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2.
Pharmacol Res ; 157: 104866, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32387301

RESUMO

COVID-19 is a medical emergency, with 20 % of patients presenting with severe clinical manifestations. From the pathogenetic point of view, COVID-19 mimics two other well-known diseases characterized by cytokine storm and hyper-activation of the immune response, with consequent organ damage: acute graft-versus-host disease (aGVHD) and macrophage activation syndrome (MAS). Hematologists are confident with these situations requiring a prompt therapeutic approach for switching off the uncontrolled cytokine release; here, we discuss pros and cons of drugs that are already employed in hematology in the light of their possible application in COVID-19. The most promising drugs might be: Ruxolitinib, a JAK1/2 inhibitor, with a rapid and powerful anti-cytokine effect, tyrosine kinase inhibitors (TKIs), with their good anti-inflammatory properties, and perhaps the anti-Cd26 antibody Begelomab. We also present immunological data from gene expression experiments where TKIs resulted effective anti-inflammatory and pro-immune drugs. A possible combined treatment algorithm for COVID-19 is here proposed.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Hematologia/métodos , Pneumonia Viral/tratamento farmacológico , Betacoronavirus/efeitos dos fármacos , Doença Enxerto-Hospedeiro/tratamento farmacológico , Humanos , Síndrome de Ativação Macrofágica/tratamento farmacológico , Pandemias
3.
Int J Lab Hematol ; 42 Suppl 1: 11-18, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32311826

RESUMO

The ongoing COVID-19 pandemic originated in Wuhan, Hubei Province, China, in December 2019. The etiologic agent is a novel coronavirus of presumed zoonotic origin with structural similarity to the viruses responsible for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). Like SARS and MERS, COVID-19 infection manifests most frequently with lower respiratory symptoms. A minority of patients progress to acute respiratory distress syndrome/ diffuse alveolar damage. In addition to its central role in the diagnosis of COVID-19 infection, the clinical laboratory provides critical information to clinicians regarding prognosis, disease course, and response to therapy. The purpose of this review is to (a) provide background context about the origins and course of the pandemic, (b) discuss the laboratory's role in the diagnosis of COVID-19 infection, (c) summarize the current state of biomarker analysis in COVID-19 infection, with an emphasis on markers derived from the hematology laboratory, (d) comment on the impact of COVID-19 on hematology laboratory safety, and (e) describe the impact the pandemic has had on organized national and international educational activities worldwide.


Assuntos
Betacoronavirus/isolamento & purificação , Serviços de Laboratório Clínico/organização & administração , Infecções por Coronavirus/epidemiologia , Linfopenia/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Trombocitopenia/epidemiologia , Anticorpos Antivirais/sangue , Betacoronavirus/patogenicidade , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , China/epidemiologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/transmissão , Hematologia/métodos , Humanos , Incidência , Itália/epidemiologia , Laboratórios/organização & administração , Linfopenia/diagnóstico , Linfopenia/fisiopatologia , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Pneumonia Viral/transmissão , Pró-Calcitonina/sangue , Distância Social , Trombocitopenia/diagnóstico , Trombocitopenia/fisiopatologia , Estados Unidos/epidemiologia , Proteínas Virais/sangue
4.
Nat Commun ; 11(1): 1162, 2020 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-32139684

RESUMO

By virtue of the combined merits of flow cytometry and fluorescence microscopy, imaging flow cytometry (IFC) has become an established tool for cell analysis in diverse biomedical fields such as cancer biology, microbiology, immunology, hematology, and stem cell biology. However, the performance and utility of IFC are severely limited by the fundamental trade-off between throughput, sensitivity, and spatial resolution. Here we present an optomechanical imaging method that overcomes the trade-off by virtually freezing the motion of flowing cells on the image sensor to effectively achieve 1000 times longer exposure time for microscopy-grade fluorescence image acquisition. Consequently, it enables high-throughput IFC of single cells at >10,000 cells s-1 without sacrificing sensitivity and spatial resolution. The availability of numerous information-rich fluorescence cell images allows high-dimensional statistical analysis and accurate classification with deep learning, as evidenced by our demonstration of unique applications in hematology and microbiology.


Assuntos
Citometria de Fluxo/métodos , Ensaios de Triagem em Larga Escala/métodos , Processamento de Imagem Assistida por Computador/métodos , Microscopia de Fluorescência/métodos , Aprendizado Profundo , Euglena gracilis , Estudos de Viabilidade , Citometria de Fluxo/instrumentação , Hematologia/instrumentação , Hematologia/métodos , Ensaios de Triagem em Larga Escala/instrumentação , Humanos , Processamento de Imagem Assistida por Computador/instrumentação , Células Jurkat , Técnicas Microbiológicas/instrumentação , Microscopia de Fluorescência/instrumentação , Sensibilidade e Especificidade
5.
Vet Clin North Am Equine Pract ; 36(1): 15-33, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31959376

RESUMO

This article uses a case-based approach, complemented with diagnostic algorithms and images, to highlight hematologic changes of pathologic relevance in horses, namely, marked erythrocytosis, anemia or leukocytosis, inflammatory leukograms, lymphocytosis in adult horses, thrombocytopenia, and pancytopenia. These hematologic abnormalities occur with certain diseases and their identification can help clinicians narrow to down differential diagnostic lists. This article highlights the importance of blood smear examination, particularly, but not only, when numerical red flags are identified on automated blood counts.


Assuntos
Doenças dos Cavalos/sangue , Cavalos/sangue , Animais , Técnicas Citológicas/métodos , Técnicas Citológicas/veterinária , Feminino , Hematologia/métodos , Masculino
7.
Nutrients ; 11(11)2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31739525

RESUMO

In athletes, no reliable indices exist for an unambiguous evaluation of hematological and iron status. Therefore, the utility of some new red blood cell (RBC) parameters was explored in 931 elite male athletes aged 13-35 years. To diagnose iron status, the values of ferritin and soluble transferrin receptor (sTfR), total iron binding capacity (TIBC), and basic blood morphology were determined in blood. The new hematological markers included among others: mean cellular hemoglobin content in reticulocytes (CHr), percentage of erythrocytes (HYPOm) and reticulocytes (HYPOr) with decreased cellular hemoglobin concentration, percentage of erythrocytes (LowCHm) and reticulocytes (LowCHr) with decreased cellular hemoglobin content, mean volume of reticulocytes (MCVr), and percentage of erythrocytes with decreased volume (MICROm). Despite adverse changes in reticulocyte hypochromia indices (CHr, LowCHr, HYPOr; p < 0.001) in the iron depletion state, the area under the receiver operating characteristic curve (AUC-ROC) values calculated for them were relatively low (0.539-0.722). In iron-deficient erythropoiesis (IDE), unfavorable changes additionally concern microcythemia indices in both reticulocytes and erythrocytes (MCVr, MCV, MICROm, and red cell volume distribution width-RDW), with especially high values of AUC-ROC (0.947-0.970) for LowCHm, LowCHr, and CHr. Dilutional sports anemia was observed in 6.1% of athletes. In this subgroup, only hemoglobin concentration (Hb), hematocrit (Hct), and RBC (all dependent on blood volume) were significantly lower than in the normal group. In conclusion, the diagnostic utility of the new hematology indices was not satisfactory for the detection of an iron depletion state in athletes. However, these new indices present high accuracy in the detection of IDE and sports anemia conditions.


Assuntos
Anemia Ferropriva/sangue , Desempenho Atlético , Eritrócitos/metabolismo , Hematologia/métodos , Hemoglobinas/metabolismo , Ferro/sangue , Reticulócitos/metabolismo , Adolescente , Adulto , Anemia , Área Sob a Curva , Atletas , Biomarcadores/sangue , Aptidão Cardiorrespiratória , Índices de Eritrócitos , Eritropoese , Ferritinas/sangue , Hematócrito , Humanos , Masculino , Estado Nutricional , Curva ROC , Receptores da Transferrina , Medicina Esportiva , Adulto Jovem
8.
Indian J Pathol Microbiol ; 62(4): 572-577, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31611442

RESUMO

Introduction: Automated body fluid (BF) analysis is gradually replacing the traditional methods of cell counting in all BFs. This study was done to analyze the high-fluorescence (HF)-BF parameter generated on Sysmex XN-1000 and study its correlation with the presence of malignant cells in the body fluids. A correlation between manual and automated differential counts was also done. Materials and Methods: A total of 1985 samples including 797 ascitic fluids (AF), 532 pleural fluids (PF), and 656 cerebrospinal fluids (CSF) were run on Sysmex XN-1000 in BF mode and cytopathology was available for 924 BFs including 389 AF, 379 PF, and 156 CSF. Both manual and automated methods were used for cell differential and cell morphology. Results: Of the 924 samples with corresponding cytopathology, malignancy was found in 59 samples. The HF-BF%/100 WBCs (24.8 ± 72.5) and HF-BF#/µL (329.86 ± 932.35) for malignant BF samples were found to be significantly higher than the nonmalignant samples (4.41 ± 8.1) and (19.57 ± 61.91), respectively. Receiver-operator-characteristic curve cutoffs for all BF for percentage and absolute HF-BF were 2.85%/100 WBCs and >12/µL. A good correlation was found between the manual and automated WBC differential counts in all fluids except CSF with total count < 5/µL. Conclusions: BFs can be reliably analyzed on automated analyzers. HF-BF parameter is helpful in identifying malignant samples but cannot be totally relied upon. If HF-BF%/# are above the lab-generated cutoffs, microscopy should be done. A complete validation study on HF-BF parameter in BF mode is desired to set the standards for the analysis of serious effusions.


Assuntos
Automação Laboratorial , Líquidos Corporais/citologia , Fluorescência , Hematologia/instrumentação , Neoplasias/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hematologia/métodos , Humanos , Lactente , Recém-Nascido , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Adulto Jovem
9.
Tunis Med ; 97(1): 93-99, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31535699

RESUMO

Docimology has allowed the development of evaluative processes assuring valid, reliable and objective assessments. It was adopted within the faculty of Medicine of Tunis since  2007. The aim of this study was to analyze the docimological survey results of hematology-oncology exams, to evaluate the interest of this analysis in the elaboration of exams and the construction of an item bank, and propose some corrections  in order to improve assessment.     Methods :We have analyzed the hematology-oncology exams of SCMS1 (Second cycle of Medical Studies 1) from educational year 2008-2009 to 2013-2014. The data input was already done with Excel. The test includes 4 disciplines (Hematology, Oncology, Genetics and the Anatomic Pathology). We have calculated docimological parameters allowing global analysis, by discipline and by item. Results : A total of 3281 papers and 1004 questions were analyzed. The average success rate per year was 91,54% ± 7,12. The highest average success rate was found in hematology (80,51% ± 10,18). The lowest rate was found in the anatomic pathology (51,61% ± 23,76). The average rate of students succeeding the test without having average note in hematology was 5,36%. It was 42,29% in the anatomic pathology. Average difficulty index was 0,57 ± 0,05. Items analysis showed that 38,04% were easy and 19,02% were difficult. Average discrimination index was 0,25 ± 0,02. Discrimination was very good in 20,51% of items and good in 17,13%. Useless and bad discrimination items were about 40,53%. The average of Cronbach Alpha coefficient was 0,84 ± 0,03, showing a good internal-consistency. Conclusion :This study allowed an objective evaluation of "contributive disciplines" in multidisciplinary evaluation and showed the interest of integrating questions. Question analysis with teachers would be important to reevaluate and improve these items.


Assuntos
Educação Médica , Avaliação Educacional/métodos , Hematologia/educação , Comunicação Interdisciplinar , Oncologia/educação , Educação Médica/métodos , Educação Médica/organização & administração , Avaliação Educacional/normas , Avaliação Educacional/estatística & dados numéricos , Hematologia/métodos , Hematologia/organização & administração , Humanos , Estudos Interdisciplinares , Oncologia/métodos , Oncologia/organização & administração , Projetos de Pesquisa , Estudos Retrospectivos , Estudantes de Medicina
10.
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
12.
Malar J ; 18(1): 262, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366365

RESUMO

BACKGROUND: The Mindray BC-6800 haematology analyzer (BC-6800) provides a dedicated flag 'Infected RBC' (InR) and the number of InR (InR#)/the permillage of InR (InR‰) in routine blood testing as a screening tool for malaria in endemic areas. This study sought to evaluate the effectiveness of the BC-6800 flag parameter for aiding the diagnosis of malaria. METHODS: A total of 181 samples were tested using the Mindray BC-6800 haematology analyzer, including 117 malaria-infected samples collected from Yunnan, China, and 64 samples from healthy controls. Microscopy examination was conducted as reference when stained thick blood film revealed the presence of malaria parasites identified as Plasmodium vivax and Plasmodium falciparum. The receiver operating characteristic (ROC) curve analysis was developed using Analyse-it v4.92.3. The Kappa value was determined to evaluate the agreement between BC-6800 and light microscopy. RESULTS: The sensitivity of InR‰ generated by BC-6800 for P. vivax and P. falciparum was 88.3 and 24.1%, respectively; specificity of InR‰ for malaria parasites was 84.3 and 84.3%, respectively; positive predictive value and negative predictive value was 89.4 and 82.7% for P. vivax, and 52.8 and 60.3% for P. falciparum. There was a strong correlation between ΔWBC and InR‰ (R2 = 0.9731 for P. vivax and R2 = 0.9757 for P. falciparum). There was also a significant correlation between parasitaemia and InR# in P. vivax-infected samples (R2 = 0.734). InR# was evaluated using ROC curve analysis, the area under the ROC curve is 0.95 with a 95% confidence interval of 0.926 to 0.974, and the cut-off value is 0.01 × 109/L for P. vivax. However, the ring stage and the early trophozoite stage of Plasmodium cannot be detected easily on BC-6800, possibly because of the small size and low nucleic acid content of these stages. CONCLUSIONS: The findings suggest that the flag 'InR' and the parameters 'InR#/InR‰' provided by the BC-6800 haematology analyzer could be used to screen for malaria in a clinical setting.


Assuntos
Análise Química do Sangue/métodos , Sangue/parasitologia , Hematologia/métodos , Malária Falciparum/diagnóstico , Malária Vivax/diagnóstico , Plasmodium falciparum/isolamento & purificação , Plasmodium vivax/isolamento & purificação , Adolescente , Adulto , Idoso , Análise Química do Sangue/instrumentação , Criança , Pré-Escolar , China/epidemiologia , Feminino , Hematologia/instrumentação , Humanos , Malária Falciparum/epidemiologia , Malária Falciparum/parasitologia , Malária Vivax/epidemiologia , Malária Vivax/parasitologia , Masculino , Pessoa de Meia-Idade , Parasitemia/diagnóstico , Parasitemia/epidemiologia , Parasitemia/parasitologia , Prevalência , Curva ROC , Sensibilidade e Especificidade
13.
Int J Lab Hematol ; 41(5): 622-634, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286670

RESUMO

INTRODUCTION: With the progression of blood analysis technology, hematology analyzers become more complex and diverse. How to choose a superb instrument is a challenge for the laboratories. In the essay, we studied whether the newest BC-6000 hematology analyzer meets the needs of a clinical hematology laboratory. METHODS: Methods comparison was performed using 350 blood samples from patients between different measurement procedures; the basic analytical performance was also tested, including the throughput, carryover, precision, and linearity in different modes. The flagging performances for blasts, immature granulocytes, and NRBC were compared with manual microscopy. RESULTS: There were minimal carryover (<0.30%) and excellent actual blood linearity for all routinely used parameters concerned by the clinicians (R2  ≥ 0.997). Repeatability and reproducibility were satisfactory at all testing levels. The functional sensitivity of leukocytes and platelets in the blood and leukocytes and erythrocytes in body fluid was excellent at the 20% CV level. BC-6000 and XN displayed very high correlations for complete blood count (CBC) parameters and very high consistency for leukocyte differentials and NRBC compared with manual microscopy. BC-6000 showed excellent sensitivity and specificity flagging ability on blasts (82.9% and 82.4%) and NRBC (80.0% and 96.9%). For immature granulocytes, BC-6000 showed excellent sensitivity but common specificity flagging ability (91.7% and 65.6%). CONCLUSION: The clinical performance of BC-6000 is excellent, and the analyzer can provide timely and accurate reporting for most of the small- to large-scale laboratories.


Assuntos
Contagem de Células Sanguíneas/instrumentação , Técnicas de Laboratório Clínico/instrumentação , Testes Hematológicos/instrumentação , Hematologia/instrumentação , Contagem de Células Sanguíneas/métodos , Técnicas de Laboratório Clínico/métodos , Testes Hematológicos/métodos , Hematologia/métodos , Humanos , Reprodutibilidade dos Testes
14.
Intervirology ; 62(2): 51-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31307046

RESUMO

BACKGROUND: Differential diagnosis between acute-phase Zika and dengue is challenging because of a similar clinical presentation and the lack of available molecular diagnosis tools in most of endemic areas. OBJECTIVES: Our study aimed to evaluate the use of simple laboratory parameters to differentiate these infections. METHODS: We retrospectively compared simple hematology and biochemistry values in 81 and 341 patients with confirmed Zika and dengue, respectively, collected from June 2013 to March 2014 during the French Polynesia outbreaks. RESULTS: Thrombocytopenia, neutropenia, leukopenia, lymphopenia, and elevated aspartate aminotransaminases were significantly more frequent in dengue than in Zika (p < 0.001). Platelets <100 × 109/L, neutrophils <0.5 × 109/L, lymphocytes <0.5 × 109/L, and aspartate aminotransaminases >100 IU/mL were found in dengue but not in Zika. The positive predictive value of the -association of leukocytes <4 × 109/L + lymphocytes <1 × 109/L + aspartate aminotransaminases >40 IU/mL for the diagnosis of dengue was 90%, with an accuracy of 82.4%. CONCLUSION: For the differential diagnosis between acute-phase Zika and dengue, there is no specific standard laboratory pattern. We identified cutoff values and a combination of laboratory parameters that are a strong argument against Zika and in favor of dengue.


Assuntos
Técnicas de Laboratório Clínico/métodos , Dengue/diagnóstico , Infecção por Zika virus/diagnóstico , Doença Aguda , Adulto , Aspartato Aminotransferases/sangue , Bioquímica/métodos , Dengue/sangue , Vírus da Dengue , Diagnóstico Diferencial , Surtos de Doenças , Feminino , Hematologia/métodos , Humanos , Masculino , Polinésia , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Adulto Jovem , Zika virus , Infecção por Zika virus/sangue
15.
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
16.
Artigo em Inglês | MEDLINE | ID: mdl-31314739

RESUMO

Background In this study, the hematological and antioxidant potential as well as the osmotic fragility effects of a Nigerian polyherbal formulation were evaluated. Materials and methods A total of 40 fats were divided into four groups of 10 rats each. Group 1 served as the control group, and the rest were assigned increasing daily oral administration of the extract for 28 days. At the end of treatment, blood was collected for hematological and osmotic fragility studies. The free radical scavenging effect of the extract was investigated via different in vitro models as well. Results Results showed that the nitric oxide scavenging and 2,2-diphenyl-1-picrylhydrazyl (DPPH) activities of the extract were significant (p < 0.05) and compared favorably with that of vitamin C. At 200 and 400 µg/mL, the nitric oxide scavenging activities for Ajumbise Polyherbal Extract (APE) were 60.71 ± 0.25% and 59.49 ± 0.98%, respectively, whereas for the same concentrations of vitamin C, 74.60 ± 0.25% and 85.24 ± 0.14 scavenging activities were obtained. The (DPPH) activity at 100 µg/mL was 81.24 ± 0.02% for the extract and 96.22 ± 0.18% for vitamin C. However, at all concentrations, the extract had significantly lower Ferric Reducing Antioxidant Power (FRAP) activity than vitamin C. Red blood cell counts (RBCC), hemoglobin and packed cell volume values (PCV) were significantly lowered only in groups treated with 400 and 800 mg/kg of the extract (p < 0.05), whereas other RBCC parameters and white blood cell counts (WBCC) were not significantly affected (p < 0.05). Platelet (PLT) count was also significantly lowered in all extract-treated groups. The extract also significantly reduced RBCC percentage hemolysis (p < 0.05). Conclusions Ajumbise polyherbal may be free of hematoxicity and may improve the integrity of the RBC membrane due to its appreciable antioxidant activity.


Assuntos
Antioxidantes/farmacologia , Fragilidade Osmótica/efeitos dos fármacos , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Animais , Ácido Ascórbico/farmacologia , Compostos de Bifenilo/farmacologia , Plaquetas/efeitos dos fármacos , Eritrócitos/efeitos dos fármacos , Flavonoides/farmacologia , Hematologia/métodos , Hemólise/efeitos dos fármacos , Leucócitos/efeitos dos fármacos , Nigéria , Óxido Nítrico/metabolismo , Fenóis/farmacologia , Fitoterapia/métodos , Picratos/farmacologia , Ratos
17.
Nagoya J Med Sci ; 81(2): 259-267, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31239595

RESUMO

The activity of fibrinogen has been reported to decrease soon after the onset of major bleeding and to be an important determinant of the final extent of bleeding and postoperative outcome. A device that measures the perioperative fibrinogen level using the dry hematology (DH) method has recently become available. The aim of this study was to compare perioperative fibrinogen levels measured by the DH method with those measured by the conventional Clauss method and to assess the effects of heparin on these measurements. The study included 206 samples from 36 patients undergoing major surgery who received high-dose heparin (HH group, 23 samples), low-dose heparin (LH group, 57 samples), or no heparin (C group, 126 control samples). Each sample was measured using the DH and Clauss methods. After excluding samples outside the effective measurement range, the three study groups (HH group, n=23; LH group, n=49; C group, n=115) were compared. The mean fibrinogen level measured by the DH method in the HH group (87.9 ± 3.1%) was significantly lower than that measured by the Clauss method. There were no significant differences between the fibrinogen measurements obtained by the two methods between the LH and C groups. In patients on high-dose heparin, the mean fibrinogen level measured by the DH method was significantly lower than that measured by the Clauss method. When hemorrhage requires emergency treatment, a method that can measure the fibrinogen level rapidly is important. The DH method may be useful for decision-making with regard to perioperative coagulation factor replacement.


Assuntos
Fibrinogênio/análise , Hematologia/métodos , Feminino , Hemorragia/tratamento farmacológico , Hemorragia/metabolismo , Heparina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade
18.
Int J Lab Hematol ; 41(5): 601-606, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31162809

RESUMO

INTRODUCTION: The Sysmex XN-10 automated hematology analyzer (Sysmex Corporation) is routinely used in hematology laboratories to perform complete blood cell count with differential (CBC w/ diff). The sensitivity of this system for blast detection is unclear, since many prior studies evaluating the blast flagging capabilities of Sysmex XN series used the white precursor cell (WPC) channel, which is not cleared for use in the United States. METHODS: We assessed the blast flagging capabilities of the Sysmex XN-10 compared with CellaVision (a cell image analyzer)-assisted visual hematology results. We evaluated the following flags: "blasts?/abnormal lymph?" and "immature granulocytes present" and compared differences in turnaround time between methods. RESULTS: We collected data on 2239 CBC w/ diff Sysmex automated analyzer differential and CellaVision-assisted visual differential from the inpatient hematology-oncology population of a tertiary care medical center. Solely analyzing the first CBC/diff from each unique patient, both flags had a combined sensitivity of 100%, specificity of 50.2%, PPV of 21.7%, and NPV of 100%. The mean turnaround time for the automated differential was 19.5 minutes (SD 35.9 minutes) compared with 66.4 minutes for the CellaVision-assisted visual differential (SD 68.5 minutes; P < 0.001; Figure 1). CONCLUSION: The Sysmex XN-10 abnormal lymphocyte/blast and immature granulocytes flags had excellent sensitivity and acceptable specificity in detecting circulating blasts with shorter turnaround time than the CellaVision-assisted visual differential. Our study suggests that automated differentials performed on Sysmex XN-10 can replace visual differentials as a first-line screening method for blast detection with improved turnaround time in hematology-oncology populations.


Assuntos
Automação Laboratorial/instrumentação , Contagem de Células Sanguíneas/instrumentação , Hematologia/instrumentação , Células-Tronco Hematopoéticas/citologia , Automação Laboratorial/métodos , Contagem de Células Sanguíneas/métodos , Hematologia/métodos , Células-Tronco Hematopoéticas/metabolismo , Humanos , Contagem de Leucócitos , Leucócitos/citologia , Leucócitos/metabolismo , Reprodutibilidade dos Testes
19.
Med Biol Eng Comput ; 57(8): 1783-1811, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31201595

RESUMO

Blood is composed of white blood cells, red blood cells, and platelets. Segmentation of the blood smear cells and extraction of features of the cells is essential in the field of medicine. Acute lymphoblastic leukemia is a form of blood cancer caused due to the abnormal increase in the production of immature white blood cells in the bone marrow. It mostly affects the children below 5 years and adults above 50 years of age. Due to the late diagnosis and cost of the devices used for the determination, the mortality rate has increased drastically. Flow cytometry technique that performs automated counting fails to identify the abnormal cells. Manual recount performed using hemocytometer are prone to errors and are imprecise. The proposed work aims to survey different computer-aided system techniques used to segment the blood smear image. The primary objective here is to derive knowledge from the different methodologies used for extracting features from white blood cells and develop a system that would accurately segment the blood smear image by overcoming the drawbacks of the previous works. The objective mentioned above is achieved in two ways. Firstly, a novel algorithm is developed to segment the nucleus and cytoplasm of white blood cell. Secondly, a model is built to extract the features and train the model. The different supervised classifiers are compared, and the one with the highest accuracy is used for the classification. Six hundred images are used in the experimentation. InfoGainAttributeEval and the Ranker Search method are used to achieve the feature selection which in turn helps in improvising the classifier performance. The result shows the classification of the acute lymphoblastic leukemia into its three respective categories namely: ALL-L1, ALL-L2, ALL-L3. The model can differentiate between a normal peripheral blood smear and an abnormal blood smear. The extracted feature values of a cancerous cell and a normal cell are also shown. The performance of the model is evaluated using the test images stained with various stains. The proposed algorithm achieved an overall accuracy of 98.6%. The promising results show that it can be used as a diagnostic tool by the pathologists. Graphical abstract.


Assuntos
Algoritmos , Interpretação de Imagem Assistida por Computador/métodos , Leucócitos/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Citoplasma/patologia , Mineração de Dados , Bases de Dados Factuais , Entropia , Fractais , Hematologia/métodos , Humanos , Processamento de Imagem Assistida por Computador/métodos
20.
BMC Med ; 17(1): 103, 2019 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-31146732

RESUMO

BACKGROUND: Accurate and timely diagnosis of malaria is essential for disease management and surveillance. Thin and thick blood smear microscopy and malaria rapid diagnostic tests (RDTs) are standard malaria diagnostics, but both methods have limitations. The novel automated hematology analyzer XN-30 provides standard complete blood counts (CBC) as well as quantification of malaria parasitemia at the price of a CBC. This study assessed the accuracy of XN-30 for malaria detection in a controlled human malaria infection (CHMI) study and a phase 3 diagnostic accuracy study in Burkina Faso. METHODS: Sixteen healthy, malaria-naive CHMI participants were challenged with five Plasmodium falciparum-infected mosquitoes. Blood was sampled daily for XN-30, blood smear microscopy, and malaria qPCR. The accuracy study included patients aged > 3 months presenting with acute febrile illness. XN-30, microscopy, and rapid diagnostic tests (HRP-2/pLDH) were performed on site; qPCR was done in retrospect. The malaria reference standard was microscopy, and results were corrected for sub-microscopic cases. RESULTS: All CHMI participants became parasitemic by qPCR and XN-30 with a strong correlation for parasite density (R2 = 0.91; p < .0001). The XN-30 accurately monitored treatment and allowed detection of recrudescence. Out of 908 patients in the accuracy study, 241 had microscopic malaria (density 24-491,802 parasites/µL). The sensitivity and specificity of XN-30 compared to microscopy were 98.7% and 99.4% (PPV = 98.7%, NPV = 99.4%). Results were corrected for qPCR-confirmed sub-microscopic cases. Three microscopy-confirmed cases were not detected by XN-30. However, XN-30 detected 19/134 (14.2%) qPCR-confirmed cases missed by microscopy. Among qPCR-confirmed cases, XN-30 had a higher sensitivity (70.9% versus 66.4%; p = .0009) and similar specificity (99.6% versus 100%; p = .5) as microscopy. The accuracy of XN-30 for microscopic malaria was equal to or higher than HRP-2 and pLDH RDTs, respectively. CONCLUSIONS: The XN-30 is a novel, automated hematology analyzer that combines standard hemocytometry with rapid, objective, and robust malaria detection and quantification, ensuring prompt treatment of malaria and malaria anemia and follow-up of treatment response. TRIAL REGISTRATION: Both trials were registered on clinicaltrials.gov with respective identifiers NCT02836002 (CHMI trial) and NCT02669823 (diagnostic accuracy study).


Assuntos
Testes Diagnósticos de Rotina , Hematologia/instrumentação , Malária/diagnóstico , Adolescente , Adulto , Animais , Antígenos de Protozoários/análise , Antígenos de Protozoários/sangue , Automação Laboratorial , Burkina Faso , Criança , Pré-Escolar , Testes Diagnósticos de Rotina/instrumentação , Testes Diagnósticos de Rotina/métodos , Método Duplo-Cego , Feminino , Hematologia/métodos , Humanos , Lactente , Recém-Nascido , Malária/sangue , Malária Falciparum/sangue , Malária Falciparum/diagnóstico , Masculino , Pessoa de Meia-Idade , Parasitemia/sangue , Parasitemia/diagnóstico , Plasmodium falciparum/imunologia , Reação em Cadeia da Polimerase em Tempo Real , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
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