Low Hematocrit Values Research Articles

Clinical and Biochemical Differences in Patients Having Non-Variceal Upper Gastrointestinal Bleeding on NSAIDs, Oral Anticoagulants, and Antiplatelet Therapy.

Introduction: Upper gastrointestinal bleeding (UGIB) is among the most common causes of morbidity and mortality worldwide, accounting for major resource allocation and increasing incidence. This study aimed to evaluate the severity of non-variceal bleeding in patients at risk of bleeding through the use of NSAIDs, oral anticoagulants, and antiplatelet therapy. Material and Method: The study included 296 patients admitted in the Gastroenterology Department of the Municipal County Emergency University Hospital, Timisoara, between 01.01.2018 and 01.04.2020, and diagnosed via gastroscopy with non-variceal gastrointestinal bleeding. The patients were divided among four groups based on their use of different drugs known to induce UGIB, i.e., aspirin and clopidogrel, NOACs, NSAIDs, and anti-vitamin K drugs, respectively. Statistical analyses were performed based on ANOVA one-way tests for continuous variables and Chi-square tests for categorical variables with pairwise comparisons based on Bonferroni adjusted significance tests. Results: The results showed several parameters having statistical significance among the different groups of patients. Patients on NOACs had statistically significant lower hemoglobin levels, lower hematocrit values, lower erythrocytes, lower RDW and higher fibrinogen levels compared to patients on VKA. Discussion: Surprisingly, the results from our study suggest that the use of NOACs was associated with a higher risk of bleeding when compared to VKA, which differs from the existing literature. Conclusions: One of the important factors causing upper non-variceal bleeding can be iatrogenic, either due to antiplatelet drugs or anticoagulants, to which NSAID treatment is additionally associated for various reasons. In our study, the use of NOACs seemed to have a more severe bleeding spectrum with higher morbidity compared to VKA.

Albinism and Blood Cell Profile: The Peculiar Case of Asinara Donkeys.

The complete blood cell count (CBC) was screened in a group of 15 donkeys, of which 8 were of Asinara breed (oculocutaneous albinism type 1, OCA1) and 7 of Sardo breed (gray coat). All donkeys were kept under same management and dietary conditions and underwent periodic health monitoring in the month of June 2024, at the peak of the positive photoperiod, at Mediterranean latitudes. One aliquot of whole blood, drawn from each individual into K2-EDTA containing tubes, was analyzed for the complete blood cell count through an automatic analyzer, within two hours of sampling. Data were analyzed and compared by one-way ANOVA, where the breed was an independent variable. All animals appeared clinically healthy, though mild eosinophilia was observed in Sardo donkeys. The red blood cell line showed peculiar traits for Asinara donkeys, which displayed significantly higher circulating red blood cell numbers than gray coat Sardo donkeys (RBC, 5.19 vs. 3.80 1012/mL ± 0.98 pooled-St. Dev, respectively; p = 0.017). RBCs also exhibited a smaller diameter and higher degree of anisocytosis in Asinara donkeys, along with lower hematocrit value, albeit within physiological ranges. Taken all together, such hematological profile depicts a peculiar trait of the red blood cell line in albino donkeys during the positive photoperiod.

Hematological and plasma biochemical profile of two species of freshwater stingrays from the Amazon.

The evaluation of hematological and plasma biochemical parameters and the subsequent establishment of reference intervals facilitate the diagnosis of the health status of animals. This work aimed to determine the blood parameters of wild specimens of the stingrays Potamotrygon motoro and Potamotrygon orbignyi from the lower Solimões River region, Amazonas, Brazil. One hundred forty-one stingrays were captured, 92 specimens of P. motoro and 49 of P. orbignyi, of both sexes and at different stages of development. No effect of sex was observed on the blood parameters of juvenile animals for both species. P. motoro neonates presented a distinct hematological and biochemical profile, with significantly lower hematocrit values, hemoglobina, number of erythrocytes, mean corpuscular hemoglobin concentration, monocytes, plasma glucose, total proteins, albumin, and globulin. On the other hand, total cholesterol and urea levels were significantly higher in this same group compared to juveniles of the same species. Comparison between species revealed lower values of triglycerides and total cholesterol in P. orbignyi of both sexes. The results obtained are pioneering for these Amazonian species in white water environments and will serve as a basis for evaluating the health status of wild stingrays. Thus, from the analysis of the blood of the P. motoro and P. orbignyi stingrays, it was possible to observe good health conditions.

Retrospective Analysis of Hematological Abnormalities in Older Diabetic Patients with SARS-CoV-2 Infection

Background: Understanding the severity of Coronavirus Disease 2019 (COVID-19) in elderly diabetic patients is crucial, considering the impact of age, comorbidities, and clinical biomarkers. However, the assessment of common haematological markers in this specific population remains limited. Methods: We conducted a retrospective cohort study involving 27 elderly patients (mean age: 61.81±7.14 years) with COVID-19 infection. We analysed the medical e-records of COVID-19 positive patients who presented to a COVID-19 centre in Qatar in July 2020. Real-Time Polymerase Chain Reaction was used to confirm COVID-19 infection using throat-swab upper respiratory samples. Clinical haematological parameters were analysed and compared with normal ranges. Results: Among the 27 patients investigated, 51.85% were male. A low viral load (cycle threshold (Ct) ≥ 30) was observed in 7.4% of patients, while 92.59% had a high viral load (Ct < 30). At presentation, 59.25% of patients were symptomatic. The observed haematological abnormalities ranked in descending order of frequency were as follows: high red blood cell counts, and high mean platelet volume (52% each), high platelet distribution width (48%), low haemoglobin values, and low haematocrit values (22% each), leukopenia, neutropenia, and lymphopenia (15% each), thrombocytosis, thrombocytopenia, leucocytosis, and neutrophilia (7% each), and lymphocytosis (4%). Conclusion: Our study highlights the common occurrence of haematological abnormalities in older diabetic patients with COVID-19 infection. Monitoring haematological parameters may be valuable in managing these patients, especially in severe cases, and could facilitate early identification of individuals requiring intensive care, potentially reducing mortality. Keywords: Geriatric Medicine; Public Health; Real-Time Polymerase Chain Reaction; Risk Factor; SARS-CoV-2; Symptomatic Infection; Thrombocytopenia; Viral Load

Red Blood Cell Partitioning Using a Microfluidic Channel with Ladder Structure.

This study investigated the partitioning characteristics of red blood cells (RBCs) within capillaries, with a specific focus on ladder structures observed near the end of the capillaries. In vitro experiments were conducted using microfluidic channels with a ladder structure model comprising six bifurcating channels that exhibited an anti-parallel flow configuration. The effects of various factors, such as the parent channel width, distance between branches, and hematocrit, on RBC partitioning in bifurcating channels were evaluated. A decrease in the parent channel width resulted in an increase in the heterogeneity in the hematocrit distribution and a bias in the fractional RBC flux. Additionally, variations in the distance between branches affected the RBC distribution, with smaller distances resulting in greater heterogeneity. The bias of the RBC distribution in the microchannel cross section had a major effect on the RBC partitioning characteristics. The influence of hematocrit variations on the RBC distribution was also investigated, with lower hematocrit values leading to a more pronounced bias in the RBC distribution. Overall, this study provides valuable insights into RBC distribution characteristics in capillary networks, contributing to our understanding of the physiological mechanisms of RBC phase separation in the microcirculatory system. These findings have implications for predicting oxygen heterogeneity in tissues and could aid in the study of diseases associated with impaired microcirculation.

Inadvertent Perioperative Hypothermia in Ambulatory Surgery Patients: Incidence, Risk Factors, and Prevention Initiatives

PurposeAlthough the number and complexity of ambulatory surgical interventions has grown considerably over the years, it has not been fully established whether hypothermia still poses a risk for these interventions. In this study, we aimed to determine the incidence, risk factors, and methods applied to prevent perioperative hypothermia in ambulatory surgery patients. DesignA descriptive research design was used. MethodsThe study was conducted with 175 patients between May 2021 and March 2022 in the outpatient units of a training and research hospital in Mersin, Turkey. Data were collected using the Patient Information and Follow-up Form. FindingsThe incidence of perioperative hypothermia was 20% in ambulatory surgery patients. Hypothermia developed in 13.7% of the patients at the 0th minute at the PACU, and 96.6% of the patients were not warmed intraoperatively. We noted a statistically significant relationship between perioperative hypothermia and advanced age (≥60 years), high American Society of Anesthesiologists' (ASA) class, and low hematocrit values. In addition, we determined that the female gender, presence of chronic diseases, general anesthesia, and a long operation time were other risk factors for hypothermia in the perioperative period. ConclusionsThe incidence of hypothermia during ambulatory surgeries is lower than that in inpatient surgeries. The warming rate of ambulatory surgery patients, which is quite low, can be improved by increasing the awareness of the perioperative team and following the guidelines.

P-003 Effect of moderate altitude hypoxia on NRBC numbers and PLT/MPV ratio in pregnant ewes having low or high hematocrit values

P-003 Effect of moderate altitude hypoxia on NRBC numbers and PLT/MPV ratio in pregnant ewes having low or high hematocrit values

Hemolysis prediction in bio-microfluidic applications using resolved CFD-DEM simulations

Background and ObjectiveHemolysis, namely hemoglobin leakage from red blood cells (RBCs), is one of the major sources of incorrect results in clinical tests, especially when passive microfluidics is involved. This is due to small characteristic dimensions which could cause strong RBCs deformation. Prediction of hemolysis is essential in the design and optimization of lab-on-a-chip devices for cell sorting and plasma separation. The aim of this work is to provide a numerical simulation tool this purpose applicable to real-scale bio-microfluidic devices with affordable computational cost. MethodsBlood is modelled as a suspension of biological cells, mainly RBCs, in liquid plasma assumed as a Newtonian, incompressible carrier fluid. Therefore, the physics of cells and carrier fluid is coupled by means of an immersed boundary concept known as resolved CFD-DEM. In this approach, the Navier-Stokes equations are numerically solved through a finite volume method with an additional penalty term to account for the presence of RBCs. RBCs’ positions and velocities are updated by solving Newton and Euler equations for conservation of linear and angular momentum. To model the RBCs deformation, a reduced-order model is employed, where each RBC is represented by a clump of overlapping rigid spheres connected by fictional numerical bonds, whose properties are tuned to reproduce the ones of RBCs viscoelastic membrane. This coupled approach allows access to cell-level information and facilitates the usage of strain-based hemolysis models. ResultsDifferent micro-channel geometries and blood hematocrits are simulated, to explore the influence of these factors on RBCs damage. Statistical analysis is performed to extract relevant biophysical quantities from numerical simulations such as hemolysis index distribution at the channel exit. Finally, the effect of carrier fluid viscosity is studied in relation to cell-cell interactions. ConclusionsSimulation results show that hemolysis occurrence is almost independent of the hematocrit values in the microchannel, implying the possibility to speed up calculation using low hematocrit values. Nevertheless, using whole blood viscosity for the carrier fluid overestimates the value of the hemolysis index by almost one order of magnitude.

Retrospective Analysis of Haematological Abnormalities in Older Diabetic Patients with COVID-19

Background: Understanding the severity of Coronavirus Disease 2019 (COVID-19) in elderly diabetic patients is crucial, considering the impact of age, comorbidities, and clinical biomarkers. However, the assessment of common haematological markers in this specific population remains limited. Methods: We conducted a retrospective cohort study involving 27 elderly patients (mean age: 61.81±7.14 years) with COVID-19 infection. We analysed the medical e-records of COVID-19 positive patients who presented to a COVID-19 centre in Qatar in July 2020. Real-Time Polymerase Chain Reaction was used to confirm COVID-19 infection using throat-swab upper respiratory samples. Clinical haematological parameters were analysed and compared with normal ranges. Results: Among the 27 patients investigated, 51.85% were male. A low viral load (cycle threshold (Ct) ≥ 30) was observed in 7.4% of patients, while 92.59% had a high viral load (Ct < 30). At presentation, 59.25% of patients were symptomatic. The observed haematological abnormalities ranked in descending order of frequency were as follows: high red blood cell counts, and high mean platelet volume (52% each), high platelet distribution width (48%), low haemoglobin values, and low haematocrit values (22% each), leukopenia, neutropenia, and lymphopenia (15% each), thrombocytosis, thrombocytopenia, leucocytosis, and neutrophilia (7% each), and lymphocytosis (4%). Conclusion: Our study highlights the common occurrence of haematological abnormalities in older diabetic patients with COVID-19 infection. Monitoring haematological parameters may be valuable in managing these patients, especially in severe cases, and could facilitate early identification of individuals requiring intensive care, potentially reducing mortality.

Kliničke karakteristike pneumonija kod bolesnika sa hroničnom opstruktivnom bolesti pluća

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.23 million deaths in 2019. The incidence of pneumonia in patients with COPD is almost twice as high as in the general population. Globally, pneumonia is a cause of increased mortality and morbidity rates. A higher incidence of pneumonia and its association with increased mortality and more frequent hospitalizations, which increases the costs of treatment, has been observed in people diagnosed with COPD in comparison to the general population. The aim of this study was to examine the basic clinical features of pneumonia in patients with COPD, as well as to assess the differences in the clinical characteristics of COPD patients in relation to the presence of pneumonia. The study was designed as a case-control study. The study included patients hospitalized and treated at the pneumophysiology department of the Health Center in Kosovska Mitrovica, in the period from January 2017 to December 2019. Data for research purposes were obtained from the patients' medical records. The study included 110 patients with COPD, of which 30 (27.3%) had pneumonia and 80 (72.7%) were not diagnosed with pneumonia. Out of the total number of patients, 65 (59.1%) were males. Patients with pneumonia had statistically significantly lower mean values of leukocytes and neutrophils at admission, and significantly lower hematocrit values at discharge in comparison to patients without pneumonia. COPD patients who had pneumonia were significantly more often treated with antibiotic combination therapy (cephalosporins and fluoroquinolones) and macrolides. Statistically significantly, the most common auscultation findings in patients with COPD and pneumonia included low-pitched and polyphonic wheezes, and complications in the form of effusions and abscesses were also significantly more often registered. In addition to prolonged hospitalization, patients with COPD and pneumonia received significantly lower doses of oxygen compared to COPD patients without pneumonia. Our study shows that pneumonia is highly prevalent and requires long-term hospitalization and treatment, which leads to increased costs, however, it can be cured with adequate treatment, primarily using a combination of several antibiotics.

Avian malaria, haematocrit, and body condition in invasive wetland passerines settled in southwestern Spain

Avian malaria and related haemosporidian parasites can negatively impact fitness in many songbirds. Research on the malaria infection and its physiological costs on their avian hosts is heavily skewed toward native passerines, with exotic species underrepresented. However, introduced species may carry on and spread new pathogens to native species, and play a role on parasite transmission cycle in invaded bird communities as pathogen reservoir. Here, we molecularly assess the prevalence and diversity of haemosporidian parasites in three introduced wetland passerines (the Red Avadavat Amandava amandava, the Yellow-crowned Bishop Euplectes afer, and the Common Waxbill Estrilda astrild) captured during the same season in southwestern Spain. We also explored the relation between parasite infection, body condition, haematocrit, and uropygial gland volume. We detected an overall parasite prevalence of 3.55%, where Common Waxbills showed higher prevalence (6.94%) than Red Avadavats (1.51%). None Yellow-crowned Bishops were infected with haemosporidians. Almost 60% of infections were caused by Leucocytozoon, and about 40% by Plasmodium. We identified four unique lineages of Plasmodium and three of Leucocytozoon. Moreover, 91% of the identified host–parasite interactions represented new host records for these haemosporidian parasites. Parasite infection was not related to body condition, haematocrit, and uropygial gland volume of the wetland passerines. Haematocrit values varied seasonally among bird species. Additionally, haematocrit was positively related to body condition in the Yellow-crowned Bishops, but not in the other species. Red Avadavats had higher haematocrit levels than Yellow-crowned Bishops, whereas Common Waxbills showed the lower haematocrit values. The uropygial gland volume was positively correlated with body condition in all bird species. Common Waxbills showed higher uropygial gland volumes related to their body size than birds from other two species. These outcomes highlight the importance of exotic invasive species in the transmission dynamics of haemosporidian parasites.

Ренальна дисфункція у пацієнток із післяпологовими кровотечами

The purpose of the study was to assess the influence of the hematocrit level on the frequency of development of renal dysfunction in massive obstetric bleeding. Materials and methods. For the study, we selected 33 women in labor in whom low hematocrit values were determined as a result of blood loss. The examined group had no risk factors and signs of renal dysfunction in the prenatal period. The average age of the women in labor was 32.5 ± 6.4 years, the average weight was 76.5 ± 12.4, and the average gestational age was 39.5 ± 1.5 weeks. Postpartum blood loss averaged 1830.5 ± 622.7 ml (from 1200 to 2500 ml). All bleeding was stopped according to current protocols. Results and discussion. Despite improvements in prenatal and delivery care, postpartum acute kidney injury, associated with massive postpartum blood loss and blood transfusions, currently remains a serious problem. A lot of factors play a role in kidney damage and the development of postpartum acute kidney injury, but it is largely related to hemodilution and low values of hematocrit and hemoglobin. At the same time, there are currently no reliable data on hematocrit threshold values in patients undergoing infusion therapy against the background of postpartum blood loss. Acute kidney injury was defined according to the Kidney Disease: Improving Global Outcomes 2012 recommendations as the presence of at least one of the following criteria: an increase in serum creatinine concentration ≥0.3 mg/dl (≥26.5 μmol/l) within 48 hours, or an increase in serum creatinine concentration ≥1.5 times from the baseline, which is known or assumed to have occurred within 7 days, or a diuresis rate <0.5 ml/kg/h within 6 hours. Conclusion. As a result of the research, it was established that the following pathological conditions and nosologies were the most frequent causes of postpartum acute kidney injury: HELLP syndrome (75% of cases), preeclampsia (70.8% of cases), postpartum hemorrhage (58.3% of cases) and gestational hypertension (45.8% of cases). At the same time, the most frequent clinical manifestation of acute kidney injury occurred with the development of oliguria/anuria (45.8%), hypertension more than 140/90 mm Hg (37.5%) and eclampsia (29.2%). The functional state of the kidneys (namely, the glomerular filtration rate) depended on the hematocrit level, and when its values decreased, the glomerular filtration rate decreased significantly. The obtained dependence was statistically reliable, which was indicated by the value of p=0.0000132 and corresponded to a strong positive correlation, which was indicated by the value r = 0.9449 and r2 = 0.8928. Hematocrit values in the range of 19.57 ± 2.18% and below are a risk factor for the development of postpartum renal dysfunction

Effect of placenta previa on umbilical cord hematocrit value

Objective Placenta previa is one of the causes of neonatal anemia. This condition is mainly explained by antenatal hemorrhage and incision of the anteriorly located placenta during cesarean section. However, the mechanism of neonatal anemia in placenta previa has not been extensively studied or well elucidated. This study investigates whether placenta previa is associated with lower hematocrit levels in newborns with no antenatal hemorrhage and placental incision. Key findings This prospective study investigated 47 patients with previa and 43 control patients who gave birth with a cesarean section at 34–38 weeks of gestation. Blood samples were obtained from the fetal end of the umbilical vein. The mean umbilical cord hematocrit value was 49.3% in the control patients and 46.7% in the patients with previa, and the difference was statistically significant (p = .029). No significant association was observed between hematocrit value and birth weight, gestational age, newborn gender, placenta position, or preoperative maternal hemoglobin level. Conclusion The study findings reveal that even if not complicated by antepartum or intrapartum hemorrhage, placenta previa may be associated with lower hematocrit values in newborns. Although in none of the cases, the umbilical cord hematocrit value was not as low as to be defined as anemia, this effect of previa on newborns should be considered because of the importance of iron status.

Clinically unrecognized plasma volume expansion predicts long-term all-cause-mortality in chronic heart failure.

IntroductionChronic heart failure (CHF) is associated with elevated total blood volume (BV) and distinct phenotypes of total red cell volume (RCV) and plasma volume (PV) elevations. Especially PV expansion during clinical decompensation is linked with adverse clinical outcomes. The role of PV expansion in compensated CHF patients is less clear. Aim of the present study is to investigate the impact of BV parameters on long‐term mortality in CHF patients investigated at a compensated state.Methods and ResultsBV, PV and RCV were determined in 44 (9 female) compensated CHF patients using an abbreviated carbon monoxide method, who were followed up for 6.0 years, (range: 3.7–6.5 years) for all‐cause mortality. In univariate analysis PV expansion but not BV and RCV predicted all‐cause mortality (p = .021). A cutoff of 1800 ml PV/m² body‐surface area allows stratification for all‐cause mortality (p = .044). PV expansion but not RCV reduction explains the significantly lower hematocrit values of nonsurvivors.DiscussionIn this pilot study, PV expansion, which was unnoticed from a clinician's perspective, but is indicated by significantly lower hematocrit, appears to be a relevant predictor of long‐term all‐cause mortality. Whether PV expansion constitutes an adverse CHF phenotype and can be targeted by diuretic therapy is currently unclear.

Effect of nadir hematocrit during cardiopulmonary bypass on the early outcomes after surgical repair of acute type A aortic dissection

Although hemodilution during hypothermic cardiopulmonary bypass (CPB) had been thought to improve microcirculation and reduce blood viscosity, there has been no report investigating the effect of low nadir hematocrit (Hct) values caused by severe hemodilution on the surgical outcomes of patients with acute type A aortic dissection (ATAAD). We retrospectively reviewed 112 consecutive patients who emergently underwent emergency surgical repair of ATAAD at our institution. The patients were classified into the high Hct (nadir Hct ≥ 21% during CPB; n = 51) and low Hct (nadir Hct < 21% during CPB; n = 61) groups. After propensity score matching of preoperative characteristics, surgical outcomes were compared between the groups. Although there was no difference in the surgical procedure, longer CPB time and more blood transfusion during surgery were needed in the low Hct group than in the high Hct group. After surgery, estimated glomerular filtration rate was significantly lower (p = .015), lactaic acid was higher (p = .045), and intubation time was longer (p = .018) in the low Hct group than in the high Hct group, although there was no difference in hospital mortality between the groups. The AUC of the nadir Hct during CPB as a prognostic indicator of prolonged postoperative ventilator support was 0.8, with the highest accuracy at 16.7% (sensitivity 88%, specificity 76.9%). In all cohorts, female sex was an independent risk factor for a lower nadir Hct value of <21% during CPB. A lower nadir Hct value of <21% during CPB may be associated with postoperative renal dysfunction and prolonged ventilator support in patients with ATAAD.

Intraoperative nadir hematocrit as a poor outcome predictor after acute type A aortic dissection surgey.

Acute type A aortic dissection is a life-threatening disease associated with high morbidity and mortality that requires urgent surgical intervention. Hemodilution is inevitable in cardiac operations performed with cardiopulmonary bypass, which leads to nadir hematocrit levels. Studies have shown that nadir hematocrit levels are associated with poor postoperative outcomes. The management strategy of intraoperative anemia in these operations is still controversial. Should we follow the patients with intraoperative low hematocrit values or should we transfuse them? In addition to intraoperative nadir hematocrit, cannulation strategies play an important role in early postoperative outcomes after aortic dissection surgery.

The paradigm shift from polycythemia to anemia in COPD: the critical role of the renin–angiotensin system inhibitors

ABSTRACT Introduction Although polycythemia has been considered a common adverse event in COPD, anemia is reported more often and has gained more importance than polycythemia over the last thirty years. Areas covered Factors considered to be associated with the development of anemia in COPD have included: Aging and kidney dysfunction with erythropoietin deficiency and bone marrow suppression due to uremic toxins; heart failure (HF), often encountered in COPD and accompanied by anemia in one-third of the cases; Low-grade chronic inflammation, directly suppressing bone marrow and diminishing iron absorption and utilization via increased hepcidin levels; long-term oxygen therapy (LTOT), ameliorating chronic hypoxia, and most important, RAS inhibitors, which are widely used for the comorbidities associated with COPD (hypertension, HF, CKD, diabetes) and have previously been shown to lower hematocrit values or cause anemia in various clinical conditions. Expert opinion Introduction of LTOT in COPD and especially the established use of RAS inhibitors form the basis for the shift from polycythemia to anemia in COPD. Interestingly, when the SGLT2 inhibitors are introduced for cardiorenal protection in COPD, one could anticipate correction of anemia or even reemergence of polycythemia, since this new class of drugs can augment erythropoietin secretion and increase hematocrit values.

Menthol as anesthetic for juvenile Lophiosilurus alexandri: Induction and recovery time, ventilatory frequency, hematology and blood biochemistry

Anesthesia is an indispensable procedure during the handling of fish. This work evaluated the effects of menthol as anesthetic for juvenile Lophiosilurus alexandri. Menthol concentrations of 0 (control), 25, 50, 150, 300 and 450 mg L−1 were tested using 14 animals for each concentration, with each fish being a replicate. Blood was sampled from seven of the juveniles in each group shortly after anesthetic induction and from the other seven at 24 h post-anesthesia and procedures to collect biometric measures, i.e., handling and air exposure. Induction time showed a linear response plateau effect (LRP) with an inflection point of 142 mg L−1, while a dose-response relationship was observed among concentrations for recovery time. Ventilatory frequency (VF) during anesthetic induction had a LRP effect with an inflection point of 127 mg L−1, while during recovery it had a quadratic effect with a maximum point of 305.45 mg L−1. Fish anesthetized with 50 mg L−1 of menthol had the lowest hematocrit values (P < 0.05), while those exposed to 450 mg L−1 had the lowest erythrocyte values (P < 0.001). Other changes in hemato-biochemical parameters are discussed. Concentrations between 50 and 300 mg L−1 of menthol were able to induce deep anesthesia in juvenile L. alexandri with induction and recovery times considered ideal for fish. The use of 50 mg L−1 of menthol was able to reduce VF during induction and recovery and also prevent increased plasma glucose, with little influence on hematological and biochemical parameters after handling.

Fully Automated Dried Blood Spot Extraction coupled to Liquid Chromatography-tandem Mass Spectrometry for Therapeutic Drug Monitoring of Immunosuppressants

Patients receiving immunosuppressant therapy, require intensive follow-up via therapeutic drug monitoring (TDM). This puts quite a burden on the patient involving frequent hospital visits and venipunctures and could (partially) be resolved by the use of dried blood microsamples (e.g. dried blood spots, DBS). One of the drawbacks of the use of DBS is the requirement for a dedicated, manual sample preparation. Fully automated DBS extraction systems, online coupled to standard liquid chromatography-tandem mass spectrometry (LC-MS/MS) configurations, could provide a solution for that. The aim of this study was to evaluate the use of the DBS-MS 500, online coupled to an LC-MS/MS system, for the TDM of immunosuppressants using DBS. Two methods for the quantification of tacrolimus, sirolimus, everolimus and cyclosporin A, in both DBS and whole blood, were developed and validated based on international guidelines. For the DBS method also DBS-specific parameters were taken into account. Both methods proved to be accurate and reproducible with biases below 11% (20% for the LLOQ) and CVs (%) below 14% (with a single exception) (20% for the LLOQ) over a calibration range from 1 to 50 ng/mL for tacrolimus, sirolimus and everolimus and 20 to 1500 ng/mL for cyclosporin A. Reproducible (CV < 15%) IS-compensated relative recovery values were obtained. However, a hematocrit-dependent relative recovery was observed for DBS, with lower hematocrit values yielding higher relative recoveries (and vice versa). Relative to the reference hematocrit of 0.37, this difference exceeded 15% at hematocrit extremes (0.18 and 0.60). Application on venous left-over patient samples showed reasonable agreement between the results of both methodologies (8,6,9 and 9/10 mean DBS results within 20% of the mean whole blood result for tacrolimus, sirolimus, everolimus and cyclosporin A, respectively), although also here an impact of the hematocrit could be discerned. As a next step, larger patient sets are needed to allow a better insight on how (correction for) the hct effect affects the quantification of immunosuppressants via fully automated DBS analysis.

Transplacental transmission of Theileria annulatain cattle confirmed by molecular techniques.

Theileria annulata (T. annulata) is a tick-borne apicomplexan parasite affecting ruminants and causes severe economic loss. The present paper reports the vertical transmission of T. annulata in a three day old crossbred Jersey calf. Molecular diagnosis of tropical theileriosis was done by PCR, cloning, sequencing and phylogenetic analysis of isolated parasites. Calf showed very low hematocrit value (HCT) (17.82%), red blood cells count (RBC) count (6.9 × 106/μL), and hemoglobin concentration (Hb) (6.6g/dL). Phylogenetic analysis of Tams 1 gene showed that T. annulata Khorda isolate (MW123091) shared 99.23%, 99.23% and 99.11% nucleotide homology with Puri, India (MN818858), Bahrain (AF214797) and Hyderabad, India (MK034702), respectively. This is the first study in Odisha, India to give an insight into the molecular detection, phylogeny and hematological analysis of T. annulata infected crossbred Jersey calf which got the infection through transplacental transmission.