral blood smear are useful tools to diagnose and predict clinical evolution and allow a better management of infection.

Hematologic parameters of captive Bothrops atrox (Squamata: viperidae)

The breeding of venomous snakes in captivity for research purposes and mainly as a source of pharmaceutical products highlights the need to determine hematological parameters for monitoring and ensuring a healthy breeding populationThe complete blood count is used to help diagnose alterations such as anemia, inflammatory diseases, parasitemia, hematopoietic disorders, hemostatic and toxicological changes, as well as bacterial and viral inclusions. Thus, the objective of this study was to define reference parameters for complete blood count in Bothrops atrox snakes. Blood samples were collected from 20 specimens of B. atrox from the Pentapharm do Brasil commercial breeding facility for laboratory examination. Mean values and standard deviation were: hematocrit 33.6 ± 5.47%, hemoglobin 10.81 ± 2.07g/dL, total number of erythrocytes 0.59 ± 0.1 x 106/mm3, leukocytes 11387.5 ± 3279.2/mm3 and thrombocytes 28175 ± 6320/mm3. No significant difference was observed between males and females and heterophils were the predominant leukocyte cell type.

Evaluation of the consistency of four hematology systems / 中华检验医学杂志

Objective:To provide consistent data basis for the application of reference intervals for children blood cell analysis in different testing systems.Methods:According to the requirements of American Institute for Clinical and Laboratory Standardization (CLSI) EP9-A3 document, 45 samples were collected and Sysmex XN20-A1 were used as reference system. Beckman DxH800, Siemens ADVIA 2120i, and Mindray BC5310 were comparison systems. Complete blood count and leukocyte classification were performed by four systems. The outliers of the detection results were tested by the generalized extreme student deviate (ESD) method. An optimal regression model was selected by scatter diagram, deviation diagram and frequency distribution diagram, which was used to fit the regression equation and calculate the deviation at the medical decision level and reference interval. The acceptable range for blood count deviation was cited from the Analytical Quality Specifications for Routine Tests in Clinical Hematology. The acceptable range for leukocyte classification was based on the EQA program of Royal College of Pathologists of Australasia (RCPA).Results:After the outliers were deleted, the scatter plot showed a linear relationship between the reference system and the three comparison systems. The deviation plot showed that the differences were variable. Deming regression or Passing-Bablok regression was selected according to the data distribution. The determination coefficient R2 of reference system and three comparison systems ranged from 0.95 to 0.99 in blood count and leukocyte classification. At the upper and lower limits of the reference interval, the deviations between XN-20A1 and ADVIA 2120 system were all acceptable, except for MONO# at 0.12×10 9/L. The deviations of all parameters at medical decision level were within acceptable ranges. The lower limit of PLT is partially unacceptable at the level of medical decision related to treatment and prognosis. Conclusions:The results of complete blood count and leukocyte classification in reference system and the comparison system had good consistency within the children′s reference interval. Our study provided a scientific basis for the feasibility of adopting a unified reference interval for different detection systems.

Predictive value of baseline CRP, NLR, and LER for aspiration pneumonia in patients with acute cerebral infarction / 中华急诊医学杂志

Objective:To investigate the predictive value of C-reactive protein (CRP), neutrophils-lymphocytes ratio (NLR) and leukocyte-erythrocyte ratio (LER) for aspiration pneumonia (AP) in patients with acute cerebral infarction (ACI).Methods:Retrospective analysis was performed on 989 consecutive hospitalized ACI patients in 2021 who were free of infection within 48 h after ACI onset. General information, past medical history, CRP and complete blood count within 24 h after admission were collected. NLR and LER were calculated based on neutrophil, lymphocyte, leukocyte and erythrocyte count. ACI patients were divided into two groups: non-AP group ( n = 883) and AP group ( n = 106) according to whether they had AP 48 h after admission. Spearman correlations of CRP, NLR and LER with AP were analyzed. The receiver operator characteristic (ROC) curves were plotted to evaluate the predictive values of CRP, NLR and LER for the occurrence of AP in ACI patients, and the sensitivity and specificity at the optimal cut-off value were also calculated. Logistic regression analysis was used for further verification. Results:Compared with the non-AP group, CRP, NLR and LER were significantly higher in the AP group ( P<0.05). Spearman correlation analysis showed that AP was positively correlated with CRP, NLR and LER ( r = 0.42, 0.36 and 0.35, P<0.01). ROC curve analysis showed that CRP, NLR and LER had certain predictive value for AP in ACI patients ( P<0.05), and the area under the curve (AUC) was 0.8917, 0.8349 and 0.8269, respectively. The optimal cutoff values of CRP, NLR and LER were 12.70 mg/L, 4.40 and 1.89 ×10 -3, respectively, with the sensitivity and specificity of 79.25% and 86.41%, 71.70% and 84.94%, and 75.47% and 79.95%, respectively. Multivariate Logistic regression analysis showed that CRP ( OR=6.65, 95% CI: 3.70-11.98, β=1.90, P<0.001), NLR ( OR=2.84,95% CI: 1.60-5.03, β=1.04, P<0.001) and LER ( OR=3.51, 95% CI: 2.00-6.16, β=1.26, P<0.001) were independent risk factors for AP in ACI patients. Conclusions:CRP, NLR and LER at baseline show certain predictive value for the occurrence of AP in ACI patients, and CRP has the strongest predictive power.

Parámetros bioquímicos y biometría hemática de pacientes con COVID-19 moderado y grave en terapia intensiva de un hospital básico de Ecuador / Biochemical parameters and blood count of patients with moderate and severe COVID-19 in intensive care at a basic hospital in Ecuador

La infección por COVID-19 se presenta principalmente de forma leve y grave, ésta última hace necesaria la hospitalización y soporte respiratorio por complicaciones como el síndrome respiratorio agudo severo (SARS), cuyo curso clínico ha sido ampliamente descrito; sin embargo, la alteración de los perfiles de laboratorio no ha sido establecida de manera precisa. Se realizó un estudio retrospectivo para determinar parámetros bioquímicos y biometría hemática en 32 pacientes con COVID-19 moderado y grave, recluidos en el Hospital Básico "Raúl Maldonado Mejía" de Cayambe, Ecuador y evaluar su utilidad como indicadores de gravedad. Se revisaron las historias clínicas, obteniendo datos clínicos, bioquímicos y hematimétricos. Se observó mayor proporción de casos COVID moderado y grave en hombres, y de la forma grave en ambos géneros, con un promedio de edad entre 45-73 años. Las comorbilidades más frecuentes fueron: hipertensión arterial (HTA), diabetes mellitus tipo 2 (DM2), insuficiencia cardíaca congestiva (ICC) y obesidad. Los parámetros bioquímicos y hematimétricos con peor pronóstico para gravedad fueron: elevación de la actividad de lactato deshidrogenasa (LDH), alanina aminotranferasa (ALT), aspartato aminotranferasa (AST), niveles de proteina C reactiva (PCR), prolongación del tiempo de protrombina (TP), contaje total de leucocitos, índice neutrófilo/linfocito (INL) y disminución de linfocitos. Los parámetros bioquímicos (LDH, PCR, ALT, AST), de coagulación (TP) y hematimétricos (recuento de leucocitos, linfocitos e INL), pueden ser útiles indicadores de gravedad en pacientes con COVID-19, permitiendo identificar precozmente pacientes con enfermedad moderada y evitar el desarrollo de la forma más severa de la enfermedad y sus complicaciones(AU)

COVID-19 infection occurs mainly in mild and severe forms, the latter requiring hospitalization and respiratory support due to complications such as severe acute respiratory syndrome (SARS), the clinical course of which has been widely described; however, the alteration of laboratory profiles has not been precisely established. A retrospective study was carried out to determine biochemical parameters and blood counts in 32 patients with moderate and severe COVID-19, confined at the "Raúl Maldonado Mejía" Basic Hospital in Cayambe, Ecuador, and to evaluate their usefulness as indicators of severity. Medical records were reviewed. , obtaining clinical, biochemical and hematometric data. A higher proportion of moderate and severe COVID cases was observed in men, and the severe form in both genders, with an average age between 45-73 years. The most frequent comorbidities were: arterial hypertension (HTA), type 2 diabetes mellitus (DM2), congestive heart failure (CHF) and obesity. The biochemical and blood count parameters with the worst prognosis for severity were: elevation of lactate dehydrogenase (LDH) activity, alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) levels, prothrombin time (PT) prolonged, total leukocyte count, ne index utrophil/lymphocyte (INL) and decreased lymphocytes. Biochemical parameters (LDH, CRP, ALT, AST), coagulation (PT) and blood counts (leukocyte count, lymphocytes and INL) can be useful indicators of severity in patients with COVID-19, allowing early identification of patients with moderate disease and avoid the development of the most severe form of the disease and its complications(AU)

Hematology and blood biochemistry profile of the freshwater stingray Potamotrygon magdalenae as a tool for population assessment in artificial environments / Perfil hematológico e bioquímico do sangue da arraia de água doce Potamotrygon magdalenae como ferramenta para avaliação da população em ambientes artificiais

Hematological and blood biochemical reference information is important to establish physiological status of freshwater stingray populations and improve care and management protocols in artificial environments. Here, we used a commercial freshwater stingray with high mortality rates in the market (Potamotrygon magdalenae), as an example to understand how artificial environments and handling protocols influence physiological status of captive freshwater stingrays. To this purpose, blood from five adult males and six adult females was collected to perform complete blood counts and blood chemistry analyses. All sampled animals showed good body condition with no differences between sexes. Differences between sexes were only found for the differential count of lymphocytes. Red blood results were consistent with previously studied potamotrygonids while white blood results showed higher values of leukocytes, thrombocytes, heterophils and lymphocytes in P. magdalenae compared to other Potamotrygonids. All types of leukocytes described for elasmobranchs were found except neutrophils and basophils. Blood metabolites showed an influence of ex situ diet in total protein, triglycerides and cholesterol. Glucose results were consistent while urea showed lower levels than those recorded for other freshwater stingrays. These results highlight the importance of physical, physiological and health analysis in freshwater stingrays as a part of welfare assessment to improve monitoring protocols and survival rates in public or private aquaria.

A informação de referência hematológica e bioquímica do sangue é importante para estabelecer o estado fisiológico das populações de arraias de água doce e melhorar os protocolos de cuidado e manejo em ambientes artificiais. Aqui, usamos uma espécie comercial de arraia de água doce com elevadas taxas de mortalidade no mercado(Potamotrygon magdalenae) como espécie exemplo para compreender de que modo os ambientes artificiais e os protocolos de manipulação influenciam o estado fisiológico das arraias de água doce em cativeiro. Para este fim, foi coletado sangue de cinco machos adultos e seis fêmeas adultas para realizar contagens completas de células sanguíneas e análises bioquímicas de sangue. Todos os animais amostrados mostraram boa condição corpórea, sem diferenças entre os sexos. Diferenças entre os sexos foram encontradas só na contagem diferencial de linfócitos. Os resultados de células sanguíneas vermelhas foram consistentes com potamotrigonídeos previamente estudados, enquanto o leucograma revelou valores mais elevados de leucócitos, trombócitos, heterófilos e linfócitos em P. magdalenae, em comparação com outros potamotrigonídeos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Os metabólitos do sangue mostraram influência da dieta ex situ nas proteínas totais, triglicerídeos e colesterol. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos do que os registrados para outras espécies de arraias de água doce. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos em P. magdalenae. Estes resultados enfatizam a importância da análise física, fisiológica e de saúde em arraias de água doce como parte da avaliação do bem-estar para melhorar os protocolos [...].

Hematology and blood biochemistry profile of the freshwater stingray Potamotrygon magdalenae as a tool for population assessment in artificial environments

Abstract Hematological and blood biochemical reference information is important to establish physiological status of freshwater stingray populations and improve care and management protocols in artificial environments. Here, we used a commercial freshwater stingray with high mortality rates in the market (Potamotrygon magdalenae), as an example to understand how artificial environments and handling protocols influence physiological status of captive freshwater stingrays. To this purpose, blood from five adult males and six adult females was collected to perform complete blood counts and blood chemistry analyses. All sampled animals showed good body condition with no differences between sexes. Differences between sexes were only found for the differential count of lymphocytes. Red blood results were consistent with previously studied potamotrygonids while white blood results showed higher values of leukocytes, thrombocytes, heterophils and lymphocytes in P. magdalenae compared to other Potamotrygonids. All types of leukocytes described for elasmobranchs were found except neutrophils and basophils. Blood metabolites showed an influence of ex situ diet in total protein, triglycerides and cholesterol. Glucose results were consistent while urea showed lower levels than those recorded for other freshwater stingrays. These results highlight the importance of physical, physiological and health analysis in freshwater stingrays as a part of welfare assessment to improve monitoring protocols and survival rates in public or private aquaria.

Resumo A informação de referência hematológica e bioquímica do sangue é importante para estabelecer o estado fisiológico das populações de arraias de água doce e melhorar os protocolos de cuidado e manejo em ambientes artificiais. Aqui, usamos uma espécie comercial de arraia de água doce com elevadas taxas de mortalidade no mercado (Potamotrygon magdalenae) como espécie exemplo para compreender de que modo os ambientes artificiais e os protocolos de manipulação influenciam o estado fisiológico das arraias de água doce em cativeiro. Para este fim, foi coletado sangue de cinco machos adultos e seis fêmeas adultas para realizar contagens completas de células sanguíneas e análises bioquímicas de sangue. Todos os animais amostrados mostraram boa condição corpórea, sem diferenças entre os sexos. Diferenças entre os sexos foram encontradas só na contagem diferencial de linfócitos. Os resultados de células sanguíneas vermelhas foram consistentes com potamotrigonídeos previamente estudados, enquanto o leucograma revelou valores mais elevados de leucócitos, trombócitos, heterófilos e linfócitos em P. magdalenae, em comparação com outros potamotrigonídeos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Todos os tipos de leucócitos descritos para elasmobrânquios foram encontrados, exceto para neutrófilos e basófilos. Os metabólitos do sangue mostraram influência da dieta ex situ nas proteínas totais, triglicerídeos e colesterol. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos do que os registrados para outras espécies de arraias de água doce. Os resultados da glicose foram consistentes, enquanto a ureia mostrou níveis mais baixos em P. magdalenae. Estes resultados enfatizam a importância da análise física, fisiológica e de saúde em arraias de água doce como parte da avaliação do bem-estar para melhorar os protocolos de monitoramento e as taxas de sobrevivência em aquários públicos ou privados.