Changes In Hematological Variables Research Articles

Phase 2 Trial of Deucravacitinib in Psoriatic Arthritis: Biomarkers Associated With Disease Activity, Pharmacodynamics, and Clinical Responses.

Our objective was to evaluate the association of serum biomarkers with baseline psoriatic arthritis (PsA) disease activity, pharmacodynamic effects of deucravacitinib on biomarker levels, and the relationship between biomarkers and clinical responses to deucravacitinib. The phase 2 trial (ClinicalTrials.gov identifier: NCT03881059) randomly assigned 203 patients with PsA 1:1:1 to placebo, deucravacitinib at 6 mg once daily (QD), or deucravacitinib at 12 mg QD. Serum biomarkers associated with the interleukin 23 (IL-23) pathway (IL-17A, β-defensin [BD-2], and IL-19), type I interferon pathway, inflammation, and collagen matrix turnover were measured by immunoassay. Clinical responses (≥75% improvement from baseline in the Psoriasis Area and Severity Index [PASI75] and ≥20% improvement from baseline in American College of Rheumatology criteria [ACR20] responses) were measured at week 16. Hematologic variables were also assessed. IL-17A, BD-2, and IL-19 had a modest association with PASI scores (r = 0.4, r = 0.56, and r = 0.5, respectively) at baseline. In deucravacitinib groups, IL-17A, BD-2, IL-19, C-X-C motif ligand 9 (CXCL9), CXCL10, C-reactive protein, matrix metalloproteinase 3, and collagen type 4 degradation marker levels were significantly reduced at week 16 versus baseline (P < 0.01); higher levels of IL-23 pathway-associated biomarkers predicted higher PASI75 and ACR20 response rates in deucravacitinib-treated patients. Significantly higher PASI75 response rates were seen in patients with high baseline IL-17A (odds ratio 15.76) and BD-2 levels (odds ratio 15.41) versus low baseline IL-17A and BD-2 levels. Changes in hematologic variables that are characteristic of JAK inhibition were not observed with deucravacitinib. Deucravacitinib significantly impacted biomarkers associated with Tyk2 signaling pathways of key inflammatory cytokines, including IL-23 and type I interferon, and those related to collagen matrix turnover. These biomarkers may predict treatment responses to deucravacitinib.

Acid-base disturbances and effects on oxygen uptake rates in Nile tilapia (Oreochromis niloticus) following acute and prolonged CO2 exposure

High levels of dissolved carbon dioxide (CO2) occur nightly in earthen ponds characterized by high respiration rates. Exposure to high CO2 conditions (hypercapnia) leads to acidosis in fish, which can be compensated by an accumulation of HCO3− to recover intra- and extracellular pH levels, with a capacity that appears to be species-specific. For Nile tilapia, a freshwater tropical teleost traditionally produced in earthen ponds, little information is available on the tolerance to dissolved levels of CO2 and associated acid-base disturbances. Here, we investigated first the effects of acute and progressively increasing CO2, from normocapnic conditions to 60 mg CO2 L−1, on oxygen uptake rates (MO2). This was followed by exposure to three concentrations of CO2; 10, 30, and 60 mg L−1 (equivalent to pCO2 of 5.4, 16.2, and 32.4 mmHg) against a normocapnic control (pCO2 0.3 mmHg), to investigate acute (1 h) or prolonged (24 h) effects on standard (SMR) and maximum metabolic rates (MMR), haematology, and extra- and intracellular acid-base status in adult Nile tilapia (mean BM 435 ± 16 g ± SE). Acute exposure to hypercapnia led to concentration-dependent decreases in both SMR and MMR. Fish were able to fully or partially recover MMR and metabolic scope (MS) after 24 h, while depression of SMR persisted at all CO2 levels. Acute exposure to CO2 caused intra- and extracellular pH levels to decrease by up to 0.5 units in a concentration-dependent manner. Only the lowest hypercapnic treatment (pCO2 5.4 mmHg) was able to fully recover within 24 h. Changes in haematological variables appeared minor, being restricted to increasing haematocrit, haemoglobin concentration, and mean cell volume in the highest CO2 treatments after 24 h exposure. Although the Nile tilapia is generally considered a species able to tolerate poor water quality, the modest or slow acid-base regulation following hypercapnic exposure suggests sensitivity to hypercapnia.

Significance of Haematological Variates in Determining Risk of Cardiovascular Complications Post SARS-CoV-2 Infection: A Prospective Cohort Study

Introduction: Coronavirus Disease-2019 (COVID-19) is an ongoing global pandemic. Changes in haematological variables in patients with COVID-19 are emerging as important features of the disease. These changes in haematological variables may provide significant clues in the prognosis post Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. Aim: To determine the significance of various haematological variables in cardiac outcomes post SARS-CoV-2 infection. Materials and Methods: This was a prospective cohort study conducted at Prince Faisal bin Khalid Cardiac Centre, Abha, Kingdom of Saudi between March 2021 and October 2021. A total of 59 patients who were infected with SARS-CoV-2 with or without cardiac complaints were involved. Demographic, clinical, and laboratory data were recorded. Leukocyte counts, Neutrophil Counts, Lymphocyte counts, Neutrophil to Lymphocyte Ratio (NLR), platelet counts, Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), and D-Dimer were assessed and compared between subjects who developed Cardiovascular Complications (CVC+ group) and the subjects who did not develop CVC post SARS-CoV-2 infection (CVCgroup). Statistical analyses were performed using R scripting language and R Studio (version 1.2.5033, Orange Blossom). For continuous variables, t-test (for normally distributed) and MannWitney U test (for non normally distributed) were employed. For categorical data, Chi-square test (c2 ) was used. A p-value &lt;0.05 was considered significant. Results: Among all the haematological variables assessed, Neutrophil counts (p&lt;0.0001), NLR (p&lt;0.0001), and PT (p&lt;0.0001) were highly significant for developing CVC post SARS-CoV-2 infection. Additionally, Leukocyte counts (p=0.028), Lymphocyte counts (p=0.0002), APTT (p=0.036), and D-dimer (p=0.022) also showed statistical significance for developing CVC post-SARSCoV-2 infection. Conclusion: Haematological testing is easily available, inexpensive, and provides almost instant results. Therefore, assessing haematological variables like Leukocyte counts, Neutrophil counts, Lymphocyte counts, NLR, PT, APTT, and D-Dimer values post SARS-CoV-2 infection can help doctors identify patients at higher risk of developing CVC and guide their interventions accordingly. This can potentially help in reducing the occurrence of cardiovascular complications.

Whole-Blood and Peripheral Mononuclear Cell Transcriptional Response to Prolonged Altitude Exposure in Well-Trained Runners.

Recombinant human erythropoietin (rHuEpo) abuse by athletes threatens the integrity of sport. Due to the overlap in physiological response to rHuEpo and altitude exposure, it remains difficult to differentiate changes in hematological variables caused by rHuEpo or altitude, and therefore, other molecular methods to enhance anti-doping should be explored. To identify the hematological and transcriptomic response to prolonged altitude exposure typical of practices used by elite athletes. Longitudinal study. University of Cape Town and Altitude Training Centre in Ethiopia. Fourteen well-trained athletes sojourned to an altitude training camp in Sululta, Ethiopia (∼2400-2500 m above sea level) for 27 days. Blood samples were taken before arrival, 24 hours, and 9, 16, and 24 days after arrival at altitude in addition to 24 hours and 6, 13, and 27 days upon return to sea level. Blood samples were analyzed for hemoglobin concentration, hematocrit, and reticulocyte percentage. The transcriptomic response in whole blood and peripheral blood mononuclear cells (PBMC) were analyzed using gene expression microarrays. A unique set of 29 and 10 genes were identified to be commonly expressed at every altitude time point in whole blood and PBMC, respectively. There were no genes identified upon return to sea level in whole blood, and only one gene within PBMC. The current study has identified a series of unique genes that can now be integrated with genes previously validated for rHuEpo abuse, thereby enabling the differentiation of rHuEpo from altitude exposure.

Declining haematocrit with increasing age in a population of male zebra finchesTaeniopygia guttata

Whole organismal declines in metabolic performance due to ageing are known to occur in virtually all higher vertebrates, the causes of such declines, however, are not fully understood. In mammals, haemoglobin concentration, haematocrit and red blood cell count begin to decrease in later life. In birds however, such knowledge on changes in haematological variables with increasing age is still scarce and existing data largely focuses on nestlings or differences between juveniles and adults. Here, forty‐five male zebra finchesTaeniopygia guttata, aged between 15 and 84 months were brought to their metabolic peak through exercise and then sampled for a full suite of haematological variables, including four directly measured primary haematological variables which were modelled against age as a continuous factor. We found a significant decline in haematocrit due to ageing in the birds (p = 0.029), a phenomenon observed in several other avian species but still unexplained. Haemoglobin did not change significantly (p = 0.156), while neither erythrocyte size or number showed any trends with age (p = 0.898 and p = 0.922 respectively) indicating that declining haematocrit is due to mechanisms other than decreasing cells size or number. We considered reticulocytes, being generally larger than mature erythrocytes as an explanation for declining haematocrit, however an a priori examination revealed an opposite result and increased with age (p = 0.016), leading us to believe that the decline in haematocrit with increasing age relates to differences in water homeostasis potential in older birds. The age dependence of haematological variables appears less clear in birds than in mammals. Besides oxygen carrying capacity, haematocrit influences the viscoelastic properties of blood, and it remains to be shown if this decline in haematocrit in birds can explain declining aerobic metabolism.

Enteral Vitamin B12 Supplementation Is Effective for Improving Anemia in Patients Who Underwent Total Gastrectomy

Background: This study aimed to investigate the efficacy of enteral supplementation of vitamin B₁₂ for vitamin B₁₂ deficiency in patients who underwent total gastrectomy for gastric cancer. Methods: The study enrolled 133 patients who underwent total gastrectomy for gastric cancer at Kochi Medical School. Clinical data were obtained to investigate associations between vitamin B₁₂ supplementation and vitamin B₁₂ levels. Vitamin B₁₂ deficiency was defined as serum vitamin B₁₂ less than 200 pg/mL. Baseline characteristics and changes in hematological variables, including vitamin B₁₂ levels, were examined. Results: Vitamin B₁₂ deficiency was present in 71.4% of the 133 patients. Vitamin B₁₂ levels at 3, 6, and 12 months after enteral supplementation were 306 pg/mL, 294 pg/mL, and 367 pg/mL, respectively, which were all significantly higher than those before supplementation (p < 0.001 for all comparisons). The median red blood cell count at 3, 6, and 12 months after enteral supplementation were 380 × 10⁴/mm³, 394 × 10⁴/mm³, and 395 × 10⁴/mm³, respectively, which were all significantly higher than those before supplementation (p = 0.020, p = 0.001, and p = 0.003, respectively). Vitamin B₁₂ levels at 3, 6, and 12 months after supplementation were significantly higher in patients supplemented enterally than those supplemented parenterally (p < 0.001 for all comparisons). Conclusions: Vitamin B₁₂ deficiency was found in 71.4% of postoperative patients who underwent total gastrectomy for gastric cancer, and enteral vitamin B₁₂ supplements might be effective to improve anemia in these patients.

The long-acting C5 inhibitor, Ravulizumab, is effective and safe in adult patients with atypical hemolytic uremic syndrome naïve to complement inhibitor treatment

Ravulizumab is a long-acting C5 inhibitor engineered from eculizumab with increased elimination half-life, allowing an extended dosing interval from two to eight weeks. Here we evaluate the efficacy and safety of ravulizumab in adults with atypical hemolytic uremic syndrome presenting with thrombotic microangiopathy. In this global, phase 3, single arm study in complement inhibitor-naïve adults (18 years and older) who fulfilled diagnostic criteria for atypical hemolytic uremic syndrome, enrolled patients received ravulizumab through a 26-week initial evaluation period. The primary endpoint was complete thrombotic microangiopathy response defined as normalization of platelet count and lactate dehydrogenase and 25% or more improvement in serum creatinine. Secondary endpoints included changes in hematologic variables and renal function. Safety was also evaluated. Ravulizumab treatment resulted in an immediate, complete, and sustained C5 inhibition in all patients. Complete thrombotic microangiopathy response was achieved in 53.6% of patients. Normalization of platelet count, lactate dehydrogenase and 25% or more improvement in serum creatinine was achieved in 83.9%, 76.8% and 58.9% of patients, respectively. Improvement in estimated glomerular filtration rate by one or more stage was achieved in 68.1% of patients by day 183. No unexpected adverse events were reported across a safety analysis set of 58 patients. Four deaths occurred (three within one month of study initiation, including one in a patient excluded based on eligibility criteria after the first dose) with none considered treatment-related by the study investigator. Thus, treatment with ravulizumab once every eight weeks resulted in rapidly improved hematologic and renal endpoints with no unexpected adverse events in adults with atypical hemolytic uremic syndrome.

More than just the numbers-contrasting response of snake erythrocytes to thermal acclimation.

Acclimation to lower temperatures decreases energy expenditure in ectotherms but increases oxygen consumption in most endotherms, when dropped below thermoneutrality. Such differences should be met by adjustments in oxygen transport through blood. Changes in hematological variables in correspondence to that in metabolic rates are, however, not fully understood, particularly in non-avian reptiles. We investigated the effect of thermal acclimation on a snake model, the grass snakes (Natrix natrix). After 6months of acclimation to either 18°C or 32°C hematocrit, hemoglobin concentration, erythrocyte number, and size were assessed. All variables revealed significantly lower values under warm compared to cold ambient temperature. Our data suggest that non-avian reptiles, similarly as birds, reduce erythrocyte fraction under energy-demanding temperatures. Due to low deformability of nucleated erythrocytes in sauropsids, such reduced fraction may be important in decreasing blood viscosity to optimize blood flow. Novel findings on flexible erythrocyte size provide an important contribution to this optimization process.

The acute effect of training fire exercises on fire service instructors

Fire service instructors (FSI) regularly experience different types of fire exercises, however the strain experienced from these scenarios is not well understood. This study aims to identify the physiological and perceptual strain of Fire Service Instructors (FSI) to three training exercises: DEMO, ATTACK, COMPARTMENT, and the different roles performed: SETTER, INSTRUCTOR. The study also aims to assess the effect that different exercise patterns over a day (BOX, MULTI, COMBINATION) have on immunological responses. Sixteen FSI (age: 41 ± 8 years, body mass: 83.7 ± 6.7 kg, height: 177.0 ± 6.7 cm) were recruited, with 10 FSI completing the three exercises. Physiological and perceptual measures were collected prior to and immediately post each exercise. Venous blood samples were collected at the beginning and end of each day. One-way analysis of variance (ANOVA) were conducted to assess differences in physiological variables between exercise types, independent samples t-tests were conducted between roles. Day changes in hematological variables were assessed by paired sample t-tests and analyzed by one-way ANOVAs to identify differences between exercise patterns. The COMPARTMENT exercise resulted in a greater change in rectal temperature (ΔTre) (0.49 ± 0.28 °C) than both the DEMO (0.23 ± 0.19 °C, p = 0.045) and ATTACK (0.27 ± 0.22 °C, p = 0.016). Within the COMPARTMENT exercise, the SETTER resulted in a greater ΔTre and rating of perceived exertion than the INSTRUCTOR (0.67 ± 0.29 °C vs. 0.43 ± 0.18 °C, p = 0.027 and 14 ± 2 vs. 11 ± 2, p = 0.001, respectively). Following a day of fire exercises white blood cells (WBC), neutrophils, lymphocytes (LYMPH), monocytes (MONO), platelets (PLT), mean platelet volume (MPV), Interleukin (IL)-6, and cardiac troponin T (cTnT) all increased (p < 0.05). Exercise patterns containing a COMPARTMENT exercise resulted in greater PLT, MPV, and IL-6. Total daily variation in ΔTre was correlated with post-exercise WBC, MONO, and LYMPH. COMPARTMENT exercises produce the greatest physiological strain, with the SETTER role within this exercise causing the greatest ΔTre. Although predominately physiological responses remain within safe limits. Exercise patterns that include a COMPARTMENT exercise also generate a greater inflammatory response.

Lower haematocrit, haemoglobin and red blood cell number in zebra finches acclimated to cold compared to thermoneutral temperature

Thermoregulation constitutes an important share of the energy budget of endotherms. Elevated thermoregulatory requirements must be met by oxygen supply through the blood, as heat is produced mainly via aerobic processes. In contrast to mammal studies, it remains unclear whether elevated thermoregulatory needs are followed by changes in haematological variables in birds. We investigated haematocrit (HCT), haemoglobin content per volume of blood (HGB), number of red blood cells (RBCcount), and size of the erythrocytes (RBCarea) in zebra finches Taeniopygia guttata acclimated to either cold or thermoneutral ambient temperatures under laboratory conditions. Seventy‐nine females were maintained for six weeks either in cold (T = +12°C) or thermoneutral (T = +32°C) ambient temperature prior to blood collection. On average, HGB, HCT and RBCcount were significantly lower by about 10% in cold acclimated compared to thermoneutral acclimated birds. Only RBCarea was not different between the two acclimation temperatures. Mean HCT, one of the most commonly measured haematological variable for example was 53 ± 0.9% (LSM ± SEM) in thermoneutral and 49 ± 0.8 % (LSM ± SEM) in cold acclimated zebra finches. On first sight, the observed lower values for three out of the four determined haematological variables in response to acclimation to cold question oxygen supply to be indeed a limiting factor for heat production. However, higher demands of oxygen supply due to increased thermoregulation in birds may instead require specific optimisation of blood viscosity and modulation by other cardiovascular properties. Nucleated red blood cells in birds may pose different strain on blood viscosity compared to non‐nucleated mammalian erythrocytes and explain the contrasting response in haematological variables to temperature acclimation between birds and mammals.

Influences of breed, sex and age on seasonal changes in haematological variables of tropical goat kids

Abstract. The influences of breed, sex and age on seasonal changes in haematological variables of kids (1–4 months old) belonging to Red Sokoto (n = 60) and Sahel (n = 60) goats were studied at the peaks of the cold-dry, hot-dry and rainy seasons in a West Africa Guinea savanna climate. The results showed that, during the hot-dry season, Sahel goat kids had significantly higher (P &lt; 0.05) packed cell volume (PCV) and red blood cell (RBC) count but lower (P &lt; 0.05) mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC) and total leucocyte count than Red Sokoto kids. Similarly, younger kids of both breed had significantly higher (P &lt; 0.05) PCV and RBC but lower MCV, MCH and MCHC compared with the older kids during the hot-dry season. Younger kids (1–2 months) of both breeds exhibited significantly (P &lt; 0.05) high PCV and RBC but low MCH and MCHC during the hot-dry season as compared with the cold-dry and rainy seasons, with the magnitude of the change being greater in Sahel kids. More remarkable seasonal fluctuations in haematological parameters were observed in buck kids than doe kids of both breeds. Multivariate analysis revealed a clear distinction between the change in haematological parameters during the cold-dry as compared with the hot-dry and rainy seasons, with MCV having the strongest discriminating power (0.91*). In conclusion, breed, age and sex variations in haematological variables of goats were more pronounced in the hot-dry season, during which the seasonal changes were more dramatic in kids of Sahel goats, as well as in younger and male kids of both breeds. These findings may be useful in the management of tropical goat kids in different seasons.

Reticulocyte and erythrocyte hypochromia markers in detection of iron deficiency in adolescent female athletes.

The aim of this study was to analyse the effectiveness of new haematology parameters related to reticulocytes and mature red blood cells to differentiate pre latent and latent iron deficiency. The study included 219 female athletes (aged 15-20 years) representing volleyball, handball, cycling, canoeing, cross-country skiing, swimming and judo. To assess iron status the concentration of ferritin, soluble transferrin receptor (sTfR), iron and total iron binding capacity (TIBC) were determined in serum. In addition to blood morphology, the mean cellular haemoglobin content in erythrocytes (CH) and reticulocytes (CHr), mean cellular haemoglobin concentration in reticulocytes (CHCMr), the percentage of erythrocytes (HYPOm) and reticulocytes (HYPOr) with decreased cellular haemoglobin concentration, the percentage of erythrocytes (LowCHm) and reticulocytes (LowCHr) with decreased cellular haemoglobin content, and percentage of erythrocytes with decreased volume (MICROm) were determined. Subjects with ferritin <30 ng/ml were classified as having stage I (pre-latent) iron deficiency (ID). The second stage (latent ID) was diagnosed when low ferritin was accompanied by elevated sTfR and/or elevated TIBC values. The frequency of ID (without anaemia symptoms) was high, amounting to 60% (stage I in 45%, stage II in 15% of subjects). In subjects with stage I ID significant changes in haematological variables concerned mainly reticulocytes: CHCMr (p<.001), CHr (p<.05), LowCHr (p<.05), HYPOr (p<.001) in comparison to normal iron stores. In athletes with latent ID, there were also significant changes (p<.001) in many indices of mature red blood cells, i.e. haemoglobin concentration (Hb), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), CH, %LowCHm, as well as %MICROm (p<.01) in relation to the group without iron deficiency. The main finding of this study was that the diminished or exhausted iron stores had already caused changes in reticulocytes, and intensified iron deficiency (stage II) increased changes in both reticulocytes’ and erythrocytes’ hypochromia indices, while microcythaemia symptoms appeared later. This suggests that the markers of hypochromia relating especially to reticulocytes are useful for diagnosis of early ID in athletes with absence of an acute phase reaction.

Erythrocyte osmotic fragility and select hematologic variables in postparturient mares and their foals.

Knowledge of hematologic function in postparturient mares and foals is crucial for the monitoring of their health status and for the prompt diagnosis of pathologic conditions. The aim of this study was to evaluate erythrocyte osmotic fragility (EOF) and select hematologic variables in mares and their foals during the first month after foaling. Blood samples were collected from each animal every 3 days from day 1 until day 30 after foaling, and tested for RBC count, HGB, HCT, MCV, and EOF. Two-way repeated measures analysis of variance (ANOVA) and Bonferroni post hoc comparison test were applied to determine the effects of time and age (mares vs foals). Pearson correlation coefficients were computed for EOF and time or MCV values. There was a significant effect of time in RBC, HGB, HCT, and EOF (P < .001). Statistically significant differences were observed between mares and foals for RBC, MCV, and EOF (P < .05) throughout the experimental period. Significant correlations between EOF and both time and MCV (P < .05) were found in mares as well as in foals. These results contribute to the understanding of perinatal changes in hematologic variables in mares and foals. In addition, the data support the relevance of specific reference intervals for postparturient mares and foals. The findings also provide useful information that could help clinicians to better interpret clinical data and diagnose equine disease.

Progression of anemia and its relationship with renal function, blood pressure, and erythropoietin in rats with chronic kidney disease.

In chronic kidney disease (CKD), anemia and hypertension are significant co-morbidities that contribute to cardiovascular and renal disease progression. The purpose of the study was to identify correlations between changes in hematologic variables against markers of renal function, blood pressure, and erythropoietin (EPO) in a naturally occurring hypertensive model of CKD, the Lewis polycystic kidney (LPK) rat. Complete blood count, systolic blood pressure, urea and creatinine concentration, urinary protein to creatinine ratio, and plasma EPO concentration were determined in control Lewis (n = 51) and LPK rats (n = 56) aged 6-24 weeks. Renal EPO gene expression and RBC osmotic fragility were also documented. Hematopoiesis in spleen and bone marrow were assessed. Lewis polycystic kidney rats had increasing urea and creatinine concentrations, concurrent with the development of a nonregenerative normocytic/normochromic anemia and hypertension, with a significant negative correlation between both HGB and HCT with urea concentration and blood pressure (P < .01). HCT was also significantly negatively correlated with creatinine concentration (P = .014). WBC was significantly negatively correlated with urea (P < .01). Plasma EPO concentration was increased and renal EPO mRNA expression was significantly upregulated in LPK animals. The former was significantly positively correlated with blood pressure and platelet count (P < .05). RBC osmotic fragility was normal in LPK rats and there was no evidence for increased RBC elimination or extramedullary hematopoiesis. Marked anemia in the LPK CKD rodent model in the presence of elevated EPO suggests inefficient erythropoiesis that is correlated with plasma urea concentration and blood pressure.

Hematological and Metabolic Changes with Balke and Bruce Maximal Exercise Protocols

BACKGROUND: Millions of people around the world from cardiac patients to elite athletes have experience the physiological demands of the maximal aerobic capacity treadmill protocols of Balke and Bruce. In classical papers Pollock et al have compared some physiological, cardiovascular, respiratory and metabolic demands of both tests. However, we have been unable to find acute hematological metabolic and lipids changes in those protocols. In this study we pretend to add results from those variables. PURPOSE: To study acute changes in hematological variables including glucose, lactate, lipids and plasma volume produced by Balke and Bruce Maximal Treadmill Exercise. METHODS: Fourt-seven subjects (25 men and 22 women) (mean 42 years) performed classical treadmill protocols of Balke and Bruce one week apart. Participants have a wide range of physical fitness. Blood samples were obtained before and after maximal test. Blood was utilized for measurement of hemoglobin, hematocrit, leucocytes, glucose, lactate, total cholesterol, HDL-C and triglycerides. Plasma volume was calculated by the micro method after Van Beaumont. RESULTS: Table 1. In our lab there was no significant difference in Maximal Heart Rate (178±12 vs 176±12 bpm). VO2 Max was higher in Bruce protocol (42.1 vs 37.2 ml*kg/min-1). Hb, Hct, leucocytes, glucose, lactate, TG, TC, HDL-C were similarly increased (P < 0.05) by both protocols. In contrast, the decrease (P < 0.05) in PV after the Bruce protocol was greater than after the Balke protocol (Table 1). CONCLUSIONS: Significant increases in all variables were observed in both tests. However, there were not significant differences between protocols. PV decrease more after Bruce protocol. Physiological hematological and metabolically responses to Balke and Bruce protocols are very similar.

Changes in hematology measurements in healthy and diseased dog blood stored at room temperature for 24 and 48 hours using theXT‐2000iV analyzer

Changes in canine hematology measurements may occur when analyses are delayed due to shipment of specimens to a laboratory. The purpose of this study was to report changes in hematologic variables in healthy and diseased canine blood measured with a Sysmex XT-2000iV during storage at room temperature for 24 and 48 hours. EDTA-K3 blood samples from 42 healthy and diseased dogs were measured on a Sysmex XT-2000iV analyzer within one hour of sampling, and after storage for 24 and 48 hours at room temperature in the dark. Storage caused little or no change in RBC count, HGB concentration and MCH, while there was a moderate increase in HCT, MCV and reticulocytes count, and a moderate decrease in MCHC. Decreased platelet counts by impedance (PLT-I) and optical (PLT-O) measurements were associated with increased mean platelet volume (MPV), platelet-large cell ratio (P-LCR) and platelet distribution width (PDW), including a right shift in the platelet histogram and a dispersion of the platelet dot plot on the scattergram. The total and differential WBC count remained stable except for decreased monocyte counts. In the scatterplots, monocytes shifted into the lymphocyte population after 24 hours, and neutrophil population shifted to the right appearing in the eosinophil gate at 48 hours of storage. The disease status had only a small effect on storage-induced changes, and observed changes had no consequences for clinical decisions. Blood storage at room temperature was accompanied by moderate variations in some hematologic variables, awareness of which helps in avoiding misinterpretations.

Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure

BackgroundThe aim of this study was to investigate the effect of a levosimendan infusion on hematological variables in patients with acute decompensated heart failure (ADHF). The predictive value of these variables for in-hospital mortality was also evaluated. MethodsA total of 553 patients (368 males; mean age, 63.4±14.9 years) with acute exacerbations of advanced heart failure (ejection fraction ≤35%) and treated with either dobutamine or levosimendan were included in this retrospective analysis. The patients that received levosimendan therapy were divided into two groups according to in-hospital mortality: group 1 (21%) included patients who died during hospitalization (n=45), while group 2 (79%) included patients with a favorable outcome (n=174) after levosimendan infusion. Changes in several hematological variables between admission and the third day after levosimendan infusion were evaluated. ResultsThe demographic characteristics and risk factors of the two groups were similar. A comparison of changes in laboratory variables after the infusion of levosimendan revealed significant improvement only in those patients who had not died (group 2) during hospitalization. The neutrophil to lymphocyte (N/L) ratio after levosimendan infusion was an independent predictor of in-hospital mortality (odds ratio: 1.310, 95% CI: 1.158–1.483, p<0.001). In a receiver-operating characteristic curve analysis, a value of 5.542 for the N/L ratio after levosimendan administration was identified as an effective cut-off point for predicting in-hospital mortality (area under the curve=0.737; 95% confidence interval=1100–1301; p<0.001). ConclusionsLevosimendan treatment was associated with significant changes in hematological variables in patients with ADHF. A sustained higher N/L ratio after levosimendan infusion is associated with an increased risk of in-hospital mortality in patients with ADHF.

Intravenous Ferric Carboxymaltose As Sole Anemia Therapy In Patients With Lymphoid Malignancies, Chemotherapy-Induced Anemia and Functional Iron Deficiency

IntroductionFor patients with chemotherapy-induced anemia (CIA) and functional iron deficiency (FID) who are treated with an erythropoiesis-stimulating agent (ESA), guidelines recommend intravenous (IV) iron supplementation and resolution of iron deficiency (ID) before ESA use to reduce blood transfusions and ESA doses (both linked to safety concerns). This prospective, randomized phase II study evaluated ferric carboxymaltose (FCM, Vifor Pharma) without additional ESA for correction of anemia and FID in patients with lymphoid malignancies receiving antineoplastic therapy. Patients and MethodsPatients with indolent lymphoid malignancies (non-Hodgkin lymphoma, multiple myeloma or chronic lymphocytic leukemia), anemia (Hb 8.5-10.5 g/dL) and FID (transferrin saturation [TSAT] ≤20% and stainable bone marrow iron or serum ferritin >30 ng/mL [women] to >40 ng/mL [men]), who had been on chemotherapy (CT) for at least 8 weeks or two cycles were randomized to FCM (1000 mg iron) or no anemia treatment (control). Iron was administered within 24 hours before or after the next chemotherapy cycle's first treatment. The primary endpoint was the mean Hb change from baseline to Weeks 4, 6 and 8 without use of blood transfusions or ESA. Secondary endpoints included Hb response (increase ≥1.0 g/dL) or Hb correction (Hb ≥11.0 g/dL) at any week and changes in hematologic variables, endogenous erythropoietin (EPO), hepcidin and interleukin (IL)-6 over time. Data are shown as median [range]. Enrollment was stopped after 19 of planned 40 patients due to low recruitment. ResultsOf 19 randomized patients, 17 (8 FCM, 9 control; 11 males, age 71 y [26-88 y]) were analyzed for the primary endpoint (full analysis set, FAS). FCM-treated patients had a significant Hb increase vs. baseline at any week (Table). Mean Hb increase at Week 8 was significantly higher in the FCM than the control group (FAS, Fig. A, Table). In the per protocol population (PPS; 5 FCM, 7 control), mean Hb increase in the FCM group was significantly higher from Week 4 onwards (Fig. B). All FCM-treated patients in the FAS achieved Hb response (time to response 2.3 [0.6-6.0] weeks) compared to only 6 of 9 (66.7%) control patients (time to response 4.4 weeks). Hb was corrected in 87.5% (7 of 8) FCM-treated and 55.6% (5 of 9) control patients. In the FCM group, median Hb was >11.0 g/dL from Week 6 and TSAT was >20% from Week 2 onwards, whereas in the control group, none exceeded these cut-offs. EPO, hepcidin and IL-6 levels did not show any significant variations (Table). No blood transfusion or ESA treatment was given in either group, and no treatment-related adverse events (AEs) were recorded during the study. Five (62.5%) patients in the FCM and one (9.1%) in the control group reported 12 and 2 unrelated AEs, respectively, in this open-label study. All AEs except one unrelated, fatal post-study injury were mild or moderate. [Display omitted] [Display omitted] ConclusionThis pilot study indicates that ferric carboxymaltose without additional ESA may effectively increase and correct Hb levels and is well tolerated in patients with lymphoid malignancies, CIA and FID. Hb improvement is supported by resolution of ID from the first post-treatment visit onwards. A larger phase 3 study in a representative patient population is warranted to confirm the results of this study. Disclosures:Hedenus:Vifor Pharma: Consultancy, Honoraria. Ludwig:Vifor Pharma: Honoraria. Felder:Vifor Pharma: Employment. Roubert:Vifor Pharma: Employment. Birgegard:Vifor Pharma: Honoraria.

Artifactual changes in hematological variables in equine blood samples stored at different temperatures and various anticoagulants

The objective of this study was to determine the effect of storage time, temperature, and anticoagulant on hematologic parameters in equine blood samples. Blood samples were obtained from 50 clinically healthy warm-blooded horses at two major equestrian complexes in Tehran, Iran. The samples were collected in three different tubes containing EDTA, sodium citrate, or heparin and were analyzed within 4 h of collection. Blood samples collected into EDTA-containing tubes were stored at 4°C or 24°C. Each sample was analyzed again at 24, 48, and 72 h after collection. The statistically significant (P < 0.05) alterations included decreased RBC count and increased hemoglobin concentration [Hgb] in blood samples stored at 24°C after 48 and 72 h; increased hematocrit in blood samples stored at 24°C after 24 h; decreased hematocrit in blood samples stored at 4°C after 72 h; decreased MCHC in blood samples stored at 4°C after 72 h; and decreased total WBC count in blood samples stored at 24°C after 48 h. Although there was no significant difference in hematologic analytes between heparinized and EDTA-anticoagulated blood samples, most of the hematologic analytes were decreased significantly (P < 0.05) in sodium citrate-containing blood samples, compared with blood samples stored in EDTA. The results of this study suggest that within certain limitations for some hematologic analytes, equine blood samples stored in EDTA at 4°C for up to 72 h may be suitable for hematologic testing.

Artifactual changes in hematological variables in equine blood samples stored at different temperatures and various anticoagulants

Artifactual changes in hematological variables in equine blood samples stored at different temperatures and various anticoagulants