Taurine amino acid supplementation impacts performance, blood hematology, oxidative stress, and jejunum morphology in broiler chickens.

Excess levels of free radicals cause oxidative damage to cells. Taurine is a rare amino acid with antioxidant effects whose dietary deficiency increases oxidative damage to the cell membrane. To investigate the effects of dietary taurine supplementation on performance, blood hematology, oxidative stress, and jejunum morphology in broilers, 300 broilers (Ras 308, 1D of age) were randomly allocated into 4 groups with 5 replicates of 15 birds. The experimental treatments included basic diet (control treatment) and basic diet with 1, 3, and 6 g/kg taurine amino acid. During 1 to 45 days, the inclusion of taurine supplementation in diets improved the body weight gain (BWG), feed consumption (FC), and feed conversion ratio (FCR) of broilers (P < 0.05). In CBC tests, the experimental treatments were significantly different concerning the red blood cell (RBC) count, the average hemoglobin in the cell, the RBC width in the curve, and the hematocrit (P < 0.05). Despite the significance of oxidative stress among the treatments, the control and fourth treatments showed the highest and the lowest oxidative stress, respectively (P < 0.05). Also, in jejunum morphology, the fourth treatment showed the best performance in terms of villus length and width and the villus length to crypt depth (V/C) ratio (P < 0.05). Overall, 6 g/kg taurine addition to the diet reduced oxidative stress and positive features in the jejunum morphology while improving the functional traits of broilers.

Evaluation of coriander seed powder supplementation on body composition, growth performance, hematology, and serum biochemical indices in common carp (Cyprinus carpio) fingerlings.

This study aimed to investigate the role of coriander seed powder (Coriandrum sativum) on growth indices, feed utilization, body composition, and haemato-biochemical parameters in common carp (Cyprinus carpio) fingerlings over 84 days. One hundred and forty-four common carp (25.24±0.05 g) were assigned into four groups fed with different diets, namely 0 (basal diet), 1%, 2%, and 4% of coriander seed powder (CSP). In the current study, C. carpio fed with dietary CSP revealed significant improvement in weight gain, final weight, specific growth rate, total feed intake, feed conversion efficiency, feed conversion ratio, protein intake, and protein efficiency ratio, in comparison to control fish fed after 84 days (P>0.05). It was also found that fish fed with 1%CSP-supplemented dietary had the best growth performance and feed utilization. The crude protein of fish fed with CSP dietary treatments increased, and significant differences were only found in the fish fed with 1%CSP diet, in comparison to the control group. The CSP supplementation groups showed significant increases in hemoglobin, hematocrit, albumin, total protein, and globulin compared to the control group. Nevertheless, differential white blood cells, mean corpuscular hemoglobin concentration, cholesterols, and triglycerides were significantly reduced in the CSP dietary group in comparison to the control group. It was also found that CSP dietary treatment significantly increased lipase and amylase in comparison to the control group (P>0.05). However, the highest lipase and amylase levels were obtained at 1%CSP and 2%CSP dietary treatment groups, compared to the control basal diet. Based on the results, CSP supplementation could improve the overall health status and growth performance of common carp fingerlings.

Child Health and the Pediatric Hematology-Oncology Workforce: 2020-2040.

Pediatric hematology-oncology (PHO) is 1 of the oldest recognized pediatric subspecialities. PHO physicians care for infants, children, adolescents, and young adults with all types of cancer and nonmalignant blood conditions, in many cases temporarily assuming the role of a primary care physician because of the complexity and intensity of treatment. However, the number of clinically active PHO subspecialists needed to care for children in the United States remains unknown. Recent papers suggest a potential oversaturation of PHO physicians in some geographic areas. This article is part of a Pediatrics supplement focused on projecting the future supply of the pediatric subspecialty workforce. It draws on information available in the literature, data from the American Board of Pediatrics, and findings from a new microsimulation model estimating the future supply of pediatric subspecialists through 2040. The model predicts a workforce growth in PHO subspecialists of 66% by 2040. Alternative scenarios, including changes in clinical time and fellowship size, resulted in a difference in growth of ±18% from baseline. The model also forecasts significant geographic maldistribution. For example, the current workforce is concentrated in the Northeast Census region and the model predicts the New England Census division will have a 2.9-fold higher clinical workforce equivalent per 100 000 children aged 0 to 18 years than the Mountain Census division by 2040. These findings suggest potential opportunities to improve the PHO subspecialty workforce and the outcomes and experiences of its patient population through educational changes, practice initiatives, policy interventions, and dedicated research.

Ameliorating impact of coenzyme Q10 on the profile of adipokines, cardiomyopathy, and hematological markers correlated with the glucotoxicity sequelae in diabetic rats.

BACKGROUND: In diabetes, high blood glucose induces glucotoxicity, resulting in the further damage of pancreatic beta-cells and then precipitating diabetic complications. This study was aimed to investigate the relationship between glucotoxicity with the level of adipokines, diabetic cardiomyopathy, and hematological markers. Moreover, the study examined the potential modulatory effect of coenzyme Q10 (CoQ10) on the aforementioned markers associated with the sequelae of diabetes mellitus. MATERIAL AND METHODS: Twenty-four male rats were randomly assigned to receive an injection of STZ to induce diabetes (n = 16) or to remain uninduced (n = 8). The hyperglycemic status was induced in fasting rats by single intraperitoneal injection of STZ (45 mg /kg b.w.) dissolved in citrate buffer (pH 4.5). Three days after STZ injection, rats were divided into three groups; Normal control group (A), Diabetic control group (B), and CoQ10- treated diabetic group (C). The group (C) was fed with the basal diet supplemented with 5 g of CoQ10 per kilogram of diet for three weeks after the diabetes induction. After 21 days, the blood and serum samples were taken to conduct biochemical analyses. Blood glucose was determined by Blood Glucose Monitoring System. Adipokines or cytokines were evaluated by ELISA from a serum sample. Cardiac myopathy biomarkers were estimated by UP-Converting Phosphor Immunoassay Analyzer, and hematological parameters were measured by automatic hematology analyzer. RESULTS: In hyperglycemic rats, the level of fasting blood glucose, and serum level of resistin, omentin, TNF-α, and cardiomyopathy biomarkers significantly increased (P < 0.05). The treatment with CoQ10 significantly decreased the profile of adipokines and cardiomyopathy markers (cardiac enzymes and LPPLA2) in diabetic rats and also reduced glucose levels (P < 0.05). Lymphocyte percentages significantly decreased while significant increases were observed in granulocytes and MID percentages in hyperglycemic rats. CONCLUSION: Diabetic rats had higher serum levels of adipokines and cardiomyopathy markers. Among the hematological markers, GRA% and MID% increased while LYM% decreased. The profile of adipokines and cardiomyopathy markers improved when CoQ10 was supplemented. The study suggests that CoQ10 may have a beneficial effect on improving diabetic complications.

Impact of Facility Dog and Certified Child Life Specialist Dyad on Children's Pain and Anxiety During Needlestick Procedures in a Pediatric Hematology Oncology Clinic Setting.

BACKGROUND: Pediatric Hematology Oncology patients undergo frequent needlestick procedures, often leading to negative outcomes including pain and anxiety. Animal-assisted therapy has been shown to minimize pediatric patient distress; however, its utilization by a Certified Child Life Specialist (CCLS) to reduce patient distress has not been widely studied. METHODS: Pediatric patients receiving needlesticks in the Hematology Oncology Clinic were enrolled between March 2018 and May 2021. Patients who had scheduled visits when the facility dog was present were assigned to the intervention group. Patients were assigned to the control group if the facility dog was not present. The primary objective was to use the Children's Anxiety and Pain Scale to determine whether the CCLS and facility dog dyad minimized patient pain and anxiety during procedures. RESULTS: A total of 285 patients, 5 to 17 years of age, were enrolled. One hundred forty-three patients were assigned the intervention and received procedural support from the CCLS and facility dog; 142 patients were assigned the control group and received support from the CCLS only. Patient-reported pain scores were significantly lower among patients who received the intervention ( P =0.033). CONCLUSIONS: Utilization of a CCLS and facility dog dyad during painful needlestick procedures decreases patient-reported pain compared with utilization of CCLS support alone.

Herbal inclusions ameliorate effect of heat stress on haematology, proinflammatory cytokines, adipokines and oxidative stress of weaned rabbit does in humid tropics.

A study was designed to evaluate the effect of Moringa oleifera, Phyllanthus amarus and Viscum album leaf meal as herbal inclusions to alleviate the detrimental outcomes of heat stress in weaned female rabbits. Forty (40) weaned rabbit does (527.99 ± 10.35 g; 28 days old) were randomly allotted to four dietary groups consisting of Diet 1(control diet; without leaf meal), Diets 2 (supplemented with 10% V. album); 3 (supplemented with 10% M. oleifera) and 4 (supplemented with 10% P. amarus) in an 84 days trial at the peak of heat stress in Southwest Nigeria. At the end of the trial, blood samples were collected to assess physiological responses and oxidative status of the rabbit does. The results obtained revealed that rabbit does were exposed to heat stress; rabbit does fed control diet had higher leucocyte and neutrophil/lymphocyte ratio compared to rabbit does fed on herbal inclusions. The herbal inclusions enhanced oxidative stability of rabbit does by lowering lipid peroxidation and enhancing antioxidant activities during heat stress conditions. Rabbit does fed control-based diet had significantly higher heat shock protein 70, leptin and adiponectin compared to rabbit does on M. oleifera, P. amarus and V. album supplemented diets. The herbal inclusions tend to suppress proinflammatory cytokines in rabbit does during heat stress condition. In conclusion, the herbal inclusions suppress inflammation, adipokines and promotes oxidative stability of rabbit does exposed to heat stress conditions.

[Update of triggers for detection of adverse drug events in hematologic patients]. / Atualização dos rastreadores para detecção de eventos adversos a medicamentos em pacientes hematológicos.

The use of triggers for the active search and detection of adverse drug events (ADEs) has been gaining ground within pharmacovigilance services. Thus, the main objective of the study was to propose a new list of triggers to be used in a center specialized in hematology in Rio de Janeiro, Brazil. The update of the list of triggers consisted of revising the current list, with the exclusion and inclusion of new triggers. To verify the performance of the new list of triggers, a cross-sectional study was conducted in which the new triggers were used to investigate the occurrence of ADEs in patients attended in the emergency unit or hospitalized from January to March 2022. For each suspected ADEs, the patient's profile and adverse drug reactions (ADRs) were characterized regarding causality and severity. The performance of the triggers and their ability to capture ADEs were estimated using the following indicators: frequency of the trigger per 100 medical records, frequency of ADEs per 100 records, and positive predictive value (PPV). To evaluate the overall performance of the proposed new list, the PPV was estimated. A total of 374 prescriptions for triggers were identified in 186 medical records. The most efficient in the detection of possible ADEs were: lidocaine, loperamide, bisacodyl, filgrastim and glycerin clyster. The overall PPV of the new suggested list was 48% versus 10% of the previous list. This study demonstrated the importance of an updated list of triggers for the monitoring of ADEs and improvement of the care provided.

A utilização de rastreadores para a busca ativa e detecção de eventos adversos a medicamentos (EAM) tem ganhado espaço nos serviços de farmacovigilância. Assim, o objetivo principal do estudo foi propor uma nova lista de rastreadores para ser empregada em um centro especializado em hematologia do Rio de Janeiro, Brasil. A atualização da lista de rastreadores consistiu na revisão da lista atual, com a exclusão e inclusão de rastreadores. Para verificar o desempenho da nova lista de rastreadores, realizou-se um estudo transversal em que os novos rastreadores foram utilizados para investigar a ocorrência de EAM em pacientes atendidos na emergência ou hospitalizados no período de janeiro a março de 2022. Para cada suspeita de EAM identificada, caracterizaram-se o perfil do paciente e as reações adversas a medicamentos (RAM) quanto à causalidade e gravidade. O desempenho dos rastreadores e sua capacidade de captação de EAM foram calculados por meio dos indicadores: frequência do rastreador por 100 prontuários, frequência de EAM por 100 prontuários e valor preditivo positivo (VPP). Para avaliar o desempenho global da nova lista proposta, calculou-se o VPP. Foram identificadas 374 prescrições de rastreadores em 186 prontuários. Os mais eficientes na detecção de possíveis EAM foram: lidocaína, loperamida, bisacodil, filgrastim e clister de glicerina. O VPP global da nova lista sugerida foi 48% contra 10% da lista anterior. Este estudo demonstrou a importância de uma lista de rastreadores atualizada para o monitoramento dos EAM e o aprimoramento da assistência prestada.

El uso de rastreadores en la búsqueda y detección activa de eventos adversos de medicamentos (EAM) viene ganando espacio dentro de los servicios de farmacovigilancia. Por lo tanto, el objetivo principal de este estudio fue proponer una nueva lista de rastreadores que se utilizarán en un centro de hematología especializado en Río de Janeiro, Brasil. La actualización de la lista de rastreadores consistió en la revisión de la lista actual, con la exclusión e inclusión de rastreadores. Para verificar el desempeño de la nueva lista de rastreadores, se realizó un estudio transversal en el que se utilizaron los nuevos rastreadores para investigar la aparición de EAM en pacientes atendidos en urgencias u hospitalizados en el periodo de enero a marzo de 2022. Para cada sospecha de EAM identificados, el perfil del paciente y las reacciones adversas a medicamentos (RAM) se caracterizaron por su causalidad y gravedad. El desempeño de los rastreadores y su capacidad para capturar EAM se calcularon mediante los indicadores: frecuencia del rastreador por cada 100 registros médicos, frecuencia de EAM por cada 100 registros médicos y valor predictivo positivo (VPP). Para evaluar el desempeño general de la nueva lista propuesta, se calculó el VPP. Se identificaron 374 recetas de rastreadores en 186 registros médicos. Los más eficientes en la detección de posibles EAM fueron lidocaína, loperamida, bisacodilo, filgrastim y enema de glicerina. El VPP general de la nueva lista sugerida fue del 48% frente al 10% de la lista anterior. Este estudio demostró la importancia de una lista actualizada de rastreadores para monitorear EAM y mejorar la atención brindada.

Analysis of haematological effects of Picralima nitida.

The protective effects of the leaf powder of Picralima nitida in male rats were evaluated to establish its haematopoietic potential. To achieve this, albino rats (n = 30), weighing 120 - 160g were grouped into 5, labelled A to E. Groups C and D were intraperitoneally induced for anaemia with 0.1mg/kg body weight (b.wt) of phenyl hydrazine for 7 day. Groups A and B and C and D orally received 200 and 400 mg/kg b.wt of Picralima nitida leaf extract respectively for 14 days. Group E served as the control. Blood sample (5.0ml) was collected from each rat on days 8 and 15 and dispensed into ethylene diamine tetra acetic acid containers for haemogram using haematology auto analyser. The result showed that on day 8, Picralima nitida leaf extract produced a significant (P<0.05) increase in haemoglobin (Hb) and haematocrit (Hct) when compared with the control. On day 15, Picralima nitida leaf extract produced a significant (P<0.05) increase in the red blood cell (RBC), Hb and Hct when compared with the experimental control. The results indicate time-dependent haematopoiesis.

A comparative multi-level toxicity assessment of carbon-based Gd-free dots and Gd-doped nanohybrids from coffee waste: hematology, biochemistry, histopathology and neurobiology study.

Here, a comparative toxicity assessment of precursor carbon dots from coffee waste (cofCDs) obtained using green chemistry principles and Gd-doped nanohybrids (cofNHs) was performed using hematological, biochemical, histopathological assays in vivo (CD1 mice, intraperitoneal administration, 14 days), and neurochemical approach in vitro (rat cortex nerve terminals, synaptosomes). Serum biochemistry data revealed similar changes in cofCDs and cofNHs-treated groups, i.e. no changes in liver enzymes' activities and creatinine, but decreased urea and total protein values. Hematology data demonstrated increased lymphocytes and concomitantly decreased granulocytes in both groups, which could evidence inflammatory processes in the organism and was confirmed by liver histopathology; decreased red blood cell-associated parameters and platelet count, and increased mean platelet volume, which might indicate concerns with platelet maturation and was confirmed by spleen histopathology. So, relative safety of both cofCDs and cofNHs for kidney, liver and spleen was shown, whereas there were concerns about platelet maturation and erythropoiesis. In acute neurotoxicity study, cofCDs and cofNHs (0.01 mg/ml) did not affect the extracellular level of L-[14C]glutamate and [3H]GABA in nerve terminal preparations. Therefore, cofNHs demonstrated minimal changes in serum biochemistry and hematology assays, had no acute neurotoxicity signs, and can be considered as perspective biocompatible non-toxic theragnostic agent.

Impacts of organic manganese supplementation on blood mineral, biochemical, and hematology in Afshari Ewes and their newborn lambs in the transition period.

OBJECTIVE: Maternal mineral status, including manganese (Mn), is critical for fetal growth as well as the health of the newborn lamb. Consequently, it is essential to supply minerals at sufficient levels for the pregnant animal to achieve the development of the embryo and fetus during gestation. METHODS: The current research was conducted to investigate the impact of organic Mn supplementation on blood biochemical, other mineral and, hematology in Afshari ewes and their newborn lambs in the transition period. Twenty-four ewes were randomly divided into three groups with eight replications. The control group was fed with a diet without organic Mn. The other groups were fed a diet supplemented with 40 (recommended by the NRC) and 80 (twice-recommended by the NRC) mg/kg of DM organic Mn. RESULTS: In this study, the consumption of organic Mn caused a significant increase in ewes and lambs plasma Mn concentration. Moreover, in the groups mentioned, levels of glucose, insulin, and superoxide dismutase were significantly increased in both ewes and lambs. Concentrations of total protein and albumin were higher in ewes fed whit organic Mn. In both ewes and newborn lambs, the levels of red blood cells, hemoglobin, hematocrit, mean corpuscular hemoglobin, and mean corpuscular concentration in groups fed with organic Mn raised. CONCLUSION: In general, the nutrition of organic Mn, improved factors of blood biochemical and hematology in ewes and their newborn lambs, and since the twice-recommended NRC level did not cause poisoning, it was recommended to supplement the diet with 80 mg of organic Mn per kg of DM.

Effect of dietary inclusion of mealworm frass on growth, hematology, and serum biochemistry of sheep.

Frass is the main component of worm by-product which exhibit anti-microbial and anti-pathogenic properties. In the present study, we assessed the possibility of mealworm frass in sheep feeding regime and evaluated its effect on health and growth performance of sheep. A total of 09 experimental sheep (18-24 months of age) were grouped into three categories (T1, T3, and T3); each group comprised 3 animals including 2 males and 1 female. Group T1 was considered control, group T2 contains 75% commercial feed and 25 mealworm frass, and T3 was 50:50 of commercial feed and mealworm frass. The sheep in group T2 showed average weight gain of 2.9 kg; however, when the dietary inclusion increased up to 50% of mealworm frass or decreased up to 50% of concentrate feed, the average weight gain decreased up to 2.01 kg (group T3). Moreover, the sheep fed with 25% mealworm frass exhibited the lowest feed refusal percentage (6.33%) in total duration of the dietary period (6 weeks). The highest volume of RBC was found in blood collected from sheep fed within group T2 (10.22 1012/L ± 0.34), followed by sheep fed in group T3 (8.96 × 1012/L ± 0.99) (P < 0.05). Significantly (P < 0.05) highest MCV volume in fL (femtoliter) was found in group T2 (32.83 ± 0.44) followed by group T3 (31.23 ± 0.23). The animals in group T3 showed significantly (P < 0.05) highest MCHC volume (40.47 g/dL ± 0.62) followed by group T2 (38.77 ± 0.97). Similar trend was found in MPV (fL); significantly (P < 0.05) highest MPV volume was found in group T3 (12.63 ± 0.09) followed by group T2 (12.53 ± 0.33). Significantly (P < 0.05) high serum phosphorous (P) (6.00 ± 0.29), TG (60.03 ± 3.11), and TP (7.63 g/dL ± 0.23) levels were found in group T3, followed by animals in group T2. We can conclude that inclusion of mealworm frass to replace 25% commercial concentrate feed improved the growth rate and overall health status of the sheep. The present study laid a foundation for the utilization of the mealworm frass (waste product) in ruminant feeding.

Hematology profile, digestive enzymes, thyroid hormones, productivity, and nitrogen balance of growing male rabbits supplemented with exogenous dietary lysozyme.

In a simple randomized design trial, 420 growing male V-Line rabbits were randomly distributed into four groups to investigate the impact of exogenous dietary lysozyme on some physiological and nutritional parameters of male growing rabbits supplemented with exogenous dietary lysozyme. The witness group received a basal diet without exogenous dietary lysozyme (LYZ0), while the exogenous dietary lysozyme groups received 50, 100 and 150 mg/kg of basal diet (Groups; LYZ50, LYZ100 and LYZ150), respectively. The results showed significantly increased in blood cell count, hemoglobin concentration, total white blood cell, lipase, protease, amylase, total protein, triiodothyronine and thyroxine levels, while thyroid stimulating hormone levels significantly lessened in rabbits received LYZ. The LYZ- rabbit diets improved total digestible nutrient, digestible crude protein, and digestible energy values, with the LYZ100 group outperforming the others. LYZ-treated rabbits had significantly higher nitrogen intake, digestible nitrogen, and nitrogen balance than the witness group. The lysozyme in a rabbit's diet is taking on a new role as a digestive enzyme, enhancement thyroid hormones, as well as improvement hematology, daily protein efficiency ratio, daily performance index, hot carcass, total edible parts, nutritional value, and nitrogen balance, with decreasing the daily caloric conversion ratio and total non-edible parts.

Complimentary effect of exogenous enzymes, essential amino acids and essential fatty acids supplemented de-oiled rice bran (DORB) based diets on hematology, liver and intestinal histoarchitecture in Labeo rohita.

A 60-day feeding trial was conducted to study the hematology, liver, and intestinal histoarchitecture of Labeo rohita fed with a combination of exogenous enzymes, essential amino acids, and essential fatty acids to DORB (De-oiled rice bran) based diets. Three treatments viz., T1 [DORB + phytase and xylanase (0.01% each)], T2 [DORB + phytase (0.01%) + xylanase (0.01%) + L-lysine(1.4%) + L-methionine (0.4%) + EPA and DHA (0.5%)] and T3 [DORB + phytase (0.01%), xylanase and cellulase (0.075%) + L-lysine (1.4%) +L-methionine (0.4%) + EPA and DHA (0.5%)] were used in the present study. Serum total protein, albumin content and A/G ratio varied significantly (p < 0.05) among groups. Globulin content did not vary significantly among groups (p ≥ 0.05). The Hb content, RBC and MCV count varied significantly (p < 0.05) whereas MCH, MCHC content, WBC and lymphocyte count did not vary significantly among groups (p > 0.05). The liver and intestine examination revealed no visible alteration and showed normal histo-architecture. Based on the finding it is concluded that DORB supplemented with exogenous enzymes, essential amino acids and essential fatty acids with phytase (0.01%), xylanase and cellulase (0.075%), L-lysine (1.4%), DL-methionine (0.4%) and EPA and DHA (0.5%) improves the health of L. rohita.

HEMATOLOGY AND PLASMA BIOCHEMISTRY REFERENCE INTERVALS FOR FREE-LIVING ADULT CHIMANGO CARACARA (MILVAGO CHIMANGO) DURING THE NONBREEDING SEASON.

Hematological and blood biochemistry values are useful in assessing the physiological, nutritional, and overall health status of captive and free-living wildlife. For the chimango caracara (Milvago chimango), the most common raptor species in Argentina, reference intervals (RIs) for hematology and blood biochemistry are lacking. For this study, 86 chimango caracaras were captured and studied in Mar del Plata and neighboring areas (Buenos Aires, Argentina) during winter (April-July) in 2018 and 2019. This is the first study to present RIs for 33 blood parameters in a large number of free-living chimango caracaras during the nonbreeding season. In addition, the variability of blood parameters according to sex and calendar year was analyzed. Overall, values for the studied parameters were similar to those described for other raptor species. There were significant differences between years for absolute monocyte counts, relative eosinophils, monocyte counts, glucose, phosphorus, and alanine aminotransferase. Only the relative count of eosinophils, aspartate aminotransferase, and calcium showed significant differences between the sexes. The values of absolute monocyte counts and the relative count of eosinophils and monocytes, glucose, phosphorus, and alanine aminotransferase were higher in 2019 than in 2018, whereas mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration were higher in 2018. Relative eosinophil counts were higher for males than for females, and aspartate aminotransferase activity and calcium concentration were significantly higher for females than for males. The RIs for hematology and plasma biochemistry from this large number of chimango caracaras is of clinical relevance not only for chimango caracaras under medical care in rehabilitation centers but also in ecological studies aimed to investigate the physiological responses of this species to natural and anthropogenic changes.

Massage therapy for children, adolescents, and young adults: Clinical delivery and effectiveness in hematology and oncology.

BACKGROUND: Children, adolescents, and young adults with hematologic and/or oncologic conditions experience multiple, significant symptoms (e.g., pain, stress, and anxiety), which may be addressed by nonpharmacologic approaches such as massage therapy (MT). The purpose of this study was to describe the clinical delivery of MT provided by a certified pediatric massage therapist and assess effectiveness in two patient groups: those with sickle cell disease (SCD) or hematologic and/or oncologic conditions excluding SCD (HemOnc). METHODS: Investigators conducted a retrospective review of MT sessions provided to patients 0-39 years with hematologic and/or oncologic conditions at a large pediatric academic medical center. RESULTS: Between October 2019 and December 2021, 3015 MT sessions were provided to 243 patients (171 HemOnc; 72 SCD) and documented in the electronic health record. Patients (mean age: 12.21 ± 7.19 years) were generally White (49.4%) or Black/African American (43.2%), non-Hispanic (94.2%), and 52.3% female. Patients in the SCD group (vs. patients in the HemOnc group) reported significantly higher (p < .05) pretreatment pain (6.95 vs. 4.46), stress (6.47 vs. 4.58), and anxiety (6.67 vs. 4.59). All patients reported clinically and statistically significant (p < .001) mean reductions in pain (-2.25 ± 1.87), stress (-2.50 ± 1.73), and anxiety (-2.52 ± 1.69), with patients in the HemOnc group reporting greater mean pain change (-2.54 vs. -1.87) than patients in the SCD group. CONCLUSIONS: This study supports the clinical effectiveness of MT for addressing acute pain, stress, and anxiety among youth with hematologic and/or oncologic conditions. Future research is needed to identify optimal MT utilization.

Integrative Hematology: State of the Art.

Blood cancers are a group of diseases with thus far frequently poor prognosis. Although many new drugs, including target therapies, have been developed in recent years, there is still a need to expand our therapeutic armamentarium to better deal with these diseases. Integrative hematology was conceived as a discipline that enriches the patient's therapeutic possibilities with the use of supplements, vitamins and a nutritional approach aiming at improving the response to therapies and the clinical outcome. We will analyze the substances that have proved most useful in preclinical and clinical studies in some of the most frequent blood diseases or in those where these studies are more numerous; the importance of the nutritional approach and the role of the intestinal microbiota will also be emphasized.

Alternative therapy improves hematological profiles of captive snakes from northeastern Brazil / Efeitos positivos de uma terapia alternativa nos perfis hematológicos de serpentes cativas no nordeste brasileiro

Objective: Evaluate the effects of alternative therapy on the hematological profiles of different families of captive snakes. Methodology: Captive snakes at NUROF-UFC were submitted to a clinical and hematological evaluation before and after applying an alternative treatment, including systematic sunbathing and hydration by soaking bathes twice a week for five weeks. The biometric, clinical, and hematological data were compared by multivariate analysis of variance and investigated for possible causal relationships by general linear models. Results: A significant difference was observed between erythrograms and global leukograms in the three families of snakes evaluated before and after treatment. The significant reduction in the heterophil: lymphocyte ratio in the Family Colubridae after treatment was noteworthy. Discussion: The results were most likely due to stress level reduction by improving thermoregulation and conversion of vitamin D during sunbathing, oral rehydration and refreshing in soaking baths, and general metabolic rates due to physical exercise. Conclusion: The results confirm the initial hypothesis, assuming that a simple but systematic treatment that included sunlight exposure and immersion hydration was efficient in reducing stress rates.

Objetivo: Avaliar a influência de banhos de sol e de imersão em água nos perfis hematológicos de serpentes cativas, antes e após a aplicação deste tratamento alternativo. Metodologia: Serpentes cativas no NUROF-UFC foram submetidas à avaliação clínica e hematológica, depois submetidas ao tratamento alternativo por cinco semanas, sendo novamente avaliadas após. Os dados obtidos foram submetidos à análise estatística multivariada (NPMANOVA e GLM) para investigação de possíveis relações causais entre o tratamento e os perfis hematológicos. Resultados: Foi observada diferença significativa entre os eritrogramas e leucogramas nas três famílias de serpentes avaliadas antes e após o tratamento. Ressalta-se a redução significativa na razão heterófilos:linfócitos na Família Colubridae após o tratamento. Discussão: A diferença estatística deveu-se provavelmente à redução nos níveis de estresse, possibilitada por aquecimento e aumento de conversão da vitamina D durante a exposição solar; reidratação oral e refrescância nos banhos de imersão, e ao recondicionamento pelo exercício físico. Conclusão: Os resultados confirmaram a hipótese inicial, admitindo que um tratamento alternativo, simples mas aplicado sistematicamente, que incluiu exposição à luz solar e hidratação por imersão em água foi eficiente em reduzir as taxas de estresse em serpentes cativas.

Effects of chronic exposure to toxic metals on haematological parameters in free-ranging small mammals.

Blood circulates through the vascular system to carry oxygen, nutrients and metabolites to and away from tissues, and as such is a key-component of animal physiology. The impacts of metal pollution on blood, however, are poorly documented in free-ranging vertebrates. While the counteracting effect of selenium on mercury toxicity is well known in marine mammals, its potential role against the toxicity of other metals is less studied, especially on terrestrial wildlife. We explored the consequences of chronic exposure to two non-essential metals (cadmium and lead) along a pollution gradient in Northern France, on eleven haematological parameters in two free ranging small mammals, the wood mouse Apodemus sylvaticus and the bank vole Myodes glareolus. We hypothesized that haematology was related to metal concentrations in tissues, and that selenium might exert modulating effects. Concentrations of cadmium and lead in the tissues indicated an increased chronic exposure to and accumulation of metals along the gradient. Some haematological parameters were not explained by any measured variables while some others varied only with gender or age. Red blood cells, red blood cells distribution width, and blood iron concentration, however, decreased with increasing cadmium in the tissues in wood mice. Red blood cells and haemoglobin decreased with increasing renal lead and hepatic cadmium, respectively, in bank voles. Red blood cells distribution width in wood mice increased with cadmium concentrations in the liver but this was counteracted by high selenium levels in the same organ. An interaction of selenium and lead on red blood cells was also observed in bank voles. Further, selenium concentrations were associated with an increase of monocytes in wood mice. The present results show that toxic metals were related to haematology changes, particularly erythrocyte indicators, and that some essential elements like selenium should be measured as well since they may counteract toxic effects.

28-day repeated dose toxicological evaluation of Coronil in Sprague Dawley rats: Behavioral, hematological, biochemical and histopathological assessments under GLP compliance.

Ayurvedic medicines are widely employed globally for prophylaxis and treatment of a variety of diseases. Coronil is a tri-herbal medicine, constituted with the traditional herbs, Tinospora cordifolia, Withania somnifera and Ocimum sanctum, with known immunomodulatory activities. Based on its proven in-vitro activity and in-vivo efficacy, Coronil has been approved as a 'Supporting Measure for COVID-19' by the Ministry of AYUSH, Government of India. The current study was aimed to assess the non-clinical safety of Coronil in a 28-day repeated dose toxicity study along with a 14-day recovery period in Sprague Dawley rats. This toxicity study was conducted in accordance with OECD test guideline 407, under GLP-compliance. Specific-Pathogen-Free animals of either sex, housed in Individually-Ventilated-Cages were particularly used in the study. The tested Coronil dose levels were 0, 100, 300 and 1000 mg/kg/day, orally administered to 5 males and 5 female rats per test group. In the current study, no mortality was observed in any group and in addition, Coronil did not elicit any finding of toxicological relevance with respect to clinical signs, ocular effects, hematology, urinalysis and clinical chemistry parameters, as well as macro- or microscopical changes in any organs, when compared to the control group. Accordingly, the No-Observed-Adverse-Effect-Level (NOAEL) of Coronil was ascertained to be 1000 mg/kg/day, subsequent to its 28-day oral administration to male and female rats. The acceptable safety profile of Coronil paves the way further toxicity assessments in rodents for a longer duration as well as in higher animals, and towards its clinical investigation.

Clinical practice guidelines for the optimization of hemato-oncological care: the ICOPraxis.

INTRODUCTION: The Catalan Institute of Oncology (ICO) is a Comprehensive Cancer Center (CCC) responsible for the oncological care of 46% of the Catalan population. OBJECTIVE: Given the increasing and ongoing approval of onco-hematological treatments, the professionals at the ICO decided to have clinical practice guidelines (called ICOPraxis) based on available evidence. In this report, we intend to share how the ICOPraxis has developed and what its impact has been in the 14 years it has been running. RESULTS: In the 14 years, since the project has been running, 17 clinical practice guidelines (some of them with several editions) have been prepared for major onco-hematology clinical conditions. These guidelines will be utilized in the four ICO centers (Girona, Badalona, Tarragona, and Hospitalet) and ICO works in a network with 18 regional hospitals. Between 2018 and 2022, the guidelines have been viewed 38.645 times and downloaded 24.614 times, with an average time spent on each page of 3 min. The ICOPraxis have been consulted in 25 countries in America (3.163 views), 20 countries in Europe (35.365 views), 10 countries in Asia (36 views), and 3 countries in Africa (12 views). The country with the highest number of downloads is Spain with a total of 34.742 downloads (Analytics [Internet]). CONCLUSION: The ICOPraxis have succeeded in establishing an evidence-based system that facilitates prescription decision-making according to the established harmonization process and reduction in variability in treatments, increasing equity in our population.