Alterations in plasma-volume-corrected blood components of marathon runners and concomitant relationship to performance.

Exertional Rhabdomyolysis

O crescente interesse de crianças e adolescentes por esportes competitivos induz a uma maior preocupação em prescrever treinamentos adequados a essa população específica. O conhecimento do impacto da intensidade de treinamento físico competitivo sobre a saúde de adolescentes são ainda incipientes na literatura científica. Este estudo objetivou investigar as respostas agudas do lactato sanguíneo (Lac) e da creatinofosfoquinase (CPK) após uma sessão de treinamento físico em atletas jovens treinados em diferentes modalidades esportivas. Participaram 43 adolescentes do sexo masculino entre 9 e 17 anos, distribuídos em três grupos: nadadores, tenistas, jogadores de futebol de salão. Os protocolos para cada modalidade seguiram o planejamento normal de uma sessão específica. A dieta no dia anterior à coleta foi padronizada e as 24 horas que precediam a avaliação foram dedicadas ao repouso dos atletas. Foram coletados 5ml de sangue da veia antecubital imediatamente antes da realização da sessão de treinamento, repetindo coleta idêntica, imediatamente após a sessão. Foi obtida a idade óssea para a avaliação da maturação esquelética pelo método de Greulich & Pyle. Análise de variância Kruskal-Wallis e teste U-de Mann-Whitney foram utilizados para comparações entre os grupos. Valores de p < 0,05 foram considerados significantes. Em todas as modalidades esportivas estudadas os valores prévios do Lac e da CPK foram inferiores aos valores pós-sessão. Com relação aos três grupos de faixas etárias, tanto para o Lac como para a CPK, os valores na pré-sessão foram inferiores aos obtidos na pós-sessão, assinalando que para o grupo de 9 aos 11 anos, tanto na situação pré como na pós, os valores foram inferiores aos observados nos grupos de idade superior. Os resultados indicaram que a magnitude de aumento da CPK e do Lac foram similares aos valores encontrados na literatura e demonstraram um aumento em função da faixa etária, indicando ser maturação biológica dependente.

ABSTRACTBackground:Levetiracetam (LEV) is a widely used antiepileptic drug (AED) in the treatment of various type of seizures, including generalized epileptic seizure as well as focal seizures, and it is generally well tolerated. Common side effects of LEV are somnolence, asthenia, dizziness, mood changes, kidney dysfunction, minor infections, and thrombocytopenia. Recently, increased creatine phosphokinase (CPK) concentration or rhabdomyolysis after LEV administration has been reported. The goal of the study was to evaluate clinical risk factors associated with increased CPK concentration or rhabdomyolysis in LEV administration.Materials and Methods:One hundred and sixty children were enrolled. The risk factors were retrospectively analyzed.Results:Among the 160 patients, 84 (52.5%) were boys and 76 (47.5%) were girls, and the mean age was 85.95 ± 49.03 months (9–188 months). Of the 160 patients, 66 (41.3%) were treated with monotherapy, and 94 (58.8%) with polytherapy. We detected increased CPK concentration or rhabdomyolysis in three patients (1.9%). The CPK values of these three patients were 943, 1504, and 5046, respectively. No significant differences were observed in the serum CPK concentration between the patients treated with LEV.Conclusion:We detected that LEV may cause increased CPK concentration or rhabdomyolysis. When treating patients with LEV, clinicians should closely monitor serum CPK level. To the best of our knowledge, this is the first study of elevated CPK concentration or rhabdomyolysis associated with LEV therapy in children.

Objective To investigate the blood specimen collection site, inspection time and hemolysis influence on biochemical test results. Methods The specimens of 2586 cases outpatients and hospitalized patients in our hospital who accepted blood routine and blood coagulation four check were analyzed.The hemolysis and qualified specimens of biochemical test results were compared. Results 2 586 specimens found unqualified blood samples in 18 cases, and the incidence rate was 0.70% (18/2 586). Samples of different section and source were compared and found there were no significant difference (F=0.36, P>0.05). In 18 cases of unqualified blood samples due to technical problems and unqualified sample accounted for 88.89% (16 / 18). The technical factors that lead to unqualified samples was significantly higher than that of the instrument factor or fixed factors, and the difference was statistically significant(χ2=152.63, 98.52, all P<0.05). In addition, hemolysis caused the most of the unqualified samples for the technical factors.To choose potassium infusion on the side ipsilateral to the site or from the opposite side of the site collected blood samples.Sodium, chlorine, creatinine, uric acid, glucose detection found in effect of blood on the same side of the infusion of the biochemical test results in varying degrees.Potassium, chlorine, sodium, creatinine decreased significantly, and uric acid, glucose and other indicators were significantly increased (t=4.51, 4.98, 5.50, 3.25, 10.18, 15.25, all P<0.05). Gamma transpeptidase, creatine kinase, sodium and uric acid and other index of hemolytic samples were significantly lower than those of normal samples, and alanine aminotransferase (ALT), direct bilirubin, potassium, phosphorus, serum creatinine and creatine kinase were significantly higher than those of the normal samples (t=14.85, 21.21, 7.15, 4.86, 10.33, 4.02, 3.11, 8.20, 7.54, 5.11, all P<0.05). This may cause the depth in erythrocytes and some related substances.The time of collecting blood to sent to the room had obvious influence on the biochemical test results, alanine aminotransferase, aspartate amino transferase, glucose, creatine kinase and hydroxybutyrate and project them 1 h after submission were significantly lower than those of the standard inspection, and 1 hour after the submission of lactate dehydrogenase and creatine kinase isoenzyme index were significantly higher than those of the standardize inspection means (t=2.95, 4.82, 2.88, 5.44, 4.05, 3.98, 4.89, all P<0.05). Conclusion Sampling sites, hemolysis and inspection time had effect on blood specimen, so for the collection of blood samples must be strictly in accordance with the requirements of the operation. Key words: Blood specimen; Collection; Biochemical test

Blood samples were collected from captive, adult, clinically normal Indian peafowl (Pavo cristatus) for hematologic and plasma biochemical analyses. Hematologic parameters investigated were total red blood cell count, hemoglobin, packed cell volume, fibrinogen, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, total white blood cell count, differential white blood cell count, and thrombocyte count. Plasma biochemical parameters investigated were alanine aminotransferase, alkaline phosphatase, amylase, aspartate aminotransferase, bile acids, total bilirubin, blood urea nitrogen, calcium, cholesterol, creatinine, creatine kinase, gamma glutamyltransferase, lactate dehydrogenase, glucose, iron, phosphorus, and uric acid, as well as plasma protein electrophoresis. Results were compared with values from studies done in houbara bustards (Chlamydotis undulata), kori bustards (Ardeotis kori), stone curlews (Burhinus oedicnemus), and taxonomically related species, including ring-necked pheasants (Phasianus colchicus), red-legged partridges (Alectoris rufa), Kashmir native fowl (Kashmirfavorella), and Bangladesh native, Fayoumi, and Assil fowl (Gallus domesticus).

Effect of scorpion Leiurus quinquestriatus (H&E) venom on the clinical chemistry parameters of the rat

A 74-year-old male patient with urinary tract infection received an intravenous infusion of levofloxacin 0.3 g twice daily. On day 4, the patient developed muscular soreness in bilateral crus. The next day, the patient's symptom of muscle pain became worse accompanied by waist and back pain and the urine was brown with decreased urine volume. Laboratory tests revealed the following results: alanine aminotransferase (ALT) 1 487 U/L, aspartate aminotransferase (AST) 106 U/L, γ-glutamine transferase (γ-GT) 94 U/L, total bilirubin (TBil) 37.4 μmol/L, direct bilirubin 25.2 (DBil) μmol/L, creatine kinase (CK) 1 446 U/L, lactate dehydrogenase (LDH) 414 U/L, alpha-hydroxybutyric dehydrogenase (α-HBDH) 464 mmol/L, creatine kinase isoenzyme (CK-MB) 34 U/L, serum creatinine 397 μmol/L, blood urea nitrogen (BUN) 28 mmol/L, uric acid (UA) 823 mmol/L, carbon dioxide combining power (CO2CP) 17 mmol/L, urine occult blood (+ + + ), urine protein(+ + + ), microscopic examination of white blood cell 3-5/HP. The patient was considered to have rhabdomyolysis with acute renal failure induced by levofloxacin. Levofloxacin was withdrawn, and he received the supplement of fluid, alkalinization of urine, diuretic and liver protection therapy. Two days later, the patient's urine volume increased. One week later, the muscle pain disappeared. Eight days later, laboratory tests revealed the following results: ALT 48 U/L, AST 39 U/L, γ-GT 60 U/L, TBil 19.6 μmol/L, DBil 11.5 μmol/L, CK186 U/L, LDH 235 U/L, α-HBDH 160 mmol/L, CK-MB 22 U/L, SCr 98 μmol/L, BUN 7.8 mmol/L, UA 397 mmol/L, CO2CP21 mmol/L. Key words: Ofloxacin; Rhabdomyolysis; Acute kidney injury

In this study, we report hematocrit and plasma chemistry values for adult captive collared scops owls (Otus lettia) and crested serpent eagles (Spilornis cheela hoya). In particular, we address the gender-specific differences within these values. We measured hematocrit (HCT) and plasma chemistry values for uric acid (UA), plasma urea nitrogen (BUN), total protein (TP), albumin (ALB), glucose (GLU), cholesterol (CHO), triglyceride (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), total bilirubin (TBIL), creatine (CRE), creatine phosphokinase (CPK), amylase (AMY), calcium (CA), ionic phosphorous (IP) and sodium (NA), potassium (K) and chloride ions (CL) in 37 adult captive collared scops owls and 39 adult captive crested serpent eagles. Significant differences between the sexes were found for UA, GLU and CPK in the collared scope owls. UA and GLU concentrations were significantly higher (P<0.01 and P<0.05) among males than females, while the CPK concentration was significantly lower (P<0.05) in males. There were no significant differences in of all of the measured parameters between male and female eagles. These finding suggested that HCT and plasma chemistry values of raptors vary individually according to species and sex. Our results provide the 1st available reference data for ranges of plasma values in adult captive collared scops owls and crested serpent eagles, making them a potentially useful complementary diagnostic tool for veterinary care of individuals for both species in captivity.

OBJECTIVE: To investigate biochemical changes related to muscle breakdown, hepatic damage, hyponatraemia, and a number of other variables in the serum of participants in a 1600 km ultramarathon run. METHODS:...

The aim of this work was to determine the role of intraperitoneally-administered vitamin E and selenium on the biochemical and haematological parameters in the blood of rats. Thirty-two adult male Wistar rats were used in this study. All rats were randomly divided into four groups. The first group was used as the control. The second group was intraperitoneally administered with vitamin E (+/-(-)alpha-tocopheroryl acetate, 10 mg day-1), the third group with Se (Na2SeO3 0.2 mg over a day), and the fourth group with vitamin E and Se (vitamin E 10 mg + Na2SeO3 0.2 mg over a day). This administration was done for 5 weeks. Blood samples were taken from animals at the end of the dosage period and biochemical parameters in serum samples and haematological parameters in total blood were determined. The levels of total cholesterol (p < 0.01) and number of white blood cell (p < 0.001) in blood were significantly higher in the vitamin E group than in the control group. The levels of ALP, total cholesterol (p < 0.01) and number of white blood cells (p < 0.01) in blood were significantly higher in the selenium group than in the controls. The levels of glucose (p < 0.05), ALP (p < 0.01), total cholesterol (p < 0.001) and number of white blood cells (p < 0.01) were higher in the vitamin E and selenium combined group than in the controls. Other parameters considered within this trial (ALT, LDH, creatinine, albumin, total protein, amylase, creatine kinase, HDL triglycerides, total lipid, sodium, chloride, uric acids, red blood cell, haemoglobin, packed cell volume, MCV, MCH, MCHC) did not show statistically significant differences between the control and injected groups. The results indicated that blood glucose and total cholesterol levels, ALP activity and white blood cell counts were significantly increased by intraperitoneal administration of vitamin E and selenium in rats.

Objective: This study explored the effect of multiple-nutrient supplementation on muscle damage and liver and kidney function after vigorous exercise under heat.Methods: After an initial pilot trial comprising 89 male participants, 85 participants were recruited and assigned into three groups: a multiple-nutrient (M) group, a glucose (G) group, and a water (W) group. Multiple-nutrient supplements contain glucose, fructose, maltose, sodium, potassium, vitamin B1, vitamin B2, vitamin C, vitamin K, and taurine. Participants were organised to take a 3-km running test (wet-bulb globe temperature 32°C) after a short-term (7 days) supplement. Blood samples were obtained to detect biochemical parameters [glucose (GLU), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), uric acid (UA), creatinine (Cr), creatine kinase (CK), lactate dehydrogenase (LDH), and lactic acid], inflammation factors [interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α)], and oxidative stress biomarkers [superoxide dismutase (SOD) and 8-iso-prostaglandin F (2alpha) (8-iso-PGF2α)].Results: In the pilot trial, BUN decreased significantly in the M and G groups immediately after the running test. AST, Cr, and UA were significantly reduced 24 h after the running test with single-shot multiple-nutrient supplementation. In the short-term trial, multiple nutrients further prevented the elevation of CK (p = 0.045) and LDH (p = 0.033) levels 24 h after strenuous exercise. Moreover, we found that multiple nutrients significantly reduced IL-6 (p = 0.001) and TNF-α (p = 0.015) elevation immediately after exercise. Simultaneously, SOD elevation was significantly higher in the M group immediately after exercising than in the other two groups (p = 0.033). 8-iso-PGF2α was reduced in the M group 24 h after exercise (p = 0.036).Conclusions: This study found that multiple-nutrient supplementation promoted the recovery of muscle damage and decreased liver and kidney function caused by strenuous exercise in a hot environment, probably through the inhibition of secondary damage induced by increased inflammatory reactions and oxidative stress. In this respect, the current study has important implications for the strategy of nutritional support to accelerate recovery and potentially prevent heat-related illness. This study was prospectively registered on clinicaltrials.gov on June 21, 2019 (ID: ChiCTR1900023988).

Serum concentrations of creatine phosphokinase and its isoenzyme were measured serially in 47 patients who underwent lumbar surgery. To analyze the significance of postoperative creatine phosphokinase MM levels as indicators of muscle trauma after lumbar surgery. The authors of the present study previously have reported on iatrogenic back muscle injury in an animal model and in man. However, the relationship between the change of the creatine phosphokinase MM isoenzyme level and muscle injury after surgery has not been clarified. Peripheral venous blood samples were collected serially before surgery, just after surgery, and at 1, 3, 7, 14, and 21 days after surgery. The serum concentration of total creatine phosphokinase and its isoenzymes was measured by agarose gel electrophoresis. The serial postoperative change of the creatine phosphokinase MM isoenzyme concentration was evaluated with respect to age, gender, body weight, types and levels of surgery, and surgery time. Creatine phosphokinase MM activity increased after surgery and reached a maximum value 1 day after surgery, followed by recovery to the normal value 1 week after surgery. The maximum concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery (P = 0.04). It was significantly higher in men than in women (P = 0.02). Serum concentration of creatine phosphokinase MM isoenzyme showed no significant correlation to the extent of muscle exposure and surgery time. The time course of postoperative serum creatine phosphokinase MM isoenzyme activity is correlated with the histologic changes of the back muscles after surgery. The concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery. It was also significantly higher in men than in women.

Clinical chemistry testing is influenced by a variety of preanalytical variables, including sample preparation. The presence of a diluted plasma layer at the top of primary tubes containing plasma citrate has recently been reported. However, no indication is available so far on the potential non-homogeneous distribution of clinical chemistry analytes during centrifugation of primary tubes containing lithium-heparin as an additive. A total of 40 lithium-heparin plasma samples were collected from volunteers and immediately centrifuged. An aliquot was obtained from the upper 0.4 mL of plasma (upper aliquot), 1.0 mL of plasma was discarded, and a second aliquot (lower aliquot) was obtained from the remaining plasma. The concentrations of alanine aminotransferase, albumin, alkaline phosphatase, amylase, amylase pancreatic, aspartate aminotransferase, direct bilirubin, total bilirubin, blood urea nitrogen, calcium, chloride, cholesterol, C-reactive protein (CRP), creatinine, creatine kinase, gamma-glutamyltransferase (GGT), glucose, high-density lipoprotein-cholesterol, iron, lactate dehydrogenase (LDH), magnesium, phosphate, potassium, total protein, sodium, triglycerides and uric acid were assayed on a Roche/Hitachi Modular System P according to the manufacturer's specifications and using proprietary reagents. Sodium, chloride and potassium were measured on a Roche/Hitachi Modular System using indirect ion-selective electrode methods. We observed a statistically significant difference between the upper and lower aliquots for CRP (3.88+/-0.67 vs. 3.94+/-0.68 mg/L; p=0.025), GGT (32.1+/-8.0 vs. 31.8+/-8.0 U/L; p=0.013), LDH (395+/-19 vs. 386+/-20 U/L; p=0.010) and triglycerides (1.29+/-0.09 vs. 1.27+/-0.09 mmol/L; p=0.001); results for the other analytes were not significantly different. In no case did the mean percentage bias recorded between aliquots exceed the current analytical quality specifications for desirable bias. The results of our investigation show that plasma layer stratification might occur in primary lithium-heparin tubes for a limited number of routine clinical chemistry tests, introducing a statistically significant bias in the measurement of GGT, LDH, triglycerides and CRP in the upper vs. the bottom section. When delayed testing is necessary for these parameters, we suggest that plasma should be separated after centrifugation and appropriately mixed before delayed/repeated analysis or aliquoting.

AIM: To generate clinical biochemical data to aid diagnosis of suboptimal performance in ostriches farmed under pastoral systems in New Zealand. METHODS: Blood and liver samples were sought from three categories of bird, viz 3–12-week-old chicks, 7–12-month-old growers, and from breeding hens, managed under pastoral conditions on farms in several locations in New Zealand. Concentrations of the minerals Ca, PO4, Mg, Na, K, Cu and Zn, activities of the enzymes gamma-glutamyl transferase (GGT), creatine kinase (CK), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST), and concentrations of total protein (TP) and uric acid and vitamin E in plasma and Se in whole blood were determined from four flocks of chicks, two flocks of growing and one flock of breeding birds. Concentrations of Cu, Fe and vitamin B12 were determined from liver samples from chicks and growing birds. Bodyweight was recorded at the times of blood-sampling, where this was feasible. RESULTS: It proved impossible to obtain blood samples by venepuncture of the radial vein from chicks <3 months of age. Plasma concentrations of minerals, with the exception of K, which were higher, were within the normal range observed in the literature for ratite species. Activities in plasma of AST and CK were almost double, and those of LDH similar, to those in the literature for ostriches. There was considerable variation in activities of the enzymes between farms, but no association with growth performance. Concentrations of Cu in plasma were lower and in liver were higher than would be expected in farmed ruminants. Though hindgut fermenters, the birds maintained concentrations of vitamin B12 in plasma and liver at least comparable to those observed in ruminants. CONCLUSIONS: Collection of blood samples by venepuncture via the wing in ostrich chicks younger than 3 months of age is difficult and unlikely to prove viable for routine diagnostic purposes. Clinical biochemistry data on mineral nutrients in ostriches farmed in New Zealand are similar to those in the literature from South Africa, but AST and CK are higher, and may be normal and a reflection of the high growth rates of the musculoskeletal system.

Objective To study the correlation between fractional excretion of uric acid (FEUA) and blood uric acid,body mass index (BMI),blood pressure,blood glucose,blood lipid and other metabolic factors in patients with primary gout.Methods Sixty-two patients with primary gout (gout group) and 32 healthy people (control group) were selected in this study.Gout group was divided into uric acid excretion decreasing group (FEUA ＜ 7％,29 cases),mixed group (7％ ≤FEUA ≤ 12％,25 cases) and uric acid production increasing group (FEUA ＞ 12％,8 cases) according to the level of FEUA.The fasting blood glucose (FPG),2-hour postprandial blood glucose (2 h PBG),blood lipid,serum creatinine,blood uric acid,glycosylated hemoglobin were tested.24 hours urine was collected and urinary uric acid and urinary creatinine was measured,FEUA was calculated and analyzed.Results BMI,mean arterial pressure,blood uric acid,glycosylated hemoglobin,total cholesterol,2 h PBG in gout group was higher than that in control group,and high density lipoprotein cholesterol,FEUA was lower than that in control group,and there was significant difference (P ＜ 0.05).There was no significant difference in age,FPG,low density lipoprotein cholesterol,triacylglycerol between two groups (P＞ 0.05).There was no significant difference in age,blood uric acid,FPG,2 h PBG,glycosylated hemoglobin,total cholesterol,low density lipoprotein cholesterol,high density hpoprotein cholesterol among uric acid excretion decreasing group,mixed group and uric acid production increasing group (P ＞ 0.05),and there was significant difference in BMI,mean arterial pressure,triacylglycerol,FEUA among three groups(P＜ 0.05).FEUA was negatively correlated with blood uric acid in control group and gout group (r =-3.900,-0.476,P ＜0.05).FEUA was positively correlated with 24 h urinary uric acid in gout group (r =0.465,P =0.001),and nagatively correlated with triacylglycerol (r =-0.304,P ＜ 0.05).Pearson analysis showed that FEUA was negatively correlated with blood uric acid in uric acid excretion decreasing group (FEUA ＜ 7％) (r =-0.392,P ＜ 0.05),FEUA was positively correlated with blood uric acid in non uric acid excretion decreasing group (FEUA ≥7％)(r =0.437,P ＜ 0.05),but 24 h urinary uric acid was not correlated with blood uric acid(P ＞ 0.05).Multi-stepwise regression analysis showed that blood uric acid,glycosylated hemoglobin,FEUA was significantly correlated with the onset of the gout (P ＜ 0.05).Conclusions Besides blood uric acid level,there are significant changes in primary gout in blood pressure,serum glucose and lipid levels.FEUA could be used to estimate the ability of renal excrete the uric acid.Mean arterial pressure,glycosylated hemoglobin and FEUA are the risk factors for gout. Key words: Gout; Uric acid; Fractional excretion of uric acid