[Procalcitonin (PCT), contemporary indicator of infection and inflammation]. / Prokalcytonina (PCT), wspólczesny wskaznik infekcji i stanów zapalnych.

Procalcitonin is a protein synthesized during sepsis and inflammation. In these states, its production is stimulated by inflammatory mediators and bacterial toxins. Routine determination of PCT concentration is useful in the rapid detection and monitoring of bacterial and fungal infections. The article presents the latest meta-analysis and clinical reports on the use of the PCT and comparison of its diagnostic sensitivity and specificity with other indicators of inflammation and infection in both neonates and in the adult population. Synthesis, properties and metabolism of PCT and the available methods and conditions of the determination are discussed. Presented data indicate a high sensitivity and specificity of PCT determinations, especially in bacterial infection and, what is very important, short duration of the assay and the use of a small sample volume. Assess the dynamics of changes in the concentrations of PCT can provide information not only about the course of infection but also facilitates the decision to introduce and then to discontinue antibiotic therapy.

Expression of P-selectin (CD62P) on platelets after thrombin and ADP in hypotrophic and healthy, full-term newborns.

BACKGROUND: Hypotrophic newborns in comparison with eutrophic newborns demonstrate a reduced blood platelet count and therefore may have haemostasis disorders. Expression of P-selectin (CD62P) on the surface of platelets is a marker of stimulated, activated blood platelets. The ability of platelets to react can be determined after the addition of the following activators: strong (thrombin) and weak (ADP). MATERIALS AND METHODS: We studied 48 hypotrophic newborns, 25 females and 23 males, weighing less than the 10th centile and 55 healthy, full-term newborns, 25 females and 30 males. Expression of CD62P on the surface of platelets was examined in the native state, after the addition of thrombin or ADP. RESULTS: Hypotrophic newborns exhibited almost double the percentage of platelets expressing CD62P compared with the control group, 4.21% versus 2.88%. After the addition of thrombin, the percentage was 31.5% versus 12.5%, p < 0.001, whereas after the addition of ADP, the percentage was 9.54% versus 4.5%, p = 0.002. CONCLUSIONS: Hypotrophic newborns are capable of greater platelet activation in comparison with healthy term newborns. However, gender does not affect the expression of P-selectin.

Platelet expression of CD62P in hypotrophic newborns.

BACKGROUND: Hypotrophic newborns demonstrate a reduced blood platelet count and therefore may have haemostasis disorders. The antigen density of CD62P on the surface of platelets may indicate the activation of blood platelets. MATERIALS AND METHODS: We have studied 31 hypotrophic newborns, and have divided these into two groups: weighing less than the 5th centile and between the 5th and 10th centiles. The antigen density of CD62P was calculated according to the procedure recommended by DAKO QIFIKIT. RESULTS: Hypotrophic newborns exhibited a median 22 000 of CD62P per platelet. There is a distinct gender difference (female median 29 768, male median 19 044 of CD62P per platelet, p = 0.001). Newborns below the 5th centile demonstrated a median 30 000 of CD62P per platelet, whereas between the 5th and 10th centiles - a median 18 700. A negative correlation (R = -0.53, p = 0.002) was found between the antigen density of CD62P and birth weight. CONCLUSION: Hypotrophy affects the expression of CD62P. There is a negative correlation between the antigen density of CD62P and birth weight.

Thrombopoiesis in small for gestational age newborns.

Thrombocytopenia in small for gestational age (SGA) newborns may be due to placental vascular pathology, fetal consumptive coagulopathy and platelet destruction, local imbalance of thromboxane A2 causing placental vasoconstriction and platelet aggregation. Thrombopoiesis in SGA newborns is poorly recognized. In 61 SGA newborns we evaluated thrombocytopoiesis in relation to gender and the rate maturity expressed as <5th percentile and <10th percentile. Female newborns demonstrated higher thrombopoietin (TPO) level at 92.06 pg/ml than male newborns at 79.81 pg/ml. Newborns less developed <5th percentile, showed increased TPO level of 92.0 pg/ml in comparison to <10th percentile of 78.0 pg/ml. This observation is more pronounced in female newborns. Contrary to our expectations we did not find any statistically significant differences in the percentage of reticulated platelets (PLRET) and platelets count in relation to gender and <5th percentile or <10th percentile. We can postulate intrauterine hypoxia is responsible for the increase of erythropoietin and impairment of thrombopoiesis in SGA newborns.

[Alariosis--newly diagnosed trematodiasis]. / Alarioza--przywrzyca nowo rozpoznawana.

The aim of this work was to present alariosis--a newly diagnosed parasitic disease caused by a trematode Alaria alata. A. alata requires two intermediate hosts: a snail and a frog. Carnivorous mammals are definitive hosts. Humans and a number vertebrates can be paratenic hosts. The pathological consequences of the presence of A. alata in the connective- and muscle tissues, relevant symptoms, and its diagnostic methods have been described. Importance of multiorgans changes inflicted by the parasite have been emphasized. Alariosis may also exist as an ophthalmic disease. As yet no pathognomonic symptoms of this disease have been described. Alariosis is an emerging parasitic disease, difficult in diagnosis and requiring exclusion of other diseases. No serological test for diagnosis of alariosis are available.

The effect of gestational age on platelet surface expression of CD62P in preterm newborns.

Hemostasis in preterm newborns is characterized by low reserve functional capacity with special reference to the presence of such risk factors as asphyxia or infection. Platelets play vitally important role in hemostasis. Expression of CD62P is a marker of stimulated or activated blood platelets. The study involved a group of 16 preterm newborns, five girls and 11 boys. DAKO QIFIKIT was applied to calculate the number of these antigens. The mean CD 62P expression was found to be 23,792 per platelet. Correlation was found between antigen density and gestational age r = 0.954, p = 0.01. Evident deficit of P-selectin on the surface of platelets in preterm newborns may be at least in part responsible for platelet dysfunction, with special reference to interaction between circulating leukocytes and combating infection.

Platelet-derived microparticles and platelet count in preterm newborns.

OBJECTIVE: Does formation of platelet-derived microparticles correspond to platelet activation? METHODS: The study was performed in 51 preterm newborns, 25 girls and 26 boys. The control group consisted of 55 term newborns, 25 girls and 30 boys. Blood samples were collected from the umbilical artery. The percentage of platelet-derived microparticles and platelet count were determined using flow cytometric analysis based on the CD61-positive antigen. RESULTS: The percentage of platelet-derived microparticles was higher in preterm newborns (5.46) in comparison to term newborns (4.22, p < 0.01). We found 4.61% of platelet-derived microparticles in preterm female newborns and 6.28% in preterm boys (p < 0.0070). The platelet count was 256 x 10(3) microl in girls and 238 x 10(3) microl in boys. Female healthy term newborns presented higher values of platelet-derived microparticles (4.4%) than male newborns (4.07%, p = 0.4725, table 1). The platelet count in girls was found to be 308 x 10(3) microl and in boys 270 x 10(3) microl. CONCLUSIONS: Higher percentage of platelet-derived microparticles in preterm newborns may provide a compensatory mechanism for the hemostatic system.

Does prematurity affect thrombocytopoiesis?

Data concerning thrombocytopoiesis in newborns are poorly recognized. Platelets have a crucial role in hemostatic physiology, which is deficient in newborns, especially in preterm newborns. A total of 51 preterm newborns (PTN), 25 girls and 26 boys, were recruited for the study. The control group consisted of 25 female and 30 male healthy term newborns (HTN). Plasma thrombopoietin (TPO) was measured using Quantikine human TPO system. Reticulated platelets (PLRET) was estimated by means of Retic-Count Kit. Platelet count (PLT) was determined using Advia(TU) 120 Hematology System. TPO was evidently higher in PTN (110.9 pg/ml) than in HTN (71.5 pg/ml), (p < 0.001). The percentage of reticulated platelets (PLRET) was also twice as high in PTN (3.49%) in comparison to HTN (1.7%), (p < 0.001). The PLT count was lower in PTN (246.7 x 10(3) microL) than in HTN (287.2 x 10(3) microL), (p < 0.01). Increased TPO levels and the percentage of PLRET indicate that thrombocytopoiesis is more active in prematurity. Our finding may be useful in therapeutic strategies.

Membrane-activated form of glycoproteins IIb/IIIa complex on newborn platelets.

BACKGROUND: GPIIb/IIIa complex is one of the laboratory markers of platelet activation. Closely associated with this process is exposure of the fibrinogen-binding site which is essential for platelets aggregation. This study was performed to evaluate the expression of GPIIb/IIIa on the platelets at time of birth. MATERIALS AND METHODS: 51 term newborns, 21 females and 30 males, were introduced to the study. They fitted all criteria for healthy term newborns. Blood was collected from umbilical artery and vein immediately after cutting the umbilical cord using Diatube TM CTAD Vacutainer System. GPIIb/IIIa was tested with PAC-1-FITC antibody using flow cytometer EPICS XL. RESULTS: 90.91% of newborn platelets express GPIIb/IIIa complex in comparison to adults, where only 12.79% platelets express this complex. Practically no differences were noted in relation to gender of newborns and umbilical artery or vein. CONCLUSIONS: Careful analysis of the presented data reveals that at time of birth platelets are hyperreactive, which may be related to the increased thrombogenesis in newborns and mothers.

The expression of vWF receptor on newborn platelets.

BACKGROUND: Platelets contain a complex known as GPIb-IX-V. The receptor for vWF is located in GPIbalpha. The number of functional receptors decreases during thrombin activation of platelets. This study was performed to evaluate the percentage of platelets displaying the GPIbalpha -IX complex on their surface. MATERIAL/METHODS: We studied 51 healthy term newborns (21 females and 30 males). Blood was collected from the umbilical artery and vein immediately after severance of the umbilical cord, using a Diatube TM CTAD Vacutainer System. The GPIbalpha-IX complex was tested with CD42b-PE antibody, using a EPICS XL flow cytometer. RESULTS: Practically no differences were observed in the percentage of platelets demonstrating CD42b in venous blood (18.59%) and arterial blood (19.37%). The percentage of platelets bearing the CD42b molecule is higher in male newborns (20.58%) than female (17.38%). Healthy control adults demonstrated an increased percentage of CD42b on platelets (30.4%) in comparison to newborns (18.98%). CONCLUSIONS: The sex of neonates affects the tested complex: higher values were noted in males. The particular umbilical vessel (vein or artery) has no effect on the percentage of platelets bearing CD42b.

Thrombocytopoiesis in healthy term newborns.

AIMS: Thrombocytopoiesis was investigated in term newborns determining thrombopoietin (TPO), reticulated platelets (PLRET) and blood platelets (PLT) in relation to gender. PATIENTS AND METHODS: The study was undertaken on 72 healthy term newborns, 33 girls and 39 boys. They fitted all criteria for healthy term newborns. Blood was collected from the umbilical vein immediately after cutting the umbilical cord. The evaluation of thrombocytopoiesis was performed by the following methods: TPO-Quantikine human TPO kit, PLRET- Retic-Count kit, PLT- Advia 120 hematology System. RESULTS: Concentrations of TPO and percentages of reticulated platelets were greater in the female group than in the male group. The changes were not statistically significant, perhaps as a result of the very wide range of parameters tested. The blood platelet count was higher in female newborns than in male newborns, P<0.001. CONCLUSION: The data may indicate that thrombocytopoiesis is more active in female than in male newborns.

Markers of platelets activation, CD 62P and soluble P-selectin in healthy term neonates.

Nearly the same expression of CD 62P antigen was found on the platelets of neonates in the vein as in the artery, in both females and males. SP-selectin concentrations in sera were elevated in the vein in comparison to the artery, higher values being noted in females than in males. The activation of platelets occurs at the time of birth. The platelets of female neonates are more activated than those of male neonates.

Antigen density of P-selectin (CD 62P) on the platelets of healthy term newborns.

Measurements have been made of the antigen density of P-selectin (CD 62P) on the surface of platelets of healthy term newborns in relation to sex and in different umbilical vessels. The effect of thrombin or ADP on the density of CD 62P has been determined. The study was performed in 18 healthy term newborns, 10 girls and eight boys. Dako QIFIKIT was applied to calculate the number of these antigens. No differences were observed in the number of antigens of CD 62P on newborn platelets between the umbilical vein and artery in both sexes. On the other hand, boys demonstrated 31,245 antigens/plt, girls 26,397/plt (P = 0.045). A statistically significant increase in the expression of CD 62P was also observed following activation of thrombin in both sexes and in the umbilical vein and artery. ADP as a weaker agonist demonstrated less changes. A high number of the CD 62P antigens on the platelets of newborns may be interpreted as an effect of increased thrombinogenesis during birth. It can be suggested that this process is more pronounced in boys than girls.