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1.
Clin Chem Lab Med ; 58(7): 1106-1115, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32352397

RESUMO

Objectives In December 2019, there was an outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, and since then, the disease has been increasingly spread throughout the world. Unfortunately, the information about early prediction factors for disease progression is relatively limited. Therefore, there is an urgent need to investigate the risk factors of developing severe disease. The objective of the study was to reveal the risk factors of developing severe disease by comparing the differences in the hemocyte count and dynamic profiles in patients with severe and non-severe COVID-19. Methods In this retrospectively analyzed cohort, 141 confirmed COVID-19 patients were enrolled in Taizhou Public Health Medical Center, Taizhou Hospital, Zhejiang Province, China, from January 17, 2020 to February 26, 2020. Clinical characteristics and hemocyte counts of severe and non-severe COVID patients were collected. The differences in the hemocyte counts and dynamic profiles in patients with severe and non-severe COVID-19 were compared. Multivariate Cox regression analysis was performed to identify potential biomarkers for predicting disease progression. A concordance index (C-index), calibration curve, decision curve and the clinical impact curve were calculated to assess the predictive accuracy. Results The data showed that the white blood cell count, neutrophil count and platelet count were normal on the day of hospital admission in most COVID-19 patients (87.9%, 85.1% and 88.7%, respectively). A total of 82.8% of severe patients had lymphopenia after the onset of symptoms, and as the disease progressed, there was marked lymphopenia. Multivariate Cox analysis showed that the neutrophil count (hazard ratio [HR] = 4.441, 95% CI = 1.954-10.090, p = 0.000), lymphocyte count (HR = 0.255, 95% CI = 0.097-0.669, p = 0.006) and platelet count (HR = 0.244, 95% CI = 0.111-0.537, p = 0.000) were independent risk factors for disease progression. The C-index (0.821 [95% CI, 0.746-0.896]), calibration curve, decision curve and the clinical impact curve showed that the nomogram can be used to predict the disease progression in COVID-19 patients accurately. In addition, the data involving the neutrophil count, lymphocyte count and platelet count (NLP score) have something to do with improving risk stratification and management of COVID-19 patients. Conclusions We designed a clinically predictive tool which is easy to use for assessing the progression risk of COVID-19, and the NLP score could be used to facilitate patient stratification management.


Assuntos
Biomarcadores/sangue , Infecções por Coronavirus/diagnóstico , Hemócitos/citologia , Pneumonia Viral/diagnóstico , Adulto , Betacoronavirus/patogenicidade , China , Coronavirus/patogenicidade , Infecções por Coronavirus/sangue , Progressão da Doença , Feminino , Humanos , Contagem de Leucócitos/métodos , Leucopenia , Contagem de Linfócitos/métodos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Pandemias , Contagem de Plaquetas/métodos , Pneumonia Viral/sangue , Prognóstico , Estudos Retrospectivos , Fatores de Risco
2.
Clin Chem Lab Med ; 58(7): 1021-1028, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32286245

RESUMO

Background As coronavirus disease 2019 (COVID-19) pandemic rages on, there is urgent need for identification of clinical and laboratory predictors for progression towards severe and fatal forms of this illness. In this study we aimed to evaluate the discriminative ability of hematologic, biochemical and immunologic biomarkers in patients with and without the severe or fatal forms of COVID-19. Methods An electronic search in Medline (PubMed interface), Scopus, Web of Science and China National Knowledge Infrastructure (CNKI) was performed, to identify studies reporting on laboratory abnormalities in patients with COVID-19. Studies were divided into two separate cohorts for analysis: severity (severe vs. non-severe and mortality, i.e. non-survivors vs. survivors). Data was pooled into a meta-analysis to estimate weighted mean difference (WMD) with 95% confidence interval (95% CI) for each laboratory parameter. Results A total number of 21 studies was included, totaling 3377 patients and 33 laboratory parameters. While 18 studies (n = 2984) compared laboratory findings between patients with severe and non-severe COVID-19, the other three (n = 393) compared survivors and non-survivors of the disease and were thus analyzed separately. Patients with severe and fatal disease had significantly increased white blood cell (WBC) count, and decreased lymphocyte and platelet counts compared to non-severe disease and survivors. Biomarkers of inflammation, cardiac and muscle injury, liver and kidney function and coagulation measures were also significantly elevated in patients with both severe and fatal COVID-19. Interleukins 6 (IL-6) and 10 (IL-10) and serum ferritin were strong discriminators for severe disease. Conclusions Several biomarkers which may potentially aid in risk stratification models for predicting severe and fatal COVID-19 were identified. In hospitalized patients with respiratory distress, we recommend clinicians closely monitor WBC count, lymphocyte count, platelet count, IL-6 and serum ferritin as markers for potential progression to critical illness.


Assuntos
Biomarcadores , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/metabolismo , Infecções por Coronavirus/mortalidade , Pneumonia Viral/imunologia , Pneumonia Viral/metabolismo , Pneumonia Viral/mortalidade , Betacoronavirus/patogenicidade , Coronavirus/patogenicidade , Humanos , Inflamação , Interleucina-10/análise , Interleucina-6/análise , Contagem de Leucócitos/métodos , Contagem de Linfócitos/métodos , Pandemias , Contagem de Plaquetas/métodos , Fatores de Risco , Índice de Gravidade de Doença
3.
Spine (Phila Pa 1976) ; 45(5): 349-356, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32045405

RESUMO

STUDY DESIGN: Retrospective cohort study of prospectively collected data. OBJECTIVE: Assess correlation between preoperative platelet counts and postoperative adverse events after elective posterior lumbar surgery procedures. SUMMARY OF BACKGROUND DATA: Preoperative low platelet counts have been correlated with adverse outcomes after posterior lumbar surgery. Nonetheless, the effect of varying platelet counts has not been studied in detail for a large patient population, especially on the high end of the platelet spectrum. METHODS: Patients who underwent elective posterior lumbar surgery were identified in the 2011 to 2016 National Surgical Quality Improvement Program database. Preoperative platelet counts were considered relative to 30-day perioperative adverse outcomes. Patients were classified into platelet categories based on determining upper and lower bounds on when the adverse outcomes crossed a relative risk of 1.5. Univariate and multivariate analyses compared 30-day postoperative complications, readmissions, operative time, and hospital length of stay between those with low, normal, and high platelet counts. RESULTS: In total, 137,709 posterior lumbar surgery patients were identified. Using the relative risk threshold of 1.5 for the occurrence of any adverse event, patients were divided into abnormally low (≤140,000/mL) and abnormally high (≥447,000/mL) platelet cohorts. The abnormally low and high platelet groups were associated with higher rates of any, major, minor adverse events, transfusion, and longer hospital length of stay. Furthermore, the abnormally low platelet counts were associated with a higher risk of readmissions. CONCLUSION: The data-based cut-offs for abnormally high and low platelet counts closely mirrored those found in literature. Based on these definitions, abnormally high and low preoperative platelet counts were associated with adverse outcomes after elective posterior lumbar surgery. These findings facilitate risk stratification and suggest targeted consideration for patients with high, as well as low, preoperative platelet counts. LEVEL OF EVIDENCE: 3.


Assuntos
Procedimentos Cirúrgicos Eletivos/efeitos adversos , Vértebras Lombares/cirurgia , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/etiologia , Cuidados Pré-Operatórios/métodos , Adolescente , Adulto , Idoso , Estudos de Coortes , Bases de Dados Factuais/tendências , Procedimentos Cirúrgicos Eletivos/tendências , Feminino , Humanos , Tempo de Internação/tendências , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/métodos , Contagem de Plaquetas/tendências , Cuidados Pré-Operatórios/tendências , Estudos Prospectivos , Estudos Retrospectivos , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Adulto Jovem
4.
Med Sci Monit ; 25: 9882-9886, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31868169

RESUMO

BACKGROUND Platelets are considered to be essential in proinflammatory environments, including atherosclerosis. The degree of platelet activation has been demonstrated to be correlated with plateletcrit and platelet distribution width. The main purpose of this study was to assess the relationship between plateletcrit (PCT), platelet distribution, and the degree of hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD). MATERIAL AND METHODS We enrolled 225 biopsy-proven NAFLD patients and 142 control subjects without NAFLD. NAFLD patients were separated into 2 groups according to percentage of steatosis. Demographic and clinical data were collected retrospectively. RESULTS PCT level was significantly higher in NAFLD group I and group II than in the control group. PCT was higher in the NAFLD groups than in the control group. However, there was no difference according to PCT and PDW levels between NAFLD groups. CONCLUSIONS In this study, a relationship was found between PCT and hepatosteatosis, but no relationship was found with PDW. PCT might be a useful biomarker for early detection of steatohepatitis in patients with nan-alcoholic fatty liver disease.


Assuntos
Plaquetas/metabolismo , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/metabolismo , Adulto , Biomarcadores , Estudos de Casos e Controles , Fígado Gorduroso/sangue , Fígado Gorduroso/metabolismo , Feminino , Humanos , Masculino , Volume Plaquetário Médio/métodos , Pessoa de Meia-Idade , Ativação Plaquetária/fisiologia , Contagem de Plaquetas/métodos , Curva ROC , Estudos Retrospectivos
5.
Medicina (Kaunas) ; 55(11)2019 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-31744048

RESUMO

Background and Objectives: The mean platelet volume (MPV) represents a possible marker of platelet activation. There is an association between the platelet count (PC) and inflammation and platelet reactivity. We assessed the association between the MPV/PC ratio and circadian alterations in blood pressure (BP). Material and Methods: One hundred and twenty subjects in total, 80 hypertensive subjects and 40 healthy subjects (controls), were enrolled in the study group. Twenty four hour ambulatory BP monitoring (ABPM) was applied to all subjects. According to ABPM results, the hypertensive subjects were separated into two groups, such as dippers (n = 40) and non-dippers (n = 40). In all subjects, the collection of venous peripheral blood samples was performed on admission for PC and MPV measurements. Results: The two groups exhibited similar clinical baseline characteristics. A significantly higher MPV/PC ratio was determined in non-dippers compared to that in dippers and normotensives. The higher MPV/PC ratio was observed in non-dippers in comparison with that in dippers and normotensives (0.046 ± 0.007 to 0.032 ± 0.004 fL/[109/L]; 0.046 ± 0.007 to 0.026 ± 0.004 fL/[109/L], p < 0.001, respectively). A receiver operating characteristic (ROC) curve analysis showed that the optimum cut-off value of the MPV/PC ratio for predicting non-dipping patterns in hypertensive patients was 0.036 (area under the curve [AUC]: 0.98, p < 0.001). According to the cut-off value, sensitivity and specificity were found to be 95% and 95%, respectively. Conclusions: The higher MPV/PC ratio was determined in non-dipper hypertensive subjects in comparison with that in dipper hypertensive subjects. An elevation of platelet activity and an increase in thrombus burden are reflected by an increase in the MPV/PC ratio. The MPV/PC ratio may underlie the increase in cardiovascular risk in non-dippers compared to that in dippers.


Assuntos
Pressão Sanguínea/fisiologia , Contagem de Plaquetas/classificação , Adulto , Plaquetas , Determinação da Pressão Arterial/métodos , Monitorização Ambulatorial da Pressão Arterial/métodos , Distribuição de Qui-Quadrado , Correlação de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/métodos , Contagem de Plaquetas/estatística & dados numéricos
6.
Thromb Res ; 183: 36-44, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31614293

RESUMO

INTRODUCTION: Sarcopenia is attracting increasing attention due to its harmful impacts on health. Chronic inflammation is proposed to be a major cause of sarcopenia. Here, we aimed to identify whether white blood cell (WBC) and platelet count have independent roles in sarcopenia occurrence. METHOD AND MATERIALS: This cross-sectional study analyzed 10,092 adults (4293 men and 5799 women) from the 2008-2011 Korea National Health and Nutrition Survey. Cut-off values for sarcopenia were defined as a skeletal muscle mass index <0.789 for men and <0.512 for women. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis after adjusting for confounding variables. ROC curve analysis was used to evaluate the ability of platelet count and white blood cell count to discriminate the presence of sarcopenia. RESULTS: After adjusting for possible confounders, the OR (95% CI) for sarcopenia occurrence according to platelet counts was 1.62 (1.20-2.19) for the T3 group in men and 1.72 (1.28-2.31) for the T3 group in women, relative to the lowest platelet count tertile. After adjusting for same confounders, the ORs (95% CI) for sarcopenia occurrence according to WBC counts was 1.86 (1.35-2.57) for the T3 group in men, and 2.36 (1.77-3.13) for the T3 group in women, relative to the lowest WBC count tertile. We also found independent significant associations between platelet count, WBC count, and sarcopenia. CONCLUSIONS: Higher platelet and WBC counts within the normal range are each independently associated with sarcopenia in Korean men and women. The inclusion of platelet, WBC, or combined platelet and WBC counts significantly improved the power to discriminate sarcopenia.


Assuntos
Contagem de Leucócitos/métodos , Contagem de Plaquetas/métodos , Sarcopenia/sangue , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
7.
Medicine (Baltimore) ; 98(39): e17300, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574855

RESUMO

We investigated associations between inflammatory marker levels and hepatitis C virus (HCV)-related compensated liver cirrhosis risk in patients with chronic hepatitis C (CHC) infection in China. We used a case-control design and data from the records of 110 Chinese patients with CHC and cirrhosis for the study; 458 CHC patients who did not have a diagnosis of cirrhosis were matched to the case group by age and sex characteristics. We also investigated fatty liver disease risk factors. The group of patients with CHC infection and cirrhosis had lower platelet-to-lymphocyte ratio (PLR) values (60.63 [44.09, 89.31]) compared with the control group patients (80.24 [57.85, 111.08]). The results indicated that the group of patients with cirrhosis had higher 4-factor fibrosis index and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) values compared with the group of patients with CHC-only (1.66 [0.98, 2.60] vs 0.71 [0.45, 1.17], respectively; P < .001 and 2.12 [0.97, 4.25] vs 0.99 [0.51, 2.01], respectively; P < .001). Compared with the control group, the AST/alanine aminotransferase ratio (AAR) values in the group of patients with cirrhosis were significantly higher (P < .001). Logistic regression analysis that included model adjustment for demographic characteristics and other factors that could affect cirrhosis risk revealed that greater 1/PLR values were associated with an increased odds of having cirrhosis (adjusted odds ratio [AOR], 95% confidence interval [CI] 0.991 [0.985-0.996]); APRI and AAR values were also independent predictors of the presence of compensated cirrhosis. We found that compared with the patients with CHC-only, the triglyceride, cholesterol, and low-density lipoprotein cholesterol levels in the patients with both CHC and fatty liver disease were significantly higher. The multivariate analysis of the risk of fatty liver development in patients with CHC infection found that cholesterol level was a statistically significant risk factor (AOR [95% CI] 1.380 [1.089-1.750], P = .008). Increased 1/PLR, APRI, and AAR values were associated with increased risks for development of cirrhosis in this population of Chinese patients with CHC infection. Higher cholesterol levels increased the risk of development of fatty liver disease in patients with CHC.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Hepatite C Crônica , Cirrose Hepática , Biomarcadores/sangue , Estudos de Casos e Controles , China/epidemiologia , Fígado Gorduroso/sangue , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/epidemiologia , Feminino , Hepacivirus/isolamento & purificação , Hepatite C Crônica/sangue , Hepatite C Crônica/complicações , Hepatite C Crônica/epidemiologia , Humanos , Lipoproteínas/sangue , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico , Cirrose Hepática/epidemiologia , Cirrose Hepática/etiologia , Contagem de Linfócitos/métodos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/métodos , Fatores de Risco
9.
Int J Immunopathol Pharmacol ; 33: 2058738419872120, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31438744

RESUMO

The treatment of severe chronic immune thrombocytopenia (SCITP) in pediatric patients is challenging. We evaluated the clinical efficacy and safety of eltrombopag in children with SCITP in China. This observational study was carried out at the Hematology Oncology Center, Beijing Children's Hospital between April 2017 and July 2018. Patients with SCITP who had at least 12 weeks of eltrombopag treatment and follow-up data were included. Baseline data, such as age, drug dosage, pre-study platelet count, concomitant medications, and bleeding severity, were collected. Treatment response rates, durable response rates, bleeding events, and adverse events were assessed during eltrombopag therapy for at least 12 weeks. The median duration of eltrombopag therapy was 16 (12-48) weeks. The overall, complete, and partial response rates were 75% (15/20), 35% (7/20), and 40% (8/20), respectively. The durable response rate was 70% (14/20). No serious bleeding events or serious adverse events occurred during the study period. Eltrombopag appears to be effective and safe in children with SCITP, although additional research is needed to confirm this.


Assuntos
Benzoatos/efeitos adversos , Benzoatos/uso terapêutico , Doença Crônica/tratamento farmacológico , Hidrazinas/efeitos adversos , Hidrazinas/uso terapêutico , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Pirazóis/efeitos adversos , Pirazóis/uso terapêutico , Adolescente , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Masculino , Contagem de Plaquetas/métodos , Resultado do Tratamento
11.
Pesqui. vet. bras ; 39(8): 614-621, Aug. 2019. tab, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1040736

RESUMO

This study compared two protocols for preparation of platelet rich plasma (PRP) and evaluated the association between manual and automated methods for platelet count using a prospective study design. Eight clinically healthy Quarter Horses had venous blood samples collected at rest. After collection, blood samples were centrifuged twice, using two different protocols including a period of sample resting, either at the start or at the end of the protocol. Platelet counting at the start of the protocol, during, and after obtaining PRP was conducted manually or with an automated counter, followed by comparison of the two methods. In order to investigate platelet degranulation during the protocol, vascular endothelial growth factor (VEGF) was measured at each preparation stage. The protocol with sample resting before centrifugation yielded a more concentrated PRP, and the study verified that both manual and automated methods are comparable and can be used interchangeably for platelet counting. VEGF concentration did not differ significantly between protocols, or among protocol stages. The results indicate that choice of protocol for PRP preparation will affect the quantity of platelets in the final product, although platelet degranulation was not observed as evidenced by the stable VEGF concentrations measured. A larger yield of non-degranulated platelets in PRP is desirable since more α-granules will be present, therefore Protocol II is recommended. Both manual and automated counts reliably allow clinicians to obtain platelet counts and the choice of utilizing a manual or automated method is unlikely to interfere with evaluation of the final PRP product.(AU)


Este estudo comparou dois protocolos de preparo de plasma rico em plaquetas (PRP) e avaliou a associação entre dois métodos de contagem plaquetária - um manual e o outro automático através de um estudo prospectivo. Sangue venoso de oito equinos da raça Quarto de Milha foi coletado e em seguida foi centrifugado duas vezes utilizando-se dois protocolos distintos: um com descanso antes da primeira centrifugação e outro após a segunda centrifugação. A contagem plaquetária ao início, no meio e ao final dos protocolos foi realizada manualmente e pelo método automatizado, seguida de comparação entre os dois métodos. Para investigar a degranulação plaquetária ocorrida durante o preparo do PRP, o fator de crescimento vascular endotelial (VEGF) foi mensurado em cada estágio dos protocolos. O método utilizando o descanso da amostra antes da primeira centrifugação proporcionou a obtenção de um PRP mais concentrado, além de o estudo verificar que ambos os métodos de contagem plaquetária (manual e automatizado) são comparáveis e podem ser usados indiferentemente. A concentração de VEGF não foi significativamente diferente entre os estágios de preparo do PRP. Os resultados indicam que o método de preparo afeta a quantidade de plaquetas obtidas no PRP, apesar da degranulação plaquetária não ter sido observada, como evidenciado pela concentração estável de VEGF. Uma maior concentração de plaquetas no PRP é desejável, pois indica que um maior número de α-grânulos estará presente na amostra, portanto, conclui-se que o Protocolo II é mais recomendável. Tanto o método manual, quanto o automatizado, pode ser usado de maneira confiável para a contagem plaquetária, não interferindo com a avaliação do produto final (PRP).(AU)


Assuntos
Animais , Contagem de Plaquetas/métodos , Contagem de Plaquetas/veterinária , Fator A de Crescimento do Endotélio Vascular , Plasma Rico em Plaquetas , Cavalos/sangue
12.
J Perinat Med ; 47(7): 775-779, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31318695

RESUMO

Objective To assess the association between fetal malnutrition (FM) and the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) in singleton term appropriate for gestational age (AGA) neonates. Methods This cross-sectional observational study was performed with 4340 singleton, term AGA neonates without perinatal disease over a two-year period. Results A total of 4320 neonates were evaluated in this study. Those diagnosed with fetal malnutrition, 284 (6%) neonates, were compared with 150 healthy term AGA neonates. Gestational week, birth weight, birth height, head circumference, maternal age, last pregnancy weight, and status of income of the FM group were found to be lower when compared to the control group (P = 0.011). Low last pregnancy weight (P = 0.017) and low level of income (P = 0.042) were found to be factors that affect the presence of FM. The NLR and PLR were found to be significantly higher in the FM group compared with term AGA healthy controls. In correlation analyses, there was a negative correlation between the NLR and PLR with fetal nutritional status (P = 0.011 and P < 0.001, respectively). When the NLR level was taken as 4.51, the sensitivity and specificity of the test for FM were calculated as 81.2% and 80.8%, respectively [area under the receiver-operating characteristic curve (AUROC): 0.81]; when the PLR level was taken as 155.4, the sensitivity and specificity of the test for FM were calculated as 87.0% and 85.4%, respectively (AUROC: 0.94). Conclusion Cord-blood NLR and PLR negatively correlate with term FM AGA neonates.


Assuntos
Sangue Fetal/citologia , Transtornos da Nutrição Fetal , Contagem de Linfócitos/métodos , Neutrófilos , Contagem de Plaquetas/métodos , Peso ao Nascer/fisiologia , Estudos Transversais , Feminino , Transtornos da Nutrição Fetal/sangue , Transtornos da Nutrição Fetal/diagnóstico , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Gravidez , Prognóstico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
13.
Complement Ther Med ; 45: 262-268, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331572

RESUMO

BACKGROUND: Using Achillea wilhelmsii as a dietary supplement for gastrointestinal disorders is common in Persian traditional medicine. Its anti-inflammatory, anti-spasmodic and antibacterial properties have been proven by different in vitro and in vivo studies, yet it has not been evaluated in a controlled clinical trial. AIM: This study intended to evaluate the efficacy and safety of A. wilhelmsii in patients with mild to moderate active ulcerative colitis in a randomized, double-blinded, placebo-controlled clinical trial. The hydroalcoholic extract of A. wilhelmsii was standardized based on caffeic acid. METHODS: Forty-nine patients were randomly received A. wilhelmsii capsules or placebo, twice daily for 4 weeks in a 1:1 ratio. The disease activity index (DAI) (Partial Mayo Score), haemoglobin, platelet count, erythrocyte sedimentation rate (ESR) and serum level of C-reactive protein (CRP) were measured at the entry and the end of the treatment. To standardize the extract, caffeic acid was detected and measured in the plant extract using high performance liquid chromatography (HPLC). RESULTS: Of 49 patients who entered the trial, 40 patients completed the study. In both treatment and placebo groups, significant reductions were observed in stool frequency, rectal bleeding, physician global assessment and partial mayo score. There was no significant difference in stool frequency (P = 0.176), rectal bleeding (P = 0.523), physician global assessment (P = 0.341) and partial mayo score (P = 1) in the treatment versus the placebo groups. Laboratory variables including hemoglobin, platelet count, ESR and CRP showed no significant difference between the treatment and the placebo group. Of all participants, only one patient in the treatment group complained about skin rash (grade 1 based on the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0). CONCLUSION: Oral administration of A. wilhelmsii powder for 4 weeks did not create a clinical response more than placebo. It seemed to be safe in UC patients. Further studies are obligatory to evaluate the therapeutic potential of A. wilhelmsii in the form of extract in UC patients.


Assuntos
Achillea/efeitos adversos , Achillea/química , Colite Ulcerativa/tratamento farmacológico , Extratos Vegetais/efeitos adversos , Extratos Vegetais/uso terapêutico , Administração Oral , Adulto , Proteína C-Reativa/metabolismo , Ácidos Cafeicos/efeitos adversos , Ácidos Cafeicos/uso terapêutico , Colite Ulcerativa/metabolismo , Método Duplo-Cego , Eritrócitos/efeitos dos fármacos , Feminino , Hemoglobinas/efeitos dos fármacos , Humanos , Masculino , Contagem de Plaquetas/métodos
14.
Int J Lab Hematol ; 41(5): 657-663, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31271528

RESUMO

INTRODUCTION: Abbott Alinity hq is a next-generation automated hematology analyzer providing complete blood count (CBC) with 6-part white blood cells (WBC) differential counts. The purpose of this study was to evaluate the performance of the analyzer to verify the diagnostic and clinical utility of the Abbott Alinity hq automated system. METHODS: We evaluated specimen stability, precision, linearity, carry-over, and method comparison to assess the performance of Alinity hq. For comparison of the Alinity hq with Sysmex XN-9000, totally 314 samples from adult and pediatric patients including both normal and abnormal hematology profiles were analyzed in parallel. The Alinity hq was also compared with the manual differential counts for the same 314 samples. RESULTS: At 4°C, the Alinity hq analyzer showed no significant changes in CBC and WBC differential count up to 48 hours. When stored at room temperature (18-25°C), all parameters except the mean platelet volume (MPV) were stable up to 36 hours. The Abbott Alinity hq analyzer demonstrated excellent reproducibility and between-batch precision for all CBC and WBC differential parameters. WBC, red blood cells (RBC), hemoglobin (HGB), and platelets showed good linearity and acceptable carry-over. Comparison with a Sysmex XN-9000 analyzer and manual 400-cell differential showed excellent correlation for CBC and WBC differential count parameters (correlation coefficient = 0.815-0.999) except for mean corpuscular hemoglobin concentration (MCHC) and basophils. CONCLUSION: We performed initial validation studies and confirmed performance specifications on specimen stability, precision, linearity, carry-over, and method comparison. The Abbott Alinity hq analyzer showed good analytical performance for all standard CBC parameters.


Assuntos
Contagem de Células Sanguíneas/instrumentação , Contagem de Eritrócitos/instrumentação , Hematologia/instrumentação , Hemoglobinas/análise , Contagem de Leucócitos/instrumentação , Contagem de Plaquetas/instrumentação , Adulto , Contagem de Células Sanguíneas/métodos , Criança , Contagem de Eritrócitos/métodos , Hematologia/métodos , Humanos , Contagem de Leucócitos/métodos , Contagem de Plaquetas/métodos , Reprodutibilidade dos Testes
15.
Medicina (Kaunas) ; 55(6)2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31141974

RESUMO

Background and Objectives: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and other components of the routine complete blood count (CBC) were found to be sensitive biomarkers of preeclampsia and other inflammatory obstetric conditions in previous studies, with conflicting results. We speculated that the same associations existed with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome in the first trimester of pregnancy. Materials and Methods: We conducted a retrospective case-control study at a tertiary care hospital in NY (USA), in the time frame between January 2016 and December 2018. Our population consisted of pregnant women in the first trimester: We compared patients with HELLP syndrome (cases) with healthy patients (controls) matched by age, body mass index (BMI), parity, and race. Patients with preeclampsia, infection, and fever were excluded. Venous blood samples were obtained as part of the routine work-up during the first prenatal visit in the first trimester, which includes a CBC. The main outcomes were NLR and PLR, and the secondary outcomes were hemoglobin, RDW, platelet count, MPV, neutrophils, and lymphocytes. Results: There were 10 patients in each group (Table 1). There were no differences in NLR and PLR levels and other CBC components between the two groups (Table 2). Conclusions: In our study NLR, PLR, and other CBC components did not predict HELLP syndrome. We speculate that HELLP syndrome has a sudden increase of tissue inflammation in the third trimester that is not manifested during the early phases of placentation. Larger studies are needed to evaluate the true ability of NLR, PLR, and CBC components to predict HELLP syndrome in the first trimester.


Assuntos
Contagem de Células Sanguíneas/classificação , Síndrome HELLP/diagnóstico , Valor Preditivo dos Testes , Primeiro Trimestre da Gravidez/sangue , Adulto , Biomarcadores/análise , Biomarcadores/sangue , Contagem de Células Sanguíneas/métodos , Contagem de Células Sanguíneas/estatística & dados numéricos , Estudos de Casos e Controles , Feminino , Síndrome HELLP/sangue , Humanos , Contagem de Linfócitos/métodos , Contagem de Linfócitos/estatística & dados numéricos , Neutrófilos , New York , Contagem de Plaquetas/métodos , Contagem de Plaquetas/estatística & dados numéricos , Gravidez , Primeiro Trimestre da Gravidez/fisiologia , Estudos Retrospectivos
16.
PLoS One ; 14(5): e0217298, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31125378

RESUMO

OBJECTIVE: The aim of this study is to evaluate the performance of different platelet counting methods (optical, impedance, fluorescence and hand counting) applied in different analysers by comparing with the international flow cytometric reference method (IRM). METHODS: A total of 333 blood samples from different subgroups (168 cases with thrombocytopenia, 136 cases with normal platelet counts and 29 cases with thrombocytosis) were tested. Regarding IRM as the gold standard, we compared the accuracy and precision of different platelet count methods; i.e. LH780 (impedance), BC-6000 Plus (optical (O) and impedance (I)), Sysmex XN-9000 (optical (O), impedance (I), fluorescence (F)), and hand counting. RESULTS: Sysmex XN-9000-F (r = 0.988) had the best correlation with IRM for thrombocytopenic samples; BC-6000 Plus-I (r = 0.966) was more relevant to IRM than any other method for samples with normal platelet counts. Correlation between Sysmex XN-9000-I (r = 0.960) and IRM was the highest among these methods for samples with thrombocytosis. For bias evaluation, the average bias of Sysmex XN-9000-F was -1.5 × 109/L (95% LA = -9.4 to +6.4) for samples with thrombocytopenia, compared with IRM. BC-6000 Plus-I had a small mean difference with IRM for samples with normal platelet counts or thrombocytosis. Moreover, all evaluated methods had acceptable sensitivity, specificity, and concordance rates as compared with IRM in the diagnosis of thrombocytopenia and thrombocytosis. CONCLUSIONS: Platelet counting by Sysmex XN-9000-F is more accurate than other methods for thrombocytopenic samples. BC-6000 Plus-I has superior association and consistency for normal platelet counts. As for thrombocytosis patients, Sysmex XN-9000-I has the highest correlation with IRM while Sysmex XN-9000-O has the highest diagnosis efficacy.


Assuntos
Citometria de Fluxo/instrumentação , Contagem de Plaquetas/instrumentação , Trombocitose/sangue , Citometria de Fluxo/métodos , Citometria de Fluxo/normas , Humanos , Contagem de Plaquetas/métodos , Contagem de Plaquetas/normas , Padrões de Referência , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Trombocitopenia/sangue
17.
Angiology ; 70(9): 867-877, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31088127

RESUMO

The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Antiplatelet Therapy (PRECISE-DAPT) score has been validated to predict bleeding complications in patients undergoing stent implantation and dual antiplatelet therapy. This score does not include the platelet count (PC), which has been shown to be an independent marker of mortality in patients with acute coronary syndrome (ACS). We assessed the role of the PRECISE-DAPT score calculated on admission for mortality risk prediction and evaluated whether the predictive accuracy of this score improved by adding the PC. In a retrospective cohort study of 1000 patients with ACS, after adjustment for relevant covariates, a PRECISE-DAPT score ≥25 was independently associated with mortality (hazard ratio [HR]: 7.91; 95% confidence interval [CI]: 4.37-14.30). When this score was combined with PC, compared to patients with PRECISE-DAPT <25 and PC ≥150 × 109/L, the adjusted HR was 7.2 (95% CI 2.4-21.6) for those with PRECISE-DAPT <25 and PC <150 × 109/L; 10.7 (95% CI: 5.2-21.9) for those with PRECISE-DAPT ≥25 and PC ≥150 × 109/L; and 17.9 (95% CI 7.0-45.4) for those with PRECISE-DAPT ≥25 and PC <150 × 109/L. Selecting thresholds for high-risk designation, the PRECISE-DAPT score integrated with PC had a higher prediction value, compared to the PRECISE-DAPT and Global Registry of Acute Coronary Events scores.


Assuntos
Síndrome Coronariana Aguda/mortalidade , Stents Farmacológicos/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Contagem de Plaquetas , Valor Preditivo dos Testes , Síndrome Coronariana Aguda/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/complicações , Quimioterapia Combinada/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/mortalidade , Inibidores da Agregação de Plaquetas/uso terapêutico , Contagem de Plaquetas/métodos , Antagonistas do Receptor Purinérgico P2Y/uso terapêutico , Medição de Risco
18.
BMC Pediatr ; 19(1): 138, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-31039810

RESUMO

OBJECTIVE: To evaluate the association between hematological parameters at birth and the risk of moderate-severe bronchopulmonary dysplasia (BPD) in a cohort of extremely preterm infants. METHODS: This is a retrospective study of all extremely premature infants admitted to the neonatal intensive care unit, Shenzhen Maternity and Child Healthcare Hospital from January 2016 to May 2018. Extremely prematurity was defined as a delivery at a gestational age ≤ 28 weeks or a birth weight ≤ 1000 g. BPD was diagnosed if oxygen exposure exceeded 28 days and the severity was decided at 36 weeks PMA or discharge. Multivariable analysis was performed to assess the independence of the association between hematological parameters at birth and risk of moderate or severe BPD. RESULTS: A total of 115 extremely premature infants were analyzed in this study. The median platelet count, neutrophil and monocyte count at birth were significantly higher in infants with moderate-severe BPD compared to infants without BPD (228 vs 194*109/l, P = 0.004; 5.0 vs 2.95*109/l, P = 0.023; 0.88 vs 0.63*109/l, P = 0.026, respectively) whereas the mean platelet volume was significantly lower in infants with moderate-severe BPD than those without BPD (9.1 vs 9.4 fl, P = 0.002). After adjusting for covariates, the risk of moderate-severe BPD was independently associated with platelet count≥207*109/l (odds ratio 3.794, 95% confidence interval: 1.742-8.266, P = 0.001). CONCLUSION: Our findings suggest that hematologic parameters at birth are different in extremely preterm infants who will develop moderate-severe BPD. A higher platelet count at birth may increase the risk of moderate-severe BPD after extremely premature birth.


Assuntos
Displasia Broncopulmonar/sangue , Cuidados Críticos/métodos , Mortalidade Hospitalar/tendências , Lactente Extremamente Prematuro , Contagem de Plaquetas/métodos , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Índice de Apgar , Peso ao Nascer , Análise Química do Sangue , Displasia Broncopulmonar/diagnóstico , Displasia Broncopulmonar/epidemiologia , China , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Modelos Logísticos , Masculino , Análise Multivariada , Gravidez , Prognóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Análise de Sobrevida
20.
J BUON ; 24(2): 585-590, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31128010

RESUMO

PURPOSE: To investigate the correlations of coagulation indexes and inflammatory changes with the prognosis of lung cancer (LC) patients complicated with thromboembolic (TE) disease. METHODS: A total of 84 LC patients complicated with TE disease admitted to hospital from January 2010 to January 2016 were enrolled in this study and their clinical data were retrospectively analyzed. A 2-year post-treatment follow-up was carried out. According to the prognosis, patients were divided into 2 groups as dead group (n=25) and alive group (n=59). The coagulation indexes and inflammatory factor levels before low-molecular weight heparin (LMWH) treatment and on the 1st, 3rd, and 7th day after treatment were compared between the two groups. Their relations with the prognosis of patients were analyzed using Pearson method. RESULTS: No statistically significant difference was found in the prothrombin time (PT), levels of Fibrinogen (FIB), D-Dimer (D-D), Interleukin-6 (IL-6) and Procalcitonin (PCT), and activated partial thromboplastin time (APTT) before treatment between the two groups (p>0.05). The PT and levels of FIB, D-D, IL-6, and PCT on the 1st, 3rd, and 7th day after treatment were significantly increased in the dead group compared to those in the alive group, while the APTT was remarkably shortened. Moreover, the PT was gradually prolonged and FIB, D-D, IL-6 and PCT levels were increased in the dead group , but the APTT was gradually shortened over time (p<0.05). The poor prognosis of LC patients complicated with TE disease was positively correlated with PT, FIB, D-D, IL-6 and PCT, but negatively correlated with APTT (p<0.05). CONCLUSION: The poor prognosis of LC complicated with TE disease has positive correlations with PT, FIB, D-D, IL-6 and PCT, and a negative association with APTT, providing a certain reference as a prognostic value in the diagnosis and treatment.


Assuntos
Inflamação/epidemiologia , Neoplasias Pulmonares/epidemiologia , Prognóstico , Tromboembolia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Testes de Coagulação Sanguínea , Feminino , Humanos , Inflamação/complicações , Inflamação/patologia , Interleucina-6/metabolismo , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/métodos , Tempo de Protrombina , Tromboembolia/complicações , Tromboembolia/metabolismo , Tromboembolia/patologia
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