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1.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1679-1682, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067973

RESUMO

OBJECTIVE: To investigate the values of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), red cell osmotic fragility test(ROFT) and hemoglobin A2(HbA2) in screening of α-thalassemia in Guangdong area. METHODS: A total of 285 peripheral blood samples in patients treated in our hospital from January 2017 to December 2017 were collected. The detection of thalassemia gene was used as the gold standard, while blood routine examination, hemoglobin electrophoresis, and red cell osmotic fragility test were simultaneously performed. The optimal cut-off values in MCV, MCH, ROFT and HbA2 in α-thalassemia were determined by receiver operator characteristic curve (ROC curve). RESULTS: The most common types of α-thalassemia gene was --SEA/αα (54.59%). Compared with the control group, the differences in MCV, MCH, ROFT and HbA2 showed statistically significantce between different types of α-thalassemia (P<0.05). The best cut-off values of MCV, MCH, ROFT, and HbA2 in the diagnosis of α-thalassemia were 81.45 fl, 27.35 pg, 79.95%, and 2.55% respectively. CONCLUSION: For different laboratories, the cut-off values need to be established for screening α-thalassemia suitable in their own local region.The values of MCV, MCH, ROFT and HbA2 shows higher accuracy and sensitivity in the diagnosis of α-thalassemia. It is recommended to use MCV<81.45fl, MCH<27.35 pg, ROFT<79.95% and HbA2<2.55% as the standards for screening α-thalassemia in Guangdong area.


Assuntos
Índices de Eritrócitos , Talassemia alfa , Hemoglobina A2/análise , Humanos , Programas de Rastreamento , Sensibilidade e Especificidade , Talassemia alfa/diagnóstico , Talassemia alfa/genética
2.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(5): 1689-1693, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33067975

RESUMO

OBJECTIVE: To evaluate the efficiency of red blood cell indices and fomulas for the differential diagnosis of the thalassemia trait (TT) and iron deficiency anemia (IDA) for children in Shenzhen area of Guangdong Province in China. METHODS: A total of 849 child patients from Shenzhen were enrolled, including 536 cases of TT and 313 cases of IDA. The sensitivity (SEN), specificity (SPE), positive predictive values (PPV), negative predictive value (NPV), and Youden's indices (YI) were analyzed using five red blood cell indices ï¼»including red blood cell count, average red blood cell volune(MCV), average amount of red blood cell hemoglobin(CMH), red blood hemoglobin cancentration(MCHC), red blood cell distribution width(RDW)ï¼½ and 10 red blood cell paramter formulas including Mentzer, Green and King, Srivastava, Ricerca, RDWI, Sirdah, Huber-Herklotz, Ehsani, Shine and Lal, and England and Fraser. Receiver operating characteristic (ROC) curve was drawn. RESULTS: Green and King was the most reliable index, as it had the highest YI (63.7%) and area under ROC curve (AUC) (0.875), the SEN and SPE was 82.5% and 81.2%. The YI, SEN, SPE, and AUC for RDWI were 62.8%, 79.1%, 83.7%, and 0.870, respectively. CONCLUSION: The formulas of Green and King and RDWI can be used for the differential diagnosis of TT and IDA, suitable for chidren in Shenzhen, China.


Assuntos
Anemia Ferropriva , Anemia Ferropriva/diagnóstico , Criança , China , Diagnóstico Diferencial , Índices de Eritrócitos , Eritrócitos , Humanos
3.
Rev Assoc Med Bras (1992) ; 66(9): 1277-1282, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027458

RESUMO

INTRODUCTION: Microcytic anemias are very common in clinical practice, with iron deficiency anemia (IDA) and thalassemia minor (TT) being the most prevalent. Diagnostic confirmation of these clinical entities requires tests involving iron metabolism profile, hemoglobin electrophoresis, and molecular analysis. In this context, several discriminant indices have been proposed to simplify the differential diagnosis between IDA and TM. OBJECTIVE: The aim of this paper was to demonstrate the clinical relevance of the use of discriminant indices in individuals with microcytic anemia to simplify the differential diagnosis between iron deficiency anemia and minor thalassemia. METHODS: A bibliographic and cross-sectional search was performed in the PubMed, SciELO and LILACS databases, using the following descriptors: iron deficiency anemia, thalassemia minor, and differential diagnosis. RESULTS: More than 40 mathematical indices based on erythrocyte parameters have been proposed in the hematological literature in individuals with microcytosis. Green & King indexes (IGK), Ehsani index, and erythrocyte count (RBC) had excellent performances, especially when their efficacy was observed in adults and children. CONCLUSIONS: Confirmatory tests for differential diagnosis between IDA and TM require time-consuming and costly methods. Despite the excellent performances of IGK, Ehsani index, and RBC, none of them presented sufficient sensitivity and specificity to establish a diagnosis. However, they can provide a powerful additional tool for diagnostic simplification between IDA and TM.


Assuntos
Anemia Ferropriva , Talassemia beta , Anemia Ferropriva/diagnóstico , Estudos Transversais , Diagnóstico Diferencial , Índices de Eritrócitos , Humanos , Talassemia beta/diagnóstico
4.
Arch Cardiovasc Dis ; 113(10): 607-616, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33039325

RESUMO

BACKGROUND: Red blood cell distribution width (RDW) is a predictor of adverse outcomes in patients with heart disease. AIM: To establish predictors of high RDW values in patients with congenital heart disease (CHD), and their relationship with cardiovascular events. METHODS: Overall, 561 patients with stable CHD who attended a single outpatient clinic and a matched control population of 2128 patients were studied. Exclusion criteria were renal failure, anaemia, receiving iron therapy and cyanosis. Blood tests included glucose, creatinine, iron, apoferritin, liver enzymes and a complete blood count. C-reactive protein and N-terminal prohormone of B-type natriuretic peptide (NT-pro-BNP) concentrations were also measured in patients with CHD. Major adverse cardiac events (MACE) were defined as cardiovascular/total mortality, arterial thrombotic events, arrhythmias, major bleedings, pulmonary embolism or heart failure needing hospital admission. RESULTS: The median age in patients with CHD was 23 (17-36) years and the median follow-up time was 5.8 (3.2-8.7) years; 103 (4.8%) controls and 40 (7.1%) patients with CHD had an RDW>15% (P=0.032). During follow-up, MACE were reported in 48 patients. CHD of great complexity, cardiovascular risk factors, low haemoglobin concentration and high NT-pro-BNP concentration were risk factors for an RDW>15%. Kaplan-Meier analysis showed a significantly worse cardiovascular outcome in patients with CHD with an RDW>15% (P<0.001). The multivariable survival analysis determined that age, CHD of great complexity, high NT-pro-BNP concentration and an RDW>15% were independent predictive factors for MACE. CONCLUSION: RDW and NT-pro-BNP concentration are independent analytical predictors of MACE in patients with CHD.


Assuntos
Índices de Eritrócitos , Cardiopatias Congênitas/diagnóstico , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Adulto Jovem
5.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(5): 703-707, 2020 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-32897199

RESUMO

OBJECTIVE: To investigate the correlation between the severity of obstructive sleep apnea syndrome (OSAS) and red cell distribution width (RDW) in elderly patients. METHODS: A cross-sectional study was conducted among 311 elderly patients diagnosed with OSAS in the snoring clinic between January, 2015 and October, 2016 and 120 healthy controls without OSAS from physical examination populations in the General Hospital of PLA. The subjects were divided into control group with apnea-hypopnea index (AHI) <5 (n=120), mild OSAS group (AHI of 5.0-14.9; n=90), moderate OSAS group (AHI of 15.0-29.9; n=113) and severe OSAS group (AHI ≥ 30; n=108). The clinical characteristics and the results of polysomnography, routine blood tests and biochemical tests of the subjects were collected. Multiple linear regression analysis was used to examine the correlation between OSAS severity and RDW. RESULTS: The levels of RDW and triglyceride were significantly higher in severe OSAS group than in the other groups (P < 0.01). The levels of fasting blood glucose and body mass index were significantly higher in severe and moderate OSAS groups than in mild OSAS group and control group (P < 0.05 or P < 0.01). Multiple linear regression analysis showed that AHI was positively correlated with body mass index (ß=0.111, P=0.032) and RDW (ß=0.106, P=0.029). The area under ROC curve of RDW for predicting the severity of OSAS was 0.687 (P=0.0001). CONCLUSIONS: The RDW increases as OSAS worsens and may serve as a potential marker for evaluating the severity of OSAS.


Assuntos
Índices de Eritrócitos , Apneia Obstrutiva do Sono , Idoso , Estudos Transversais , Humanos , Polissonografia , Índice de Gravidade de Doença
6.
Medicine (Baltimore) ; 99(36): e22075, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899077

RESUMO

Red blood cell distribution width (RDW) is a component of routine complete blood count, which reflects variability in the size of circulating erythrocytes. Recently, there have been many reports about RDW as a strong prognostic marker in various disease conditions in the adult population. However, only a few studies have been performed in children. This study aimed to investigate the association between RDW and pediatric intensive care unit (PICU) mortality in critically ill children. This study includes 960 patients admitted to the PICU from November 2012 to May 2018. We evaluated the associations between RDW and clinical parameters including PICU mortality outcomes. The median age of the study population was 15.5 (interquartile range, 4.8-54.5) months. The mean RDW was 15.6% ±â€Š3.3%. The overall PICU mortality was 8.8%. As we categorized patients into 3 groups with respect to RDW values (Group 1: ≤14.5%; Group 2: 14.5%-16.5%; and Group 3: >16.5%) and compared clinical parameters, the higher RDW groups (Groups 2 and 3) showed more use of vasoactive-inotropic drugs, mechanical ventilator support, higher severity scores, including pediatric risk of mortality III, pediatric sequential organ failure assessment, pediatric logistic organ dysfunction-2 (PELOD-2), and pediatric multiple organ dysfunction syndrome scores, and higher PICU mortality than the lower RDW group (Group 1) (P < .05). Based on multivariate logistic regression analysis adjusted for age and sex, higher RDW value (≥14.5%) was an independent risk factor of PICU mortality. Moreover, adding RDW improved the performance of the PELOD-2 score in predicting PICU mortality (category-free net reclassification index 0.357, 95% confidence interval 0.153-0.562, P = .001). In conclusion, higher RDW value was significantly associated with worse clinical parameters including PICU mortality. RDW was an independent risk factor of PICU mortality and the addition of RDW significantly improved the performance of PELOD-2 score in predicting PICU mortality. Thus, RDW could be a promising prognostic factor with advantages of simple and easy measurement in critically ill pediatric patients.


Assuntos
Estado Terminal/mortalidade , Mortalidade Hospitalar/tendências , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Fatores Etários , Biomarcadores , Pré-Escolar , Índices de Eritrócitos , Feminino , Humanos , Lactente , Masculino , Insuficiência de Múltiplos Órgãos/mortalidade , Escores de Disfunção Orgânica , Prognóstico , Estudos Prospectivos , Curva ROC , República da Coreia/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais
7.
Medicine (Baltimore) ; 99(37): e22119, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925759

RESUMO

The presence of left ventricular hypertrophy has been confirmed to be an independent risk factor for stroke and death in patients with atrial fibrillation. This retrospective study aimed to evaluate the potential risk factors for left ventricular hypertrophy in patients with atrial fibrillation.A series of consecutive patients diagnosed with atrial fibrillation between June 2018 and December 2019 were included. The patients' clinical data were analyzed. The cut-off values, sensitivity and specificity of the independent risk factors were calculated using a receiver operating characteristic curve.Among 87 patients with atrial fibrillation, 39 patients with left ventricular hypertrophy and 48 patients without left ventricular hypertrophy were included. Multivariate logistic regression analysis showed that red blood cell distribution width (odds ratio [OR] 4.89, 95% confidence interval [CI]: 1.69-14.13, P < .05) was an independent risk factor, while the concentration of low-density lipoprotein (OR 0.37, 95% CI: 0.17-0.83, P < .05) and left ventricular ejection fraction (OR 0.88, 95% CI: 0.82-0.95, P < .05) were inversely associated with left ventricular hypertrophy in atrial fibrillation patients. The receiver operating characteristic curve demonstrated that the area under the curve was 0.80 (95% CI: 0.71-0.90, P < .05) with a cut-off value of 13.05, and the red blood cell distribution width predicted left ventricular hypertrophy status among atrial fibrillation patients with a sensitivity of 72.1% and a specificity of 76.9%.Red blood cell distribution width was associated with left ventricular hypertrophy in patients with atrial fibrillation.


Assuntos
Fibrilação Atrial/sangue , Índices de Eritrócitos , Hipertrofia Ventricular Esquerda/sangue , Hipertrofia Ventricular Esquerda/diagnóstico , Idoso , Fibrilação Atrial/complicações , Feminino , Humanos , Hipertrofia Ventricular Esquerda/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Fatores de Risco
8.
JAMA Netw Open ; 3(9): e2022058, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32965501

RESUMO

Importance: Coronavirus disease 2019 (COVID-19) is an acute respiratory illness with a high rate of hospitalization and mortality. Biomarkers are urgently needed for patient risk stratification. Red blood cell distribution width (RDW), a component of complete blood counts that reflects cellular volume variation, has been shown to be associated with elevated risk for morbidity and mortality in a wide range of diseases. Objective: To investigate whether an association between mortality risk and elevated RDW at hospital admission and during hospitalization exists in patients with COVID-19. Design, Setting, and Participants: This cohort study included adults diagnosed with SARS-CoV-2 infection and admitted to 1 of 4 hospitals in the Boston, Massachusetts area (Massachusetts General Hospital, Brigham and Women's Hospital, North Shore Medical Center, and Newton-Wellesley Hospital) between March 4, 2020, and April 28, 2020. Main Outcomes and Measures: The main outcome was patient survival during hospitalization. Measures included RDW at admission and during hospitalization, with an elevated RDW defined as greater than 14.5%. Relative risk (RR) of mortality was estimated by dividing the mortality of those with an elevated RDW by the mortality of those without an elevated RDW. Mortality hazard ratios (HRs) and 95% CIs were estimated using a Cox proportional hazards model. Results: A total of 1641 patients were included in the study (mean [SD] age, 62[18] years; 886 men [54%]; 740 White individuals [45%] and 497 Hispanic individuals [30%]; 276 nonsurvivors [17%]). Elevated RDW (>14.5%) was associated with an increased mortality risk in patients of all ages. The RR for the entire cohort was 2.73, with a mortality rate of 11% in patients with normal RDW (1173) and 31% in those with an elevated RDW (468). The RR in patients younger than 50 years was 5.25 (normal RDW, 1% [n = 341]; elevated RDW, 8% [n = 65]); 2.90 in the 50- to 59-year age group (normal RDW, 8% [n = 256]; elevated RDW, 24% [n = 63]); 3.96 in the 60- to 69-year age group (normal RDW, 8% [n = 226]; elevated RDW, 30% [104]); 1.45 in the 70- to 79-year age group (normal RDW, 23% [n = 182]; elevated RDW, 33% [n = 113]); and 1.59 in those ≥80 years (normal RDW, 29% [n = 168]; elevated RDW, 46% [n = 123]). RDW was associated with mortality risk in Cox proportional hazards models adjusted for age, D-dimer (dimerized plasmin fragment D) level, absolute lymphocyte count, and common comorbidities such as diabetes and hypertension (hazard ratio of 1.09 per 0.5% RDW increase and 2.01 for an RDW >14.5% vs ≤14.5%; P < .001). Patients whose RDW increased during hospitalization had higher mortality compared with those whose RDW did not change; for those with normal RDW, mortality increased from 6% to 24%, and for those with an elevated RDW at admission, mortality increased from 22% to 40%. Conclusions and Relevance: Elevated RDW at the time of hospital admission and an increase in RDW during hospitalization were associated with increased mortality risk for patients with COVID-19 who received treatment at 4 hospitals in a large academic medical center network.


Assuntos
Infecções por Coronavirus/mortalidade , Índices de Eritrócitos , Eritrócitos , Hospitalização , Pneumonia Viral/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Biomarcadores/sangue , Boston/epidemiologia , Coronavirus , Infecções por Coronavirus/sangue , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Admissão do Paciente , Pneumonia Viral/sangue , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Síndrome Respiratória Aguda Grave
9.
Environ Health Prev Med ; 25(1): 44, 2020 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-32861244

RESUMO

BACKGROUND: Petrol is the non-specific term for petroleum which is used for inside combustion of engines. Petrol filling workers are highly vulnerable to occupational exposure to these harmful substances which lead to hemato-toxicity and blood disorders such as leukemia, aplastic anemia, and dysplastic bone marrow. Thus, this study was aimed to assess hematological parameters of petrol filling workers in Gondar town, Northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted from January to March 2019 in Gondar town, Northwest Ethiopia. A total of 110 study participants comprising 55 study groups and 55 controls group were recruited by a convenient sampling technique. Socio-demographic data were collected using a structured questionnaire, and 3 ml of venous blood was collected for the determination of hematological parameters. The data were entered into Epi info 7.2.0.1 and analyzed by SPSS version of 20. Mean, standard deviation, median, and interquartile ranges were used to present the data. Independent t test and Mann-Whitney U test were used to compare the mean or median difference between parametric and non-parametric hematological parameters, respectively. Moreover, Pearson product-moment and Spearman's rank-order bivariable correlations analyses were used to describe the correlation between hematological parameters and duration of exposure to petrol. A P value of ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that mean red blood cell count and hemoglobin level as well as the median hematocrit, mean cell hemoglobin concentration, platelet count, absolute lymphocytes count, and red cell distribution width values of petrol filling workers showed a significant increment compared with the control group. On the other hand, the mean cell hemoglobin value of petrol filling workers showed a significant decrement compared with healthy controls. Moreover, the duration of exposure to petrol showed a significant positive correlation with red blood cell count and mean cell hemoglobin concentration; however, a significant negative correlation was observed with mean cell volume. CONCLUSION: This study showed that the majority of hematological parameters of petrol filling workers showed an increment compared with healthy controls which might be associated with exposure to petrol chemicals. However, further longitudinal study with a larger sample size should be conducted to explore the impact of petrol exposure on hematopoiesis.


Assuntos
Contagem de Eritrócitos , Índices de Eritrócitos , Hematócrito , Contagem de Linfócitos , Exposição Ocupacional/análise , Indústria de Petróleo e Gás , Contagem de Plaquetas , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
10.
J Assoc Physicians India ; 68(8): 39-42, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32738839

RESUMO

Objective: The present study was undertaken to evaluate prognostic relevance of select circulating immune mechanistic biomarkers in COVID-19 positive patients for early identification and categorization of symptomatic patients who would need critical care with consequent adequate and optimal resource allocation and definitive management protocol. Materials and Methods: The present retrospective observational study, on 35 symptomatic and 35 asymptomatic patients, was carried out in SMS Medical College and Hospital, Jaipur comparatively assessing epidemiological history, clinical features and laboratory investigations. Results: During the course of study, 35 symptomatic and 35 asymptomatic patients were assessed. All the patients were of Indian ethnicity and had a history of contact with a COVID 19 positive case. Male patients constituted of 67 % of the population. The median age of patients in symptomatic and asymptomatic group was 60 years and 30 years, respectively. Out of the 70 patients studied, 47 (67%) patients recovered and were discharged whereas 23 (32.8 %) succumbed to the disease process. Lymphopenia was observed in 80% of symptomatic patient population, though only 11.5% of asymptomatic patients documented lymphopenia. Among the patients who died of COVID 19 (n=23), lymphopenia was observed in 18 (82%) patients, with moderate lymphopenia present in 13 (59 %) and severe lymphopenia present in 5 (22.7%) patients. Neutrophilia was observed across both category of patients, symptomatic and asymptomatic. Neutrophilia featured prominently in the symptomatic COVID-19 group with a median nadir in ALC of 7 × 109/L as compared to that of 3.8 × 109/L so observed in asymptomatic sample population. Red cell distribution width was slightly raised in both groups with a median RDW of 15.3% in COVID 19 patients which was raised as compared to that observed in normal population (range: 12.8 ± 1.2 %). Conclusion: Lymphopenia is an effective and reliable indicator of onset of symptoms and severity of disease in COVID-19 patients. RDW was found to be higher in COVID 19 patients in comparison to normal patients, however it had no significant relationship with appearance of symptoms or severity of the disease.


Assuntos
Infecções por Coronavirus/diagnóstico , Índices de Eritrócitos , Contagem de Linfócitos , Pneumonia Viral/diagnóstico , Betacoronavirus , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Índice de Gravidade de Doença
11.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(4): 1312-1315, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32798418

RESUMO

OBJECTIVE: To investigate the influence of iron deficiency on the index of thalassemia screening. METHODS: 876 blood samples of the couples at childbearing age, who underwent red blood cell analysis, hemoglobin electrophoresis, ferritin and gene diagnosis were selected. The samples were divided into normal, iron deficiency, αthalassemia, α-thalassemia combining with iron deficiency, ß-thalassemia and ß-thalassemia combining with iron deficiency group. The differences of hematology index and hemolobin value A2 between each groups were analyzed. RESULTS: The value of Hb, MCV, MCH, MCHC in iron deficiency, αthalassemia, α-thalassemia combining with iron deficiency, ß-thalassemia and ß-thalassemia combining with iron deficiency group all were lower than that of normal group, while the value of RDW-CV was higher, in which the difference between ß-thalassemia was the highest. The distribution of HbA2 among each groups was not significantly different expect of ß-thalassemia. There was no significant correlation between HbA2 and ferritin level. CONCLUSION: RDW-CV increases in both iron deficiency and thalassemia. Iron deficiency has no significant effect on the level of hemoglobin A2.


Assuntos
Anemia Ferropriva , Talassemia beta , Índices de Eritrócitos , Ferritinas , Hemoglobina A2/análise , Humanos
12.
Medicine (Baltimore) ; 99(34): e21408, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846758

RESUMO

Noninvasive tests for the assessment of liver fibrosis are highly needed for the management of patients with autoimmune hepatitis (AIH). We aimed to investigate the accuracy of red cell distribution width to platelet ratio (RPR) in predicting liver fibrosis in AIH patients. One hundred nineteen AIH patients who underwent liver biopsy were enrolled. Liver fibrosis stage was diagnosed using the Scheuer scoring system. The diagnostic accuracy was evaluated by the area under the receiver operating characteristic curve (AUROC). RPR values in AIH patients with S2-S4 (0.10, interquartile range [IQR] 0.08-0.15), S3-S4 (0.10, IQR 0.09-0.14), and S4 (0.14, IQR 0.09-0.19) were significantly higher than patients with S0-S1 (0.07, IQR 0.06-0.08, P < .001), S0-S2 (0.08, IQR 0.06-0.12, P = .025) and S0-S3 (0.09, IQR 0.07-0.13, P = .014), respectively. The RPR was positively correlated with fibrosis stages (r = 0.412, P < .001), while aspartate transaminase to platelet ratio index (APRI) and fibrosis-4 score (FIB-4) were not significantly associated with fibrosis stages in AIH patients. The AUROCs of RPR in identifying significant fibrosis (S2-S4), advanced fibrosis (S3-S4), and cirrhosis (S4) were 0.780 (95% confidence interval [CI] 0.696-0.865), 0.639 (95% CI 0.530-0.748), and 0.724 (95% CI 0.570-0.878), respectively. The AUROCs of RPR were significantly higher than APRI and FIB-4 in diagnosing significant fibrosis, advanced fibrosis, and cirrhosis. Our study demonstrates that the RPR is a simple predictor of liver fibrosis and is superior to APRI and FIB-4 in identifying liver fibrosis in AIH patients.


Assuntos
Hepatite Autoimune/complicações , Cirrose Hepática/sangue , Índices de Eritrócitos , Feminino , Hepatite Autoimune/sangue , Humanos , Cirrose Hepática/diagnóstico , Cirrose Hepática/imunologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
Klin Lab Diagn ; 65(8): 487-491, 2020 Jul 20.
Artigo em Russo | MEDLINE | ID: mdl-32762190

RESUMO

The aim of this study was to investigate RDW variability and conduct a comparative analysis of the RDW level in patients depending on their belonging to a defined nosological group of diseases according to the ICD-10 classification. All patients who complete blood count tests in our hospital from January to December 2016 were included in the study. The identification of the patient's belonging to a specific nosological group according to the ICD-10 classification was carried out on the basis of the disease analysis code indicated in the direction of the blood test. 8056 patient records were included in the final analysis. Deviations beyond the upper reference range for the RDW indicator (> 14.5%) in this study were identified for patients of the following nosological groups according to ICD-10: C - neoplasms; D - blood diseases; S - injuries; T - poisoning. Significant intergroup differences were obtained according to the Kruskal-Wallis rank analysis of variance (Kruskal-Wallis test: H (19, n= 7622) = 214.9672 p = 0.0000). According to the results of this study, we can conclude that RDW has specificity for certain diseases (neoplasms; blood diseases; injuries; poisoning). In case of cardiovascular and other diseases, deviations of this indicator beyond the limits of the upper reference values were not found in this study.


Assuntos
Índices de Eritrócitos , Classificação Internacional de Doenças , Humanos , Valores de Referência , Estudos Retrospectivos
14.
Clin Med (Lond) ; 20(4): e114-e119, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32620590

RESUMO

The SARS-CoV-2 pandemic has dramatically increased the workload for health systems and a consequent need to optimise resources has arisen, including the selection of patients for swab tests. We retrospectively reviewed consecutive patients presenting to the emergency department with symptoms suggestive of COVID-19 and undergoing swab tests for SARS-CoV-2. Complete blood counts (CBCs) were analysed looking for predictors of test positivity. Eight significant predictors were identified and used to build a 'complete' CBC score with a discriminatory power for COVID-19 diagnosis of AUC 92% (p<0.0001). When looking at the weight of individual variables, mean corpuscular volume (MCV), age, platelets and eosinophils (MAPE: MCV ≤90 fL, 65 points; age ≥45 years, 100 points; platelets ≤180×103/µL, 73 points; eosinophils <0.01/µL, 94 points) gave the highest contribution and were used to build a 'simplified' MAPE score with a discriminatory power of AUC 88%. By setting the cut-off MAPE score at ≥173 points, sensitivity and specificity for COVID-19 diagnosis were 83% and 82%, respectively, and the actual test positivity rate was 60% as compared to 6% of patients with MAPE score <173 points (odds ratio 23.04, 95% confidence interval [CI] 9.1-58.3, p-value <0.0001). In conclusion, CBC-based scores have potential for optimising the SARS-CoV-2 testing process: if these findings are confirmed in the future, swab tests may be waived for subjects with low score and uncertain symptoms, while they may be considered for asymptomatic or oligosymptomatic patients with high scores.


Assuntos
Betacoronavirus , Contagem de Células Sanguíneas , Técnicas de Laboratório Clínico , Infecções por Coronavirus/sangue , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/sangue , Pneumonia Viral/diagnóstico , Fatores Etários , Área Sob a Curva , Eosinófilos , Índices de Eritrócitos , Humanos , Pessoa de Meia-Idade , Nasofaringe/virologia , Pandemias , Contagem de Plaquetas , Curva ROC , Estudos Retrospectivos
15.
Biosci Rep ; 40(8)2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32725148

RESUMO

The new 2019 coronavirus disease (COVID-19), according to the World Health Organization (WHO), has been characterized as a pandemic. As more is being discovered about this virus, we aim to report findings of the complete blood count (CBC) of COVID-19 patients. This would serve in providing physicians with important knowledge on the changes that can be expected from the CBC of mild and normal COVID-19 patients. A total of 208 mild and common patients were admitted at the Dongnan Hospital located in the city of Xiaogan, Hubei, China. The CBCs of these patients, following a confirmed diagnosis of COVID-19, were retrospectively analyzed and a significant P<0.05 was found after a full statistical analysis was conducted using the Statistical Package for the Social Sciences (IBM SPSS). CBC analysis revealed changes in the levels of red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and C-reactive protein (CRP). Clinicians should expect similar findings when dealing with the new COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Doença das Coronárias/diagnóstico , Infecções por Coronavirus/diagnóstico , Diabetes Mellitus/diagnóstico , Hipertensão/diagnóstico , Pneumonia Viral/diagnóstico , Insuficiência Respiratória/diagnóstico , Adulto , Idoso , Doenças Assintomáticas , Contagem de Células Sanguíneas , Proteína C-Reativa/metabolismo , China/epidemiologia , Comorbidade , Doença das Coronárias/sangue , Doença das Coronárias/epidemiologia , Doença das Coronárias/fisiopatologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/fisiopatologia , Índices de Eritrócitos , Eritrócitos/patologia , Eritrócitos/virologia , Feminino , Hematócrito , Hemoglobinas/metabolismo , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Insuficiência Respiratória/sangue , Insuficiência Respiratória/epidemiologia , Insuficiência Respiratória/fisiopatologia , Estudos Retrospectivos , Índice de Gravidade de Doença
16.
J Anim Sci ; 98(8)2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32717077

RESUMO

Developments of pulmonary diseases, often accompanied by infections of bacteria, severely affect the meat production and welfare of pigs. This study investigated 307 pigs at age of 240 d from an eight-breed cross reared under standardized housing conditions for associations among the extent of lung lesions, bacteria load inferred from 16S rRNA sequencing of bronchoalveolar lavage fluid, as well as 57 immune cells and 25 hematological traits. We showed that the pigs under study suffered substantial and varied lung lesions, and the Mycoplasma is the most associated bacteria genera. At a false discovery rate of 0.05 (FDR < 0.05), the severity of lung lesions were significantly associated with greater CD8+ to CD3+ cell ratio, neutrophil-to-lymphocyte ratio (NLR), and standard deviation of red blood cell volume distribution width (RDW-SD), and lower CD4-CD8-/CD3+, CD3+CD4-CD8-/PBMCs (peripheral blood mononuclear cells) and CD14-CD16-/PBMCs cell ratios, mean corpuscular hemoglobin concentration, lymphocyte count, and lymphocyte count percentage, reflecting an status of inflammation, immune suppression, and hypoxia of the pigs accompanying the progression of the lung lesions. The Mycoplasma abundance showed positive correlations with neutrophil count, neutrophil count percentage, NLR, monocyte count, coefficient of variation in red blood cell volume distribution width , and RDW-SD, and negative correlations with mean corpuscular hemoglobin concentration, lymphocyte count, and lymphocyte count percentage; these correlations are largely consistent with those of lung lesions, supporting the comorbidity of lung lesions and Mycoplasma infection. We also observed nonlinear associations that sharp increases in neutrophil count and neutrophil count percentage occurred only when Mycoplasma abundance raised above the population-average level. The results provide helpful insights into the changes of host immune status in response to Mycoplasma relevant lung diseases in pigs.


Assuntos
Carga Bacteriana , Infecções por Mycoplasma/veterinária , Doenças dos Suínos/microbiologia , Animais , Índices de Eritrócitos/veterinária , Predisposição Genética para Doença , Inflamação/patologia , Inflamação/veterinária , Contagem de Leucócitos/veterinária , Leucócitos Mononucleares , Pulmão/patologia , Contagem de Linfócitos/veterinária , Linfócitos , Mycoplasma/imunologia , Infecções por Mycoplasma/genética , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/patologia , Neutrófilos , RNA Ribossômico 16S , Suínos , Doenças dos Suínos/genética , Doenças dos Suínos/patologia
17.
J S Afr Vet Assoc ; 91(0): e1-e6, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-32633985

RESUMO

BACKGROUND: Peripartum is a challenging phase for the health of cows. OBJECTIVES: This study analysed the haematological profile of Holstein cows during peripartum. METHOD: Blood samples were collected on days 18, 12, 8, 5 and 2 before calving, at parturition, and on days 1, 7, 14, 21, 30, 45 and 60 postpartum. Analyses of red blood cell (RBC) count, haemoglobin concentration, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration and RBC distribution width were performed; body condition score (BCS) and milk yield were evaluated. RESULTS: Red blood cell (the highest value was 6.10 × 1012/L at parturition and the lowest recorded value was 5.03 × 1012/L 21 days after parturition), haemoglobin and haematocrit (the highest values were 10.48 g/dL and 33.47% at parturition, respectively and the lowest values were 8.28 g/dL and 26.13% on day 30 after parturition, respectively); BCS (the highest and the lowest values were 3.50 points and 2.73 points on days 18 before parturition and 45 after parturition, respectively) and milk production (the lowest and the highest values were 21.48 L and 27.02 L on days 7 and 45 after parturition, respectively) were significantly different (p 0.05) during the peripartum period. Of the total cows (n = 48), 41.7% had RBC, haemoglobin and haematocrit below the reference intervals during at least one collection point during the postpartum period. CONCLUSION: This study demonstrated that dairy cows included in this investigation suffered alterations in select haematological variables during the postpartum period.


Assuntos
Bovinos/sangue , Contagem de Eritrócitos/veterinária , Índices de Eritrócitos/veterinária , Período Periparto/sangue , Animais , Feminino
18.
Medicine (Baltimore) ; 99(23): e20638, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32502047

RESUMO

To evaluate the diagnostic power of red cell distribution width-to-lymphocyte ratio (RLR) for HBV-related liver cirrhosis via a retrospective cohort study.Seven hundred fifty healthy controls, 327 chronic hepatitis B (CHB) patients, and 410 patients with HBV-related liver cirrhosis (HBV-LC) were enrolled in this study. RLR, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), AST to platelet ratio index (APRI), and fibrosis index based on the 4 factors (FIB-4) were compared between the 3 groups. The predictive powers of RLR and RDW for HBV-related liver cirrhosis and patient prognosis were evaluated using AUROC.Patients with HBV-related liver cirrhosis had higher RLR, FIB-4, NLR, RDW, APRI, and lower LMR compared with the control and CHB groups. RLR in the HBV-LC group was significantly higher than both CHB and control groups (both P < .05). While RLR in the CHB group was also higher than the control group, the difference was not statistically significant (P > .05). The AUROC of RLR for predicting HBV-related liver cirrhosis was 0.87, and was superior to RDW (0.81), FIB-4 (0.79), and APRI (0.60). With an optimized cut-off value (10.87), RLR had the highest sensitivity (0.88) and specificity (0.72), and was superior to RDW (0.86, 0.64), FIB-4 (0.80, 0.65), and APRI (0.85, 0.48) as a biomarker. For all 3 groups, RLR was negatively correlated (all P < .05) with serum platelet (PLT) and was positively correlated (all P < .05) with FIB-4 and APRI. There was no significant statistical difference in RLR for patients in HBV-LC group who had different prognosis (P > .05).The RLR, a routinely available, inexpensive, and easily calculated measure, can be used as a predictor of HBV-related liver cirrhosis, but not as a predictor of prognosis for patients with liver cirrhosis. Use of RLR may reduce the need for frequent liver biopsies in CHB patients.


Assuntos
Índices de Eritrócitos , Hepatite B Crônica/sangue , Cirrose Hepática/sangue , Contagem de Linfócitos , Biomarcadores/sangue , Estudos de Casos e Controles , Hepatite B Crônica/complicações , Humanos , Cirrose Hepática/etiologia , Valor Preditivo dos Testes
19.
Ecotoxicol Environ Saf ; 201: 110824, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32544747

RESUMO

The aim of the study was to investigate the effects of sublethal concentrations (0.3, 0.6 and 1.2 mg L-1) of the herbicide Ronstar on the hematology and some immune parameters in Clarias gariepinus juvenile (mean weight and length 58.72 ± 2.46 g and 27.60 ± 1.62 cm, respectively). The hematological and some immune parameters were studied for 21 days in a static renewal bioassay system in which the water and the herbicide were changed daily. The erythrocyte count, hemoglobin concentration (Hb), and packed cell volume (PCV) were significantly (p < 0.05) reduced in the treatment groups. When compared with the control, there were significant (p < 0.05) leucocytosis, lymphocytosis, neutropenia and monocytopenia in the treatment groups. Both the mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) were reduced ((p < 0.05) in the Ronstar-exposed fish. The result showed that the treated fish suffered hypochromic microcytic anemia. The total immunoglobulin and phagocytic indices (phagocytic capacity and phagocytic index) were significantly (p < 0.05) reduced in the treatment groups. while the respiratory burst was significantly (p < 0.05) increased in the treatment groups. The result showed that exposure to Ronstar had adverse effects on the hematology and immunocompetency of the fish.


Assuntos
Peixes-Gato , Herbicidas/toxicidade , Imunoglobulinas/sangue , Oxidiazóis/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Peixes-Gato/sangue , Peixes-Gato/imunologia , Relação Dose-Resposta a Droga , Contagem de Eritrócitos , Índices de Eritrócitos/efeitos dos fármacos , Eritrócitos/citologia , Eritrócitos/efeitos dos fármacos , Hematócrito , Hemoglobinas/análise , Fagócitos/citologia , Fagócitos/efeitos dos fármacos
20.
Int Heart J ; 61(3): 524-530, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32350204

RESUMO

Infectious endocarditis (IE) is a rare disease with high mortality rate. Recently, red cell distribution width (RDW) has drawn special attention for predicting cardiovascular disease. This study aims to explore the relationship between RDW value and postoperative death of IE patients.Clinical records of patients with definite IE from Chinese People's Liberation Army General Hospital department of cardiovascular surgery were collected and analyzed. Clinical, echocardiographic, and biochemical variables were evaluated along with RDW.Results: A total of 158 consecutive IE patients (mean age 47.0 ± 16.3 years, male 61.4%) were enrolled in this study. According to receiver operating characteristic (ROC) curve analysis, the optimal RDW cutoff value for predicting mortality was 15.45% (area under the curve 0.913, P < 0.001). A total of 28 patients (17.8%) died postoperatively; of these, 89.3% had RDW value >15.45%. Binary regression analysis showed that aging, multiple valvular involved, valvular vegetation formation, pulmonary hypertension, and high RDW are strong predictors of postoperative death. Multiple regression analysis revealed that high RDW value was independent predictors of postoperative mortality in patients with IE (ß: 3.704, 95% confidence interval (95%CI): 2.729-604.692, P < 0.05).IE has a high inhospital mortality rate, and increased RDW is an independent predictor of postoperative death in these patients.


Assuntos
Endocardite/sangue , Índices de Eritrócitos , Adulto , China/epidemiologia , Endocardite/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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