Prevalence of HEV RNA in Croatian blood donors.

OBJECTIVES: HEV infection is asymptomatic for immunocompetent blood donors (BD). Transfused HEV-infected blood products may cause potentially hazardous HEV infection in immunocompromised patients. Evaluation of the need for routine BD HEV RNA screening primarily demands the establishment of HEV infection prevalence in Croatian BD. MATERIALS AND METHODS: We tested BD samples in ID-NAT with the Procleix UltrioPlex E screening test for simultaneous detection of HBV DNA, HCV RNA, HIV-1,2 RNA, and HEV RNA (Grifols, Spain). HEV infection was confirmed with HEV RNA quantitative test (Altona Diagnostics, Germany) and HEV IgM and HEV IgG antibody test (DIA.PRO Diagnostic Bioprobes, Italy). We analysed the HEV RNA sequence and performed a phylogenetic analysis. We recorded BD's anamnestic data and dietary habits. BDs gave follow-up samples after two months and did not donate blood for six months. RESULTS: Between December 2021 and March 2022, we tested 8,631 donations and found four HEV RNA-positive donations, which equals to one in 2,158 donations (0.046 %, 95 % confidence interval, 0.018 %-0.119 %). Confirmatory HEV RNA testing gave results from negative to 4.73E + 3 IU/ml HEV RNA. Three donations were in the serological window period. We have genotyped HEV RNA of two infected BD as genotype HEV-3c. Blood donors didn't report any health problems and their diet included pork. Testing on follow-up samples presented seroconversion and no HEV RNA could be detected. CONCLUSION: The incidence of HEV RNA infection in BD in Croatia corresponds with other European data. The decision on implementation of HEV NAT screening in Croatia needs an expert team evaluation of the possible risk of TT-HEV infection.

Human neutrophil antigen-1, -3, -4, and -5 allele and genotype frequencies in the Croatian blood donor population and their clinical significance.

OBJECTIVES: Human neutrophil antigens (HNAs) and antibodies play an important role in allo- and autoimmunity associated with immune neutropenia and transfusion reactions. The aim of this study was to determine the HNA-1, -3, -4 and -5 allele and genotype frequencies in the Croatian blood donor population to assess the role of HNA-1, -3, -4, and -5 alleles in the development of neonatal alloimmune neutropenia and antibody-mediated transfusion-related acute lung injury. MATERIAL AND METHODS: A total of 371 blood samples from unselected healthy blood donors were analyzed. Samples from all 371 donors were genotyped for HNA-1, samples from 160 donors were genotyped for HNA-3, and samples from 142 donors were genotyped for HNA-4 and HNA-5 using the polymerase chain reaction with sequence-specific primers (PCR-SSP) method. RESULTS: The frequencies of the FCGR3B*01, FCGR3B*02 and FCGR3B*03 HNA-1 alleles were 0.393, 0.607 and 0.022, and of the SLC44A2*01 and SLC44A2*02 HNA-3 alleles 0.781 and 0.219, respectively. The frequencies of the ITGAM*01 and ITGAM*02 HNA-4 alleles were 0.796 and 0.204, and of the ITGAL*01 and ITGAL*02 HNA-5 alleles 0.718 and 0.282, respectively. CONCLUSION: These are the first results on the HNA allele and genotype frequencies in the Croatian blood donor population. We observed no deviations from previous reports on Caucasian populations. Determination of the HNA antigen frequencies in the population is important to estimate the risk of alloimmunization to HNA, especially the risk of fetal-maternal incompatibility and alloantibody production by transfusion of the HNA incompatible blood components.

Transient pseudothrombocytopenia (PTCP) in the neonate due to the mother.

Thrombocytopenia with platelet count <50×109/L is common laboratory finding in a severely ill newborn in neonatal intensive care units (ICU). Neonates with severe thrombocytopenia are at risk of bleeding. Most dangerous is intracerebral hemorrhage (ICH) frequently leading to death or lifelong neurological sequels. Pseudothrombocytopenia (PTCP) is a rare in vitro phenomenon of falsely low platelet count determined on hematology analyzers due to platelet clumping in ethylenediaminetetraacetic acid (EDTA) anticoagulated blood. PTCP was also reported in pregnant women with isolated thrombocytopenia. EDTA-PTCP in the neonate due to the transplacental transmission of maternal antibodies has been reported only in a few cases. Although PTCP is rare phenomenon, it should always be excluded in newborns with isolated thrombocytopenia to avoid erroneous interpretation of platelet and leukocyte count, unnecessary laboratory investigation of false positive antiplatelet antibodies and needless platelet transfusions. We report on two cases of transient PTCP in a neonate due to transplacental transfer of maternal EDTA-dependent autoantibodies of IgG class from the same mother.

Oxacillinases and antimicrobial susceptibility of Ralstonia pickettii from pharmaceutical water systems in Croatia.

This study evaluated antibiotic susceptibility and presence of blaOXA22 and blaOXA60 genes in 81 isolates of Ralstonia pickettii obtained from different purified and ultra-pure water systems in two different geographical areas of Croatia. E-test and disc diffusion test were performed to determine antibiotic susceptibility. Polymerase chain reaction was applied to detect genes encoding OXA-22 and OXA-60 oxacillinases previously identified in R. pickettii. The isolates were genotyped by pulsed-field gel electrophoresis. The results revealed variable susceptibility/resistance profiles. Our isolates exhibited high susceptibility rates to ceftriaxone, cefotaxime, piperacillin-tazobactam, ciprofloxacin, imipenem, cefepime and in lesser extent to ceftazidime. High rates of susceptibility were also observed for sulphamethoxazole-trimethoprim and piperacillin. High resistance rates were noticed for ticarcillin-clavulanate, aztreonam and meropenem, as well as for all aminoglycosides tested. Modified Hodge test was positive in 51·9% strains, indicating production of carbapenemases. blaOXA22 and blaOXA60 genes were detected in 37·0 and 80·3% strains, respectively. Pulsed-field gel electrophoresis identified three major clusters containing subclusters. R. pickettii should be taken seriously as a possible cause of nosocomial infections to ensure adequate therapy, to prevent the development of resistant strains and to try to reduce the possibility of R. pickettii surviving in clean and ultra clean water systems.

Prenatal RHD genotyping in Croatia: preliminary results.

OBJECTIVES: Croatian Institute of Transfusion Medicine (CITM) implemented non-invasive fetal RHD genotyping as a request for targeted antenatal anti-D prophylaxis. The diagnostic performance of in-house RT-PCR method for fetal RHD genotyping and preliminary results are analyzed. MATERIALS AND METHODS: Evaluation included results of RHD genotyping for 205 RhD negative pregnant women, 12-36th week of gestation, whose samples were received in period between 2015 and 2020. QIAsymphony SP DSP Virus Midi Kit was used for cffDNA extraction on QIAsymphony SP platform (Qiagen, Germany). Fragments of RHD exons 7 and 10 and later exon 5 were RT-PCR amplified. As internal controls, amplification of SRY gene or RASSF1A fragment and ß-actin genes digested with BsTUI were used. RESULTS: We identified 70.72% (145/205) positive and 28.78% (59/205) negative fetal RHD genotypes. We had one inconclusive result (0.50%) due to the interference of maternal DNA with variant genotype RHD*09.02.00/01/*01N.01. When compared to newborns RhD phenotypes, no false negative and three false positive results (3/199, 1.50%) were observed. The test yielded 100% sensitivity and 95.08% specificity, while diagnostic accuracy was 98.48%. We were able to determine one case of fetal variant genotype RHD*04.04/*01N.01 inherited from the father. The negative and positive predictive test values were 100% and 97.86%, respectively. CONCLUSION: Automated cffDNA extraction and RT-PCR amplification of fetal RHD exons 5,7,10 and fragments of SRY, RASSF1A genes represents highly reliable system for determining fetal RHD status which enables targeted antenatal anti-D prophylaxis. To obtain high specificity of cffDNA extraction, strict and thoroughly cleaning procedures are required.

Warm red blood cell autoantibodies and clinical diagnoses in patients with or without autoimmune hemolysis.

OBJECTIVES: Red blood cell autoantibodies (RBC autoAbs) of IgG class are found in the majority of patients with warm autoimmune hemolytic anemia (wAIHA) but sometimes also during the pretransfusion testing of patients with different diagnoses but without hemolysis. The aim of the study was to identify the main differences between these two groups of patients according to age, gender, subclass and titer of IgG RBC autoAbs and diagnosis. MATERIAL AND METHODS: In the 9-year retrospective study, data were collected from records of 291 patients with IgG RBC autoAbs detected by gel technique, from which 111 with wAIHA. RESULTS: More than 85% of patients in both groups were over 40 years old, with male to female ratio 1:1.9 in wAIHA vs 1:1.3 in patients without hemolysis (P=0.0916). The main characteristics of patients with wAIHA vs patients without hemolysis were: IgG only 38% vs 70%, IgG+Complement 62% vs 30%, total IgG1 79% vs 55%, IgG1+IgG3 35% vs 11%, titer of 100 for IgG1+IgG3 17% vs 3% (P<0.0001), respectively, while titer of 100 for IgG1 18% vs 9% (P=0.0241). The underlying diagnosis in wAIHA vs patients without hemolysis: hematologic disorders 41% vs 22% (P=0.0006), autoimmune disorders 12% vs 13% (P=0.8033), solid tumors 5% vs 14% (P=0.0154) and surgery procedures 6% vs 26% (P<0.0001). CONCLUSION: We observed more wAIHA patients with high titer of IgG1 and high prevalence of IgG1+IgG3 and consider that patients without hemolysis having identical results might be interesting to find out how they are protected from damage by RBC autoAbs.

Use of Gonadotropin-Releasing Hormone Analogs in Children: Update by an International Consortium.

This update, written by authors designated by multiple pediatric endocrinology societies (see List of Participating Societies) from around the globe, concisely addresses topics related to changes in GnRHa usage in children and adolescents over the last decade. Topics related to the use of GnRHa in precocious puberty include diagnostic criteria, globally available formulations, considerations of benefit of treatment, monitoring of therapy, adverse events, and long-term outcome data. Additional sections review use in transgender individuals and other pediatric endocrine related conditions. Although there have been many significant changes in GnRHa usage, there is a definite paucity of evidence-based publications to support them. Therefore, this paper is explicitly not intended to evaluate what is recommended in terms of the best use of GnRHa, based on evidence and expert opinion, but rather to describe how these drugs are used, irrespective of any qualitative evaluation. Thus, this paper should be considered a narrative review on GnRHa utilization in precocious puberty and other clinical situations. These changes are reviewed not only to point out deficiencies in the literature but also to stimulate future studies and publications in this area.

High Lithium Transference Number Electrolytes Containing Tetratriflylpropene's Lithium Salt.

Electrolytes with a high lithium transference number linked with high ionic conductivity are urgently needed for high power battery operation. In this work, we present newly synthesized lithium tetra(trifluoromethanesulfonyl)propene as a salt-in-glyme-based "salt-in-solvent" electrolyte. We employ impedance spectroscopy in symmetric Li/electrolyte/Li cells and pulsed field gradient nuclear magnetic resonance spectroscopy to investigate the lithium conduction mechanism. We find predominant lithium conductivity with very high lithium transference numbers (∼70% from the polarization experiments) and three times higher ionic conductivity compared to well-known lithium triflate in diglyme electrolyte. This is a consequence of the reduced mobilities of large anions linked with improved ionic dissociation.

Caffeine induces metformin anticancer effect on fibrosarcoma in hamsters.

OBJECTIVE: We investigated the effect of metformin and caffeine on fibrosarcoma in hamsters. MATERIALS AND METHODS: 32 Syrian golden hamsters of both sexes, weighing approximately 100 g, were randomly allocated to 3 experimental and 2 control groups, with a minimum of 6 animals per group. 2 x 106 BHK-21/C13 cells in 1 ml were injected subcutaneously into the animals' back in 4 groups. The first experimental group started peroral treatment with metformin 500 mg/kg daily, the second with caffeine 100 mg/kg daily and the third with a combination of metformin 500 mg/kg and caffeine 100 mg/kg daily, via a gastric probe 3 days before tumor inoculation. After 2 weeks, when the tumors were approximately 2 cm in the control group, all animals were sacrificed. The blood was collected for glucose and other analyses. The tumors were excised and weighed and their diameters were measured. The tumor samples were pathohistologically (HE) and immunohistochemically (Ki-67, CD 31, COX IV, GLUT-1, iNOS) assessed and the main organs toxicologically analyzed, including the control animals that had received metformin and caffeine. Tumor volume was determined using the formula LxS2/2, where L was the longest and S the shortest diameter. Ki-67-positive cells in the tumor samples were quantified. Images were taken and processed by software UTHSCSA Image Tools for Windows Version 3.00. Statistical significances were determined by the Student's t-test. RESULTS: The combination of metformin and caffeine inhibited fibrosarcoma growth in hamsters without toxicity. CONCLUSIONS: Administration of metformin with caffeine might be an effective and safe approach in novel nontoxic adjuvant anticancer treatment.

Magneto-structural correlations in oxalate-bridged Sr(ii)Cr(iii) coordination polymers: structure, magnetization, X-band, and high-field ESR studies.

The results of high-field electron spin resonance (HF-ESR) spectroscopy on the title 1D coordination polymers at frequencies up to 415 GHz, supported by X-ray diffraction, thermal, magnetic susceptibility, and X-band (10 GHz) ESR studies, are presented. The heterometallic compounds {SrCr2(phen)2(C2O4)4}·H2O (SrCrPhen) and {SrCr2(bpy)2(C2O4)4(H2O)}·5H2O (SrCrBpy) (phen = 1,10-phenanthroline, bpy = 2,2'-bipyridine) were synthesized. Structural analysis revealed double oxalate-bridged zigzag Sr-Cr chains while magnetic susceptibility studies showed paramagnetic behaviour of the complexes. HF-ESR spectroscopy data were analysed with a relevant spin-Hamiltonian, yielding the g, D and E parameters of the Cr(iii) ions. Both complexes showed small magnetic easy-axis type anisotropy with |D| ∼ 1 K; SrCrBpy has uniaxial anisotropy while SrCrPhen has biaxial anisotropy. HF-ESR studies have enabled us to establish rational magneto-structural correlations and revealed significant differences between very similar crystal structures. Additionally, the ability of SrCrPhen and SrCrBpy to be single-source precursors for the formation of Sr-Cr oxides was investigated.

Effect of metformin on fibrosarcoma in hamsters.

OBJECTIVE: We investigated the effect of metformin on an in vivo solid tumor model of fibrosarcoma in hamsters. MATERIALS AND METHODS: 33 Syrian golden hamsters of both sexes, weighing approximately 100 g, were randomly allocated to 3 experimental and 2 control groups. 2 x 106 BHK-21/C13 cells in 1 ml were injected subcutaneously into the animals' back in 4 groups. The first experimental group (7 animals) started peroral treatment with metformin 500 mg/kg daily via a gastric probe 7 days before tumor inoculation, the second (8 animals) 3 days before inoculation and the third (6 animals) immediately after inoculation. After 2 weeks, when the tumors were approximately 2-3 cm in the control group with tumors (6 hamsters), all animals were sacrificed. The blood was collected for glucose and other analyses. The tumors were excised and weighed and their diameters were measured. The tumor samples were histologically assessed and the main organs toxicologically analyzed, including 6 control animals that had received metformin without tumor inoculation. Tumor volume was determined using the formula Lx S2/2, where L was the longest and S the shortest diameter. Ki-67-positive cells in the tumor samples were quantified; images were taken and processed by software UTHSCSA Image Tools for Windows Version 3.00. Statistical significances of differences in tumor weight, volume, number of Ki-67-positive cells and other parameters were determined by the Student´s t-test. RESULTS: Metformin inhibited fibrosarcoma growth in hamsters without toxicity. The seven-day pretreatment was important for the statistically significant effect. CONCLUSIONS: Administration of metformin as an anti-tumor drug might be an effective and safe therapeutic approach in novel non-toxic therapies for human sarcomas.

Combined cell index in assessing blood donor iron stores.

OBJECTIVES: The aim of this study was to assess the appropriateness of using combined cell index (CCI) in the assessment of iron stores in blood donors. This index is calculated by the formula: red blood cell distribution width (RDW) × 104 × mean corpuscular volume (MCV)-1 × mean corpuscular haemoglobin (MCH)-1 . BACKGROUND: Ferritin measurement is a reliable method for estimating iron stores in blood donors. The sensitivity of red blood cell (RBC) parameters of complete blood count in detecting non-anaemic iron deficiency is significantly lower. Consequently, there were several attempts to increase the detection sensitivity by combining these parameters in different indices. METHODS: This study included 1084 male and 792 female whole blood donors accepted for blood donation. For six RBC parameters with the highest level of correlation relative to ferritin [Hgb, MCV, MCH, mean corpuscular haemoglobin concentration (MCHC), RDW and CCI], diagnostic efficacy in the detection of iron depletion (ferritin <12 µg L-1 ) was assessed using receiver operating characteristic (ROC) analysis. RESULTS: CCI showed the highest degree of correlation with ferritin (r = -0·373 for men and r = -0·590 for women) and the highest area under the curve (0·961 for men and 0·864 for women). Using the cut-off value of 52·6 for men and 50·6 for women, the corresponding Youden index was the highest for CCI in both genders (0·851 for men and 0·612 for women). The sensitivity and specificity of CCI in the population of male donors were higher in comparison to female donors (0·941 and 0·910 vs 0·851 and 0·761, respectively). CONCLUSIONS: Study results confirmed the satisfactory diagnostic value of CCI in detecting depleted iron stores in blood donors.

Prostaglandin E2, trace elements and levels of oxidative processes in spontaneous miscarriages.

OBJECTIVE: We investigated the significance of prostaglandin (PG)E2, trace elements level, pro-oxidative and antioxidative parameters changes in spontaneous miscarriages. PATIENTS AND METHODS: In the 125 first trimester pregnancies, 35 with complete spontaneous abortion (group S), 40 with missed abortion (M) and 50 healthy (H), PGE2 plasma concentrations were analysed by commercial ELISA kits, plasma trace elements colorimetrically, lipid peroxidation and the antioxidative enzyme activities in hemolysate by commercial sets. Student's t-test and ANOVA were applied. RESULTS: Average PGE2 plasma concentration in the group H was higher than in S and M (p < 0.05). The higher average plasma Cu concentration, glutathione peroxidase and catalase contents were in the group H than in groups S and M (p < 0.01). Significantly lower value of lipid peroxidation was in the group H than in the groups S and M (p < 0.01). The lowest superoxide dismutase (SOD) content was in the group H and the highest in group S (p < 0.01). CONCLUSIONS: In patients with abortions significantly lower levels of plasma PGE2, plasma Cu and anti-oxidative enzymes, except SOD, and significantly higher level of lipid peroxidation products than in healthy pregnancies may be important for miscarriage etiology and prevention.

Relative risk for cardiovascular morbidity in hemodialysis patients regarding gene polymorphism for IL-10, IL-6, and TNF.

Uremia-related inflammation is prone to be a key factor to explain high cardiovascular morbidity in hemodialysis patients. Genetic susceptibility may be of importance, including IL-10, IL-6, and TNF. The aim was to analyze IL-10, IL-6, and TNF gene polymorphisms in a group of hemodialysis patients and to correlate the findings with cardiovascular morbidity. This study included 169 patients on regular hemodialysis at Zvezdara University Medical Center. Gene polymorphisms for IL-10, IL-6 and TNF were determined using PCR. These findings were correlated with the cardiovascular morbidity data from patient histories. Heterozygots for IL-10 gene showed significantly lower incidence of cardiovascular events (p = 0.05) and twice lower risk for development of myocardial infarction, but experienced twice higher risk for left ventricular hypertrophy. Regarding TNF gene polymorphism, patients with A allele had 1.5-fold higher risk for cerebrovascular accident and cardiovascular events and 2-fold higher risk for hypertension and peripheral vascular disease. Patients with G allele of IL-6 gene experienced 1.5-fold higher risks for cerebrovascular accident. We need studies with larger number of patients for definitive conclusion about the influence of gene polymorphisms on cardiovascular morbidity in hemodialysis patients and its importance in everyday clinical practice.

Intra-amnial methotrexate in cervical pregnancy treatment.

Cervical pregnancy is an extremely rare condition with potential devastating consequences if not diagnosed and treated early enough. The authors present a case with ultrasound images of early cervical ectopic pregnancy in a woman with a history of previous cesarean section who was successfully treated with intra-amnial methotrexate (MTX).

Soggy-sand electrolytes: status and perspectives.

Soggy-sand electrolytes (solid-liquid composites, typically gel electrolytes, with synergistic electrical properties) are reviewed as far as status and perspectives are concerned. Major emphasis is put on the understanding of the local mechanism as well as the long-range transport along the filler network. The beneficial property spectrum includes enhanced conductivity of one ion type and decreased conductivity of the counter ion, but also the exciting mechanical properties of the solid-liquid composites. Inherent but not insurmountable problems lie in the reproducibility and stationarity of the composites microstructure and morphology. Owing to the huge parameter complexity and hence to the multitude of adjusting screws, there are various strategies for materials optimization. The technological relevance is enormous, in particular for battery electrolytes as here all the above-mentioned electrical and mechanical benefits are welcome. The soggy-sand electrolytes combine high Li(+) conductivity, low anion conductivity and good wettability of electrode particles with the mechanical stability of semi-solids.

Construction and functional analysis of novel dominant-negative mutant of human SOX18 protein.

SOX18 transcription factor plays important roles in a range of biological processes such as vasculogenesis, hair follicle development, lymphangiogenesis, atherosclerosis, and angiogenesis. In this paper we present the generation of a novel SOX18 dominant-negative mutant (SOX18DN) encoding truncated SOX18 protein that lacks a trans-activation domain. We show that both wild-type SOX18 (SOX18wt) and truncated human SOX18 proteins are able to bind to their consensus sequence in vitro. Functional analysis confirmed that SOX18wt has potent trans-activation properties, while SOX18DN displays dominant-negative effect. We believe that these SOX18wt and SOX18DN expression constructs could be successfully used for further characterization of the function of this protein.