Hematologic Analytes Research Articles

HEMATOLOGY IN AN EASTERN MASSASAUGA (SISTRURUS CATENATUS) POPULATION AND THE EMERGENCE OF OPHIDIOMYCES IN ILLINOIS, USA.

Disease events are threatening wildlife populations across North America. Specifically, mortality events due to Ophidiomyces (snake fungal disease; SFD) have been observed recently in snakes in Illinois, US. We investigated the health of a population of eastern massasaugas ( Sistrurus catenatus ) in south-central Illinois using 1) a meta-analysis of hematologic findings from 2004, 2011, 2013, and 2014; 2) a determination of the prevalence of SFD in snakes examined in 2013 and 2014; and 3) the examination of 184 museum specimens collected from 1999-2013 for signs and presence of SFD. For the meta-analysis and prevalence of SFD, hematologic analytes were reduced to three principle components that explained 67.5% of the cumulative variance. There were significant differences among one principle component (total white blood cell counts, monocytes, lymphocytes, and basophils) across years when it was highest in 2004 and 2014. The top general linear model explaining the difference in principle components included the main effects of year and stage, body condition index (BCI), and the interaction between stage and BCI. The prevalence of SFD was 18% (n=7) in 2013 and 24% (n=11) in 2014, and no hematologic analytes were associated with SFD. In museum specimens, Ophidiomyces DNA was first detected from an individual collected in 2000. Studies such as these, integrating multiple modalities of health, can elucidate the epidemiology of diseases that may pose conservation threats.

SELECTED HEMATOLOGIC AND PLASMA BIOCHEMISTRY ANALYSIS OF FERRUGINOUS DUCKS (AYTHYA NYROCA) IN ISRAEL.

The ferruginous duck (Aythya nyroca) is a medium-sized chestnut-colored diving duck that inhabits wetlands of Europe and Asia. In recent years, this species has been declining throughout much of Europe--a decline that is attributed mainly to destruction of natural habitats, and to hunting and pollution. The ferruginous duck is listed as "near threatened" by the International Union for Conservation of Nature, and as a critically endangered nesting species in Israel. In 2009, a captive-breeding/reintroduction program was established in Israel, aiming to increase the species' population. The objective of this study was to collect data on normal hematology and plasma biochemistry analytes of ferruginous ducks in order to promote the species' conservation. Blood was collected from 49 birds, and 27 analytes were quantified. Compared to most other anseriformes studied, the ferruginous ducks in this study had lower white blood cell counts, which were dominated by heterophils rather than by lymphocytes.

ESTABLISHMENT OF REFERENCE INTERVALS FOR HEMATOLOGY AND BIOCHEMISTRY ANALYTES IN A CAPTIVE COLONY OF STRAW-COLORED FRUIT BATS (EIDOLON HELVUM).

Straw-colored fruit bats (Eidolon helvum) are an ecologically important species of megachiropteran bat that are common both in captivity and in the wild. This study attempts to determine reference intervals from a group of 45 captive individuals for a variety of hematologic and biochemistry parameters. Most of the values are similar to values previously seen in other pteropodid bat species. Differences included a lower than expected reference interval for the total white blood cell count, a wider reference interval for glucose, and a higher reference interval for 25-hydroxyvitamin D. Establishing reference intervals for hematologic and biochemistry analytes for bats that were maintained on the same diet and under the same husbandry parameters for several years will help in the future assessment of other bats maintained in a similar manner.

Alterations due to dilution and anticoagulant effects in hematologic analysis of rodent blood samples on the Sysmex XT-2000iV.

Clinical pathology of rodents is hindered by sample volume limitations. A single whole heparinized blood sample is often submitted for hematologic and clinical chemistry analysis in exploratory research settings, and sample dilution may be required. Published information on the potential impact of sample dilution and heparin use on hematology variables in rodents is sparse. The purpose of the study was to evaluate the effects of sample dilution and of anticoagulant on hematologic analysis of mouse and rat blood samples on the Sysmex XT-2000iV. Mice and rats were obtained from various ends of study research projects, and whole blood was collected via terminal cardiocentesis in lithium heparin, and additionally in EDTA when paired samples were obtained from rats. Hematology analytes were measured on the Sysmex XT-2000iV straight and diluted from ×2 to ×5. Significant differences between heparinized samples analyzed straight vs diluted were found for MCV and MCHC, with a bias for several additional variables. Significant differences between paired heparinized and EDTA-anticoagulated samples at each dilution point were found for most variables, with the largest differences found in platelet count. Evidence of platelet clumping presumably due to heparin exposure was noted in numerous samples. Dilution-induced changes occur in some hematologic variables and may render dilution unacceptable in the exploratory research environment. Many variables, most notably platelet count, differ based on the anticoagulant used, and values from heparinized vs EDTA-anticoagulated samples should not be directly compared.

Evaluation of Argatroban as a Potential Anticoagulant for Clinical Laboratory Analysis: Precision, Stability and Interference Study.

Argatroban is a small, synthetic molecule which is a direct thrombin inhibitor and has been confirmed to be a potent anticoagulant in clinical treatments. However, only a few applications related to laboratory medicine have been reported. The purpose of this study was to understand the performance and value of argatroban as an anticoagulant for clinical laboratory analysis in a single test tube. We examined 93 blood samples and evaluated the anticoagulation time, precision, stability, and interference of argatroban in routine laboratory tests. The anticoagulation time was associated positively with the concentration of argatroban. Chemical and hematological results for argatroban-treated samples were similar to those obtained with serum or ethylenediaminetetraacetic acid treated specimens. Only the white blood cell count was decreased in the first 5 hours after blood collection and the difference was outside clinically acceptable limits; the mean corpuscular hemoglobin concentration was affected slightly by different concentrations of argatroban. Argatroban is an attractive candidate for use as a laboratory anticoagulant that can be used for evaluation of chemical and hematological analytes in a single test tube in routine laboratory work.

Baseline Hematologic Results for Free-ranging White Rhinoceros (Ceratotherium simum) in Kruger National Park, South Africa.

Complete blood counts (n = 115) and red blood cell analytes (n = 80) were assessed in free-ranging white rhinoceros (Ceratotherium simum) from Kruger National Park (KNP), South Africa. Blood was collected from healthy animals immobilized between February and September 2009-11 for management purposes. Our objectives were to establish baselines for KNP's white rhinoceros population and to compare results based on sex and age group. Significant differences in total white blood cells, total eosinophils, and hemoglobin were found between adult and subadult rhinoceros. Female rhinoceros had significantly higher total white blood cells and lower hemoglobin compared with males. Hematologic analytes were similar to those published for other rhinoceros populations, although the impact of capture and sampling methods, nutritional status, and habitat should be considered when comparing data. This baseline hematology for healthy free-ranging white rhinoceros in KNP may be useful in assessing health status for translocation and medical interventions, including treatment of poaching cases.

Reference intervals for hematology, serum biochemistry, and basic clinical findings in free-ranging Chinese Pangolin (Manis pentadactyla) from Taiwan.

There are 8 species of Pangolins found in Asia and Africa. Among them, the Chinese Pangolin (Manis pentadactyla) is an endangered insectivorous mammal found only in Asia. Hematology and serum chemistry reference intervals are critical for evaluating an animal's well-being and can be useful for clinical diagnostic purposes. Currently, there are no such reference intervals available for any Pangolin species. The purpose of the present study was to establish reference intervals for hematology and serum biochemical analytes, and some basic clinical findings, in Chinese Pangolins. Reference intervals for the hematology and serum chemistry variables, and basic clinical findings (body weight, heart rate, body temperature, blood oxygen saturation) were collected from 100 clinically healthy Chinese Pangolins (51 males and 49 females) using parametric and nonparametric percentile methods. In addition, seasonal, age-related, and sexual differences for all variables were statistically analyzed. No significant differences in the reference intervals were found between males and females, except for body weight. However, significant seasonal differences were observed for heart rate, body temperature, serum ALT and lipase activities, and phosphate concentrations. The variables, which were significantly different between adult and sub-adult Pangolins were heart rate, MCH, creatinine, total protein, phosphate, glucose, and potassium concentration, and amylase activity. Seasonal and age group differences should be taken into consideration when using these reference intervals. The findings from the present study represent a valuable resource for assessing the health of Chinese Pangolins, and contribute toward the conservation of this endangered mammal.

Age- and sex-specific dynamics in 22 hematologic and biochemical analytes from birth to adolescence.

Pediatric laboratory test results must be interpreted in the context of interindividual variation and age- and sex-dependent dynamics. Reference intervals as presently defined for separate age groups can only approximate the age-related dynamics encountered in pediatrics. Continuous reference intervals from birth to adulthood are not available for most laboratory analytes because of the ethical and practical constraints of defining reference intervals using a population of healthy community children. We applied an indirect method to generate continuous reference intervals for 22 hematologic and biochemical analytes by analyzing clinical laboratory data from blood samples taken during clinical care of patients. We included samples from 32 000 different inpatients and outpatients (167 000 samples per analyte) from a German pediatric tertiary care center. Measurements were performed on a Sysmex-XE 2100 and a Cobas Integra 800 during clinical care over a 6-year period. The distribution of samples considered normal was estimated with an established indirect statistical approach and used for the calculation of reference intervals. We provide continuous reference intervals from birth to adulthood for 9 hematology analytes (hemoglobin, hematocrit, red cell indices, red cell count, red cell distribution width, white cell count, and platelet count) and 13 biochemical analytes (sodium, chloride, potassium, calcium, magnesium, phosphate, creatinine, aspartate transaminase, alanine transaminase, γ-glutamyltransferase, alkaline phosphatase, lactate dehydrogenase, and total protein). Continuous reference intervals capture the population changes in laboratory analytes during pediatric development more accurately than age groups. After local validation, the reference intervals provided should allow a more precise consideration of these dynamics in clinical decision making.

Clinical pathology reference intervals for an in-water population of juvenile loggerhead sea turtles (Caretta caretta) in Core Sound, North Carolina, USA.

The loggerhead sea turtle (Caretta caretta) is found throughout the waters of the Atlantic, Pacific, and Indian Oceans. It is a protected species throughout much of its range due to threats such as habitat loss, fisheries interactions, hatchling predation, and marine debris. Loggerheads that occur in the southeastern U.S. are listed as “threatened” on the U.S. Endangered Species List, and receive state and federal protection. As part of an on-going population assessment conducted by the National Marine Fisheries Service, samples were collected from juvenile loggerhead sea turtles in Core Sound, North Carolina, between 2004 and 2007 to gain insight on the baseline health of the threatened Northwest Atlantic Ocean population. The aims of the current study were to establish hematologic and biochemical reference intervals for this population, and to assess variation of the hematologic and plasma biochemical analytes by season, water temperature, and sex and size of the turtles. Reference intervals for the clinical pathology parameters were estimated following Clinical Laboratory Standards Institute guidelines. Season, water temperature, sex, and size of the turtles were found to be significant factors of variation for parameter values. Seasonal variation could be attributed to physiological effects of decreasing photoperiod, cooler water temperature, and migration during the fall months. Packed cell volume, total protein, and albumin increased with increasing size of the turtles. The size-related differences in analytes documented in the present study are consistent with other reports of variation in clinical pathology parameters by size and age in sea turtles. As a component of a health assessment of juvenile loggerhead sea turtles in North Carolina, this study will serve as a baseline aiding in evaluation of trends for this population and as a diagnostic tool for assessing the health and prognosis for loggerhead sea turtles undergoing rehabilitation.

Haematological and biochemical reference intervals in adult Maine Coon cat blood donors.

The objectives of this study were to derive Maine Coon haematological and biochemical reference intervals (RIs) from adult healthy blood donors, to validate (or reject) the use of published RIs for the general feline population in this breed, and to evaluate the effects of age, sex and weight on the haematological and biochemical results. Haematological and biochemical data were retrieved retrospectively from a database of 81 healthy adult Maine Coon cat blood donors and were analysed to generate normal RIs. RIs were determined and compared with established non-breed-specific feline RIs according to the Clinical and Laboratory Standards Institute guidelines and the American Society of Veterinary Clinical Pathology guidelines using Reference Value-Advisor (version 2.1) software. The age of the cats ranged from 1-8 years (mean 4.4 years), 42 were female and 39 were male, and weights ranged from 4.9-8.5 kg (mean 6.7 kg). New Maine Coon RIs were proposed for red blood cell count, mean corpuscular volume, mean corpuscular haemoglobin concentration, reticulocyte count and percentage. Haematocrit was higher in male cats (mean HCT 42.9% vs 41% in females; P = 0.001) and in heavier cats (P = 0.003; slope 1.0, regression equation HCT = 35.1 + 1.0 × weight). New biochemical RIs were proposed for urea, aspartate aminotransferase, γ-glutamyl transpeptidase (GGT), alkaline phosphatase, total protein and albumin in Maine Coons. Females had higher GGT (median GGT value in females 4.0 vs 3.0 in males; P = 0.011) and albumin values (mean albumin value 3.3 in females vs 3.1 in males; P = 0.013). Currently published RIs for some haematological and biochemical parameters are not appropriate for use in adult Maine Coon cats. A breed-specific variation could be a plausible explanation for the new haematological and serum biochemical analytes proposed in this study. Breed-specific RIs for Maine Coon cats will help prevent misinterpretation of laboratory results in diagnosis and in the selection of ideal blood donors.

Critical values in patient care

Lundberg coined the term critical (panic) values (CVs) for results, representing a pathophysiological state at such variance with normal as to be life-threatening unless something is done promptly, and for which some corrective action could be taken. [1] For routine chemistry and hematology analytes, the CV lists vary between laboratories and outpatient versus inpatient reporting. A change in therapy resulted from 65% of reported CVs, with 94.9% of physicians indicating that critical results are valuable for patient care. [2] Well-defined guidelines being absent and scant literature addressing the issue in anatomic pathology, common sense, and personal experience of the pathologist determines the decision to communicate to the clinicians. What constitutes this list of CVs? Some examples are unexpected malignancy or infection in the tissue removed. Most CVs in laboratory medicine are time sensitive but in anatomic pathology, they are information sensitive. Guidelines for definition, methods of implementing, and communication time frame in consensus with clinicians would determine CVs in individualized service or common to all services. In my experience, I have received a mixed reaction from clinicians when CVs are conveyed, some happy and others

Hematologic, plasma biochemistry, and acid-base analysis of adult Negev Desert tortoises (Testudo werneri) in Israel.

The Negev Desert tortoise (Testudo werneri) is one of the smallest tortoise species in the Mediterranean region. This is a critically endangered species (CITES I) in its native habitat, which includes the Saharo-Arabian sands of northern Egypt, Sinai, and the Negev Desert in Israel. Great efforts have been invested in captive breeding and reintroduction of this tortoise to the wild. The purpose of this study was to collect blood samples from healthy Negev Desert tortoises kept in well-managed zoologic collections in order to describe hematologic, plasma biochemistry, and acid-base analytes for this species. Data of 36 different blood analytes were collected using the Abaxis Vetscan bench-top analyzer and i-STAT handheld analyzer, and a significant difference was observed between males and females in 13 of the measured analytes. To the authors' knowledge, this is the first report of blood analytes for the Negev Desert tortoise; however, the data do not fully meet the strict ASVCP guidelines required for reference range determination and thus can only provide a rough estimate for evaluating the health status of Negev Desert tortoises using similar testing methodology.

Reference values for hematology and plasma biochemistry variables, and protein electrophoresis of healthy Hermann's tortoises (Testudo hermannissp.)

Hermann's tortoise, Testudo hermanni, is currently on the International Union for Conservation of Nature (IUCN) red list of endangered species. Reptile medicine relies also on laboratory analyses to evaluate health status, but reference ranges for hematology and biochemistry variables and protein electrophoresis in plasma of healthy tortoises are not available. The purposes of this study were to establish reference ranges for select hematologic and biochemical variables in clinically healthy Hermann's tortoises, and evaluate the impact of sex and season. Blood samples were collected from 34 healthy tortoises at the end of September and beginning of July. Blood smears, HCT, concentrations of HGB and select plasma biochemical analytes, select enzyme activities, and plasma protein fractions were evaluated. Reference ranges were determined and checked for influence of sex and sampling time point. Typical reptilian RBC and WBC were observed in blood smears. HCT and concentrations of HGB, uric acid and urea, and ALT and AST activities were significantly higher in males than in females. Concentrations of glucose, uric acid, and phosphate, and AST activity were significantly higher at the beginning of July, whereas concentrations of urea and Cl were higher at the end of September prior to hibernation. The electrophoretic protein fractions included albumin, and α, β, and γ globulins. The reference ranges defined in the present study are useful for clinical tortoise medicine and conservation. Sex and seasonal sampling were identified as factors significantly affecting hematology and blood chemistry analytes; they should be taken into consideration when assessing tortoise health status.

Understanding the impact of pre-analytic variation in haematological and clinical chemistry analytes on the power of association studies.

Background: Errors, introduced through poor assessment of physical measurement or because of inconsistent or inappropriate standard operating procedures for collecting, processing, storing or analysing haematological and biochemistry analytes, have a negative impact on the power of association studies using the collected data. A dataset from UK Biobank was used to evaluate the impact of pre-analytical variability on the power of association studies.Methods: First, we estimated the proportion of the variance in analyte concentration that may be attributed to delay in processing using variance component analysis. Then, we captured the proportion of heterogeneity between subjects that is due to variability in the rate of degradation of analytes, by fitting a mixed model. Finally, we evaluated the impact of delay in processing on the power of a nested case-control study using a power calculator that we developed and which takes into account uncertainty in outcome and explanatory variables measurements.Results: The results showed that (i) the majority of the analytes investigated in our analysis, were stable over a period of 36 h and (ii) some analytes were unstable and the resulting pre-analytical variation substantially decreased the power of the study, under the settings we investigated.Conclusions: It is important to specify a limited delay in processing for analytes that are very sensitive to delayed assay. If the rate of degradation of an analyte varies between individuals, any delay introduces a bias which increases with increasing delay. If pre-analytical variation occurring due to delays in sample processing is ignored, it affects adversely the power of the studies that use the data.

Age- and gender-specific dynamics from birth to adolescence — Indirect determination of pediatric reference intervals in 22 hematological and biochemical analytes

Age- and gender-specific dynamics from birth to adolescence — Indirect determination of pediatric reference intervals in 22 hematological and biochemical analytes

Hematological and biochemical data obtained in rural northern Uganda.

Reference intervals for common hematological and clinical chemistry parameters constitute an important basis for health care. Moreover, with increasing priority in drug and vaccine development for infectious diseases in Africa, the first priority is the safety evaluation and tolerability of the candidate interventions in healthy populations. To accurately assess health status and address adverse events, clinical reference intervals in the target population are necessary. We report on hematological and biochemical indices from healthy volunteers who participated in a clinical trial in Lira, northern Uganda. Median and nonparametric 95% percentiles on five hematology and 15 biochemistry analytes are shown. Although most hematological analytes conformed to reported reference intervals and trends in Africa, literature review from different African countries highlight the need for a region-specific children reference interval that can be appropriate for the population.

Method of comparison - making the right choice

Method of comparison - making the right choice

Actualización de las especificaciones de la calidad analítica 2014. Consenso de las Sociedades Científicas nacionales

The aim of this study is to calculate minimum quality specifications (MQS) in urine biochemistry, blood glycosylated hemoglobin and several hematological analytes, and to compare these specifications with those from other countries, as well as to update the values for the 80 analytes studied. Materials used in this work are the results from laboratories participating in the external quality assurance programs organized by four Spanish scientific societies, and obtained in the time period 2007-2010. A total of 13,054 results were obtained for glycosylated hemoglobin, and from 14,180 (albumin) to 20,594 (creatinine) for urine biochemistry, and for hematology, from 1,839 (fetal hemoglobin) to 6,961 (antithrombin).The conclusions found were: to achieve the MQS for glycosylated hemoglobin does not ensure meeting clinical requirements, whereas MQS for urine biochemistry also meet the requirements based on biological variation. The MQS studied in this work could not be compared with those from other countries (there are no published values), and some of them could require calculations stratified according to several concentration levels.

Population-Based Pediatric Reference Intervals in General Clinical Chemistry: A Swedish Survey.

SummaryVery few high quality studies on pediatric reference intervals for general clinical chemistry and hematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The Swedish survey included 701 healthy children. Reference intervals for general clinical chemistry and hematology were defined.

COMPARISON OF SELECT HEMATOLOGY AND SERUM CHEMISTRY ANALTYES BETWEEN WILD-CAUGHT AND AQUARIUM-HOUSED LAKE STURGEON (ACIPENSER FULVESCENS)

Hematology and serum chemistry analytes were compared between wild-caught and aquarium-housed lake sturgeon (Acipenser fulvescens) to potentially improve understanding of medical issues in lake sturgeon. Blood samples were taken from 30 lake sturgeon exhibited in 11 institutions in the United States and from 23 experimentally stocked lake sturgeon caught in gill nets in the lower Genesee River in Rochester, New York, USA. For hematology, only segmented neutrophil count was significantly different, with wild-caught fish having a higher number of circulating neutrophils. For clinical chemistry analytes, chloride, uric acid, calcium, phosphate, glucose, aspartate aminotransferase, triglycerides, and creatine kinase were significantly different between the two cohorts. These differences are likely not clinically significant and are attributable to handling stress, variability in environmental parameters, or differences in nutritional status. This is the first report of hematology and serum chemistry values in aquarium-housed lake sturgeon and provides useful reference intervals for clinicians.