Immature platelet fraction in hypertensive pregnancy.

BACKGROUND: Imbalance in hemostatic mechanisms can occur during pregnancy with a tendency for hypercoagulability and increased thrombosis risk. Pregnant women with hypertensive disorder, especially preeclampsia, show alterations in platelet indexes. Immature platelet fraction (IPF) has been suggested as a sensitive index for monitoring changes in platelet production and destruction. OBJECTIVES: To evaluate the IPF in patients diagnosed with a gestational hypertensive disorder (GHD). PATIENTS AND METHODS: A cross-sectional study was conducted at an University Hospital to estimate maternal blood IPF index in 99 pregnant women, divided into three groups: normotensive pregnancy (NP), preeclampsia syndrome (PES), and non-proteinuric hypertensive pregnancy (nPHP). Following ethical approval and written informed consent, samples were collected from 33 NP, 34 PES, and 32 nPHP women. Platelet indexes were measured by fluorescent flow cytometry. RESULTS: IPF and mean platelet volume (MPV) counts in GHD were significantly higher than in NP (IPF: 3.8, 2.4-5.1%; 8.6, 5.8-10.6%; 7.3, 4.2-10.2%; p < 0.001 and MPV: 10.6 ± 0.9 fL; 12.1 ± 1.0 fL; 11.6 ± 1.0 fL; p < 0.001 for NP, PES, and nPHP, respectively). No difference was detected between PES and nPHP groups. The distribution of patients with an IPF above 6.1%for NP, PES, and nPHP was 9%, 65%, and 43.8%, respectively (p < 0.001). IPF as a test to differentiate GHD from the controls achieved an area under the curve of 0.83 on a receiver operating characteristics curve. CONCLUSION: A distinct profile in platelet indexes was detected in hypertensive pregnancies. It suggests that these markers could be used in daily routine as an additional tool in the management of pregnant women.

Marcador de risco hemostático associado a eventos cardiovasculares em síndrome metabólica / Hemostatic risk marker associated with cardiovascular events in metabolic syndrome

Fundamentos: A doença cardiovascular (DCV) é a principal causa de morte nos países em desenvolvimento. Os indivíduos com síndrome metabólica (SM) apresentam risco elevado para DCV. Os fatores de risco tradicionais em conjunto, não explicam todos os eventos cardiovasculares. O fator von Willebrand (FvW), envolvido na agregação plaquetária e trombose, tem sido investigado nesse contexto. Objetivo: Investigar a relação entre FvW e DCV, em pacientes portadores de SM, com e sem eventos cardiovasculares prévios. Métodos: Estudados 77 pacientes ambulatoriais, ≥18 anos, portadores de SM de acordo com os critérios estabelecidos pela NCEP-ATP III. Mediu-se o nível plasmático do FvW e comparou-se os valores médios entre os grupos com DCV prévia (n=30) e sem DCV documentada (n=47). Resultados: Da população estudada, 66,0% eram do sexo feminino, 78,0% de etnia branca, média de idade 63,7±8,9 anos, peso médio 82,9±14,9 kg e índice de massa corpórea 32,2±4,8 kg/m2. O nível plasmático médio do FvW foi similar nos pacientes com e sem DCV prévia, com valores de 154,5±52,1 e 155,47±41,4, respectivamente. Observou-se associação entre o diabetes mellitus (DM) e DCV estabelecida, que permaneceu significativa após ajuste para as demais variáveis incluídas no modelo multivariado. Conclusões: Não houve diferença no nível plasmático médio do FvW entre os pacientes portadores de SM, com e sem DCV documentada. A presença de DM, entretanto, esteve associada de forma independente com DCV nesta população.

Background: Cardiovascular disease (CVD) is the leading cause of death in developing countries. Individuals with metabolic syndrome (MS) are at increased risk for CVD. The traditional risk factors, altogether, do not explain all cardiovascular events. The von Willebrand factor (vWF), involved in platelet aggregation and thrombosis, has been investigated in this context. Objective: To investigate the relationship between the vWF and CVD in patients with MS, with and without previous cardiovascular events. Methods: The study included 77 outpatients, ≥18 years, with MS, according to the criteria established by NCEP-ATP III. The plasma level of vWF was measured and the mean values were compared between the groups with prior CVD (n=30) and without documented CVD (n=47). Results: In the study population, 66.0% were female, 78.0% were white, mean age 63.7±8.9, mean weight 82.9±14.9 kg, and body mass index 32.2±4.8 kg/m2. The average plasma level of vWF was similar in patients with and without previous CVD, with values of 154.5±52.1 and 155.47±41.4, respectively. There was an association between diabetes mellitus (DM) and established CVD, which remained significant after adjusting for other variables included in the multivariate model. Conclusions: There was no difference in the mean plasma level of vWF among patients with MS, with and without documented CVD. The presence of DM, however, was independently associated with CVD in this population.

Avaliação do desempenho do equipamento de hematologiaSysmex XE2100D em um laboratório municipal / Evaluation of the performance of the Sysmex XE2100D hematology equipment in a municipal laboratory

Validar o analisador hematológico Sysmex XE-2100D (Kobe, Japan), descreveras etapas do processo e avaliar seu desempenho antes da sua inserção na rotina detrabalho do Laboratório Municipal de Gravataí, RS. Métodos: O estudo foi realizado com101 amostras de sangue total de pacientes adultos. Foram realizados quatro testes:precisão intraensaio, linearidade, exatidão e carreamento. Resultados: Os testes deprecisão apresentaram resultados adequados para a maioria dos parâmetros. Somentea contagem absoluta de monócitos e a quantificação de plaquetas tiveram valoressuperiores aos preconizados em algumas amostras. O coeficiente de variação foi inferiora 1,5% para a série vermelha. Para linearidade, os coeficientes de correlação foramsuperiores a 0,99; no teste de exatidão, superiores a 0,98 para a maioria dos parâmetros,e o percentual de carreamento inferior a 1,0% para todos os parâmetros analisados.Conclusão: Ao se analisarem amostras com perfis semelhantes aos testados pelofabricante, os resultados de precisão foram excelentes; entretanto, conforme esperado,as amostras com resultados alterados apresentaram coeficientes de variação maiores.Os resultados de precisão indicam a necessidade de outros estudos utilizando amostrascom resultados fora do limite de normalidade para determinação do coeficiente de variaçãoaceitável para esse tipo de amostra. Os resultados de linearidade, exatidão e carreamentoforam semelhantes aos obtidos em outros estudos. Considerando os resultados obtidos,o equipamento foi aprovado para utilização no laboratório...

Lamellar body count and stable microbubble test on gastric aspirates from preterm infants for the diagnosis of respiratory distress syndrome.

BACKGROUND: Lamellar body count (LBC) in amniotic fluid is being used to identify infants at risk of respiratory distress syndrome (RDS) who would benefit from surfactant prophylaxis or very early therapy. The test in gastric aspirates of newborns has not been properly explored. OBJECTIVE: The main objective of this research was to evaluate the performance of LBC alone or in combination with the stable microbubble test (SMT), done on gastric aspirates from preterm babies to predict RDS. METHODS: A total of 34 preterm infants with RDS and 29 without RDS, with a gestational age between 24 and 34 weeks, were included in the study. Gastric fluid was collected in the delivery room. A diluent (dithiothreitol) allowed all samples to be processed, even the thickest and non-homogeneous ones, without centrifugation. The SMT was done for comparison. RESULTS: The best cut-off value was <42,000 lamellar bodies/microl to predict RDS, with a sensitivity of 92% (95% CI 73-100%) and specificity of 86% (95% CI 77-95%). The area under the receiver-operating characteristic curve was 0.928 (95% CI 0.86-0.99). SMT showed similar results. LBC and SMT together in series (positive result if both tests were positive) showed a sensitivity of 100% and a specificity of 86%. CONCLUSION: LBC on gastric aspirates diluted in a solution of dithiothreitol can be rapidly and easily performed, and may be used alone or in combination with SMT as a predictor of RDS, allowing selective prophylaxis or very early treatment only in surfactant-deficient newborns.