Research progress on biomarkers for endometriosis based on lipidomics / 浙江大学学报·医学版

The pathogenesis of endometriosis is not well understood at the moment, and the lack of effective biomarkers often leads to delayed diagnosis of the disease. Lipidomics provides a new approach for the diagnosis and prediction of endometriosis. Sphingomyelin, phosphatidylcholine and phosphatidylserine in peripheral blood, endometrial fluid, peritoneal fluid and follicular fluid have good diagnostic value for endometriosis and disease classification; the lipid metabolites in the eutopic endometrium tissue are expected to be biomarkers of early endometriosis; and the lipid metabolites in peripheral blood are also of great value for predicting endometriosis-related infertility. The development of lipidomics technique will further advance the progress on the pathogenesis, prediction, diagnosis and treatment of endometriosis.

Current trends in the analytical determination of vitamin D / Tendencias actuales en la determinación analítica de vitamina D

Vitamin D is a micronutrient that plays a large role in bone disease, and researchers are now discovering that it also does so in non-skeletal disease, thus making high-quality analytical determination necessary. To make this determination, a series of immunochemical and physical methods are used. These methods present a series of different ways of handling samples as well as different methodologies that bring a series of advantages and limitations based on the scope of work in which the vitamin D analysis methodology is applied. Although the Liquid Chromatography-tandem Mass Spectrometry (LC-MS/MS) is the gold standard method of analytical vitamin D determination, and is the only one to offer a more complete and accurate view of all metabolites of this vitamin, it is necessary to standardize all the analysis methodologies that allow accurate, reliable and quality analytical determination, since it is essential to obtain results that can reliably be extrapolated to the population, and that can be decisive in assessing a large number of pathologies

La vitamina D es un micronutriente que ejerce un gran papel en enfermedades óseas y actualmente se está descubriendo que también lo hace en enfermedades no óseas, por lo que una determinación analítica de calidad es necesaria. Para realizar esta determinación se emplean una serie de métodos inmunoquímicos y físicos, los cuales van a presentar una serie de tratamientos diferentes de las muestras, así como diferentes metodologías que van a traer una serie de ventajas y limitaciones conforme al ámbito de trabajo en que se aplique la metodología de análisis de la vitamina D. A pesar de que la cromatografía líquida-espectrometría de masas en tándem (LC-MS/MS) es el método gold standard de determinación analítica de la vitamina D, y de que es el que ofrece una visión más completa y precisa de todos los metabolitos de esta vitamina, es necesaria una estandarización de todas las metodologías de análisis que permitan una determinación analítica precisa, fiable y de calidad, ya que es imprescindible obtener unos resultados que sean extrapolables con fiabilidad a la población y que puedan ser determinantes para valorar un gran número de patologías

Importancia del estudio del frotis de sangre periférica en ancianos / Importance of peripheral blood smears study in the elderly

El estudio del frotis de sangre periférica consiste en precisar e informar las alteraciones morfológicas de los elementos formes de la sangre; este es un examen sencillo, poco costoso, rápido en la realización del informe de sus resultados, pero a la vez requiere de mucho cuidado y experiencia y esto está dado por el tiempo e interés que se le dedique a su aprendizaje, a la calidad de la extensión y a su tinción. Se presenta una revisión de la literatura en la que se describen las variaciones de la lámina periférica que pueden presentarse en las enfermedades que con más frecuencia afectan a los pacientes de la tercera edad, con el objetivo de ofrecer un material para la docencia en residentes de hematología y geriatría(AU)

The study of smear of peripheral blood consists on specifying and informing the morphological alterations of blood elements; This is a simple, inexpensive, quick exam in reporting its results, but at the same time requires much care and experience, given the time and interest that is devoted to its learning, the quality of the extension and its staining. We present a literature review describing the variations of the peripheral lamina that can occur in diseases that most frequently affect the elderly, with the objective of offering a material for teaching residents of Hematology and Geriatric(AU)

Assay of IL-22 and IL-25 in serum, whole blood, and peripheral blood mononuclear cell cultures of patients with severe asthma

BACKGROUND: Although some studies show that IL-22 and IL-25 play critical roles in the pathogenesis of asthma, little is known about the systemic production of these cytokines. The aim of this study was to assay IL-22 and IL-25 in serum, in mitogen-activated whole blood (WB), and in mitogen-activated peripheral blood mononuclear cell (PBMC) cultures of patients with severe asthma. METHODS: In this cross-sectional study, a questionnaire was prepared to determine the severity of asthma. Through the questionnaire, information including clinical signs, clinical symptoms, and past medical history were acquired. Information collected allowed all patients who were active or ex-smokers to be excluded. A trained observer assessed airway reversibility, peak flowmetry, and spirometry in the remaining patients. Twenty-one patients and simultaneously, twenty age- and sex-matched healthy controls were selected. Sterile blood (10 ml) was taken from each study participant. Sera were isolated and anticoagulant blood used for WB and PBMC cultures and haematological tests. Phytohaemagglutinin and lipopolysaccharide (LPS) were used to activate WB and PBMC. The data from these two groups were compared using Student's t-test. RESULTS: Although the total white blood cell count was elevated in the asthmatic group, other haematological indices, including IL-22 and IL-25 levels in the asthmatic group were not significantly (p > 0.05) different from controls. CONCLUSIONS: The levels of IL-22 and IL-25 in patients with severe asthma are no higher than those of non-asthmatic individuals. Any major role for IL-22 and IL-25 in severe asthma is likely to be localised to the lungs and bronchial tissues

No disponible

AICDA single nucleotide polymorphism in common variable immunodeficiency and selective IgA deficiency

BACKGROUND: Primary antibody deficiencies (PADs) are a heterogeneous group of disorders, characterised by increased susceptibility to recurrent bacterial infections. Common variable immunodeficiency (CVID) is the most important PAD from the clinical point of view and selective IgA deficiency (IgAD) is the most common PAD. However, the underlying gene defect in both is still unknown. As a recent study in Europe showed an association between a single nucleotide polymorphism (SNP) of AICDA gene with PADs, this study was performed to evaluate such an association in Iranian patients. METHODS: Fifty-eight patients with PAD, including 39 CVID and 19 IgAD, as well as 34 healthy volunteers, were enrolled in this study. Genotyping was done in all groups for an intronic SNP in AICDA (rs2580874), using real-time PCR genotyping assay. RESULTS: The less frequent genotype of AICDA in IgAD patients was AA, seen in 10.5% of the patients, which was much lower than the 30.8% in CVID patients and 38.2% in the controls. However, these differences were not significant. Indeed the GG genotype in the patients with PADs was seen in 20.7%, compared to 8.8% in the controls without any significant difference. CONCLUSIONS: There was no significant association between the previously reported genetic variant of AICDA gene and the development of CVID or IgAD, but further multi-center studies are also needed

No disponible

Increased level of interleukin-13, but not interleukin-4 and interferon-γ in chronic rhinosinusitis with nasal polyps

BACKGROUND: This study was performed to investigate the serum level of interleukin (IL)-13, IL-4, and interferon (IFN)-γ in chronic rhinosinusitis with nasal polyps (CRSwNP) and subsequent inflammation pattern and comorbidities including asthma and aspirin intolerance. METHODS: A case-control study was conducted on 60 adult patients with CRSwNP with mean age of 37.7 ± 12.7 (ranging from 18 to 70) years, and on 20 healthy controls. Serum levels of IL-13, IL-4, and IFN-γ were assessed, using enzyme-linked immunosorbent assay to be compared between case and control groups. Serum level of total immunoglobulin (Ig) E was also assessed in the patients with CRSwNP. RESULTS: Serum level of IL-13 in the patients with CRSwNP was significantly higher than the controls (0.98 ± 1.56 vs. 0.34 ± 0.16 pg/ml, respectively, p = 0.002). IL-4 and IFN-γ did not differ significantly between the two groups. Total IgE level was significantly increased in the patients with CRSwNP, compared to the normal values (301.43 ± 516.54 IU/ml, p = 0.033). Among the patients with CRSwNP, 12/60 (20%) had aspirin intolerance and 44/60 (73.3%) had asthma. IgE was also higher in asthmatics than non-asthmatics patients (364.9 ± 586.6 vs. 126.7 ± 135.7, respectively, p = 0.015). Patients with aspirin intolerance had higher levels of IFN-γ (4.7 ± 1.4 vs. 4.1 ± 0.6, respectively, p = 0.022). CONCLUSIONS: IL-13 with high level of total IgE was observed in the patients with CRSwNP, which predisposes them to have concomitant asthma. IFN-γ seems to be down-regulated in the patients with CRSwNP, but could be over-expressed in the presence of aspirin intolerance

No disponible

¿Cuál es la rentabilidad diagnóstica del frotis de sangre periférica? / What is the diagnostic yield of the peripheral blood smear?

Fundamento y objetivo. A pesar de que el frotis de sangre periférica es una herramienta muy útil en el diagnóstico de diversas enfermedades, para que aporte beneficio es crucial que el encargado de examinarlo conozca datos clínicos del paciente y sepa qué tiene que buscar o descartar. El objetivo de nuestro trabajo fue evaluar el beneficio real que aporta el frotis y los factores que predicen su impacto en la práctica clínica. Pacientes y métodos. Se analizaron de forma prospectiva todos los frotis consecutivos (n = 618) solicitados en un mes por 6 hospitales de la comunidad de Madrid y revisados en nuestro laboratorio. En cada frotis se evaluó la información previa aportada por el médico peticionario y la serie hematológica alterada. Clasificamos cada frotis, según lo que aportó al clínico, en: a) sin información relevante; b) confirma diagnóstico ya conocido, y c) aporta información relevante para el diagnóstico o pronóstico. Resultados. No se obtuvo ninguna información relevante en 402 frotis (65,04%). En los frotis útiles se observó mayor proporción de sospechas diagnósticas previas (20%) en comparación con los no diagnósticos (5,1%) (p < 0,001) y menos peticiones con hemograma normal (3,8 vs 42,7%, p < 0,001). Conclusiones. En nuestra experiencia, 2 de cada 3 frotis solicitados no aportan ninguna información relevante. Conocer la sospecha diagnóstica y tener al menos una de las 3 series alteradas tiene impacto significativo en la rentabilidad del frotis(AU)

Background and objetive. Although examination of peripheral blood smear is a very helpful tool in the diagnosis of several pathologies, it is essential that the person who performs it knows the patient clinical data and what to look for in order to obtain the highest benefit. The aim of this study is to determine the proportion of useful blood smears in clinical practice and to identify possible predictive factors. Patients and methods. We prospectively analysed 618 consecutive peripheral blood smears performed in our laboratory, requested by 6 hospitals in Madrid. Clinical features provided by the physician and abnormalities in complete blood count (none / white cells / red cells / platelets / all of them) were evaluated in each case. According to the information obtained from them, blood smears were classified into: a) non-diagnostic; b) a previously-known diagnosis is confirmed, and c) new relevant information provided. Results. No useful information was obtained by 402 (65.04%) blood smears. A higher proportion of previous clinical suspicions was observed in helpful blood smears compared to non-diagnostic ones (20% vs 5.1%, P<.001), and also less for completely normal blood counts (3.8% vs 42.7%, P <.001). Conclusions. In our experience, two thirds of requested peripheral blood smears provide no useful information at all. Clinical suspicion and the presence of at least one abnormality in complete blood count showed a significant impact in blood smear yield(AU)

Glicemia capilar medida por dois aparelhos de automonitorizaçäo: quanto eles podem estimar a glicemia plasmática na rotina médica? / Capillary blood glucose measurement by tho self-monitoring equipment: how can they to estimate a plasma blood grucose in medical routine?

O desenvolvimento de monitores portáteis para automonitorização da glicose sangüínea tem fácil aceitação pelos pacientes e médicos, sendo amplamente utilizado atualmente, o que torna essencial avaliar o quanto esses resultados correspondem à glicemia plasmática. Assim, avaliamos a acurácia e precisão de dois monitores digitais à disposição no mercado: um utiliza a glicose desidrogenase (Ap1) e o outro a glicose oxigenase (Ap2) na mensuração da glicemia capilar

El hemograma

El hemograma o cuadro hemático es una de las pruebas que más se solicita al laboratorio clínico, y sin duda alguna, la prueba de laboratorio que más aporta al clínico en la evaluación de un paciente. Desde el punto de vista técnico se reconocen cinco tipos de hemograma. que van desde los tradicionales que se hacen con métodos manuales hasta los más sofisticados que se hacen con métodos electrónicos que utilizan una combinación de tecnología. Se establecen los criterios que definen los tipos de hemograma y se analizan los parámetros y las características de cada uno de acuerdo con la metodología utilizada. Se enfatiza en los parámetros de mayor utilidad clínica. El medio debe solicitar el hemograma que le permita tener mayor certeza posible en los parámetros reportados y el laboratorio clínico debe hacer la inversión tecnológica que le permita ofrecer los resultados con el más bajo coeficiente de variación posible.

Semiología del hemograma

El hemograma es una de las pruebas de laboratorio más utilizadas en la clínica como prueba de laboratorio es un grupo de exámenes que evalúa cuantitativa y cualitativamente los tres componentes celulares de la sangre. las alteraciones cuantitativas del componente eritrocitario en un ser humano son la policitemia y la anemia: del componente leucocitario son la leucocitosis y la leucopenia, con sus diversas variables de acuerdo con las líneas celulares comprometidas; y , del componente plaquetario son la trombocitosis y la trombocitopenia. de la identificación adecuada y oportuna de cada una de estas alteraciones depende la verdadera utilidad clínica de la prueba. Se definen las principales alteraciones cuantitativas y cualitativas de cada una de las series hematopoyéticas y se establece su relación con las principales enfermedades con las cuales están asociadas.