Decrease In Hemoglobin Concentration Research Articles

Dietary administration of Bacillus subtilis , inulin and its synbiotic combination improves growth and mitigates stress in experimentally infected Pseudoplatystoma reticulatum

Juveniles of Pseudoplatystoma reticulatum (36.25 g and 19.32 cm) were randomly distributed in 16 tanks with 80 L of water. The fish were fed with diets containing probiotic (2%), prebiotic (0.5%), synbiotic (2% probiotic +0.5% prebiotic) and diet without additives (control). After 60 days of feeding, the fish were challenged with inoculation of the Aeromonas hydrophila (0.9 × 106 CFU/mL). Growth performance, physiological, immunological and haematological analyses were evaluated. Fish fed with probiotic, inulin and synbiotic diet showed greater (p = 0.018) weight gain when compared to control fish, and the condition factor was better (p < 0.001) in fish fed with probiotic. Cortisol concentrations increased in all treatments after challenge (p = 0.27), however, after A. hydrophila injection of 6 h, the cortisol levels increased significantly in fish that received control diet. The haematocrit (p < 0.001) and lymphocytes percentages (p < 0.001) decreased after A. hydrophila injection of 3 and 6 h, and neutrophils percentages increased (p < 0.001), without difference among treatments. The not supplemented and supplemented with prebiotic and synbiotic fish groups had decreased haemoglobin concentration (p = 0.01) at after 3 and 6 h. The juvenile catfish fed with probiotic (2% Bacillus subtilis), prebiotic (0.05% inulin) and the synbiotic combination for 60 days had better productive performance, ensuring greater weight gain and growth. The supplemented diets inhibited the cortisol increase when fish are challenged with A. hydrophila, but it does not inhibited the effects of the stress imposed by the bacterial infection.

Analysis of Selected Nutritional Parameters in Patients with HPV-Related and Non-HPV-Related Oropharyngeal Cancer before and after Radiotherapy Alone or Combined with Chemotherapy.

Simple SummaryThe aim of this study was to assess and compare the nutritional status (NS) of patients with HPV-related (HPV+) and non-HPV-related (HPV-) oropharyngeal cancer (OPC) before and after radiotherapy (RT) or chemoradiotherapy (CRT). The analysis included 127 patients with OPC who underwent radiotherapy (RT) alone, or in combination with chemotherapy (CRT). In both groups, a significant decrease in all analyzed nutritional parameters was noted after RT/CRT. Overall survival (OS) and disease-free survival (DFS) were significantly better in patients with a higher BMI in the HPV- group; DFS was significantly better in patients with total lymphocyte count (TLC) >1.28/mm3 in the HPV+ group. Higher NRS 2002 was an independent adverse prognostic factor for OS and DFS in HPV-, but not in the HPV+ group. Regardless of HPV status, patients with OPC can develop malnutrition during RT/CRT. Therefore, nutritional support during RT/CRT is required in patients with HPV- and HPV+ OPC.Background: Radiotherapy plays an essential role in the treatment of oropharyngeal carcinoma (OPC). The aim of this study was to assess and compare the nutritional status (NS) of patients with HPV-related (HPV+) and non-HPV-related (HPV-) OPC before and after radiotherapy (RT) or chemoradiotherapy (CRT). Methods: The analysis included 127 patients with OPC who underwent radiotherapy (RT) alone, or in combination with chemotherapy (CRT), in the I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (formalin-fixed, paraffin-embedded) tissue material and/or extracellular circulating HPV DNA. Basic anthropometric and biochemical parameters before and after RT/CRT were compared between the HPV- and HPV+ groups. The effect of NS on survival was also analyzed. Results: In both groups, a significant decrease in all analyzed nutritional parameters was noted after RT/CRT (p < 0.01). CRT caused significant weight loss and decreases in BMI, albumin, total lymphocyte count (TLC), and hemoglobin concentration, as well as an increase in the Nutritional Risk Score (NRS) 2002, in HPV- and HPV+ patients. A significant decrease in prealbumin levels after CRT was noted only in HPV+ patients. RT caused a significant decrease in hemoglobin concentration and TLC in HPV- patients. There were no significant differences regarding other nutritional parameters after RT in either group. RT did not have negative impact on body mass index (BMI), weight, NRS, CRP, Alb, Prealb, or PNI. Overall survival (OS) and disease-free survival (DFS) were significantly better in patients with a higher BMI in the HPV- group (OS, p = 0.011; DFS, p = 0.028); DFS was significantly better in patients with C-reactive protein (CRP) < 3.5 g/dL in the HPV- (p = 0.021) and HPV+ (p = 0.018) groups, and with total lymphocyte count (TLC) >1.28/mm3 in the HPV+ group (p = 0.014). Higher NRS 2002 was an independent adverse prognostic factor for OS and DFS in HPV-, but not in the HPV+ group. Kaplan–Meier analysis showed that both OS and DFS were significantly better in HPV- patients with lower NRS 2002 scores. However, this relationship was not observed in the HPV+ group. Conclusions: Regardless of HPV status, patients with OPC can develop malnutrition during RT/CRT. Therefore, nutritional support during RT/CRT is required in patients with HPV- and HPV+ OPC.

A PROSPECTIVE STUDY OF RED CELL INDICES FOR THE DIAGNOSIS OF EARLY NUTRITIONAL ANAEMIA IN NORMAL RANGE HAEMOGLOBIN CONCENTRATION

Background: Anaemia is a condition where there is a decrease in total number of RBC or decrease in haemoglobin concentration.(1) According to the Oxford University, in 2019, the global prevalence of Anaemia in all ages was 22.8% (95% CI: 22.6-23.1) (2). With this magnitude of disease burden, It is important to diagnose anaemia before its full blown symptoms appear. This study has been done to emphasize on Red Cell Indices as a useful tool to diagnose anaemia in a patient who still fall under normal range of Haemoglobin. Method: It’s a prospective observational study in which 100 Heathy Adults were observed for a period of 6 months. Their basic demographic data has been collected, and they were subjected to routine haematology and Biochemistry investigations. Appropriate therapy was given to them and follow-up was done after 2 months and their respective data was compared. Results: Out of 100 Adults, 75% have Low Normal Haemoglobin level. After intervention there was a signicant difference between mean Pre-treatment and mean Post-treatment Haemoglobin concentration (14.176 to 14.943), Red Blood Cell Count (4.696 to 5.272), MCV of macrocytic Anaemia (108.99 to 89.32), MCV of dimorphic Anaemia (89.80 to 83.21), and MCH (30.24 to 28.63). Conclusion: In our study, we noticed that even if an individual’s Haemoglobin fall under normal range, he/she might be in PreAnaemic state where his/her Red-cell Indices will help us to early detect and treat the individual in order to decrease the morbidity and incidence of anaemia.

A Case Study: Role of Darvyadi Lauha in Pandu Roga

Ayurvedic classics have always attempted to meet the requirement for knowledge breakthroughs in order to keep up with the demands of time. The stated goal of Ayurveda as a medical system is to help humanity live a healthier and longer life. Pandu or Anemia, is one of the most common illnesses that people face. Pandu is a disorder that causes pale discoloration of the body. Pandu Roga is a disease that is described in Ayurveda's main classical texts. Pandu Roga is a Rasa pradoshaja vikara, according to Acharya Charak. Pandu Roga was given a name according on how it was presented. The symptoms of pandu roga are similar to anemia. Anemia is a disease which is characterized by decreased hemoglobin concentration. Because Anemia is such a widespread ailment in today's culture, and the adverse effects of allopathic iron preparations, like constipation and gastrointestinal irritation, are so common, a healthier alternative, named Darvyadi Lauha, is required. Triphala, Trikatu, Daruhaldi, Vidanga and Lauhabhasama are the ingredients. These herbs function on the levels of Dosha, Dushya, Agni, and Strotas, while Lauha Bhasma has Rakta Dhatu Vardhan property.

Total Knee Arthroplasty: Superiority of Intra-Articular Tranexamic Acid Over Intravenous and Cell Salvage as Blood Sparing Strategy - A Retrospective Study.

PurposeTotal knee arthroplasty is associated with considerable perioperative hemorrhage. The decrease in hemoglobin concentration and the need for allogenic blood transfusion are related to increased morbidity and mortality. Strategies for minimizing perioperative bleeding are used, such as tranexamic acid and cell salvage. The study aimed to compare intravenous, intra-articular tranexamic acid and cell salvage protocols regarding perioperative hemoglobin variation. Secondary outcomes included blood loss; allogenic transfusions; complications and in-hospital stay.Patients and MethodsPatients submitted to unilateral total knee arthroplasty between January and December 2018 were retrospectively evaluated. After excluding 62 patients, 204 were subdivided into 3 groups according to the protocol used. Statistical analysis was performed with SPSS version 26.0. One-way ANOVA and Kruskal–Wallis tests were used. Considered a p-value of <0.05 for statistical significance.ResultsVariation of hemoglobin in the intra-articular tranexamic acid group was significantly lower than that of intravenous (p < 0.001) and cell salvage (p = 0.001) groups. Blood loss, variation of hematocrit, need for blood transfusion and in-hospital stay were also statistically significantly lower in the intra-articular tranexamic acid group. The only related complications were in the intravenous tranexamic acid group. No thromboembolic complications were identified which further solidifies the safety of tranexamic acid administration.ConclusionThis data shows superiority of the intra-articular administration of tranexamic acid over the other techniques in total knee arthroplasty. We propose this protocol as an efficient, low-risk blood-sparing strategy.

Influence of putrefactive decay of the hoof horn in sheep on its biochemical and biomechanical properties and hemodynamics in sick animals

Sheep breeding is currently an intensively developing branch of animal husbandry. However, one of the limiting factors of its further economically viable development is the mass distribution in the conditions of large sheep-breeding farms with a non-walking technology for keeping purulent-necrotic and putrefactive lesions in the tissues of the distal part of the limbs. The etiology and pathogenesis of these pathologies is currently not fully scientifically substantiated and detailed. In this regard, we assessed the effect of putrefactive decay of the hoof horn in sheep on its biochemical and biomechanical properties, as well as on hemodynamics in diseased animals in comparison with clinically healthy ones. According to the results of the studies, it was determined that during the putrefactive decay of the hoof horn, the percentage of moisture was higher by 12.37%, and the inorganic residue (ash), fat, protein and sulfur was lower by 73.84%, 36.84%, 5.92 % and 3.82% than in its normal morpho-functional state, respectively. This, in turn, had an impact on the biomechanical properties of the hoof horn, namely, during its putrefactive decay, a decrease in compressive elasticity by 3.82%, tensile strength by 28.76%, resistance to repeated bending by 9.61% was recorded relative to similar biomechanical indicators in samples of the hoof horn obtained from clinically healthy sheep. At the same time, in the hemodynamics of diseased animals with putrefactive decay of the hoof cover, in a comparative aspect with similar hematological indicators in clinically healthy sheep, a decrease in the number of erythrocytes and platelets by 28.94% and 7.03%, a decrease in hemoglobin concentration and hematocrit value by 22.88 % and 8.80%, an increase in the number of leukocytes and erythrocyte sedimentation rate by 89.14% and 44.70%, respectively.

Abnormal oxidative metabolism in the cuprizone mouse model of demyelination: An in vivo NIRS-MRI study

Disruptions in oxidative metabolism may occur in multiple sclerosis and other demyelinating neurological diseases. The impact of demyelination on metabolic rate is also not understood. It is possible that mitochondrial damage may be associated with many such neurological disorders. To study oxidative metabolism with one model of demyelination, we implemented a novel multimodal imaging technique combining Near-Infrared Spectroscopy (NIRS) and MRI to cuprizone mouse model. The cuprizone model is used to study demyelination and may be associated with inhibition of mitochondrial function. Cuprizone mice showed reduced oxygen extraction fraction (−39.1%, p ≤ 0.001), increased tissue oxygenation (6.4%, p ≤ 0.001), and reduced cerebral metabolic rate of oxygen in cortical gray matter (−62.1%, p ≤ 0.001). These changes resolved after the cessation of cuprizone exposure and partial remyelination. A decrease in hemoglobin concentration (−34.4%, p ≤ 0.001), but no change in cerebral blood flow were also observed during demyelination. The oxidized state of the mitochondrial enzyme, Cytochrome C Oxidase (CCO) increased (46.3%, p ≤ 0.001) while the reduced state decreased (−34.4%, p ≤ 0.05) significantly in cuprizone mice. The total amount of CCO did not change significantly during cuprizone exposure. Total CCO did decline after recovery both in control (−23.1%, p ≤ 0.01) and cuprizone (−28.8%, p ≤ 0.001) groups which may relate to age. A reduction in the magnetization transfer ratio, indicating demyelination, was found in the cuprizone group in the cerebral cortex (−3.2%, p ≤ 0.01) and corpus callosum (−5.5%, p ≤ 0.001). In summary, we were able to detect evidence of altered CCO metabolism during cuprizone exposure, consistent with a mitochondrial defect. We observed increased oxygenation and reduced metabolic rate associated with reduced myelination in the gray and white matter. The novel multimodal imaging technique applied here shows promise for noninvasively assessing parameters associated with oxidative metabolism in both mouse models of neurological disease and for translation to study oxidative metabolism in the human brain.

Saffron (Crocus sativus L.) Flower Water Extract Disrupts the Cecal Microbiome, Brush Border Membrane Functionality, and Morphology In Vivo (Gallus gallus).

Saffron (Crocus sativus L.) is known as the most expensive spice. C. sativus dried red stigmas, called threads, are used for culinary, cosmetic, and medicinal purposes. The rest of the flower is often discarded, but is now being used in teas, as coloring agents, and fodder. Previous studies have attributed antioxidant, anti-inflammatory, hepatoprotective, neuroprotective, anti-depressant, and anticancer properties to C. sativus floral bio-residues. The aim of this study is to assess C. sativus flower water extract (CFWE) for its effects on hemoglobin, brush boarder membrane (BBM) functionality, morphology, intestinal gene expression, and cecal microbiome in vivo (Gallus gallus), a clinically validated model. For this, Gallus gallus eggs were divided into six treatment groups (non-injected, 18 Ω H2O, 1% CFWE, 2% CFWE, 5% CFWE, and 10% CFWE) with n~10 for each group. On day 17 of incubation, 1 mL of the extracts/control were administered in the amnion of the eggs. The amniotic fluid along with the administered extracts are orally consumed by the developing embryo over the course of the next few days. On day 21, the hatchlings were euthanized, the blood, duodenum, and cecum were harvested for assessment. The results showed a significant dose-dependent decrease in hemoglobin concentration, villus surface area, goblet cell number, and diameter. Furthermore, we observed a significant increase in Paneth cell number and Mucin 2 (MUC2) gene expression proportional to the increase in CFWE concentration. Additionally, the cecum microbiome analysis revealed C. sativus flower water extract altered the bacterial populations. There was a significant dose-dependent reduction in Lactobacillus and Clostridium sp., suggesting an antibacterial effect of the extract on the gut in the given model. These results suggest that the dietary consumption of C. sativus flower may have negative effects on BBM functionality, morphology, mineral absorption, microbial populations, and iron status.

Diagnostic study of trypanosomiasis of cats in Mosul, Iraq.

Trypanosomiasis is a zoonotic parasitic disease endemic in Iraq but with limited information about its occurrence in cats. This study was designed to detect Trypanosoma spp. in cats using microscopic examination by Giemsa stain and conventional polymerase chain reaction (PCR) technique in Mosul, Iraq. A total of 120 blood samples from cats were microscopically examined using Giemsa stain. Only 35 positive blood samples were examined by the conventional PCR technique. Hematological changes were also reported. The infection rate of Trypanosoma spp. was 34.2% (41 out of 120). Results of conventional PCR technique for the positive 35 blood samples indicated 31.4% as Trypanosoma spp. and 20% Trypanosoma evansi. This study showed that the infection in younger cats was significantly more than in older cats, with significant differences between females and males. Affected cats suffered from fever, dullness, pale mucous membranes, emaciation, muco-purulent ocular discharge, anorexia, incoordination, and anemia. Results of the blood picture indicated increase in total leukocyte count and decrease in hemoglobin concentration, packed cell volume, and total red blood cells. Trypanosoma spp. and T. evansi infection in Mosul of Iraq is reported for the first time in cats, and younger cats were more affected than older cats.

Hermansky–Pudlak Syndrome Type 6 Accompanied with Bowel Vascular Malformation: Clinical Case

Background. Hermansky–Pudlak syndrome type 6 is rare hereditary disease caused by pathogenic variants in base sequence, deletions, and insertions in the HPS6 gene encoding the transmembrane protein of the same name. This disease occurs with hemorrhagic syndrome, oculocutaneous albinism, and inflammatory bowel diseases (in some cases). The clinical picture of the disease, including the gastrointestinal tract pathology, has not been studied completely due to the syndrome rarity.Clinical case description. We would like to present the description of clinical case of the patient with Hermansky–Pudlak syndrome type 6 accompanied with bowel vascular malformation. The patient diagnosed with “oculocutaneous albinism” at the age of 4.5 has shown recurrent intestinal bleedings, blood hemoglobin concentration decrease to 45 g/l; platelet count, mean platelet volume and platelet distribution width remained within the reference values. Slight decrease of Quick’s value to 68% (normal range 70–120%) was revealed. The study of platelet morphology has revealed a decrease in the number of dense granules: &lt; 3 in 25% platelets, &lt; 6 — in 64%. Ultrasound investigation has revealed signs of vascular malformation in ascending colon: significant changes of diameter (widening) and shape of intestinal wall vessels. Molecular genetic analysis (NGS) has revealed the nucleotide variant c.1133T&gt;G (p.Leu378Arg) in homozygous state in the HPS6 gene. The same variant in homozygous state was revealed in the younger proband sister who also had vascular changes in the ascending colon wall.Conclusion. Differential diagnosis of Germanic–Pudlak syndrome type 6 should be performed with other types of this syndrome as well as with syndrome and non-syndrome forms of oculocutaneous albinism. Molecular genetic confirmation of the diagnosis is suggested via massive parallel sequencing (NGS) methods (exome sequencing included) due to the rarity of Hermansky–Pudlak syndrome.

Oxidative damage of canine erythrocytes after treatment with non-steroidal anti-inflammatory drugs.

To investigate oxidative erythrocyte damage in dogs treated with different non-steroidal anti-inflammatory drugs. Case-controlled prospective observational study using blood obtained from dogs presenting for lameness examinations or standard surgical procedures to a private referral clinic. Sampling was performed from April 2018 to July 2019. Groups comprised dogs receiving either metamizole (dipyrone) (22 dogs), carprofen (20 dogs) or meloxicam (20 dogs) for a minimum of 10 days. Dogs with gastrointestinal hemorrhage were excluded from the study. A complete hematological, as well as a basic biochemical profile were performed in every dog. Pappenheim stained blood smears were evaluated for eccentrocytes and brilliant cresyl blue stained smears for Heinz bodies. EDTA blood was frozen at -80°C immediately after sampling for measurement of superoxide dismutase and gluthathione peroxidase activity at an external laboratory. Hemoglobin concentration, superoxide dismutase and gluthathione peroxidase activities, reticulocyte count, eccentrocyte and Heinz body numbers were determined prospectively as key parameters for further statistical assessment with Kruskal-Wallis test and Dunn's multiple comparisons test. Dogs receiving metamizole showed a significant increase in eccentrocyte (median 14.5/500 cells vs. 0/500 cells in the other groups, p < 0.0001) and reticulocyte number (median 191.4 × 109/l vs. 31.6-37.9 × 109/l, p < 0.0001) and a significant decrease in hemoglobin concentration (median 8.4 mmol/l vs. 10.1-10.5 mmol/l, p < 0.0003). No significant difference in superoxide dismutase and gluthathione peroxidase activities was observed between dogs receiving metamizole and the other groups. Heinz bodies were not found in any of the dogs. Treatment with metamizole for 10 or more days resulted in decreased hemoglobin concentration, eccentrocytosis and reticulocytosis in dogs in this study. This might be a sign of increased oxidative damage caused by this drug. Prolonged metamizole therapy should be evaluated critically in patients already affected by severe illness or underlying anaemia.

Uterine exteriorization versus in situ repair in Cesarean delivery: a systematic review and meta-analysis.

We conducted an updated systematic review and meta-analysis on maternal outcomes associated with uterine exteriorization compared with in situ repair in women undergoing Cesarean delivery. We searched for randomized controlled trials comparing uterine exteriorization with in situ repair during Cesarean delivery. Primary outcomes were intraoperative nausea and vomiting (IONV) and perioperative decrease in hemoglobin concentration. Secondary outcomes were postoperative nausea and vomiting (PONV), estimated blood loss, fever, endometritis, wound infection, intraoperative and postoperative pain, postoperative analgesic use, duration of surgery and hospital stay, and time to return of bowel function. Twenty studies with 20,909 parturients were included. Exteriorization was associated with higher risk of IONV (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.66 to 2.63; I2 = 0%), with no difference in perioperative hemoglobin concentration decrease (mean difference, -0.06 g·dL-1; 95% CI, -0.20 to 0.08; I2 = 97%) compared with in situ repair. There were no significant differences in estimated blood loss, transfusion requirement, PONV, duration of surgery, duration of hospital stay, time to return of bowel function, fever, endometritis, or wound infection. Postoperative pain (incidence of pain graded > 5/10) at six hours (OR, 1.64; 95% CI, 1.31 to 2.03; I2 = 0%) was higher with exteriorization, but there was no difference in need for rescue analgesia (OR, 2.48; 95% CI, 0.89 to 6.90; I2 = 94%) or pain scores at 24 hr compared with in situ repair. In this updated systematic review and meta-analysis, uterine exteriorization was associated with an increased risk of IONV but no significant change in perioperative hemoglobin decrease compared with in situ repair. PROSPERO (CRD42020190074); registered 5 July 2020.

MGUS and Chip: Two Faces, but Not of the Same Medal

Clonal, pre-clinical expansions of hematopoietic cells are increasingly recognized. Clonal hematopoiesis of indeterminate potential (CHIP) has been recently described. It is characterized by the presence of mutations usually involved in myeloid neoplasia in people without any sign of hematological malignancy. Well before CHIP, another pre-clinical clonal expansion has been described for plasma cells (PC) based on the presence of a serum monoclonal protein, namely monoclonal gammopathy of undetermined significance (MGUS). Despite both being frequent, the association between these two bone marrow (BM) clonal entities has not been determined yet. Since the incidence of MGUS and CHIP rises with age reaching >10% of people >70y, we analyzed a unique oldest-old population dataset to define a possible association between these two different BM clonal disorders.We analyzed a cohort of 777 patients with a median age of 91 years (range, 81 - 104), significantly higher than previous studies on MGUS. 579 (74.5%) were females and 198 (25.5%) males. CHIP was assessed in all but 45 through sequencing of a myeloid specific gene panel. Serum protein electrophoresis was available in all of them to assess the prevalence of MGUS. The prevalence of CHIP and MGUS were 17.5% (128/732) and 9.5% (74/777), respectively. Importantly, CHIP and MGUS did not associate in our cohort but rather showed a non-significant trend towards anti-correlation (Fisher's Exact test, p-val = 0.09). We then tested associations with different clinical and laboratory features, finding that, as expected, MGUS associated with higher concentration of gamma-globulins (Wilcoxon test, p-val = 0.01414), but also with absolute lower levels of albumin (Wilcoxon test, p-val = 0.01398). No significant association was found with the mean corpuscular value (MCV), hemoglobin levels or age. These results were confirmed by a logistic univariate model, in which also the male gender resulted associated with the presence of a monoclonal component with borderline significance. Then, to further corroborate our results we performed univariate linear regression analyses. Given that CHIP and MGUS are mainly considered two aging conditions, we investigated in linear regression models the impact of age, as a continuous variable, on other clinical features. In particular, we observed that the increase of age was significantly correlated with lower albumin levels (F-stat: 1.921e+04, Adj R-squared: 0.9288, p-val: < 2.2e-16), decreasing hemoglobin concentration (F-stat: 1.434e+05, Adj R-squared: 0.9898, p-val < 2.2e-16), increasing levels of gamma-globulins (F-stat: 9.21e+04, Adj R-squared: 0.9843, p-val < 2.2e-16) and higher MCV (F-stat: 18.04, Adj R-squared: 0.01144, p-val 2.3e-05). Then, a significant anti-correlation between gamma-globulin and serum albumin levels was also confirmed (F-stat: 2.807e+04, Adj R-squared: 0.9501, p-val < 2.2e-16). Finally, we implemented two different multivariate logistic models using as independent variables the presence or absence of MGUS or CHIP, respectively. In these models, the presence of a monoclonal component was only positively associated with a higher level of gamma-globulins (Est: 0.16238, p-val = 0.00079) and not with increasing age (Est: 0.02680, p-val = 0.31819). Interestingly, the presence of an MGUS confirmed a tendency to an anti-correlation with the presence of CHIP (Est: -0.78959, p-val = 0.06468). On the contrary, CHIP as independent variable resulted significantly correlated with increasing age (Est: 0.07396, p-val = 0.00021). The spectrum of mutations in CHIP cases with or without MGUS was not significantly different, with DNMT3A and TET2 being the most frequently mutated genes.Our study shows that, in a large cohort of oldest-old patients, CHIP and MGUS are not correlated but follow two seemingly independent patterns, showing a tendency to a mutual exclusivity and associating with different clinical and laboratory values. One limitation of our study is the skewing towards female sex, where MGUS is less prevalent, but this is explained by the cohort's median age knowing that females have a longer expected life. Based on this, our findings that CHIP but not MGUS increased with age in our cohort suggest different selective pressures in this extreme age range. These results warrant further investigation as to whether there could be age-specific drivers for MGUS, and their clinical relevance. DisclosuresBolli: Amgen: Honoraria; Takeda: Honoraria; Janssen: Consultancy, Honoraria; Celgene/BMS: Consultancy, Honoraria.

Changes in haematological parameters in hens under short-term exposure to adverse environmental factors

Short-term exposure to adverse factors is a common phenomenon in industrial egg production. An urgent problem is to understand the impact of environmental changes on poultry use. A comparative analysis of changes in haematological parameters in hens under short-term exposure to adverse environmental factors of different natures was performed. For this purpose, a control and 3 experimental groups of hens were established in a modern complex for the production of food eggs. Within 24 hours, the hens of the 2nd group were deprived of fodder, the 3rd group – of light, and the 4th group – were kept in significant overcrowding. The smallest changes in the blood system of hens were observed under the influence of the factor of lack of fodder, namely an increase, within the physiological standard, in the content of leukocytes and erythrocyte sedimentation rate, a decrease in haemoglobin concentration, hematocrit, erythrocytes, platelets, and a violation of the ratio of different forms of leukocytes – an increase in the concentration of heterophils (3.3%&gt;normal) against a decrease in the concentration of monocytes (1.6%&lt;normal), lymphocytes and basophils. Therewith, under the influence of the factor of the absence of light, a higher content of leukocytes in the blood by 10.6%, a lower concentration of haemoglobin by 22.4%, hematocrit – by 4.2%, platelets – by 9.8%, and a higher erythrocyte sedimentation rate by 9.8%, a higher concentration of heterophils by 5.9% and a lower concentration of lymphocytes – by 4.6% were identified compared to the factor of the absence of fodder. The most significant changes in the blood system were noted under the influence of the factor of significant over-consolidation of hens, namely, a higher content of leukocytes in the blood by 17.1 and 5.9%, a lower concentration of haemoglobin by 29.6 and 9.2%, hematocrit – by 5.9 and 1.7%, erythrocytes – by 10.3%, platelets – by 35.8 and 28.8%, and higher erythrocyte sedimentation rate by 4.9%, a higher concentration of heterophils by 11.3 and 5.4 % and lower concentration of monocytes by 0.8 and 0.4%, lymphocytes by 9.4 and 4.8% and eosinophils by 0.7% compared to the factor of lack of fodder and lack of light, respectively. Thus, in production conditions, it is necessary to avoid the over-compaction of poultry, as this factor has the greatest adverse effect

Ionophore-mediated swelling of erythrocytes as a therapeutic mechanism in sickle cell disease.

Sickle cell disease (SCD) is characterized by sickle hemoglobin (HbS) which polymerizes under deoxygenated conditions to form a stiff, sickled erythrocyte. The dehydration of sickle erythrocytes increases intracellular HbS concentration and the propensity of erythrocyte sickling. Prevention of this mechanism may provide a target for potential SCD therapy investigation. Ionophores such as monensin can increase erythrocyte sodium permeability by facilitating its transmembrane transport, leading to osmotic swelling of the erythrocyte and decreased hemoglobin concentration. In this study, we treated 13 blood samples from patients with SCD with 10 nM of monensin ex vivo. We measured changes in cell volume and hemoglobin concentration in response to monensin treatment, and we perfused treated blood samples through a microfluidic device that permits quantification of blood flow under controlled hypoxia. Monensin treatment led to increases in cell volume and reductions in hemoglobin concentration in most blood samples, though the degree of response varied across samples. Monensin-treated samples also demonstrated reduced blood flow impairment under hypoxic conditions relative to untreated controls. Moreover, there was a significant correlation between the improvement in blood flow and the decrease in hemoglobin concentration. Thus, our results demonstrate that a reduction in intracellular HbS concentration by osmotic swelling improves blood flow under hypoxic conditions. Although the toxicity of monensin will likely prevent it from being a viable clinical treatment, these results suggest that osmotic swelling should be investigated further as a potential mechanism for SCD therapy.

Selective Arterial Embolization with N-Butyl Cyanoacrylate Prior to CT-Guided Percutaneous Cryoablation of Kidney Malignancies: A Single-Center Experience.

The study’s purpose was to assess the safety, feasibility and efficiency of selective arterial embolization (SAE) using N-butyl cyanoacrylate (NBCA) glue before percutaneous cryoablation (PCA) of renal malignancies in patients whose tumor characteristics and/or comorbidities resulted in an unacceptable risk of bleeding. In this single-center retrospective study of 19 consecutive high-risk patients (median age, 74 years) with renal malignancies managed in 2017–2020 by SAE with NBCA followed by PCA, data about patients, tumor and procedures characteristics, complications, renal function and hemoglobin concentration before and after treatment, as well as recurrence were collected. Charlson comorbidity index was ≥4 in 89.5% of patients. Ten patients were treated by antiplatelet and/or anticoagulant therapy. Median tumor largest diameter was 3.75 cm (range, 1–6.5 cm) and R.E.N.A.L. nephrometry score was ≥7 in 80%, indicating substantial tumor complexity. No major complications were recorded and minor complications occurred in 7 patients. No residual tumor was found at 6-week imaging follow-up in 18/19 patients. Tumor recurrence was visible in 1/16 patients at 6-month imaging follow-up. No significant difference was found for renal function after treatment (p = 0.07), whereas significant decrease in hemoglobin concentration was noted (p = 0.00004), although it was relevant for only one patient who required only blood transfusion and no further intervention. SAE prior to PCA is safe and effective for managing renal malignancies in high-risk patients.

Hematological disorders in HIV-infected children on the background of antiretroviral therapy

Introduction. In most cases, HIV infection in children is accompanied by the development of anemia.Objective: to study the nature of the disturbance of the cellular composition of blood in HIV-infected children on the background of antiretroviral therapy.Materials and methods. In the period from September 2015 to January 2017, 124 patients aged from 0 to 18 years old were examined with a diagnosis of HIV infection at various stages of its development. In all patients in the peripheral blood, the hemoglobin concentration, the absolute number of red blood cells, leukocytes and their varieties in a blood volume unit were determined, the hematocrit value was calculated.Results and discussion. Against the background of ongoing antiretroviral therapy, the formation of hypochromic anemia is associated with a consistent decrease in hemoglobin concentration and the number of circulating red blood cells to 104,86±2,80 g/l and to 3,81–3,67×1012/l, which may be accompanied by a decrease in their content in each erythrocyte and the appearance of macrocytic erythroid forms in circulating blood. Leukopenia develops due to the formation of an absolute deficiency of circulating lymphocytes and neutrophilic granulocytes.Conclusion. The specific assessment of cytopenia depends on the type of primary damage to the blood cells, and the choice of specific treatment depends on the type of disorder. Therefore, timely correction of these disorders could possibly reduce the development of the immunodeficiency state.

The effect of malaria on haemoglobin concentrations: a nationally representative household fixed-effects study of 17,599 children under 5\xa0years of age in Burkina Faso

BackgroundAlthough the association between malaria and anaemia is widely studied in patient cohorts, the population-representative causal effects of malaria on anaemia remain unknown. This study estimated the malaria-induced decrease in haemoglobin levels among young children in malaria-endemic Burkina Faso.MethodsThe study was based on pooled individual-level nationally representative health survey data (2010–2011, 2014, 2017–2018) from 17 599 children under 5 years of age. This data was used to estimate the effects of malaria on haemoglobin concentration, controlling for household fixed-effects, age, and sex in a series of regression analyses. The fixed-effects controlled for observed and unobserved confounding on the household level and allowed to determine the impact of malaria infection status on haemoglobin levels and anaemia prevalence. Furthermore, the diagnostic results from microscopy and rapid diagnostic tests were leveraged to provide a quasi-longitudinal perspective of acute and prolonged effects after malaria infection.ResultsThe prevalence of both malaria (survey prevalence ranging from 17.4% to 65.2%) and anaemia (survey prevalence ranging from 74% to 88.2%) was very high in the included surveys. Malaria was estimated to significantly reduce haemoglobin levels, with an overall effect of − 7.5 g/dL (95% CI − 8.5, − 6.5). Acute malaria resulted in a − 7.7 g/dL (95% CI − 8.8, − 6.6) decrease in haemoglobin levels. Recent malaria without current parasitaemia decreased haemoglobin concentration by − 7.1 g/dL (95% CI − 8.3, − 5.9). The in-sample predicted prevalence of severe anaemia was 9.4% among malaria positives, but only 2.2% among children without malaria.ConclusionMalaria infection has a strong detrimental effect on haemoglobin levels among young children in Burkina Faso. This effect seems to carry over even after acute infection, indicating prolonged haemoglobin reductions even after successful parasite-elimination. The quasi-experimental fixed-effect approach adds a population level perspective to existing clinical evidence.

Assessment of Three-Dimensional Reconstruction in Percutaneous Nephrolithotomy for Complex Renal Calculi Treatment.

Introduction: Three-dimensional (3D) reconstruction is a novel imaging technique widely used to improve surgical operations. Some studies have identified its role in Urology for percutaneous nephrolithotomy (PCNL).Objective: To explore the potential benefits of 3D reconstruction technology in PCNL for complex renal calculi treatment.Methods: A retrospective study involving 139 patients with complex kidney stones who underwent PCNL was conducted between September 30, 2018, to September 30, 2019. Group A patients (72) underwent the 3D reconstruction technique before PCNL, while group B (67) did not. The operation time, the duration of the hospital stay, the puncture accuracy, the decrease in hemoglobin concentration, the stone clearance rate, and the postoperative complications were noted and compared between the two groups.Results: The initial stone clearance rates 2 weeks after PCNL were 81.9 and 64.2% in groups A and B, respectively (P < 0.05). The first-time puncture success rates were 87.5 and 47.8 % in groups A and B, respectively (P < 0.05). Group A had a shorter operation time than group B (62 vs. 79 min, P < 0.05). Besides, the 3D reconstructive technique-assisted patients (91.7%) had no or mild complications, compared with (74.6%) group B patients. There was no significant difference in hemoglobin decline and hospital stay between the two groups.Conclusions: The 3D reconstruction technology is an effective adjunct to PCNL in the complex renal calculi treatment.

Methods of pathogen inactivation in whole blood and red blood cells: current state of knowledge

Although pathogen reduction technology was implemented for platelet concentrates and plasma, the risk of pathogen transmission has not been completely eliminated as no inactivation procedures were implemented for red blood cells and whole blood. Research was therefore focused on developing methods for effective pathogen inactivation in red blood cell components. Attempts were made to apply either chemical compounds (porphyrins and Sylsense compounds) or photosensitizers such as methylene blue (Theraflex MB Plasma System) and amotosalen hydrochloride (Intercept System) already in use for pathogen inactivation in plasma. None proved effective for pathogen inactivation in red blood cells. Approval was recently given to pathogen inactivation methods based on S-303 compound (for red blood cells) and with riboflavin (for whole blood). Clinical trials are ongoing. Pilot studies have shown that during storage of packed red blood cells subjected to pathogen inactivation with S-303 demonstrated slight loss of red blood cells, decrease in hemoglobin concentration, significantly lower lactate concentration, and lower pH. Pathogen inactivated whole blood stored at room temperature for up to seven days showed slight hemolysis (within the normal range). This paper presents several pilot clinical trials with pathogen inactivated red blood cells or whole blood. It focuses primarily on the recovery of red blood cells in the recipient's organism and on hemoglobin concentration.