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1.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190003.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596374

RESUMO

OBJECTIVE: To describe reference values for blood counts obtained from laboratory tests in the Brazilian adult population according to laboratory results from the National Health Survey (Pesquisa Nacional de Saúde - PNS), by gender, age group and skin color. METHODS: The initial sample consisted of 8,952 adults. To determine the reference values, individuals with prior diseases and outliers were excluded. Mean values, standard deviation and limits were stratified by gender, age group and skin color. RESULTS: For red blood cells, men presented a mean value of 5.0 million per mm3 (limits: 4.3-5.8) and women, 4.5 million per mm3 (limits: 3.9-5.1). Hemoglobin levels were higher among men with a mean of 14.9 g/dL (13.0-16.9), and in women, 13.2 g/dL (11.5-14.9). The mean number of white blood cells among men was 6.142/mm3 (2.843-9.440) and 6.426/mm3 (2.883-9.969) for women. Other parameters showed close values between the genders. Regarding age groups and skin color, mean values, standard deviation and limits of the exams presented small variations. CONCLUSION: Hematological reference values based on the national survey allow for the establishment of specific reference limits for gender, age and skin color. The results presented here may contribute to the establishment of better evidence and criteria for the care, diagnosis and treatment of diseases.


Assuntos
Contagem de Células Sanguíneas/normas , Técnicas de Laboratório Clínico/normas , Inquéritos Epidemiológicos/normas , Adolescente , Adulto , Fatores Etários , Brasil/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Sexuais , Adulto Jovem
2.
Ann Biol Clin (Paris) ; 77(4): 422-428, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31418703

RESUMO

Despite the continuing improvement of automated blood cell counters, confirmation by blood smear examination remains the gold standard in case of anomalies. With a constant goal of standardisation, different experts committees (e.g. the French-speaking cellular hematology group (Groupe francophone d'hématologie cellulaire, GFHC and the ISLH International society for laboratory hematology) recently published criteria for microscopic analysis of blood smears. Cornet et al. evaluated the application of those criteria and propose to suppress any review for 72 hours when a "Blast/Abn lymph" flag is triggered for a sample with no abnormal cell on the microscopic review. The aims of our study were to retrospectively evaluate whether this 72-hour rule adequately operates and whether it is possible to extend the arbitrary 72-hour timeframe to 96h and 144h. To achieve this goal, 40,688 blood samples were collected from three French-speaking hospitals. 1,548 samples presented an isolated "Blast/Abn lymph" flag. Only 221 samples presented the application of the 72-hour rule at least once for our study period. We were able to extend this rule to 144 hours for 10 samples of them. All blood smears for which the rule was applied were verified and there was no abnormal cell on smears at 72 and 144 hours. In conclusion, the 72-hour rule derived from the GFHC's criteria is secure and reduces the slide review rate and thus the production costs and the turnaround time of hemogram results. Further investigations could confirm that its extension to 144 hours is also adequate.


Assuntos
Contagem de Células Sanguíneas , Hematologia/instrumentação , Hematologia/normas , Guias de Prática Clínica como Assunto , Fluxo de Trabalho , Automação Laboratorial/instrumentação , Automação Laboratorial/métodos , Automação Laboratorial/normas , Bélgica , Contagem de Células Sanguíneas/instrumentação , Contagem de Células Sanguíneas/métodos , Contagem de Células Sanguíneas/normas , Coleta de Amostras Sanguíneas/normas , Citodiagnóstico/instrumentação , Citodiagnóstico/métodos , Citodiagnóstico/normas , Reações Falso-Positivas , França , Testes Hematológicos/instrumentação , Testes Hematológicos/métodos , Testes Hematológicos/normas , Hematologia/métodos , Humanos , Ensaio de Proficiência Laboratorial , Contagem de Leucócitos/instrumentação , Contagem de Leucócitos/métodos , Contagem de Leucócitos/normas , Leucócitos/citologia , Linfócitos/citologia , Fase Pré-Analítica/normas , Estudos Retrospectivos , Sensibilidade e Especificidade , Fatores de Tempo
3.
Pan Afr Med J ; 32: 5, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31068998

RESUMO

Introduction: Haematological reference values are very important for diagnostic orientation and treatment decision. The aim of this study was to establish haematological reference values for Malian healthy adults. Methods: A cross-sectional study including 161 male Malians aged between 19 and 54 years old was performed. Median and reference ranges were calculated for haematological and biochemical parameters. Parametric student's t-test was used to determine any statistically significant differences by age, smoker status, body mass index (BMI) and occupation. Ranges were further compared with those reported for other African, Afro-American and Caucasian populations. Results: Increased levels of MCV, MCH, PLT and EOS were found in younger Malians who had abnormal BMI and altered platelets parameters. Notably, significantly lower eosinophil and monocyte counts were observed in Malians compared to Europeans The smoking status did not seem to directly affect RIs. Conclusion: This is the first study to determine normal laboratory parameters in Malian adult males. Our results underscore the necessity of establishing region-specific clinical reference ranges that would allow clinicians and practitioners to manage laboratory tests, diagnosis and therapies. These data are useful not only for the management of patients in Mali, but also to support European and American clinicians in the health management of asylum seekers and migrants from Mali.


Assuntos
Contagem de Células Sanguíneas/normas , Análise Química do Sangue , Plaquetas/fisiologia , Índice de Massa Corporal , Adulto , Fatores Etários , Estudos Transversais , Humanos , Masculino , Mali , Pessoa de Meia-Idade , Ocupações/estatística & dados numéricos , Valores de Referência , Fumar/epidemiologia , Adulto Jovem
4.
Clin Chem Lab Med ; 57(6): 918-926, 2019 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-30838839

RESUMO

Background The cell population data (CPD) parameters reported by XN analyzers (Sysmex Corporation, Kobe, Japan) reflect the size and internal structure of leukocytes. We explored whether CPD values could contribute to recognize those patients with fever at risk to develop sepsis. A profile of sepsis was developed combining CPD parameters and other markers. Methods We recruited 295 patients at the onset of fever, with infection confirmed by positive cultures. We studied the diagnostic performance of the CPD parameters in the differential diagnosis of sepsis vs. non-systemic bacterial infection using receiver operating characteristic (ROC) curve analysis. Additionally, the K-means unsupervised clustering method was applied. Once the clusters had been defined, the relationship between them and the CPD parameter values was assessed with the non-parametric Wilcoxon test. Lastly, the relationship between the clusters obtained and the categorical variables was examined with the χ2-test (or Fisher's exact test). Results ROC analysis demonstrated that NE-FSL, NE-WY, NE-WZ and MO-WZ had areas under the curve (AUCs) >0.700 for predicting sepsis. Using the K-means clustering algorithm, 80 patients (66.67%) were assigned to Cluster 1 and the others to Cluster 2. Out of 80 of patients in Cluster 1, 45 (56.25%) presented a PCT value ≥2 ng/mL, whereas almost 80% of Cluster 2 patients had a PCT <2 ng/mL. Cluster 1 was characterized by high NE-SFL, NE-WY, MO-X, MO-WX and MO-Z values (p<0.05). Conclusions CPD related to monocyte complexity and neutrophil activation were found to be significant, with high values suggesting sepsis.


Assuntos
Contagem de Células Sanguíneas/métodos , Leucócitos/citologia , Sepse/diagnóstico , Área Sob a Curva , Contagem de Células Sanguíneas/normas , Análise por Conglomerados , Humanos , Análise de Componente Principal , Controle de Qualidade , Curva ROC , Estudos Retrospectivos
5.
Int J Lab Hematol ; 41(3): 331-337, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30786141

RESUMO

INTRODUCTION: Reference intervals for pediatric laboratory tests need to be interpreted in the context of age- and sex-dependent dynamics. However, few reference intervals for healthy ethnic Han Chinese children have previously attempted to establish using large sample sizes. As such, there are no national hematological standards in China for pediatric reference intervals. METHODS: We used a direct method to enroll a total of 2164 healthy 1- to 7-year-old children from Henan province. Hematological reference intervals were established by analyzing venous blood sample data on 17 hematologic analytes. The reference values for different ages and sexes were estimated using both parametric methods (mean ± 2 SD) and nonparametric methods (2.5-97.5th percentiles). RESULTS: We provided reference intervals for 17 hematologic analytes including red blood count, hemoglobin concentration, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and red cell distribution width, white blood count and differential count as well as platelet count and related parameters. CONCLUSION: We established age- and sex-specific reference intervals that can provide more evidence-based guidance for the diagnosis and treatment for pediatric diseases. Our findings provide the basis for the next step in establishing national blood testing standards.


Assuntos
Contagem de Células Sanguíneas/normas , Índices de Eritrócitos , Fatores Etários , Biomarcadores , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Valores de Referência , Fatores Sexuais
6.
Int J Lab Hematol ; 41(3): 338-344, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30742354

RESUMO

INTRODUCTION: The aim of the present study was to evaluate the diagnostic ability of blast flags generated by Sysmex instruments (XE/XN) by comparing with immunophenotyping by flow cytometry (IFCM). Additionally, the ability of manual microscopy and CellaVision DM96 (pre- and reclassification) to predict the presence of "true" blasts was investigated. METHODS: Blood samples (n = 240) with suspect pathology flags reported by the XE were collected from the daily workload and examined by the XN, by manual microscopy, by CellaVision DM96 and by IFCM (CytoDiff Panel). RESULTS: The ROC analysis for blasts showed an area under the curve of 0.64 ("Blasts?") (XE), 0.57 ("Blasts/Abn Lympho?") (XN), 0.75 (CellaVision preclassification procedure), 0.78 (CellaVision reclassification procedure), and 0.81 (manual microscopy). The sensitivity of blast detection varied between the methods from 0.41 (XE) to 0.90 (XN), and the specificity varied from 0.17 (XN) to 0.95 (CellaVision reclassification). CONCLUSIONS: The CellaVision reclassification procedure has a diagnostic ability for predicting blasts close to that of manual microscopy. The blood smear methods show a notable number of false negative results. The Sysmex XN reported a higher rate of true positive blast flags than the XE. Taken together, the CytoDiff method could be a useful alternative to smear examination to correctly identify blasts.


Assuntos
Células Sanguíneas/patologia , Citometria de Fluxo , Microscopia , Contagem de Células Sanguíneas/métodos , Contagem de Células Sanguíneas/normas , Citometria de Fluxo/métodos , Citometria de Fluxo/normas , Humanos , Imunofenotipagem , Leucócitos/patologia , Microscopia/métodos , Microscopia/normas , Curva ROC
7.
Vet Clin Pathol ; 48(1): 100-113, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30676655

RESUMO

BACKGROUND: The effects of sex, age, and season on blood analyte concentrations have not been investigated for the killer whale (Orcinus orca). Defining these changes provides background data for improving the care of managed populations and defines normal changes that could occur in wild counterparts. OBJECTIVES: We aimed to define hematologic and serum biochemical variation by age, sex, and season for an ex situ killer whale population. METHODS: Blood samples collected from killer whales during normal wellness exams were retrospectively identified. Killer whales were categorized by age; calf (0-2.9 years), juvenile (3-10.9 years), early adult (11-20.9 years), adult (21-30.9 years), and aged (>30.9 years); sex; and season. Standard CBC and biochemistry were collated, and only samples without evidence of disease were used. A mixed effects maximum likelihood regression with animal identification (ID) as the random effects variable was used to compare groups with a significance set at P ≤ 0.01. RESULTS: All analytes differed by age, while only four differed by sex. Red blood cell parameters and associated renal analytes increased with age, while liver-associated analytes and glucose decreased. Season affected 59% of the blood analytes. CONCLUSIONS: Aged killer whales showed strong evidence of altered physiology as compared with younger animals. Anemia did not develop with age as was observed in one bottlenose dolphin population. Observed decreases in renal function could be caused by chronic disease or dehydration. Decreases in immune function parameters suggest immune senescence. These results provide background data for evaluating the health of managed and free-ranging killer whales.


Assuntos
Orca/sangue , Fatores Etários , Animais , Contagem de Células Sanguíneas/normas , Contagem de Células Sanguíneas/veterinária , Glicemia/análise , Proteínas Sanguíneas/análise , Contagem de Eritrócitos/normas , Contagem de Eritrócitos/veterinária , Feminino , Testes Hematológicos/normas , Testes Hematológicos/veterinária , Masculino , Valores de Referência , Estações do Ano , Fatores Sexuais
8.
Clin Chem Lab Med ; 57(5): 716-729, 2019 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-30226204

RESUMO

Background The use of laboratory reference intervals based on younger populations is of questionable validity in older populations. We established reference intervals for 16 complete blood count (CBC) parameters in healthy elderly Koreans aged ≥60 years and compared them to those of individuals aged 20-59 years. Methods Among 64,532 individuals (39,609 men and 24,923 women) aged ≥20 years who underwent medical checkups, 8151 healthy subjects (12.6%, 5270 men and 2881 women, including 675 and 511, respectively, who were ≥60 years of age) were enrolled based on stringent criteria including laboratory, imaging and endoscopy results; previous medical history; and medication history. CBC parameters were measured using an Advia2120i instrument. Results Overall, healthy individuals aged ≥60 years did not require separate reference intervals from those aged <60 years except for red cell distribution width (RDW) and mean corpuscular hemoglobin (MCH) in women. However, subjects aged ≥60 years still required sex-specific reference intervals for red blood cell count, hemoglobin, hematocrit, MCH, monocytes and eosinophils. Separate reference intervals were required for MCH, eosinophils and basophils for certain age subgroups of men aged ≥60 years, and for MCH and RDW in certain age subgroups of women aged ≥60 years, compared to counterparts <60 years of age. Conclusions Healthy elderly Koreans can use the same reference intervals as younger populations. Thus, abnormal CBC results may not necessarily be attributable to physiologic changes but possible underlying diseases that should be investigated.


Assuntos
Contagem de Células Sanguíneas/normas , Adulto , Fatores Etários , Idoso , Análise Química do Sangue/normas , Feminino , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , República da Coreia , Adulto Jovem
9.
Int J Lab Hematol ; 41(1): 15-22, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30138534

RESUMO

INTRODUCTION: Effective medical laboratory quality management systems ensure confidence in analyzing and reporting accurate and reliable patient results. To guarantee quality assurance, each laboratory needs appropriate internal quality control (IQC) procedures to monitor their test systems. The Institute for Quality Management in Healthcare (IQMH) Centre for Proficiency Testing conducted a survey on quality control (QC) practices in routine hematology. METHODS: An online survey was sent to 184 Ontario laboratories performing complete blood counts (CBC) and leukocyte differentials. RESULTS: All participants used three levels of commercial QC for test system monitoring. Eighty percent of laboratories supplement with in-house patient QC. The frequency of QC analysis was variable based on: Manufacturer recommendations (80%) Parameter stability (25%) Clinical impact of incorrect results (21%) Number of samples potentially requiring retesting if there is a QC failure (11%). All laboratories used established QC rules and limits to monitor results. They utilized various methods in establishing limits including: Standard deviation of QC results (60%) Manufacturer precision goals (55%) Published precision goals (24%) IQMH allowable performance limits (APLs) (37%). CONCLUSION: Considerable variation in QC practices of Ontario laboratories was identified, and consensus practice recommendations and precision goals were developed to guide and standardize QC practice.


Assuntos
Contagem de Células Sanguíneas/normas , Padrões de Prática Médica/normas , Controle de Qualidade , Técnicas de Laboratório Clínico/normas , Hematologia/métodos , Hematologia/normas , Humanos , Ontário , Inquéritos e Questionários
10.
Vet Clin Pathol ; 47(3): 368-376, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30168859

RESUMO

BACKGROUND: Quality control procedures are an important part of the overall quality assurance for production of accurate and reliable hematologic results. OBJECTIVES: This study aimed to validate a quality control material-based procedure and assess two patient-based quality control procedures (repeat patient testing [RPT] and average of normals [AoN]) with the ADVIA 120 Hematology System. METHODS: Requirements for quality control procedures were obtained with the computerized statistical and quality program, EZRules3. The procedures were evaluated comparing the probability of error detection (Ped), probability of false rejection (Pfr), and sigma metrics. RESULTS: All three of the quality control procedures could be applied with 1-3s control rules, achieving the desired quality requirements. Validation of the quality control materials achieved values for Ped and Pfr of ≥90% and 0%, respectively. Patient-based procedures obtained a ≥85% Ped and a 0% Pfr, except for platelets in the AoN procedure, which achieved a 77% Ped. The RPT achievable total errors were similar to those of the traditional quality control materials and the AoN procedures, except for platelets, which had an achievable total error of 75%. CONCLUSIONS: Patient-based procedures are suitable for veterinary laboratories. The RPT approach may benefit laboratories with limited budgets and low hematology caseloads. The AoN procedure may benefit laboratories with higher hematology caseloads.


Assuntos
Hematologia/normas , Patologia Veterinária/normas , Controle de Qualidade , Animais , Contagem de Células Sanguíneas/instrumentação , Contagem de Células Sanguíneas/métodos , Contagem de Células Sanguíneas/normas , Contagem de Células Sanguíneas/veterinária , Cães/sangue , Hematologia/instrumentação , Hematologia/métodos , Patologia Veterinária/instrumentação , Patologia Veterinária/métodos , Reprodutibilidade dos Testes
11.
Acta Neurochir (Wien) ; 160(10): 2039-2047, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30066191

RESUMO

BACKGROUND: Device infection is a major complication of placement external ventricular drains (EVD). Diagnostic features are often masked by underlying disease or cerebrospinal fluid (CSF) contamination by blood. We aim to assess which diagnostic modalities are applied for EVD-related infection (ERI) diagnosis and evaluate their accuracy. METHODS: This observational prospective study included 187 adult patients with an EVD. Modalities of clinical diagnosis of ERI diagnosed by treating physicians on clinical grounds and blood and CSF analysis (clinically diagnosed ERI (CD-ERI)) were assessed prospectively. Additionally, the diagnostic accuracy of clinical and laboratory parameters for the diagnosis of culture proven ERI (CP-ERI) was evaluated, using data of the study patients and including a retrospective cohort of 39 patients with CP-ERI. RESULTS: Thirty-one CD-ERIs were diagnosed in the prospective cohort. Most physicians used CSF analysis to establish the diagnosis. ROC analysis revealed an AUC of 0.575 (p = 0.0047) for the number of positive SIRS criteria and AUC of 0.5420 (p = 0.11) for the number of pathological neurological signs for diagnosis of CP-ERI. Diagnostic accuracy of laboratory values was AUC 0.596 (p = 0.0006) for serum white blood cell count (WBCC), AUC 0.550 (p = 0.2489) for serum C-reactive protein, AUC 0.644 (p < 0.0001) for CSF WBCC and AUC 0.690 for CSF WBC/red blood cell count ratio (both p < 0.0001). Neither a temporal trend in potential predictors of CP-ERI nor a correlation between clinical diagnosis and proven CSF infection was found. CONCLUSIONS: Clinicians base their diagnosis of ERI mostly on CSF analysis and occurrence of fever, leading to over-diagnosis. The accuracy of the clinical diagnosis is low. Commonly used clinical and laboratory diagnostic criteria have a low sensitivity and specificity for ERI.


Assuntos
Derivações do Líquido Cefalorraquidiano/efeitos adversos , Drenagem/efeitos adversos , Infecção dos Ferimentos/sangue , Adulto , Idoso , Contagem de Células Sanguíneas/normas , Proteína C-Reativa/análise , Cateteres/efeitos adversos , Derivações do Líquido Cefalorraquidiano/instrumentação , Drenagem/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecção dos Ferimentos/epidemiologia , Infecção dos Ferimentos/etiologia
12.
Trop Doct ; 48(4): 334-339, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30153769

RESUMO

There is scant documentation of the stability of common haematological parameters on storage of blood samples under tropical conditions. K2EDTA samples in multiple vials were taken from 20 healthy blood donors, baseline readings taken, and stored at 33°C and 37°C. Readings from the stored vials were taken after 1, 3 and 6 h. The percent change against the baseline readings at each time point for each storage temperature was calculated. Platelet counts showed an unacceptable shift within 1 h at 37°C and 3 h at 33°C; red cell volume related parameters showed an unacceptable shift within 3 h at 37°C and 6 h at 33°C. Haemoglobin, red blood cell count, white blood cell count and mean corpuscular haemoglobin remained stable for 6 h at both temperatures. The unacceptable change for many parameters on storage at ≥33°C demonstrates the importance of ensuring pre-analytical control in regions experiencing such climatic conditions.


Assuntos
Contagem de Células Sanguíneas/normas , Células Sanguíneas/citologia , Coleta de Amostras Sanguíneas/normas , Contagem de Plaquetas , Manejo de Espécimes/normas , Temperatura Ambiente , Clima Tropical , Índices de Eritrócitos , Humanos
13.
Ann Lab Med ; 38(6): 503-511, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30027692

RESUMO

BACKGROUND: Sampling a healthy reference population to generate reference intervals (RIs) for complete blood count (CBC) parameters is not common for pediatric and geriatric ages. We established age- and sex-specific RIs for CBC parameters across pediatric, adult, and geriatric ages using secondary data, evaluating patterns of changes in CBC parameters. METHODS: The reference population comprised 804,623 health examinees (66,611 aged 3-17 years; 564,280 aged 18-59 years; 173,732 aged 60-99 years), and, we excluded 22,766 examinees after outlier testing. The CBC parameters (red blood cell [RBC], white blood cell [WBC], and platelet parameters) from 781,857 examinees were studied. We determined statistically significant partitions of age and sex, and calculated RIs according to the CLSI C28-A3 guidelines. RESULTS: RBC parameters increased with age until adulthood and decreased with age in males, but increased before puberty and then decreased with age in females. WBC and platelet counts were the highest in early childhood and decreased with age. Sex differences in each age group were noted: WBC count was higher in males than in females during adulthood, but platelet count was higher in females than in males from puberty onwards (P<0.001). Neutrophil count was the lowest in early childhood and increased with age. Lymphocyte count decreased with age after peaking in early childhood. Eosinophil count was the highest in childhood and higher in males than in females. Monocyte count was higher in males than in females (P<0.001). CONCLUSIONS: We provide comprehensive age- and sex-specific RIs for CBC parameters, which show dynamic changes with both age and sex.


Assuntos
Contagem de Células Sanguíneas/normas , Adolescente , Adulto , Fatores Etários , Plaquetas/citologia , Criança , Pré-Escolar , Eritrócitos/citologia , Feminino , Humanos , Leucócitos/citologia , Masculino , Pessoa de Meia-Idade , Valores de Referência , República da Coreia , Fatores Sexuais , Adulto Jovem
15.
BMC Res Notes ; 11(1): 400, 2018 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-29925425

RESUMO

OBJECTIVE: This retrospective study was conducted in 2017 with the objective of evaluating the value of acute phase peripheral blood parameters in predicting dengue haemorrhagic fever (DHF). Patients, who were admitted to Teaching Hospital Peradeniya between January and August 2017 due to dengue illness, were recruited into this study. RESULTS: A total of 515 patients participated in the study. Among them, 333 were DHF patients while 182 patients were managed as DF. There was a significant difference in mean values of platelets and haemoglobin observed during acute phase in non-leakers compared to the patients who progressed to DHF, while no significant difference was observed for white blood cells, neutrophils, lymphocytes and haematocrit values. A significantly higher mean value was observed in white blood cells and hemoglobin in leakers compared to non-leakers during day 5. Mean day 5 platelet value was significantly lower among leakers compared to non-leakers but no significant difference between haematocrit, neutrophil and lymphocyte values were observed. ROC curve performed for acute phase platelet values and haemoglobin values to gain a predictive value for female and male DHF patients and cut off values with high sensitivity and specificity to predict DHF could be obtained for the platelet count.


Assuntos
Contagem de Células Sanguíneas/normas , Dengue/sangue , Dengue/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Dengue Grave/sangue , Dengue Grave/diagnóstico , Sri Lanka , Adulto Jovem
16.
PLoS One ; 13(6): e0198444, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29879171

RESUMO

BACKGROUND: There are racial, ethnic and geographical differences in complete blood count (CBC) reference intervals (RIs) and therefore it is necessary to establish RIs that are population specific. Several studies have been carried out in Africa to derive CBC RIs but many were not conducted with the rigor recommended for RI studies hence limiting the adoption and generalizability of the results. METHOD: By use of a Beckman Coulter ACT 5 DIFF CP analyser, we measured CBC parameters in samples collected from 528 healthy black African volunteers in a largely urban population. The latent abnormal values exclusion (LAVE) method was used for secondary exclusion of individuals who may have had sub-clinical diseases. The RIs were derived by both parametric and non-parametric methods with and without LAVE for comparative purposes. RESULTS: Haemoglobin (Hb) levels were lower while platelet counts were higher in females across the 4 age stratifications. The lower limits for Hb and red blood cell parameters significantly increased after applying the LAVE method which eliminated individuals with latent anemia and inflammation. We adopted RIs by parametric method because 90% confidence intervals of the RI limits were invariably narrower than those by the non-parametric method. The male and female RIs for Hb after applying the LAVE method were 14.5-18.7 g/dL and 12.0-16.5 g/dL respectively while the platelet count RIs were 133-356 and 152-443 x10(3) per µL respectively. CONCLUSION: Consistent with other studies from Sub-Saharan Africa, Hb and neutrophil counts were lower than Caucasian values. Our finding of higher Hb and lower eosinophil counts compared to other studies conducted in rural Kenya most likely reflects the strict recruitment criteria and healthier reference population after secondary exclusion of individuals with possible sub-clinical diseases.


Assuntos
Contagem de Células Sanguíneas/métodos , Adolescente , Adulto , Idoso , Contagem de Células Sanguíneas/instrumentação , Contagem de Células Sanguíneas/normas , Feminino , Hemoglobinas/análise , Humanos , Quênia , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/normas , Valores de Referência , Fumantes , População Urbana , Adulto Jovem
17.
Clin Chim Acta ; 483: 271-274, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29753681

RESUMO

BACKGROUNDS: The BD Vacutainer® Barricor™ Plasma collection tube (BD Barricor) uses an innovative non-gel separation method. This study compared the plasma residual cell count (PRCC) obtained from BD Barricor and from BD PST II plasma tubes. METHODS: Four BD Barricors and one BD PST II were collected from 40 donors. BD PST II was centrifuged at 1300g/10 min, while the BD Barricors were centrifuged at 1800g/10 min, 4000g/3 min, 4000g/7 min and 4000g/15 min. PRCC was evaluated measuring white blood cells (WBC), red blood cells (RBC) and Platelets (PLT) counts by Siemens ADVIA 2120. Cell-free hemoglobin was quantified by haemolysis index (HI) by Roche Cobas c501. RESULTS: BD PST II Median WBC, RBC and PLT counts were 0.38 (109/L), 0.0291 (1012/L) and 113.5 (109/L), respectively. Considering the BD PST II as reference, PRCC differences were expressed as median bias percentage. WBC showed a significant reduction at all the conditions (p < 0.01), being the reductions: 63.9% (1800g/10 min), 69.9% (4000g/3 min), 75.0% (4000g/7 min) and 82.7% (4000g/15 min). RBC reductions 29.7% (1800g/10 min), 33.8% (4000g/3 min), 39.6% (4000g/7 min) and 66.4 (4000g/15 min) were all significant (p < 0.01). PLT reductions were 1.6% at 1800g/10 min (p = ns), 1.2% at 4000g/3 min (p = ns), 27.1% at 4000g/7 min (p = 0.046) and 46.6% at 4000g/15 min (p = 0.005). BD Barricor centrifuged for 7 and 15 min at 4000g showed an increased haemolysis. CONCLUSIONS: BD Barricors plasma quality improved with increasing the centrifugation times but already at 4000g/3 min, the suggested centrifugation condition, a significant improvement was achieved.


Assuntos
Contagem de Células Sanguíneas/normas , Coleta de Amostras Sanguíneas/métodos , Coleta de Amostras Sanguíneas/instrumentação , Centrifugação/efeitos adversos , Hemólise , Humanos
18.
Trop Med Int Health ; 23(7): 765-773, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29752840

RESUMO

OBJECTIVE: Reference intervals (RIs) currently being used in Ethiopia are derived from western populations. Thus, this study aimed to establish locally derived haematological and immunological RIs. METHOD: The study was conducted in Amhara State, Ethiopia with a total of 967 (55.2% males) participants. 56.9% of males and 43.1% of females were eligible for haematological and immunological RI determination. A non-parametric test was used for the determination of upper (97.5th percentile) and lower (2.5th percentile) reference interval limits with 95% CI. The Harris and Boyd Rule was used to determine the need of partitioning of reference intervals based on gender. RESULT: The established 95% reference intervals (2.5th-97.5th percentile) were: for WBC: 3-11.2 × 109 /l; for platelet: 90-399 × 109 /l; for RBC: 4-6 × 1012 /l for males and 3.5-5.6 × 1012 /l for females; for haemoglobin: (Hgb) 12-18.9 g/dl for males and 10.7-17.5 g/dl for females; for PCV: 35.7-55.3% for males and 32.2-50.1% for females; for CD4: 400-1430 × 109 /l for males and 466-1523 × 109 /l for females; for CD4 percentage: 18-49.1% for males and 21.3-52.9% for females; for MCV: 81-100 fl; for MCH: 25.3-34.6 pg; MCHC: 28.8-36.9%; for RDW: 11.6-15.4% and for MPV: 8-12.3 fl. Males had significantly higher RBC, Hgb and PCV than females. CD4 counts and CD4 percentage were significantly higher in females. CONCLUSION: The reference intervals established in this study differ from others and thus should be used for the interpretation of laboratory results in diagnosis and safety monitoring in clinical trials in Amhara.


Assuntos
Contagem de Células Sanguíneas/normas , Contagem de Linfócito CD4/normas , Hemoglobinas/análise , Adolescente , Adulto , Etiópia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Adulto Jovem
19.
Sci Rep ; 8(1): 5823, 2018 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-29643468

RESUMO

Circulating endothelial cells (CEC) represent a restricted peripheral blood (PB) cell subpopulation with high potential diagnostic value in many endothelium-involving diseases. However, whereas the interest in CEC studies has grown, the standardization level of their detection has not. Here, we undertook the task to align CEC phenotypes and counts, by standardizing a novel flow cytometry approach, within a network of six laboratories. CEC were identified as alive/nucleated/CD45negative/CD34bright/CD146positive events and enumerated in 269 healthy PB samples. Standardization was demonstrated by the achievement of low inter-laboratory Coefficients of Variation (CVL), calculated on the basis of Median Fluorescence Intensity values of the most stable antigens that allowed CEC identification and count (CVL of CD34bright on CEC ~ 30%; CVL of CD45 on Lymphocytes ~ 20%). By aggregating data acquired from all sites, CEC numbers in the healthy population were captured (medianfemale = 9.31 CEC/mL; medianmale = 11.55 CEC/mL). CEC count biological variability and method specificity were finally assessed. Results, obtained on a large population of donors, demonstrate that the established procedure might be adopted as standardized method for CEC analysis in clinical and in research settings, providing a CEC physiological baseline range, useful as starting point for their clinical monitoring in endothelial dysfunctions.


Assuntos
Contagem de Células Sanguíneas/métodos , Separação Celular/normas , Células Endoteliais , Endotélio Vascular/citologia , Citometria de Fluxo/normas , Adulto , Variação Biológica da População , Contagem de Células Sanguíneas/normas , Separação Celular/métodos , Estudos de Viabilidade , Feminino , Citometria de Fluxo/métodos , Voluntários Saudáveis , Hematologia/métodos , Hematologia/normas , Humanos , Laboratórios/normas , Masculino , Pessoa de Meia-Idade , Valores de Referência , Sensibilidade e Especificidade , Adulto Jovem
20.
Int J Lab Hematol ; 40(4): 478-483, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29704448

RESUMO

INTRODUCTION: Laboratory reference ranges are essential for diagnostic orientation and treatment decision. As complete blood count parameters are influenced by various factors, including gender, geographic origin, and ethnic origin, it is important to establish specific hematologic reference values for specific populations. METHODS: This study was conducted at the Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Blood samples were taken from healthy adults aged 18-60 years that attended a health check-up program at our hospital during February 2015 to July 2015. Hematologic and routine chemistry analysis were performed. Participants were determined to be healthy based on medical history and routine medical examinations. Serum vitamin B12, folate, ferritin, and hemoglobin typing were also analyzed to exclude the possible presence of anemia. RESULTS: A statistically significant difference was observed between males and females for Hb level, hematocrit level, red blood cell count, mean corpuscular hemoglobin concentration, percentage neutrophils, monocytes and eosinophils, and absolute neutrophil, lymphocyte, basophil, and platelet counts. Accordingly, gender-specific reference intervals were established for all complete blood count parameters in healthy Thai adult population. CONCLUSIONS: The reference value ranges established in this study reflect significant differences between genders. It is possible that these reference ranges may be generalizable to adults living in Thailand. The findings of this study emphasize the importance of establishing specific hematologic reference values for specific populations.


Assuntos
Contagem de Células Sanguíneas/normas , Fatores Sexuais , Adolescente , Adulto , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Tailândia , Adulto Jovem
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