Mean Corpuscular Volume Levels Research Articles

Anemia and hematinic deficiencies in anti-gastric parietal cell antibody-positive or all autoantibodies-negative recurrent aphthous stomatitis patients.

Approximately 13% of recurrent aphthous stomatitis (RAS) patients have serum anti-gastric parietal cell antibody (GPCA) positivity. This study assessed whether serum GPCA or RAS itself was a significant factor causing hematinic deficiencies and anemia statuses in GPCA-positive RAS (GPCA+/RAS) and all autoantibodies-negative RAS (Abs-/RAS) patients. The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of three groups of 31 GPCA+/RAS patients, 240 Abs-/RAS patients, and 342 healthy control subjects. GPCA+/RAS patients had significantly lower mean Hb and serum iron level (for women only) as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy control subjects. Moreover, GPCA+/RAS patients had a significantly higher MCV and a significantly greater frequency of vitamin B12 deficiency than Abs-/RAS patients. Furthermore, Abs-/RAS patients did have significantly lower mean Hb, MCV, iron, and folic acid levels and significantly greater frequencies of Hb, iron, vitamin B12, and folic acid deficiencies than healthy control subjects. Of 31 GPCA+/RAS patients, 3 (9.7%) had PA, 6 (19.4%) had vitamin B12 deficiency, and 3 (9.7%) had macrocytosis. Moreover, normocytic anemia (54.0%) and iron deficiency anemia (26.4%) are the two more common types of anemia in our RAS patients. We conclude that serum GPCA plays a significant role in causing vitamin B12 deficiency and high MCV in GPCA+/RAS patients. RAS itself does play a significant role in causing anemia and hematinic deficiencies in both GPCA+/RAS and Abs-/RAS patients.

Evaluation of Choroidal Thickness in Children With Iron Deficiency Anemia.

The purpose of this study was to determine whether there are differences in choroidal thickness in children with iron deficiency anemia (IDA). Fifty-two patients with IDA and 54 healthy children between 3 and 16 years of age were enrolled in this study. After complete eye examinations were conducted for each participant, the choroidal thickness was measured using optical coherence tomography. Correlations between the choroidal thickness and clinical and laboratory parameters were also evaluated. There were no statistically significant differences between the two groups in terms of visual acuity, intraocular pressure, central corneal thickness, or axial length (P > 0.05). The choroidal thicknesses at the foveal center were 303.13 ± 27.14 μm in the IDA patients and 333.67 ± 39.77 μm in the healthy control children (P < 0.001); additionally, the choroidal thicknesses at each point within the horizontal nasal and temporal quadrants were thinner in the IDA group. There were positive correlations between the choroidal thickness and hemoglobin (r = 0.337; P < 0.001), mean corpuscular volume (r = 0.305; P = 0.001), iron (r = 0.264; P = 0.006), and ferritin (r = 0.287; P = 0.003) levels; however, there were no correlations between the clinical or ocular characteristics and the choroidal thickness. The patients with IDA had significantly thinner choroidal thicknesses than those of the healthy children. Choroidal thinning in childhood may be an early sign of deterioration in the ocular blood circulation, without any risk of atherosclerosis in advanced age in the patients with IDA.

Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity.

Serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) are found in some erosive oral lichen planus (EOLP) patients. This study assessed whether serum GPCA, TGA and TMA and EOLP itself played significant roles in causing anemia and hematinic deficiencies in TGA/TMA-positive EOLP patients with GPCA positivity (GPCA+/TGA/TMA/EOLP patients) or negativity (GPCA-/TGA/TMA/EOLP patients). The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of the four groups of 29 GPCA+/TGA/TMA/EOLP patients, 80 GPCA-/TGA/TMA/EOLP patients, 198 all antibodies-negative EOLP patients (Abs-/EOLP patients), and 218 healthy control individuals. GPCA+/TGA/TMA/EOLP patients had significantly lower mean Hb and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy controls. GPCA+/TGA/TMA/EOLP patients had significantly lower serum vitamin B12 level and higher MCV as well as a significantly greater frequency of vitamin B12 deficiency than GPCA-/TGA/TMA/EOLP patients. Furthermore, both GPCA-/TGA/TMA/EOLP and Abs-/EOLP patients did have significantly lower mean Hb, MCV, and iron (for women only) levels, as well as significantly greater frequencies of Hb and iron deficiencies than healthy controls. However, there were no significant differences in measured blood data between GPCA-/TGA/TMA/EOLP and Abs-/EOLP patients. We conclude that serum GPCA is the major factor causing vitamin B12 deficiency, macrocytosis and pernicious anemia in GPCA+/TGA/TMA/EOLP patients. ELOP itself but not TGA/TMA positivity plays a significant role in causing anemia and hematinic deficiencies in GPCA-/TGA/TMA/EOLP patients.

The acute effect of erythropoietin on mean corpuscular volume levels during hypoxia-reoxygenation injury in rats

The acute effect of erythropoietin on mean corpuscular volume levels during hypoxia-reoxygenation injury in rats

D43 - Capecitabine and Regorafenib-related increased mean corpuscular volume of red blood cell may be a predictive marker of treatment response and survival in patients with metastatic colorectal cancer

Background: Erythrocyte mean corpuscular volume (MCV) increase has been described in patients treated with capecitabine. Moreover, tyrosine kinase inhibitors have been shown to induce macrocytosis in patients with renal cancer cell and gastrointestinal stromal tumors, presumably via the inhibition of erythroid progenitor cells of the bone marrow. Therefore, the aim of our study was to evaluate the potential association of the erythrocyte MCV increase with tumor response and survival in patients with metastatic colorectal cancer (mCRC) treated with capecitabine and regorafenib. Patients and methods: A retrospective review of 30 patients with mCRC who were treated with capecitabine or regorafenib for at least 3 months at the Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy. Complete blood count (CBC) including red blood cell indices were recorded at baseline and after 4, 8 and 12 weeks from capecitabine or regorafenib treatment. Results: Baseline MCV levels and MCV levels after 4, 8 and 12 weeks were registered for each patient treated with capecitabine or regorafenib. Median ΔMCV [(post-treatment MCV values after 12 weeks) - (baseline MCV values)] was calculated. Patients were grouped according to ΔMCV into two groups in order to carry out survival analysis and correlation with tumor response. Moreover, univariate and multivariate analysis was performed to investigate if MCV increase was independently associated with favorable survival outcomes. Conclusions: Erythrocyte MCV increase may be used as a predictive marker for treatment response, PFS and OS in patients with mCRC treated with capecitabine or regorafenib. In the future, response to TAS-102 (trifluridine-tipiracil) and MCV increase will be also evaluated.

Assessment of mutagenic, hematological and oxidative stress biomarkers in liver of Nile tilapia, Oreochromis niloticus (Linnaeus, 1758) in response to sublethal verapamil exposure

The influx of pharmaceutical drugs and their metabolites have been reported to cause negative impact on aquatic biota. In this study, effects of long-term exposure of verapamil on mutagenic, hematological parameters and activities of the oxidative enzymes of Nile tilapia, Oreochromis niloticus were investigated for 60 days exposure at the concentrations of 0.29, 0.58 and 1.15 mg L−1 in the fish liver. The exposure resulted in significantly high (p < 0.05) micronuclei induction of peripheral blood cells at the peak on day 30 at 1.15 mg L−1. Compared with the control, there was significant increase (p < 0.05) in white blood cell counts and red blood cell distribution width (RDW), with a reduction in hemoglobin (Hb), red blood cell counts (RBCs), mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) level as the concentration of the drug increased. The indices of oxidative stress biomarkers (lipid peroxidation and carbonyl protein) showed elevated level, depicting a positive correlation with both time and concentration. More so, the activity of energy-related parameter (Na+ -K+- ATPase) in the tissue was significantly inhibited (p < 0.05) at the end of 60 days exposure period. Further, the activity of catalase (CAT) was inhibited while reduced glutathione (GSH) level was decreased in the liver tissue. There was increase in the activities of superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione–S-transferase (GST) after 30 days at 0.29 mg L−1. The study demonstrated that prolonged exposure to verapamil at sublethal concentration can result in mutagenic effects and oxidative dysfunctions in O. niloticus.

Hematological manifestations of autoimmune gastritis

Aim of investigation. To estimate hematological disorders in patients with high titer of anti-parietal cell antibodies (APCA). Material and methods. Overall 71 patient with high serum APCA titer were included in original study. At all patients scores of clinical and biochemical blood tests were investigated. The special attention was given to RBC color index (CI), mean corpuscular volume (MCV), mean hemoglobin content per cell and serum iron and vitamin В12 concentration. Results. The mean indices of clinical and biochemical blood tests in APCA-positive patients were within normal range. Hematological changes were revealed in 25,4% of patients. In 11,3% of the cases either macrocytic or microcytic anemia was diagnosed. Increase in mean corpuscular volume and serum cobalamin level were found out in 16,9% of the cases, while low hemoglobin level - only at 25% of them. No Helicobacter pylori infection has been revealed in the patients with macrocytic anemia, however no significant difference on its prevalence in patients with different serum cobalamin level was found out. Conclusion. The majority of cases with high APCA titer has no hematological signs of autoimmune gastritis. In 25,4% of patients with APCA changes in common blood count were revealed, most often - of MCV and the CI. Anemia was diagnosed in 11,3% of patients. In investigated group cobalamin deficiency was found in 16,9% of patients, iron deficiency - in 9,9% of the cases. In 75% of patients increase in MCV was the only sign of cobalamin deficiency. Iron deficiency was more common in women.

Association of the Single Nucleotide Polymorphisms in RUNX1, DYRK1A, and KCNJ15 with Blood Related Traits in Pigs.

The aim of this study was to detect positional candidate genes located within the support interval (SI) regions based on the results of red blood cell, mean corpuscular volume (MCV), and mean corpuscular hemoglobin quantitative trait locus (QTL) in Sus scrofa chromosome 13, and to verify the correlation between specific single-nucleotide polymorphisms (SNPs) located in the exonic region of the positional candidate gene and the three genetic traits. The flanking markers of the three QTL SI regions are SW38 and S0215. Within the QTL SI regions, 44 genes were located, and runt-related transcription factor 1, dual-specificity tyrosine-(Y)-phosphorylation regulated kinase 1A (DYRK1A), and potassium inwardly-rectifying channel, subfamily J, member 15 KCNJ15–which are reported to be related to the hematological traits and clinical features of Down syndrome–were selected as positional candidate genes. The ten SNPs located in the exonic region of the three genes were detected by next generation sequencing. A total of 1,232 pigs of an F2 resource population between Landrace and Korean native pigs were genotyped. To investigate the effects of the three genes on each genotype, a mixed-effect model which is the considering family structure model was used to evaluate the associations between the SNPs and three genetic traits in the F2 intercross population. Among them, the MCV level was highly significant (nominal p = 9.8×10−9) in association with the DYRK1A-SNP1 (c.2989 G<A), and explained 4.9% of the phenotypic variance. However, since linkage disequilibrium is quite extensive in an F2 intercross, our approach has limited power to distinguish one particular positional candidate gene from a QTL region.

Hematological and Immunological plasma assays for grass carp (Ctenopharyngodon idella) infected with Aeromonas hydrophila as an immune model in carp aquaculture.

Aeromonas hydrophila is the causative agent of bacterial septicemia, a common disease observed in grass carp, Ctenopharyngodon idella. In our study, C.idella specimens were infected with A.hydrophila, and parameters of Hematological and Immunological plasma parameters were monitored. At blood cell level, levels of red blood cells (RBCs), hematocrit (HCT), and mean corpuscular volume (MCV) showed no differences between the treatment and control groups, but levels of white blood cells (WBCs) increased. The monocyte and neutrophil varied significant according to stimulation by A.hydrophila at 1 DPI, the thrombocyte and lymphocyte at 14 and 21 DPI. At serum level, total protein, lysozyme, and IgM increased at the early infection phase and then decreased at other time points; however, peroxidase levels were significantly lower in the treatment group than that in the control group during the early infection phase. ACH50 was significantly higher in the treatment group than that in the control group during the late infection phase. On the basis of the results, we suggest that innate and adaptive immune mechanisms of C.idella are able to neutralize the virulence factors secreted by A.hydrophila. Our findings would help in understanding the mechanisms underlying resistance to infection by A.hydrophila.

The prevalence of iron deficiency anemia in children with severe early childhood caries undergoing dental surgery under general anesthesia

PurposeSevere early childhood caries (SECC) is known to affect young children worldwide. However, there is little information about the effects of SECC on Iron deficiency anemia (IDA). The aim of this study was to investigate the IDA in children with severe caries undergoing dental surgery under general anesthesia. MethodsA total of 160 children were evaluated; age ranged from two to six years and mean age was 4.8 ± 1.1 years. Before performing general anesthesia, blood samples were assessed regarding hemoglobin (Hgb), hematocrit (Hct), mean corpuscular volume (MCV) as biochemical indicators of IDA. ResultsThe mean deft score was 10.1 ± 4.1. The children in this study were defined to have SECC. All of the anemia-related measurements were in the standard ranges, except for MCV values. There were no statistically significant differences between serum Hgb (p = 0.205) and Hct levels (p = 0.386), but statistically significant differences were found among serum MCV levels (p = 0.018) in children with severe caries. Pearson Correlation analysis among SECC and Hgb (p = 0.54),Hct (p = 0.88) and MCV (p = 0.39) revealed that there were no significant differences. ConclusionsThere was no association between SECC and serum Hgb, Hct and MCV levels, but low levels of MCV might be an indicator of microcytic anemia which is most commonly caused by iron deficiency. In the present study, we concluded that SECC might be a risk marker for iron deficiency.

Influence of new antiretrovirals on hematological toxicity in HIV-exposed uninfected infants.

Maternal combined antiretroviral therapy (cART) successfully prevents HIV mother-to-child transmission but also causes hematological toxicity in the HIV-exposed uninfected (HEU) infant. We performed a single-center prospective observational study. Hematological toxicity during the first year of life (at 3 and 6weeks, and 3, 6, and 12months) was compared between HEU infants born in two different time periods: P1 (2000-2001) and P2 (2007-2013). Mother-infant pairs in P1 (n = 55) and P2 (n = 48) mainly differed in maternal ethnic origin, HIV route of transmission, and cART regimens. Anemia and neutropenia were both less common in P2 than P1, albeit not significantly. Earlier normalization of red blood cell mean corpuscular volume levels in P2 infants suggests that current cART maternal regimens and shorter neonatal prophylaxis are less toxic. Leukocyte, lymphocyte, and platelet counts remained within normal values during follow-up, without differences between groups. New cART regimens have had very little impact on the hematological toxicity in HEU infants. • Antiretroviral drugs during pregnancy and the neonatal period very effectively prevent mother-to-child transmission of HIV infection. • Hematological toxicity has been widely reported among HIV-exposed uninfected children. What is New: • In HIV-exposed uninfected children, hematological toxicity is still mainly caused by exposure to zidovudine. • New antiretroviral drugs have very little impact on hematological toxicity among HIV-exposed uninfected children.

Female cotton rats (Sigmodon hispidus) develop chronic anemia with renal inflammation and cystic changes.

The cotton rat (Sigmodon hispidus) is a laboratory rodent that has been used for studies on human infectious diseases. In the present study, we observed that female cotton rats, not the male cotton rats, developed chronic anemia characterized by reduced red blood cell, hemoglobin, and hematocrit levels from 5 to 9months of age without any changes in the mean corpuscular hemoglobin and volume levels. In peripheral blood, the reticulocyte count did not increase in response to anemia in female cotton rats, and no extramedullary hematopoiesis was observed in the liver or spleen. Further, the serum levels of urea nitrogen and creatinine increased from 5 to 9months of age in female cotton rats compared to male cotton rats, and these increases became more prominent from 10months of age onward, indicating chronic kidney disease. Histopathologically, female cotton rats manifested tubulointerstitial lesions characterized by the infiltration of mononuclear cells, including plasma cells and CD3(+) T-cells, as well as the dilation of calbindin-D28k(+) distal tubules from 5 to 9months of age. The severity of these lesions progressed from 10months of age onward, and renal fibrotic features and numerous tubular cysts appeared without any obvious glomerular lesions. A significant decrease in the erythropoietin protein levels was observed in the kidney of aged female cotton rats, and significant correlations were detected between anemia and tubulointerstitial damage. These results suggest that aged female cotton rats chronically develop renal anemia, and this rodent may serve as a novel model to elucidate its pathogenesis.

Elevated red cell distribution width at initiation of critical care is associated with mortality in surgical intensive care unit patients

PurposeRecent evidence suggests that red cell distribution width (RDW) is associated with mortality in mixed cohorts of critically ill patients. Our goal was to investigate whether elevated RDW at initiation of critical care in the intensive care unit (ICU) is associated with 90-day mortality in surgical patients. MethodsWe performed a retrospective, single-center cohort study. Normal RDW was defined as 11.5%–14.5%. To investigate the association of admission RDW with 90-day mortality, we performed a logistic regression analysis, controlling for age, sex, race, body mass index, Nutrition Risk Screening 2002 score, Acute Physiology and Chronic Health Evaluation II score, hospital length of stay, as well as levels of creatinine, albumin, and mean corpuscular volume. Results500 patients comprised the analytic cohort; 47% patients had elevated RDW and overall 90-day mortality was 28%. Logistic regression analysis demonstrated that patients with elevated RDW had a greater than two-fold increased odds of mortality (OR 2.28: 95%CI 1.20–4.33) compared to patients with normal RDW. ConclusionsElevated RDW at initiation of care is associated with increased odds of 90-day mortality in surgical ICU patients. These data support the need for prospective studies to determine whether RDW can improve risk stratification in surgical ICU patients.

Macrocytosis as a potential parameter associated with survival after tyrosine kinase inhibitor treatment

Aim of the studyAs a rise in mean corpuscular volume (MCV) of the erythrocyte is frequently seen during treatment with imatinib and sunitinib, we investigated whether macrocytosis (MCV > 100 fl) also occurs as a class effect in other tyrosine kinase inhibitors (TKIs) and whether occurrence of macrocytosis is associated with outcome. Materials and methodsIn 533 patients, using 5 TKIs, we investigated if macrocytosis and an increase in MCV were associated with progression-free survival and overall survival (OS) in specific tumour-treatment combinations. ResultsMacrocytosis as well as an increase in MCV from baseline of >10 fl (ΔMCV +10 fl), when included as a time-dependent covariate, were associated with improved OS in patients with renal cell cancer (RCC) treated with sunitinib (macrocytosis, hazard ratio [HR] = 0.61, p = 0.031, and ΔMCV +10 fl, HR = 0.58, p = 0.016). ConclusionIn sunitinib-treated patients with RCC, the occurrence of macrocytosis, or a substantial increase in MCV levels after start of treatment, could potentially serve as a positive prognostic factor for survival, if validated prospectively.

Association of severe early childhood caries with iron deficiency anemia.

Severe tooth decay is known to affect the health and well-being of young children. However, there has been minimal research showing the association of severe early childhood caries (S-ECC) and iron deficiency anemia (IDA). The primary aim of this study was to investigate an association between S-ECC with IDA. The secondary objective was to find an association between severe caries and body weight of the child. The oral health-related quality of life of children with S-ECC was also assessed. Following the ethical approval, 60 children aged 2-6 years (30 with S-ECC and 30 controls with caries status <2) were recruited for this cross-sectional association study. Each child received a clinical examination for dental caries status using deft index and a blood investigation to determine various parameters; hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration, and packed cell volume (PCV). Children underwent venipuncture after due parental consent, and 2.5 mL blood was collected from each child to evaluate the above parameters. Following this, the parents filled up a 10 point questionnaire to determine the child's quality of life. Data were then analyzed by t-test and Fischer's exact t-test. On comparison of percentage of children with IDA in S-ECC and control group, it was found that children with S-ECC were more likely to have IDA odds ratio (95% confidence interval): 10.77 (2.0, 104.9), (P = 0.001). In addition to this, S-ECC children were significantly more likely to have low Hb, MCV, and PCV levels (P < 0.001) which imply that S-ECC may be a risk marker for the development of anemia. More children (93%) with severe caries were found to have less body weight than ICMR standard weight for age as compared to children with low caries (P < 0.05%). S-ECC is strongly associated with the anemia due to iron deficiency, and efforts should be made toward the preventive and curative aspects of ECC, which may improve the general well-being and quality of life of a child.

Unrefined Peanut Oil as a Lipid Source in Diets for Juveniles of Two‐banded Seabream Diplodus vulgaris

AbstractA feeding study with Two‐banded Seabream Diplodus vulgaris was conducted to determine the effects of replacement of fish oil (FO) by unrefined peanut oil (PO) on growth performance, feed utilization, body composition, fatty acid composition, and serum biochemical and hematological variables. Three isonitrogenous (35.8%) and isoenergetic (21.15 kJ/g) diets were formulated by replacing dietary FO with PO at levels of level 0% (PO0), 50% (PO50), or 100% (PO100). Fish were fed twice a day until satiation for an experimental period of 8 weeks. The best growth performance was observed in fish fed with the PO0 and PO50 diets. A significant increase was observed in hematocrit and mean corpuscular volume levels of fish fed with PO50 diet compared with the other groups. Hemoglobin, mean corpuscular hemoglobin, total protein, albumin, and globulin were not affected by dietary PO treatment and did not differ among experimental groups. The glucose level was highest in the PO100 group. Triglyceride and cholesterol levels were lower in fish fed diets with PO inclusions than in those fed the control diet. The fatty acid composition of fish was significantly affected by the experimental diets. Glutamic oxaloacetic transaminase, glutamic pyruvictransaminase, lactate dehydrogenase, and alkaline phosphatase were not affected by dietary PO treatment. The n‐3:n‐6 ratio in fish fed the PO0 diet was also higher than in fish fed the PO‐supplemented diets. The results of the present study showed that FO could be substituted by PO up to 50% in Two‐banded Seabream diets without any negative effect on growth performance or serum biochemical and hematological features.

Thermoregulatory responses and blood parameters of locally adapted ewes under natural weather conditions of Brazilian semiarid region

&lt;p&gt;The effect of the natural weather conditions on respiratory rate, rectal temperature and hematologic parameters such as glucose, total cholesterol, triacylglycerol, total protein, albumin, globulin, red blood cells, microhematocrit, mean corpuscular volume, serum triiodothyronine (T3) and thyroxine (T4) levels was evaluated in red (RMN) and white (WMN) coat colored Morada Nova ewes, of different class of body condition score (CBCS), during the dry (from july to december) and wet (from january to june) seasons, which exhibited different (P&amp;lt;0.05) air temperature, relative humidity and radiant thermal load averages. Tukey’s test was used and the difference considered was to P&amp;lt;0.05. Significant greater averages of respiratory rate were observed in the dry period compared to the rainy period (42.26±8.96 and 36.89±8.20 breaths min-1, respectively), mainly in the RMN (45.54±8.23 breaths min-1) compared with the WMN (39.27±8.57 breaths min-1). No differences were observed in rectal temperature measurements between the dry and the wet periods (38.59±0.58 and 38.60±0.56 oC, respectively), but the WMN had higher values than the RMN (38.77±0.54 and 38.40±0.54 oC, respectively). The glucose and total cholesterol were higher in the wet season, with no variation due to breed variety and CBCS. The triacylglycerol did not change between breed varieties and seasons. The albumin was similar between varieties and in different seasons, being different in CBCS. Total protein and globulin serum were higher during the wet season, but total protein was higher and globulin was lower in better CBCS. T3 and T4 levels were higher in the rainy season (0.25±0.07 and 6.74±11.37 ?g dL-1, for T3 and T4, respectively) than in the dry season (0.18±0.08 and 6.31±1.64 ?g dL-1, for T3 and T4, respectively). The red blood cells showed no difference, but microhematocrit was higher in WMN and in the better CBCS and mean corpuscular volume was higher in the dry season. The concentration of T3 was lower in the RMN than in the WMN (0.19±0.07 and 0.24±0.08 ?g dL-1, respectively), while T4 did not differ between them (6.53±1.51 and 6.52±1.46 ?g dL-1, respectively). The Morada Nova sheep showed positive physiological responses to the heat stress, notably an increase of respiratory rate and a reduction of T3 and T4 levels. All another hematologic parameters analyzed were within the normal range for all sheep, indicating a good ability to cope with the climatic changes of the Brazilian semiarid region. Both varieties were heat tolerant, but the red variety required major adjustments to maintain homeothermy.&lt;/p&gt;

Thermoregulatory responses and blood parameters of locally adapted ewes under natural weather conditions of Brazilian semiarid region

The effect of the natural weather conditions on respiratory rate, rectal temperature and hematologic parameters such as glucose, total cholesterol, triacylglycerol, total protein, albumin, globulin, red blood cells, microhematocrit, mean corpuscular volume, serum triiodothyronine (T3) and thyroxine (T4) levels was evaluated in red (RMN) and white (WMN) coat colored Morada Nova ewes, of different class of body condition score (CBCS), during the dry (from july to december) and wet (from january to june) seasons, which exhibited different (P&lt;0.05) air temperature, relative humidity and radiant thermal load averages. Tukey’s test was used and the difference considered was to P&lt;0.05. Significant greater averages of respiratory rate were observed in the dry period compared to the rainy period (42.26±8.96 and 36.89±8.20 breaths min-1, respectively), mainly in the RMN (45.54±8.23 breaths min-1) compared with the WMN (39.27±8.57 breaths min-1). No differences were observed in rectal temperature measurements between the dry and the wet periods (38.59±0.58 and 38.60±0.56 oC, respectively), but the WMN had higher values than the RMN (38.77±0.54 and 38.40±0.54 oC, respectively). The glucose and total cholesterol were higher in the wet season, with no variation due to breed variety and CBCS. The triacylglycerol did not change between breed varieties and seasons. The albumin was similar between varieties and in different seasons, being different in CBCS. Total protein and globulin serum were higher during the wet season, but total protein was higher and globulin was lower in better CBCS. T3 and T4 levels were higher in the rainy season (0.25±0.07 and 6.74±11.37 ?g dL-1, for T3 and T4, respectively) than in the dry season (0.18±0.08 and 6.31±1.64 ?g dL-1, for T3 and T4, respectively). The red blood cells showed no difference, but microhematocrit was higher in WMN and in the better CBCS and mean corpuscular volume was higher in the dry season. The concentration of T3 was lower in the RMN than in the WMN (0.19±0.07 and 0.24±0.08 ?g dL-1, respectively), while T4 did not differ between them (6.53±1.51 and 6.52±1.46 ?g dL-1, respectively). The Morada Nova sheep showed positive physiological responses to the heat stress, notably an increase of respiratory rate and a reduction of T3 and T4 levels. All another hematologic parameters analyzed were within the normal range for all sheep, indicating a good ability to cope with the climatic changes of the Brazilian semiarid region. Both varieties were heat tolerant, but the red variety required major adjustments to maintain homeothermy.

Hypersegmented Neutrophil Percentage Using Automated Digital Cell Morphology: A Simple Laboratory Parameter to Monitor Hydroxyurea Therapy in Sickle Cell Disease Patients

Fetal hemoglobin (HbF) induction with hydroxyurea (HU) remains the only specific pharmacological treatment for sickle cell disease (SCD) patients. Compliance is key to achieve high HbF levels, but assessing patient adherence to long-term treatment is difficult. Since patient interviews are often unreliable, most hematologists rely on mean corpuscular volume (MCV) and HbF levels to monitor compliance, but red blood cell indices change slowly. Hypersegmented neutrophils (HN) have been for long recognized in patients taking HU, and automated digital cell morphology platforms allow routine peripheral blood smears to be conveniently photographed and stored for analysis. We have designed a protocol to determine the percentage of circulating HN and have studied how this parameter compares with others commonly used in clinical practice during HU therapy, such as HbF, MCV, and reticulocyte count.We collected blood samples from 38 patients with SCD in steady state, receiving an average dose of 20.5mg/kg/day of HU (range 10.2-33.3) at our Hematology outpatient clinic. Complete blood counts and HN percentage determinations were performed on a Sysmex XE-5000/Cellavision DM96 equipment. HbF levels were determined by HPLC (Bio-Rad). Statistical analysis was performed using GraphPad Prism 6.0 software. Standard protocol for image acquisition initially recorded 100 cells per smear and HN count was performed independently by two experienced laboratory personnel using the same image database, by counting cells with 5 or more nuclear segments. To increase precision due to the relatively low numbers of neutrophils in some samples, analysis was subsequently improved by acquiring 300 images per smear aiming to picture 100 neutrophils.Mean hemoglobin level in our population was 8.6±1.3g/dL (mean±SD), MCV 103.8±14.2fL, reticulocyte count 222,950±129,090/uL, and HbF was 13.1±7.8% (range 2.1-30.9%). HN percentage as determined with 100 images per smear displayed only borderline correlation with HbF levels (P =0.094), but acquisition of 300 images per smear yielded over 90 neutrophil images in 35/38 samples. Average HN percentage was 14,5% (range 2,0-45,0%) and correlated positively with HbF (r=0.4172, P =0.009) and MCV (r=0.4301, P =0.007). As expected, HbF also correlated with MCV (r=0.5777, P =0.0001) and reticulocyte count (r=-0.489, P =0.003). Despite our limited number of patients, ROC curve analysis showed that HN percentage had an area under curve of 0.7241 to detect patients with HbF>20% (P =0.047). Patients with more than 6 segments per neutrophil were also more likely to have higher HbF. Average daily HU dose did not correlate with HbF or any of the parameters analyzed.Lack of correlation between dose and HbF supports that medication adherence may indeed be suboptimal in the study population, but that may also be caused by individual differences in HU metabolism. While MCV still displayed the strongest correlation with HbF in our study, HN percentage performed similarly, with higher counts associated with higher HbF. Neutrophils have a much shorter half-life than erythrocytes, with an estimated half-life of hours rather than the 20 days calculated for sickle red blood cells. Therefore, digital cell morphology analysis enables clinical laboratories to determine HN counts that can change more quickly than HbF, MCV, or reticulocyte counts during HU therapy. Monitoring the number of HN may allow more timely assessment of compliance in patients starting HU or in those in need for HU in combination with sporadic blood transfusions, since neutrophil hypersegmentation should not be affected by changes in red blood cell mass. Further studies should investigate HN percentage as a potential surrogate marker of response to HU and of patient compliance.Financial support: FAPESP DisclosuresNo relevant conflicts of interest to declare.

Mean corpuscular volume levels and all-cause and liver cancer mortality

An elevated mean corpuscular volume (MCV) is associated with aging, nutrition, alcohol abuse and more, and it is known as a survival predictor in chronically ill patients. The aim of this study was to investigate the association between MCV levels and mortality from all-causes, cancer and site-specific cancer in a non-anemic healthy population. A total of 36,260 participants aged 40 years or older who underwent routine check-ups at Seoul National University Hospital Health Promotion Center between 1995 and 2008 were followed-up for mortality until December 31, 2008, retrospectively. During an average follow-up of 8.0 years, 1107 deaths including 547 cancer deaths were observed. The adjusted hazard ratios (aHRs) of the subjects with the highest quartile of MCV ≥95.8 fL in men and MCV ≥94.2 fL in women for all-cause and cancer mortality were 1.44 [95% confidence interval (CI), 1.15-1.80] and 1.51 (95% CI, 1.10-2.07) for men and 1.55 (95% CI, 1.08-2.22) and 1.25 (95% CI, 0.74-2.11) for women, respectively, compared with those in the reference group (90.5 fL≤MC <93.0 fL in men and 89.2 fL≤MCV<91.6 fL in women). Elevated MCV level was related to an increased risk of liver cancer mortality in men (aHR, 3.55; 95% CI, 1.75-7.21). This study suggests that the elevated MCV level in non-anemic cancer-free individuals was associated with increased all-cause mortality in both men and women, and with cancer mortality, in particular liver cancer mortality in men. Future prospective studies are required to consolidate our findings.