Mean Red Blood Cell Research Articles

Effects of Gender on Hematologic Parameters in Kangal Shepherd Dogs

Kangal Shepherd Dogs are highly valuable working dogs unique to Turkey, known for their robustness in withstanding harsh climatic conditions and possessing advanced herd protection and management abilities due to their genetic characteristics. Haematological values serve as crucial indicators of the physiological and physiopathological parameters in animals. A complete blood cell count (CBC) emerges as a powerful diagnostic tool when appropriately assessed. Given the establishment of pure breeds, it is essential to acknowledge that breedspecific hematologic values may exhibit variations influenced by factors such as gender, lifestyle, age, and geographical location. Therefore, understanding the physiological distinctions between genders becomes paramount. This study aims to assess the impact of gender on the complete blood count in Kangal Shepherd Dogs. Upon comparing hematologic parameters between female and male Kangal Shepherd Dogs, a statistically significant difference was observed in the mean platelet volume (MPV) value, which was higher in females than males (p < 0.05). While the mean red blood cell (RBC), haemoglobin (HGB), and haematocrit (HCT) values were higher in males, no statistically significant results were found (p > 0.05)

Complete Blood Counts Parameters and Erythrocyte Transfusions in Predicting Retinopathy of Prematurity

Aim:This study investigates the association of complete blood count parameters and erythrocyte transfusions with retinopathy of prematurity (ROP) requiring treatment in infants born prematurely under 32 weeks of gestation. Materials and Methods:The single-center, retrospective, observational study included 130 patients with a gestational age between 24-32 weeks who were born in the same hospital and hospitalized in the neonatal intensive care unit of the hospital between 2016-2018. Results:Mean complete blood count parameters at postnatal 0-24 hours and postnatal 24-72 hours as well as erythrocyte transfusions were compared in terms of retinopathy of prematurity requiring treatment. Mean hemoglobin, hematocrit and red blood cell count at postnatal 24-72 hours were significantly lower in patients with ROP requiring treatment than in those without. Conclusion: The study suggests that low erythrocyte mass and an increased number of early erythrocyte transfusions are important risk factors for the development of ROP requiring treatment.

Haematological changes induced by experimental Escherichia coli infection in layer chicken

This study examined the haematological alterations in layer hens infected with experimental Escherichia coli (E. coli). Twenty laying chickens (20 weeks old) were acquired and randomly divided into two groups of ten layers each (infected and control). After challenging the infected group with 0.5 milliliters of bacterial aliquot containing 109 colony forming units (CFU) of the bacteria intratracheally, 1 ml of blood was collected from each group on days 0, 2, 4, 6, 14, 21, 28, 35, and 42 post-infections (pi) for haematology. The mean PCV of the infected group dropped significantly (p<0.05) to its lowest value of 17.0 ± 0.71% on day 4, and then ascended to a peak level of 24.6 ± 1.03% on day 28. In the infected group, the mean Total White Blood Cell count grew considerably (p<0.05) from day 2 (14.81 ± 3.28 × 109/L) to day 14 pi, when it peaked at 29.16 ± 0.81 × 109/L. From day 2 pi to the lowest value (1.63 ± 0.07 × 1012L) on day 14 pi, the mean Red Blood Cell count fell; from day 21 to the maximum value (2.55 ± 0.08 × 1012L) on day 28 pi, it improved. The infected group's mean lymphocyte counts rose from day 4 to a peak level (21.59 ± 0.92 × 109/L) on day 14 pi. After that, it declined, but continued to be significantly (p<0.05) higher than the control group up to day 42. In conclusion, E. coli infection in layer chickens induced haematological changes.

RESULTS OF IRON SUPPLEMENTATION FOR REGULAR VOLUNTARY NON-REMUNERATED BLOOD DONORS AT NATIONAL INSTITUTE OF HEMATOLOGY AND BLOOD TRANSFUSION

Objective: To evaluate the results of iron supplementation for RRVBD at the National Institute of Hematology and Blood Transfusion (NIHBT). Subjects and methods: Including 279 RRVBD with serum ferritin below 26 ng/ml taking iron tablets containing 35 mg of elemental iron. Methods: Cross-sectional description, prospective study. Results: The average age of RRVBD taking iron tablets is 27.8 years old, the average number of blood donations is 11 times, the average time of re-testing is 169.5 days. The proportion of RRVBD taking iron tablets and testing on time is 43.4%, the proportion of RRVBD not taking iron tablets or not taking enough iron tablets is 18.3%, the proportion of RRVBD taking enough iron tablets and not coming to the test on time is 18.6%. The proportion of RRVBD dropping out of the study is 19.7%. Hematological parameters (red blood cell count, hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean serum iron concentration) of RRVBD taking iron tablets are within the normal range, the serum ferritin concentration of RRVBD recovered after taking iron tablets is: in the group of blood donors taking enough iron tablets and testing on time, the mean serum ferritin concentration before taking iron tablets is 15.8 ± 5.5 ng/ml and after taking iron tablets is 24.7 ± 14.9 ng/ml, the proportion of blood donors with ferritin returning to normal range after taking iron tablets is 39.7%. In group of blood donors not taking iron tablets or not taking enough iron tablets, serum ferritin before iron intake is 18.1 ± 5.3 ng/ml and after iron intake is 14.2 ± 10.9 ng/ml, the proportion of blood donors having serum ferritin returning to normal range after iron intake is 7.8%. In group of RRVBD taking enough iron tablets and not coming to the test on time, the mean serum ferritin concentration before iron intake is 16.5 ± 5.9 ng/ml and after iron intake is 28.8 ± 17.1 ng/ml, the proportion of blood donors with serum ferritin concentration returning to normal range after blood donation is 51.9%. Conclusion: The proportion of regularly repeated voluntary blood donors taking enough iron tablets and testing on time is 43.4%, the proportion of regularly repeated voluntary blood donors not taking iron tablets or not taking enough iron tablets is 18.3%, the proportion of regularly repeated voluntary blood donors taking enough iron tablets and not coming to the test on time is 18.6%, the proportion of regularly repeated voluntary blood donors not taking iron tablets and not testing is 19.7%. Hematological parameters (red blood cell count, Hb, MCV, MCH and mean serum iron concentration) of regularly repeated voluntary blood donors taking iron tablets before and after iron intake are within the normal range. The proportion of blood donors with serum ferritin concentration after iron intake returning to the normal range: blood donors taking enough iron tablets and testing on time is 39.7%, blood donors not taking iron tablets or not taking enough iron tablets is 7.8% and blood donors taking enough iron tablets and not coming to the test on time is 51.9%.

Haematological Profile of Various Inbred Strains of Mice Maintained at IMTech Centre for Animal Resources and Experimentation (iCARE)

Animal models are frequently employed in scientific studies to collect data from an entire set of experiments. Haematological tests on these laboratory mice are essential for confirming scientific findings because diverse mouse strains have been used to examine various diseases and novel therapeutic methods. This work is aimed to establish haematological values in mouse strains used in biomedical research. Blood samples were taken from the retro-orbital sinus of mice from various strains and haematological parameters including total White Blood Cells (WBC), Red Blood Cells (RBC), Haemoglobin (HGB), Haematocrit (HCT), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC), Red Blood Cell Dimension Width ( RDW), platelets, Mean Platelet Volume (MPV) and Platelet Dimension Width (PDW) were assessed. Compared to other strains (BALB/c, M:9.61, F:9.51; C57BL6/N, M:10.13, F:10.73; DBA/2, M:11.96, F:10.88), the mean values of WBCs (*103/μL) in DBA/1 mice were higher (M:14.02; F:14.65) and lower in NOD (M:7.14; F:6.54). The mean RBCs in different strains of mice used in this study ranged from 8.78-11.67*106/μL. Male mean haemoglobin valves in BALB/c, C57BL/6N, DBA/1, DBA/2 and NOD were 14.60, 13.32, 13.00, 14.35 and 13.48 (g/dL), respectively, while in females were 14.3, 14.09, 13.11, 12.65 and 13.24 (g/dL), respectively. The mean platelet counts in NOD mice (M:1826.60 and F:1557.80*103/μL) were significantly higher than other strains. Haematological profiles of the mice used in the study were consistent as reported previously for mice maintained in different animal facilities. The haematological values presented in this study can be used as reference values in biomedical research.

Relationship between red blood cell lifespan and endogenous carbon monoxide in the common bottlenose dolphin and beluga.

Certain deep-diving marine mammals [i.e., northern elephant seal (Mirounga angustirostris), Weddell seal (Leptonychotes weddellii)] have blood carbon monoxide (CO) levels that are comparable with those of chronic cigarette smokers. Most CO produced in humans is a byproduct of heme degradation, which is released when red blood cells (RBCs) are destroyed. Elevated CO can occur in humans when RBC lifespan decreases. The contribution of RBC turnover to CO concentrations in marine mammals is unknown. Here, we report the first RBC lifespans in two healthy marine mammal species with different diving capacities and heme stores, the shallow-diving bottlenose dolphin (Tursiops truncatus) and deep-diving beluga whale (Delphinapterus leucas), and we relate the lifespans to the levels of CO in blood and breath. The belugas, with high blood heme stores, had the longest mean RBC lifespan compared with humans and bottlenose dolphins. Both cetacean species were found to have three times higher blood CO content compared with humans. The estimated CO production rate from heme degradation indicates some marine mammals may have additional mechanisms for CO production, or delay CO removal from the body, potentially from long-duration breath-holds.NEW & NOTEWORTHY This is the first study to determine the red blood cell lifespan in a marine mammal species. High concentrations of carbon monoxide (CO) were found in the blood of bottlenose dolphins and in the blood and breath of belugas compared with healthy humans. Red blood cell turnover accounted for these high levels in bottlenose dolphins, but there may be alternative mechanisms of endogenous CO production that are contributing to the CO concentrations observed in belugas.

A Phase 1b Double-Blind, Placebo-Controlled Study of DISC-0974, an Anti-Hemojuvelin Antibody, in Patients with Non-Dialysis Dependent Chronic Kidney Disease and Anemia

Hepcidin, a central regulator of iron homeostasis, is pathologically elevated in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) and anemia. Elevations in hepcidin contribute to the onset, maintenance, and severity of anemia. DISC-0974 is an investigational, first-in-class, monoclonal antibody that blocks hemojuvelin (HJV), a co-receptor in the bone morphogenetic protein-signaling pathway regulating hepcidin expression. In a healthy volunteer study, DISC-0974 demonstrated dose-dependent reductions in serum hepcidin, increases in serum iron with doses up to 56 mg administered subcutaneously (SC), and increasing trends in reticulocyte count, reticulocyte hemoglobin, mean corpuscular hemoglobin, total hemoglobin (Hgb), and red blood cell count. In a rat model of anemia in CKD, DISC-0974 decreased hepcidin, increased serum iron, and normalized hemoglobin (Wu et al., ASH 2022). DISC-0974-103 is a Phase 1b, double-blind, placebo-controlled, single-ascending dose study (NCT05745883) to assess the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of DISC-0974 in patients with NDD-CKD and anemia. Eligible participants include patients over 18 years of age with NDD-CKD, stages 2-5, hemoglobin (Hgb) <10.5 g/dL in women and <11.0 g/dL in men, serum ferritin ≥100 μg/L, and transferrin saturation (TSAT) ≤30%. Major exclusionary criteria include: concomitant treatment with therapeutic oral iron, intravenous iron, erythropoietin-stimulating agents, or blood transfusions; splenectomy; and nutritional, genetic, infectious, or autoimmune causes of anemia. Approximately 32 participants will be enrolled. On Day 1, participants will receive a single dose of DISC-0974 SC with evaluations for safety, PK, and PD through 57 days of follow-up. Dose escalation is planned across 4 cohorts consisting of 8 participants each, randomized 3:1 active treatment to placebo, treated at single doses of 28, 40, 60, and 90 mg SC DISC-0974. Safety Review Committee assessments are planned to gate escalation decisions. Primary endpoints include adverse events (AEs), clinical laboratory assessments, vital signs, physical examinations, and electrocardiograms. Secondary endpoints include changes in serum hepcidin-25, iron, TSAT, ferritin, Hgb, and other hematology biomarkers. Enrollment is currently ongoing, and available study results will be presented at the meeting.

A Phase 1b Trial of DISC-0974, an Anti-Hemojuvelin Antibody, in Patients with Myelofibrosis and Anemia

Hepcidin, a central regulator of iron homeostasis, is pathologically elevated in patients with myelofibrosis (MF) and anemia. Chronic elevations in hepcidin contribute to the onset and severity of anemia. DISC-0974 is an investigational, first-in-class, monoclonal antibody that blocks hemojuvelin, a co-receptor in the bone morphogenetic protein-signaling pathway driving hepcidin expression. Preclinical studies have shown that DISC-0974 suppresses hepcidin and increases serum iron. A healthy volunteer study has demonstrated dose-dependent reductions in serum hepcidin, increases in serum iron with doses up to 56 mg administered subcutaneously, and increasing trends in reticulocyte count, reticulocyte hemoglobin, mean corpuscular hemoglobin, total hemoglobin (Hgb), and red blood cell count. In this Phase 1b/2a, open-label, multiple-ascending dose study (NCT05320198), we are assessing the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of DISC-0974 in patients with MF and anemia. Eligible participants include patients over 18 years of age with intermediate-2 or higher-risk MF and anemia. MF is required to be confirmed using the World Health Organization 2016 criteria. Anemia is defined per protocol as Hgb < 10 g/dL or transfusion dependence, as defined by the International Working Group for Myelofibrosis Research and Treatment (IWG-MRT). A stable dose of hydroxyurea and/or Janus kinase (JAK) inhibitor is allowed on trial. Major exclusion criteria include: liver iron concentration ≥ 7 mg/g dry weight; splenectomy; nutritional, genetic, infectious, or autoimmune causes of anemia. Dose escalation is based on a Bayesian optimal interval design with accelerated titration. Safety Review Committee assessments gate escalation decisions. Dosing occurs monthly for a total of 6 doses. Primary endpoints include safety and tolerability assessments of adverse events (AEs), clinical laboratory assessments, vital signs, physical examinations, and electrocardiograms. Secondary endpoints include anemia response as defined by the IWG-MRT, transfusion response as defined by a decrease of 50% in transfusion requirement over any 8-week period, standard PK parameters and PD metrics including serum hepcidin-25, iron, transferrin saturation, ferritin, and hematology biomarkers. All data are summarized using descriptive statistics. Initial data show a dose-related increase in pharmacokinetic parameters. DISC-0974 treatment led to dose-dependent reductions in serum hepcidin-25 and increases in serum iron levels. There have been no serious AEs or AEs leading to study withdrawal. Most AEs were mild, transient, and unrelated to DISC-0974. As of August 1, 2023, enrollment and dose escalation are ongoing. Safety, PK, and PD data from at least the first two cohorts will be presented.

Longitudinal Assessment of Transfusion Intensity in Patients with JAK Inhibitor-Naive or -Experienced Myelofibrosis Treated with Momelotinib in the Phase 3 Simplify-1 and Momentum Trials

Introduction: Anemia is a cardinal feature of myelofibrosis (MF), along with splenomegaly and constitutional symptoms. Red blood cell (RBC) transfusions, often used to manage anemia in patients (pts) with MF, are a negative prognostic factor for overall survival and are associated with diminished quality of life and increased healthcare-related economic burden. Momelotinib (MMB), a Janus kinase (JAK) 1/JAK2/activin A receptor type 1 inhibitor, has demonstrated clinically meaningful and durable improvements in anemia, splenomegaly, and symptoms. Prespecified anemia endpoints in MMB phase 3 studies prioritized achievement of a strict transfusion independence response, defined as no transfusions for ≥12 wk immediately before the end of wk 24, with all hemoglobin levels ≥8 g/dL. Longitudinal analysis of transfusion intensity (units per 28 days) in a phase 2 trial of MMB in pts with transfusion-dependent MF demonstrated a reduction in transfusion burden in most (85%) pts (Harrison C, et al. EHA 2023). Here, we further characterize the impact of MMB and comparators on transfusion burden in pts with JAK inhibitor-naive and -experienced MF from the phase 3 SIMPLIFY-1 and MOMENTUM trials. Methods: This analysis evaluated time-dependent transfusion burden in pts enrolled in the phase 3 SIMPLIFY-1 (NCT01969838) and MOMENTUM (NCT04173494) trials. SIMPLIFY-1 included pts with JAK inhibitor-naive MF randomized (1:1) to receive MMB or ruxolitinib (RUX). In MOMENTUM, pts with symptomatic (Myelofibrosis Symptom Assessment Form Total Symptom Score ≥10), anemic (hemoglobin <10 g/dL), JAK inhibitor-experienced MF were randomized (2:1) to receive MMB or danazol (DAN). All RBC units transfused were collected during the 24-wk randomized treatment period of each study and during the 84 days before receipt of randomized treatment on study for baseline assessment. Time-dependent transfusion burden was quantified by number of RBC units administered, in a tabular display of baseline- and treatment-period intensity. Pts were grouped jointly based on the baseline- and treatment-period intensity of RBC units per 28 days into ordinal bins: exactly zero units, >0 to 1 unit, >1 to 2 units, >2 to 3 units, >3 to 4 units, and >4 units. Results: In SIMPLIFY-1 (JAK inhibitor-naive pts), 150 of 213 evaluable pts (70%) in the MMB arm and 163 of 216 evaluable pts (76%) in the RUX arm required zero units of RBC transfusion per 28 days at baseline. Of pts who required zero units of transfusion at baseline, a higher proportion in the MMB arm (142 of 150 [95%]) maintained a requirement of zero RBC transfusions during randomized treatment of 24 wks vs the RUX arm (93 of 163 [57%]). Overall, the mean RBC transfusion burden per 28 days declined 0.10 units (SD, 0.701) from baseline to randomized treatment in the MMB arm and increased 0.39 units (SD, 1.016) in the RUX arm. Using ordinal bins, 87% of pts in the MMB arm maintained (144 [67.6%]) or improved (41 [19.2%]) RBC transfusion intensity during randomized treatment compared with baseline vs 54% in the RUX arm (maintained, 94 [43.5%]; improved, 23 [10.6%]) (Figure). In MOMENTUM (JAK inhibitor-experienced pts), most pts had some transfusion requirement at baseline, with 26 of 130 (20%) in the MMB arm and 11 of 65 (17%) in the DAN arm requiring zero units of RBC transfusion per 28 days. During randomized treatment, a higher proportion of pts in the MMB arm (46 of 130 [35%]) required zero units of RBC transfusion vs the DAN arm (11 of 65 [17%]), including a higher proportion of those who had zero RBC transfusion requirement at baseline who maintained zero RBC transfusion requirement during randomized treatment (MMB, 92%; DAN, 64%). The mean RBC transfusion burden per 28 days declined 0.86 units (SD, 1.748) from baseline to randomized treatment in the MMB arm and declined 0.28 units (SD, 1.584) in the DAN arm. Using ordinal bins, 85% of pts in the MMB arm maintained (25 [19.2%]) or improved (85 [65.4%]) RBC transfusion intensity compared with baseline vs 63% in the DAN arm (maintained, 7 [10.8%]; improved, 34 [52.3%]). Conclusions: These data demonstrate that MMB was associated with better maintenance of RBC transfusion intensity and zero RBC transfusion status vs RUX in pts with MF who were JAK inhibitor naive and showed greater reduction in RBC transfusion burden from baseline vs DAN in pts with MF who were JAK inhibitor experienced. Across both trials, ≥85% of pts treated with MMB maintained or improved transfusion intensity.

The Pyruvate Kinase (PK) Activator AG-946 Improves PK Properties and Red Blood Cell (RBC) Characteristics upon Ex Vivo treatment of RBCs from Patients with Myelodysplastic Syndromes

Background: Myelodysplastic syndromes (MDS) consist of a heterogenous group of clonal myeloid malignancies, characterized by dysplasia, ineffective hematopoiesis and cytopenias. MDS patients frequently suffer from anemia, directly affecting quality of life. The limited therapeutic options often do not result in the desired clinical improvement. Interestingly, in MDS the activity of the red blood cell (RBC) enzyme pyruvate kinase (PK), a key regulatory enzyme of glycolysis, may be decreased. The activation of PK via small molecules is hypothesized to be beneficial in a wide range of anemias. Currently, a phase 2a, open-label, proof of concept trial is running on the use of the PK activator AG-946 in low-risk MDS patients (NCT05490446). In light of these developments, we investigated the effect of ex vivo treatment of MDS RBCs with AG-946. Objectives: To evaluate RBC PK and cellular properties of patients with MDS, and to determine the effect of ex vivo treatment with the PK activator AG-946. Methods: Eleven low-risk non-transfusion dependent MDS patients and six healthy controls (HCs) were studied. Baseline PK activity and PK thermostability were measured in RBC lysates of purified RBCs, under V max conditions (phosphoenolpyruvate (PEP) 5mM final concentration). Hexokinase (HK) activity was included to relate PK activity to mean RBC age. Ex vivo treatment was performed by incubating MDS RBCs for 16 hours at 37 °C in presence or absence of the PK activator AG-946 (10μM or 5μM) using dimethylsulfoxide (DMSO) as a blank. Effect was assessed by measuring PK activity (using a final concentration of PEP 0.5mM) and levels of adenosine triphosphate (ATP) (LC-MS/MS). Functional RBC analysis was performed by osmotic gradient ektacytometry (Lorrca MaxSis). To investigate the effect on PK thermostability, RBC lysates were incubated with AG-946 (2μM or 1μM) or DMSO, after which residual PK activity was measured (PEP 0.5mM). The effect of AG-946 on erythroid development was studied using peripheral blood mononuclear cells, cultured in MethoCult TM H4434 medium for 14 days in the presence or absence of AG-946 (10μM or 625nM, DMSO as blank). Differences between conditions were determined using Unpaired T-test, ANOVA with Dunnett's test or Kruskal-Wallis with Dunn's test via GraphPad Prism. Results: Mean PK/HK ratio was significantly lower in RBCs from MDS patients compared to HCs (6.1 (SD 1.8) versus 10.5 (SD 1.5), p<0.001). Upon ex vivo treatment, PK activity significantly increased (independent of dosage) when compared to DMSO (10μM AG-946, mean increase 30% ( p<0.001); 5μM, 28% ( p<0.0001)) (Figure 1A). MDS RBCs displayed decreased PK thermostability at baseline under V max conditions (HCs 79% residual activity versus 68% in MDS, p<0.01). This was restored by ex vivo treatment with AG-946 (DMSO, 33% residual activity, 2μM AG-946, 85% ( p<0.0001); 1μM, 87% ( p<0.0001)). The increase in PK activity was accompanied by significantly increased ATP levels (N=10, DMSO, mean ATP 14.9 μg/mL RBC; 10μM AG-946, 21.0 μg/mL RBC ( p<0.01); 5μM, 21.1 μg/mL RBC ( p<0.01)) (Figure 1B). Functionally, RBC properties improved upon ex vivo treatment with AG-946 as reflected by the modest yet significant increase in O hyper, indicating improved hydration status (10μM AG-946, mean increase 2.3% ( p<0.001); 5μM, 2.9% ( p<0.0001)). To date, culture assays were performed in 8 patients; 3/8 showed an increase in the number of burst forming units-erythroid (BFU-Es) upon treatment with AG-946 when compared to DMSO. The percentual increases differed per patient: increase of 25% with 10μM AG946 and 150% with 625nM, increase of 40% (10μM) and 39% (625nM), and for the third an increase of 22% (10μM) and 39% (625nM). Conclusion: Our findings show that RBCs from MDS patients have decreased PK activity and thermostability. We demonstrate that ex vivo treatment with AG-946 increases PK activity and ATP levels and restores PK thermostability. Moreover, ex vivo treatment with AG-946 improves RBC hydration, suggesting that improved energy status directly improves RBC functional properties. The preliminary results of the culture assay could indicate that in certain patients, dyserythropoiesis may be ameliorated upon PK activation. To better understand the effects on erythropoiesis additional experiments are required. In conclusion, our data might support a rationale for the use of PK activators as a novel therapeutic option for MDS.

CBC Differences between Survived and Deceased COVID-19 Patients: A Cohort Study.

The Coronavirus disease 2019 (COVID-19) pandemic showed the importance of simple, low-cost, and accessible tests for patient triage. Complete Blood Count (CBC) can be considered a good option for predicting the prognosis of COVID-19 and daily follow-up of hospitalized patients. CBC tests of 100 COVID-19 patients admitted to the general ward or intensive care unit (ICU) were monitored for ten days. Routine laboratory tests were also performed. In addition, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated at the time of admission. The WBC count of the ICU-admitted patients was significantly lower than in the non-ICU-admitted group (P = 0.008). The mean lymphocyte percentage of deceased patients was significantly lower than in the survived patients (P = 0.041), whereas the mean neutrophil percentage of the former group was higher than the latter ( P = 0.012). Moreover, the mean monocyte percentage of the survivors was significantly more than that of non-survivors (P = 0.003). However, there was no significant difference in mean platelet counts, hemoglobin levels, and red blood cell count between the studied groups. A lower WBC, lymphocyte percentage, and monocyte percentage, in addition to a higher neutrophil percentage, may indicate a poor prognosis in moderate to severe COVID-19 patients.

Folate, vitamin B12 and vitamin D status in healthy and active home-dwelling people over 70 years

BackgroundAgeing is characterised by physiological changes that can affect the nutrient availability and requirements. In particular, the status of vitamin D, cobalamin and folate has often been found to be critical in older people living in residential care. However, there is a lack of studies investigating the status of these nutrients in healthy and active home-dwelling elderly people.MethodsThe aim of this cross-sectional study was to assess the status of vitamin D based on serum concentrations of 25-hydroxycholecalciferol [25-(OH)D], cobalamin based on serum concentrations of holotranscobalamin (holoTC) and folate based on red blood cell (RBC) folate in unsupplemented, healthy and active German home-dwelling subjects ≥ 70 years of age (n = 134, mean ± SD: 75.8 ± 4.5 years). Dietary intake was assessed by 3-day food recalls. The study was conducted between March and November of 2021 (during the COVID-19 pandemic).ResultsThe mean 25-(OH)D concentration was high at 85.1 ± 26.0 nmol/L, while the majority of women (92%) and men (94%) had 25-(OH)D concentrations ≥ 50 nmol/L. Less than 10% of men and women had 25-(OH)D concentrations < 50 nmol/L. The mean holoTC concentration was 88.9 ± 33.7 pmol/L (94.8 ± 34.6 pmol/L in women and 73.6 ± 25.6 in men). Only 8% of the women were cobalamin deficient (< 50 pmol/L holoTC) compared to 22% of the men. The mean RBC folate concentration was 831 ± 244 nmol/L, while the prevalence of folate deficiency was 10%. Linear regression analysis showed that only folate equivalent intake was associated with the relevant nutrient status marker.ConclusionOur findings suggest that healthy, independently living older people with high levels of education, physical activity, and health awareness are not necessarily at higher risk of vitamin D, folate and cobalamin deficiency. Further studies are needed to verify these findings and to identify lifestyle and dietary patterns that can predict adequate nutrient status for healthy ageing.Trial registrationThis study is officially recorded in the German Clinical Trials Register (DRKS00021302).

The blood count as a compass to navigate in the ever-changing landscape of the carrier state of hemoglobinopathies: a single-center Italian experience.

Approximately 7% of the worldwide population exhibits variations in the globin genes. The recent migration of populations from countries where hemoglobin disorders are endemic has resulted in important epidemiological changes with the diffusion of newly discovered or poorly characterized genetic variants and new combinations and very heterogeneous clinical phenotypes. The aim of our study is to assess the parameters that are more significant in predicting a positive genetic testing outcome for hemoglobinopathies in a pediatric population of patients presenting with anemia or microcythemia, without a definite diagnosis. This study included patients evaluated in our hematological outpatient clinic for anemia and/or microcythemia despite normal ferritin levels. A screening of pathological hemoglobins using high-performance liquid chromatography (HPLC) was performed for the entire population of the study. Subsequently, patients with hemoglobin (Hb) S trait and patients with an HPLC profile compatible with beta thalassemia trait were excluded from the study. Genetic screening tests for hemoglobinopathies were performed on the remaining patients, which involved measuring the red blood cell (RBC) counts, red blood cells distribution width (RDW), reticulocyte count, and mean corpuscular volume of reticulocytes (MCVr). This study evaluated a total of 65 patients, consisting of nine patients with negative genetic analysis results and 56 patients with positive genetic analysis results. The Hb and RDW values in these two groups did not demonstrate statistical significance. On the other hand, there were statistically significant differences observed in the mean corpuscular volume (MCV), RBC count, reticulocyte count, and MCVr between the two groups. Furthermore, in the group of patients with positive genetic test results, specific genetic findings associated with different HPLC results were observed. In particular, 13 patients with positive genetic test results had normal HPLC findings. This study has demonstrated that HPLC, while serving as a valuable first-level test, has some limitations. Specifically, it has been observed that some patients may exhibit a negative HPLC result despite a positive genetic analysis. In addition to the presence of low levels of Hb and HPLC alterations, other parameters could potentially indicate the underlying mutations in the globin genes. Therefore, we propose that the complete blood cell count be utilized as a widely available parameter for conducting targeted genetic analyses to avoid the risk of overlooking rare hemoglobinopathies.

Comparative Analysis of Red Blood Cells, White Blood Cells, Platelet Count, and Indices in Type 2 Diabetes Mellitus Patients and Normal Controls: Association and Clinical Implications.

Diabetes mellitus (DM) is a major health burden affecting 537 million adults worldwide, characterized by chronic metabolic disorder and various complications. This case control study aimed to assess the impact of type 2 diabetes mellitus (T2DM), including hyperglycemia levels, on hematological parameters and complete blood count (CBC) derived parameters. A total of 250 known diabetic patients from the Jazan Diabetic Center, Saudi Arabia, between January 2021 and December 2022, along with 175 healthy adult controls were recruited from Jazan Hospital's blood donation center. Demographic characteristics, medical histories, and relevant factors such as gender, age, BMI, treatment, disease duration, and comorbidities were collected with informed consent. The results of the red blood cell (RBC) count, RBC indices, and mean platelet volume showed significant differences between patients and controls, while the white cell (WBC) and platelet count were comparable between the two groups. CBC-derived parameters, especially neutrophil/lymphocyte ratio (NLR), and platelet/neutrophil ratio (PNR) exhibited significant differences. CBC and derived parameters serve as inexpensive tools for T2DM patients monitoring, indicating early blood cell alterations and potential development of anemia. Further studies are needed to explore their role in predicting T2DM pathogenesis and progression, aiming to reduce severe complications, mortality and morbidity.

The Effect of Helicobacter pylori Density on Serum Vitamin B12 and Folate Levels in Patients With Non-atrophic Gastritis.

Introduction Chronic infection with Helicobacter pylori (Hp) is an essential cause of gastrointestinal pathologies in adults. Despite being a microorganism proven to play a role in vitamin B12 deficiency by causing gastric atrophy, Hp's role in patients with non-atrophic gastritis has not been fully explained. Our study investigated whether the presence and density of Hp is related to vitamin B12 and folate deficiencies in patients with non-atrophic gastritis. Methods This retrospective cohort study analyzed the following parameters, vitamin B12, folate, and mean red blood cell volume (MCV) in the hemogram; these were measured simultaneously in patients diagnosed with non-atrophic gastritiswho had undergone gastroscopy to investigate Hp levels. Patients with conditionsthat could have caused vitamin B12 and folate deficiencieswere excluded from the study. The study included 244 patientswho met the criteria. The Sydney classification was used for histopathologic grading and staging of gastric biopsies of patients with gastritis. Results There was no relationship between the presence and density of Hp with vitamin B12 levels. However, folate levels were significantly lower in Hp-positive patients than in Hp-negative patients (p = 0.017). Folate levels were substantially lower in patients with chronic pan-mucosal gastritis than in patients with chronic inactive gastritis (p = 0.034). Statistically, a significant difference was found between folate levels on the basis of neutrophil activity and inflammation score (p = 0.011 and p <0.001, respectively). Conclusions Although there was no statistically significant relationship between the presence and density of Hp and vitamin B12, our study found an association between folate levels and Hp density. This may be associated with the time for the depletion of vitamin B12 and folate stores and the relatively early stage of gastritis. In cases with vitamin B12 and folate deficiencies, appropriate studies should be performed for specific epidemiological reasons in respective fields.

Examination of the haematological profile of pregnant Polish Holstein-Friesian black-and-white cattle in the early stage.

Cattle health and welfare are monitored via the analysis of the haematological profile, and it shows cattle's ability to adapt to changing environmental conditions, pregnancy and lactation; profile changes also indicate reproductive disorders. The literature lacks reports of the examination of the haematological profile in cows up to the 50th day of pregnancy (dop). Therefore, this research examined that in cows up to this pregnancy stage. A total of 101 Polish Holstein-Friesian black-and-white cows were divided into groups. The control groups consisted of non-pregnant heifers (group C00) and non-pregnant cows (group C0), and the experimental groups were pregnant heifers (group T1 at dop ≤ 28 and group T2 at dop ≥ 29-dop < 45) and pregnant cows (group T3 at dop ≥ 29-dop ≤ 50). In addition, the T3 group was divided into cows pregnant for up 45 dop and cows between 45 and 50 dop. Blood samples were collected in March and April 2021 from each animal and analysed. A transrectal ultrasound examination was performed to detect and confirm pregnancy. Statistically significant differences (P ≤ 0.01) between the group of cows at dop < 45 dop and those at dop ≥ 45-dop ≤ 50 dop were noted in granulocyte percentage (GRA%), white and red blood cell counts (WBC/RBC), platelets (PLT), platelet distribution width (PDW), haematocrit (HCT) and lymphocyte percentage (LYM%). No statistically significant differences were found in the mean corpuscular haemoglobin, monocytes (MON), monocyte percentage (MON%), mean platelet volume (MPV), thrombocrit or red blood cell distribution width (RDW). Similar statistically significant differences (P ≤ 0.01) emerged between the groups of heifers in PLT, GRA, RBC, lymphocytes, LYM% and HCT, and no significant differences were found between MPV, MON, MON% or RDW. Examining the haematological profile in high-yielding cattle is vital in maintaining herd profitability and high reproduction, which depend on the quick diagnosis of disorders facilitated by haematology. This study analysed the haematology profile of dairy cattle at dop ≤ 50 for the first time, indicating changes in lymphocyte levels, which suggests that the animals experienced direct stress during the study.

Simultaneous Occurrence of Mycotoxins Citrinin and Ochratoxin A in Popcorn Grains and Their Biological Effect on some Physiological Blood Parameters

This study was conducted with the aim of verifying the simultaneous occurrence of mycotoxin Citrinin (CIT) and Ochratoxin A (OTA) in popcorn grains consumed on a wide range throughout Iraq. It is enhanced by studying the biologically combined effects of these toxins compared to their effect separately. The results of the chromatographic analysis using HPLC technology to detect the simultaneous occurrence of mycotoxins Citrinin and Ochratoxin A in the analyzed samples showed that all samples were contaminated with Ochratoxin A, while 17 samples were contaminated with both of mycotoxins out of 18 main samples, and in varying proportions, The highest incidence and concentration of Ochratoxin A 100% was with a concentration of 31.795 μg/kg for sample T8, followed by CIT 94.4% with 17.868 μg/kg for sample Q7, However, the lowest concentration of 4.066 μg/kg, 12.161 μg/kg for Citrinin and Ochratoxin A were detected in samples T8 and D17 respectively. While the results vevealed different effects on the physiological blood parameters of chicks, exposure to mycotoxins CIT and OTA alone or simultaneously caused a decrease in white bood cells (WBC), monocytes (MON), lyphocytes (LYM), mean corpuscular volume (MCV), hematatocrit (HCT) and platelet (PLT), while the two treatments OTA and OTA+CIT caused a decrease in hemoglobin (HGB), mean corpuscular haemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH) and granulocyte (GRA) While CIT caused an increase compared to control treatment, the results were reflected in both mean platelet volume (MPV) and red blood cell distribution width (RDW). When combining CIT and OTA, the treatment showed synergistic or antagonistic effects compared to their effects individually, which differed depending on the treated cells.

Super-massive transfusion during liver transplantation.

Massive hemorrhage and transfusion during liver transplantation (LT) present great challenges. We aimed to investigate the incidence and risk factors for super-massive transfusion (SMT) and survival outcome and factors that negatively affect survival in patients who received SMT during LT. We included adult patients undergoing LT from 2004 to 2019. SMT was defined as transfusion of ≥50 units of red blood cells (RBC) during LT. Independent risk factors were identified by multivariable logistic regression. Ninety-day survival was recorded and factors that negatively affected survival were analyzed by the Cox survival test. Of 2772 patients, 158 (5.6%) received SMT during LT. Mean RBC transfusion was 72.6 (±23.4) units with a maximum of 168 units. Four variables (MELD-Na score, previous upper abdominal surgery, portal vein thrombosis, and remote retransplant) were independent risk factors for SMT (odds ratio 1.800-8.274, 95% CI 1.008-16.685, all p < .005). The 90-day survival rate in SMT patients was 81.6%. Preoperative pulmonary hypertension and massive postreperfusion transfusion negatively affected 90-day survival (hazard ratio 2.658-4.633, 95% CI 1.144-10.130, and all p < .05). In this large retrospective study, we found that SMT occurred in a small percentage of patients and was associated with relatively satisfactory short-term survival. Identification of preoperative risk factors for SMT and factors that negatively affect survival improve our understanding of this unique LT patient population.

Associations of n-3 polyunsaturated fatty acid status and intake with paediatric major depressive disorder in Swiss adolescents: A case-control study

BackgroundObservational studies suggest a link between n-3 polyunsaturated fatty acid (PUFA) intake, n-3 PUFA status, and depression in adults, but studies in adolescents are scarce. This study aimed to determine associations of n-3 PUFA status and intake with paediatric major depressive disorder (pMDD) in Swiss adolescents. MethodsWe conducted a matched case-control study in 95 adolescents diagnosed with pMDD and 95 healthy controls aged 13 to <18 years. We analysed red blood cell (RBC) fatty acid (FA) composition (% of total FA). n-3 PUFA intake was assessed using a focused food frequency questionnaire and depression severity was assessed by the Children's Depression Rating Scale-Revised (CDRS-R). ResultsMean RBC eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were lower in cases than controls (EPA: 0.41 ± 0.11 vs 0.46 ± 0.12, p < 0.001; DHA: 4.07 ± 1.04 vs 4.73 ± 1.04, p < 0.001). Subsequently, the mean RBC n-3 index was lower (4.51 ± 1.10 vs 5.20 ± 1.11, p < 0.001) and the n-6/n-3 PUFA ratio higher (5.51 ± 1.25 vs 4.96 ± 1.08, p < 0.001) in cases than controls. Adolescents with a higher n-3 index had lower odds for depression (OR = 0.49 [95% CI: 0.32–0.71]). In contrast, the n-6/n-3 PUFA ratio was associated with higher odds for depression (OR = 1.58 [95% CI: 1.14–2.25]). Intake of alpha-linolenic acid, EPA and DHA did not differ between cases and controls. ConclusionOur results suggest that a higher RBC n-3 PUFA status during adolescence is associated with a lower risk for pMDD, whereas a higher n-6/n-3 PUFA ratio is associated with a higher risk for pMDD. Differences in n-3 PUFA intake did not explain the observed differences in n-3 PUFA status.

The catch in complete blood count when vitamin B12 deficiency is hiding behind microcytic anemia

Abstract Background Insufficient stores of vitamin B12 in human body are thought to result in macrocytic anemia. However, anemia in most of the patients is multifactorial. This is commonly owing to mixed nutritional deficiencies or bowel disorders affecting absorption of more than one element. Resultantly, a single causative agent of anemia like vitamin B12 deficiency may take macrocytic, normocytic, or microcytic forms. Patients presenting with microcytic anemia may have underlying insufficiency of this vitamin in some instances. Assessment of complete blood count (CBC) parameters may be helpful to identify such cases. Methods This study was conducted on 155 patients of microcytic anemia. Assessment of complete blood count (CBC) parameters and vitamin B12 was done using state of the art analyzers. The overall data was analyzed using SPSS version 23. Results Subnormal vitamin B12 levels were found in 17.4% of the studied cases. CBC parameters showed distinct changes in this group. Mean hemoglobin and red blood cell values were lower compared to the subjects having normal B12 values, and mean corpuscular volume and mean corpuscular hemoglobin concentration had an upward trend in cases of severe deficiency. Features of leucopenia and pancytopenia were more frequent also. Macrocytic red blood cells on peripheral smear were useful to detect the hidden deficiency even when the predominant picture consisted of microcytic cells. Conclusions Vitamin B12 deficiency maybe underlying in microcytic anemia patients. Important clues in CBC include very low hemoglobin but mildly decreased MCV values in the presence of leucopenia and macrocytic RBCs on peripheral smear.