Mean Hb Values Research Articles

Effects of α-thalassaemia mutations on the haematological parameters of β-thalassaemia carriers

BackgroundThalassaemia is a haemoglobin disorder caused by a reduction in, or a complete absence of, the production of α- or β-globin genes. Detection of β-thalassaemia carriers is the first step...

Reference Intervals for Hemoglobin and Age- and Gender-Related Trends in the Population of Southwest China

The establishment of a proper reference range is necessary for both the prognosis and diagnosis of clinical disease. Our study aimed to establish the hemoglobin reference interval for the population of Southwest of China and to compare this with published data for other races. A total of 21085 healthy individuals (11561 men and 9524 women, age range 18 - 100 years) living in Southwest China were selected. CBC was performed on an XE-2100 hematology analyzer. The medians were calculated and reference values were determined at the 2.5th and 95th percentiles. There was a statistically significant gender difference for RBC count, Hb, and MCV (p = 0.000). The comparison of Hb by gender showed higher values among males, with lower values in females and this difference was similar to the values for RBC count and MCV. For males, mean values for Hb and RBC decreased with age. However, mean values for Hb in females increased after middle age. Reference intervals for major red blood cell parameters established in this study showed significant gender differences. For males, mean values for Hb and RBC decreased with age. This is the first region-wide population study on hematologic reference values among people in Southwest China.

Haemato-biochemical changes in experimentally induced cadmium chloride toxicity in Wistar rats

The present study was conducted to evaluate the effect of Cadmium chloride toxicity in Wistar rats. Group I (control) rats were given commercial diet with normal water while group II, III and IV rats were given commercial diet with Cadmium chloride at 200, 400 and 800 ppm in drinking water, respectively for a period of 8 weeks. Mean values of Hb, PCV, TEC, MCV, MCH, MCHC and TLC concentration was found to be significantly (P<0.05) lower in treatment group rats in comparison with control group rats in dose and duration dependent manner. Cadmium exposed rats also showed significant increase in neutrophil counts, whereas, lymphocyte count was decreased significantly as compared with control group rats. However, monocyte, basophil and eosinophil counts did not vary significantly among different groups at all the intervals. The cadmium treated rats showed significant decrease in total serum protein, albumin, globulin concentration and A:G ratio, whereas, AST and ALT activity and serum creatinine concentration was increased significantly as compared to the control group rats.

Haematobiochemical alterations of induced ethylene glycol toxicity and its amelioration byTribulus terestrisin rats

In the present study effect of alcoholic extract of Tribulus terrestris in ethylene glycol induced toxicity in rats was assessed through hemato-biochemical estimation. A total 30 rats were divided into five groups (T1, T2, T3, T4 and T5). Group ‘T1’ served as negative control treated with normal saline. Group ‘T2’ kept as positive control, which received ad-libitum 0.75% ethylene glycol in drinking water for 28 days while group T3 was administered with Hydrochlorthiazide @ 5mg/kg body weight. Alcoholic extract ofTribulus terrestris was prepared and administered @ 50 mg/kg and 100 mg/kg body weight along with ethylene glycol in the test group T4 and T 5 respectively. This study was carried out for 28 days wherein hemato-biochemical parameters were recorded at the end of experiment. The mean values of Hb and TLC showed significant differences between T2 (positive control) and treatment groups. While values for TEC and PCV in The T2 (positive control) doesn't show significant difference. Groups treated with Tribulus terrestris extract revealed elevated hematological values as normal group. The mean values of serum calcium, serum alkaline phosphates, serum urea and serum creatinine revealed significant differences between T 2 (positive control) and rest of the other treatment groups. However, serum phosphorus showed significance difference (P<0.05). The present study concludes that Tribulus terrestris reduces the toxicity potency of the ethylene glycol.

Haemato-biochemical alterations in induced chlorpyrifos toxicity in broiler chickens

Effect of graded doses of chlorpyrifos on haemato-biochemical indices in broiler chickens was investigated. A total of 72 broiler chickens, 3 week old, were divided into four groups (I to IV) consisting of 18 birds each. Group I served as control, whereas groups II, III and IV received 3.2, 1.6 and 0.6 mg kg−1 B.W. chlorpyrifos in corn oil daily for 6 weeks. Blood samples were collected in sterile vials containing EDTA (@ 1 mg mL−1) as anticoagulant for haematological studies and without anticoagulant for biochemical parameters. Mean values of Hb, PCV, TEC, MCV, MCH, MCHC, TLC and lymphocyte counts decreased significantly in all the treatment groups, whereas platelet count increased significantly. Serum total protein, albumin and A:G ratio showed decrease, whereas serum ALT, AST, RBC acetyl cholinesterase and butryl-cholinesterase activities exhibited increase. The study revealed that chlorpyriphos has haemotoxic, immune-toxic, hepatotoxic, nephrotoxic and neurotoxic effects in broiler chickens.

Effect of Feeding Compressed Complete Feed Block Containing Guar Meal on Blood Biochemical Profile of Crossbred Calves

A study was conducted to assess the effect of feeding compressed complete feed block (CCFB) containing 5% guar meal on the blood biochemical profile in the crossbred (CB) calves. Twelve growing crossbred male calves (6–10 months old), were selected and divided into two groups (six in each) by using paired random design. The control group (T1) was fed CCFB alone while treatment group (T2) was fed with CCFB containing 5% guar meal. Both the diets were iso-nitrogenous and were formulated to meet the requirement of 600 g/d average daily gain. The study was conducted for 120 days. Blood was collected to harvest the serum and serum metabolites were analyzed using standard protocol. The mean values for Hb (mg/dl), serum glucose (mg/dl), total protein (g/dl), albumin (g/dl), globulin (g/dl), A: G ratio, SGOT, SGPT (IU/L) and serum urea-N (mg/dl) of all the experimental CB calves were found to be statistically similar with that of the control group. It is concluded that the inclusion of guar meal at 5% in CCFB has no any adverse effect on the blood biochemical profile in the CB calves in long term feeding.

Effect of occasional epoetin use in combination with a stable darbepoetin dosage on anemia management in hemodialysis patients.

AimTaking advantage of the characteristics of both darbepoetin (DA) and epoetin (EPO) might be a reasonable option for stabilizing hemoglobin (Hb) control in hemodialysis (HD) patients. The effect of DA assisted by EPO (DA/EPO) on Hb control was evaluated retrospectively in comparison with that of EPO monotherapy.MethodsTwenty-six HD patients whose annual mean Hb values were available for both an EPO monotherapy period and a DA/EPO period were selected for analysis. During the DA/EPO period, DA was given on the second HD day of a week, and EPO was given if needed on the first and third HD days. Under stable DA dosage, when Hb rose >12 g/dL, EPO was eliminated. When Hb decreased <10 g/dL, EPO was added again. The variability of annual mean Hb values from the 26 HD patients during the DA/EPO period was compared with that during the EPO period. Additionally, the distance in Hb (d-Hb; absolute value of difference) between the annual mean Hb values and the target Hb (11 g/dL) during the DA/EPO period was compared with that during the EPO period.ResultsThe variability of annual mean Hb values during the DA/EPO period was significantly smaller than that during the EPO period (11.2±0.25 g/dL versus [vs] 11.0±0.50 g/dL; the F-test for equality of variance, P<0.001). Additionally, the d-Hb during the DA/EPO period was significantly smaller than that during the EPO period (0.22±0.21 g/dL vs 0.38±0.31 g/dL, P<0.03). The total doses (as EPO equivalents) of DA with EPO were reduced to 82.2% of the baseline EPO dose during the EPO monotherapy period. The expenditure for the DA/EPO period was significantly reduced to 80.9% of that for the EPO monotherapy. Also, the annual total amount of intravenous iron supplementation during the DA/EPO period was significantly reduced compared with that during the EPO period (546±304 mg/year vs 684±314 mg/year, P<0.05).ConclusionThe occasional use of EPO in combination with a stable DA dosage may be useful for Hb control within a narrow range of the target level.

Devlet Hastanesine Başvuran Gebelerde Anemi Görülme Sıklığı ve Etkileyen Faktörler

Aim: This study was performed to determine the prevalance of anemia and related nutrition and other risk factors in pregnant women who admitted to the hospital for prenatal care. Material and Methods: This descriptive and cross-sectional study to receive prenatal care to the hospital admitted 311 women participated. The data on socio-demographic characteristics of pregnant women, pregnancy information and dietary habits using a questionnaire that was collected using face to face interviews. To determine anemia in pregnant women in the hospital laboratory records made during routine pregnancy examination hemoglobin (Hb) values were used. Hb values of Results: The mean age of pregnants was 25.7±5.2 years. 90% of women were housewife and 37.3% were primary school graduates. Mean gestational age was 27.8 ± 11.2 weeks, mean number of pregnancy was 2.4 ± 1.5, mean number of abortion was 0.2 ± 0.5 and mean number of curettage was 0.1 ± 0.4. Mean hb values was 11.9±1.2 g/dl and anemia prevalance was 23.5%.According to the gestation period prevalence of anemia 22.0% in the first trimester, 27.5% in the second trimester, 22.4% in the third trimester. Maternal age, occupation, education level, social security, family type, income status, location, duration of marriage, the last birth type and duration between pregnancies were no significant difference between the prevalence of anemia compared (p>0.05). Similarly, pregnancy, abortion and curettage with the numbers there is no significant difference between the prevalance of anemia (p> 0.05). Not using iron-multivitamin preparations in pregnant women (32.9%) than those using (20.4%) were seen significantly more anemia, and anemia among pregnants who drank dark tea was more prevalent than pregnants who drank light tea and the difference was significant (33.9% vs 17.2%) (p<0.05). Conclusion: Anemia seen in one of every four pregnant women, admitted to the hospital for routine prenatal care, and not taking iron-multivitamin preparations regularly and consumption of dark tea seemed to be related with gestational anemia. Thus, anemia should be diagnosed earlier in pregnant and iron supplements should be started; and all pregnant women should be informed about the nutrition related factors affecting anemia such as not drinking dark tea, by the relevant health care stuff especially dietitians, nurses and midwives.

Study of Plasma Metanephrine Level As Biochemical Parameter in Pregnant Women with Preeclampsia

Pregnancy- including hypertension(PIH), also known as preeclampsia, is one of the major causes of maternal and fetal death. This study was carried out on 30 pregnant women with preeclampsia and 30 healthy pregnant women as control ranging in age mean ±SD (28.84±3.55) years , BMI (76.80±9.78) Kg/m2 and gestation age(30.82±0.75)week. The aim of this research was studied the plasma Metanephrine level and other biochemical parameters such as Hemoglobin(Hb), serum Protein, S. Albumin, Globulin, Albumin/Globulin ratio (Alb/Glu. ratio), S.Glutamate Pyruvate aminotransferase (GPT), S.Glutamate Oxaloacetate aminotransferase(GOT). The obtained results have been compared with 30 healthy pregnant women as control group. The result showed that there was significant increase in mean value of Hb in group A(pregnant women with preeclampsia) when compared to group B(healthy pregnant women). The present study showed no significant changes was observed in the level of S. Protein, globulin, Alb./Glu. ratio, GPT and GOT as compared to control group. While Albumin showed a significant decrease in group A(pregnant women with preeclampsia) when compared with group B(healthy pregnant women) and significant increase in the levels of metanephrine, metanephrine/protein ratio, metanephrine/Alb ratio in group A (pregnant women with preeclampsia) to group B(healthy pregnant women).The present study conclude that the increase in the levels of metanephrine, metanephrine/protein ratio, metanephrine/Alb ratio in pregnant women with preeclampsia may be used as a marker to evaluate the development of disease. The current study recommend to take more case and measurement metanephrine in plasma and urine.

Study of Plasma Metanephrine Level As Biochemical Parameter in Pregnant Women with Preeclampsia

Pregnancy- including hypertension(PIH), also known as preeclampsia, is one of the major causes of maternal and fetal death. This study was carried out on 30 pregnant women with preeclampsia and 30 healthy pregnant women as control ranging in age mean ±SD (28.84±3.55) years , BMI (76.80±9.78) Kg/m2 and gestation age(30.82±0.75)week. The aim of this research was studied the plasma Metanephrine level and other biochemical parameters such as Hemoglobin(Hb), serum Protein, S. Albumin, Globulin, Albumin/Globulin ratio (Alb/Glu. ratio), S.Glutamate Pyruvate aminotransferase (GPT), S.Glutamate Oxaloacetate aminotransferase(GOT). The obtained results have been compared with 30 healthy pregnant women as control group. The result showed that there was significant increase in mean value of Hb in group A(pregnant women with preeclampsia) when compared to group B(healthy pregnant women). The present study showed no significant changes was observed in the level of S. Protein, globulin, Alb./Glu. ratio, GPT and GOT as compared to control group. While Albumin showed a significant decrease in group A(pregnant women with preeclampsia) when compared with group B(healthy pregnant women) and significant increase in the levels of metanephrine, metanephrine/protein ratio, metanephrine/Alb ratio in group A (pregnant women with preeclampsia) to group B(healthy pregnant women).The present study conclude that the increase in the levels of metanephrine, metanephrine/protein ratio, metanephrine/Alb ratio in pregnant women with preeclampsia may be used as a marker to evaluate the development of disease. The current study recommend to take more case and measurement metanephrine in plasma and urine.

Haematological profile of subchronic oral toxicity of molybdenum in buffalo calves

An experimental trial was conducted to assess the influence of excess dietary molybdenum for prolonged period of time on haematological profile of healthy buffalo calves. Repeated oral administration of sodium molybdate @3 mg/kg/day for 90 consecutive days produced profound decline in the mean values of Hb, TLC, TEC, and MCHC in buffalo calves. It is suggested that exposure to excess dietary molybdenum should be avoided in buffalo calves.

Spatial distribution of vector borne disease agents in dogs in Aegean region, Turkey

ABSTRACTObjective. Assess the spatial distribution of seroprevalence of infection with or exposure to 4 vector-borne pathogens Ehrlichia canis, Anaplasma phagocytophilum, Borrelia burgdorferi and Dirofilaria immitis, across the coastal states of the Aegean region with special reference to clinical signs and haematological variances related to disease condition. Materials and methods. A convenience sample, targeting blood from at least 10 pet dogs from İzmir, Aydin, Denizli, Mugla and Manisa cities involved was evaluated using a canine point-of-care ELISA kit. Results. Out of 307 dogs tested the overall seroprevalence was highest for E. canis (24.42%), followed by E. canis + A. phagocytophilum co-infection (10.42%), A. phagocytophilum (7.49%) and D. immitis (2.28%). Only 2 cases were seropositive to B. burgdorferi albeit 10 dogs were co-infected with more than 2 agents. For both dogs infected with E. canis and co-infected with E. canis and A. phagocytophilum, anemia, thrombocytopenia and leukocytosis, were more commonly detected, whereas thrombocytopenia and leukocytosis were significant finding in dogs infected with A. phagocytophilum or D. immitis, respectively. Variance analysis showed significant differences for mean RBC, Hb, PCV and PLT values (p&lt;0.01) among control group and other groups. Conclusions. Seropositivity for vector-borne pathogens other than B. burgdorferi, is moderately to widely distributed in dogs residing in the Aegean region in Turkey.

Evaluation of Two Different Methods for Hemoglobin Screening of Blood Donors to Use in Mobile Blood Collection Team

AIM: The aim of the study is to compared two point-of care hemoglobin concentration measuring devices with laboratory measurements to determine their accuracy in mobile blood collection conditions. This two devices were the Pronto-7 (Masimo Corp., Irvine,CA) pulse co-oximeter and HemoCue Hb 201+ uses spectrophotometric method. METHODS: Blood samples were collected from 152 individuals. The samples were tested for total hemoglobin measurement by three different methods: noninvaziv pulse co-oximeter device Pronto-7, finger-stick blood sample on an automated spectrophotometric device HemoCue and venous samples on an automated hemotology analyzer (reference device) RESULTS: According to the venous samples (mean Hb value is 14.6 g/dl), the mean hemoglobin levels were detected slightly higher in the fingerstick samples (mean Hb value is 15.1 g/dl) and slightly lower in the pulse co-oximetry (mean Hb value is 14.1 g/dl). The sensivity of HemoCue, Pronto-7 was 97.7%, 81.6% and their specifity was 31.2% and %43.7, respectively. The positive predictive values (PPV) of HemoCue and Pronto-7 were high (92.3% and 92.5%, respectively) but both of their negative predictive values (NPV) were low (62.5% and 21.8%, respectively). Of blood donors, 88.4% (138/152) percent were correctly classified with HemoCue and 78.2% were with Pronto-7. COCLUSION: Taking automated laboratory hemoglobin measurement as a reference, Pronto-7 gave lower readings for Hb value and was less accurate than the Hemo-Cue system

Hemoglobin Trend in Critically Ill Patients with Long ICU Stay

Introduction: Critically ill patients develop anemia due to several reasons: bleeding prior or during intensive care unit (ICU) stay, frequent flebotomies, hemodilution and inflammatory status with altered erythropoiesis. The aim of this study was to assess the trend of hemoglobin (Hb) level during long ICU stay (more than 7 days) in transfused and nontransfused patients. Materials and Methods: We conducted a prospective observational study that included all patients with long ICU length of stay (LOS) admitted during 1 year in a 19-beds mixed ICU of a tertiary care university hospital. Patients were divided into two groups: never transfused (NT) and ever transfused (ET) according to their transfusional status during ICU stay. Collected data: demographic data, severity scores, Hb values during ICU stay transfusion status and outcome. Statistical analysis was conducted with SPSS 15.0. Results: 132 patients (54 NT, 78 ET) were enrolled in the study. On ICU admission, overall mean Hb level was 9.2 g% (95%CI 8.72-9.72) with a significant difference between NT and ET group (10.1 g% versus 8.5 g%; p<0.01). By the day 7 there was little change in overall mean Hb value (9.1 g%; 95%CI 8.85-9.43) as in NT group the Hb values continued to drop while in ET group raised as a result of transfusions. However, at two weeks after ICU admission there was a significant decrease in mean Hb value, from 9.2 g% in day 1 to 8.1 g% (95%CI 7.71-8.49) in day 14. The variance also had a significant decrease over time (8.94 in day 1; 1.58 in day 14) indicating a convergence of Hb values in studied patients, regardless of their transfusion status. Conclusions: Despite the fact that Hb values on ICU admission may vary widely, after 14 days of ICU stay the Hb values tend to converge. The Hb level in critically ill patients with long ICU stays decreases stadly over time no matter the transfused or non-transfused status.

Effect of Feeding Graded Levels of Leaf Meal on Digestibility, Clinical Chemistry and Rumen Fermentation of Lambs

In order to study the effect of replacing conventional concentrates with graded levels of leaf meal (LM) mixture in total mixed rations (TMR), 20 Corriedale lambs were divided randomly into four equal groups. The animals of control group (T1) were maintained on the TMR comprising of oats straw and concentrate mixture while in T2, T3 and T4 groups, the concentrate mixture in TMR was replaced with LM @ 15, 30 and 45%, respectively. Blood analysis was carried out at the start and end of the 120d experiment. Rumen studies was carried out at the end of the trial period. DM intake was significantly (P<0.05) improved in groups fed LM at 30 and 45% of concentrate mixture. The lambs fed rations with concentrate mixture replaced at 0 (T1) and 30% (T3) level by LM had significantly (P<0.05) higher gain in weight. Mean values of Hb and PCV, total protein, albumin, globulin, urea, creatinine and cholesterol, Ca and P and SGOT, SGPT and ALP were similar among the groups except for significant variation seen in serum urea. The ruminal pH, TVFA, NH3-N and NPN varied significantly among the groups. Cost of production lowered significantly (P<0.01) due to inclusion of LM mixture with highest percent reduction in feed cost per kg LW gain (19.27) at 30% and lowest (2.77) at 15% replacement. It is concluded that replacement of concentrate mixture in TMR by LM had no adverse effects on health, growth and rumen fermentation pattern in lambs and better results could be obtained at 30% replacement level.

Cytogenetic and Heamatological Profile of Sarotherodon melanotheron Exposed to Carica papaya L. In Fish Feed as Replacement for Rice Bran

The aquatic environment makes up the major part of our environment and resources, its safety is directly related to the safety of our health and food security. This study investigated the cytogenetic effect of black jaw Tilapia, Sarotherodon melanotheron exposed to pawpaw leaf ( Carica papaya L.) as replacement for rice bran for twelve weeks (90 days). The haematological effects of feeding Carica papaya leaf meal rations to Sarotherodon melanotheron Juvenile were also carried out. The study also investigated the haematological effects of feeding Carica papaya leaf meal rations to Sarotherodon melanotheron Juvenile. The treatments of the pawpaw leaves for the experiment were T 0 (0%), T 1 (25%), T 2 (50%), T 3 (75%) and T 4 (100%). The physico-chemical parameters showed a significant difference (p 0.05) in the micronuclei present in 30 day in all the treatment while, day 60 and 90 showed a significant difference (p < 0.05) in all treatments. Analysis of Variance ( ANOVA) showed a statistical significant difference (p < 0.05) in the blood parameters: Mean Hb (g/dl), PCV (%), WBC (109/L), MCH (pg), Neutrophils (%) and Lymphocytes (%) values at 0 %, 25%, 50%, 75% and 100% level of inclusions. The trends observed in the haemoglobin, red blood cells and packed cell volumes' for the experimental fish were indications that the dietary inclusion levels of 50%, 75% and 100% favoured an increase in haematological parameters. Carica papaya leaf meal at 75% and 100% inclusion in Clarias gariepinus Juvenile diet showed significant weight gain and feed utilization and the ration was cost effective. It can serve as promising replacement for maize when Physico-chemical parameters of culture water were monitored within optimum range. It is evident from this finding that exposure of test fish to pawpaw ( Carica papaya L.) replaced for rice bran in fish feed does not lead to cytogenetic damage and brings about little breakage of nucleus to form micronucleus cells.

Prevalence of Anaemia among Pregnant Women in Braithwaite Memorial Specialist Hospital (BMSH) Port Harcourt

To assess the prevalence of anaemia in pregnancy and recommend a cut-off value for antenatal women in developing countries, a cross sectional study was carried out in the Braithwaite Memorial Specialist Hospital (BMSH), Port Harcourt, a tertiary health care centre in Nigeria. 346 apparently healthy asymptomatic pregnant women visiting the antenatal clinic for the first time were enrolled for the study. Hemoglobin concentrations were determined using standard hematological procedures. Out of the 346 pregnant women studied, 50 (14.5%) were non-anaemic and 296 (85.5%) were anaemic giving a prevalence rate of 85.5%. There is moderate prevalence of anaemia in pregnancy in this part of the world. Since the mean Hb value of the pregnant women in this study was 11.25gldl and the pregnant women with Hb values around 10gldl are apparently healthy, a cut-off value of 10.0gldl may be considered ideal for defining anaemia in developing countries.

The first report of The Latin American Society of Nephrology and Hypertension (SLANH) Anemia Committee in chronic hemodialysis patients.

Anemia almost invariably occurs in patients with chronic kidney disease. Limited data are available regarding anemia management in Latin American (LA) hemodialysis (HD) patients. To evaluate the results of the first anemia survey of the Anemia Committee of the SLANH. This is a multinational, voluntary survey that collected anemia management data from adult HD patients from independent, non-chain owned HD units, between 09/2009 and 03/2010. T-test, ANOVA, chi-square test and multivariate logistic regression were used for statistical analysis. The survey received responses from 134 HD units of 16 countries providing data from 9,025 patients. Mean values of Hb, ferritin, and transferrin saturation (TSAT) were 10.5 ± 1.8 g/dL, 570 ± 539 µg/l, and 29.8 ± 15%, respectively. Only 32.7% of patients were within the Hb target of 10.5-12.0 g/dL (46.3% were below and 21.1% above). Erythropoietin-stimulating agents (ESAs) were administered to 84.3% patients and 68.3% received intravenous iron (IV). Iron deficiency (TSAT≤20%) was present in 27.5% patients and among those receiving erythropoietin, 47% did not achieve Hb target. The independent variables associated with the lowest Hb level (<10.5 g/dL) were: female gender, TSAT<25% and age<50 years. According to these results, nearly half of LA chronic HD patients did not achieve the recommended Hb target despite wide use of ESAs and IV iron.

Non-Invasive Hemoglobin Measurements In Anemic Patients

BackgroundNon-invasive Hemoglobin Measurement (NIHM) devices have recently become available in clinical practice. These point-of-care devices use spectrophotometry to measure hemoglobin (Hb), providing real-time results and do not require blood draws. However, the validity of this technology has not been examined in patients with moderate to severe anemia (Hb< 90g/L).The purpose of this study is to examine the validity and performance of non-invasive hemoglobin measurements (NIHM) among anemic patients in the real world setting. MethodsPatients were recruited from two clinical settings that are highly applicable this technology.(i) The intensive care setting, where frequent blood draws contribute to anemia.Patients were recruited from three tertiary care critical care units(ii) A developing country setting. Patients were recruited from the Internal Medicine and Paediatrics wards at Mulago hospital in Kampala, Uganda.An additional cohort of patients was recruited from an outpatient Hematology clinic which served as a comparator group.All patients were enrolled in a consecutive manner. In the ICU population, patients were recruited through a consecutive, convenience sample in order to maximize patients with hemoglobin values < 90 g/L.The Pronto 7® NIHM device was compared to Coulter Counter Complete Blood Count (CBC) measurements. All CBC were processed at College of American Pathologist or Ontario Laboratory Accreditation approved labs; all CBC determinations were drawn within 4 hours of the Pronto determination in patients with stable hemoglobin values. Basic demographics along with suspected etiology of anemia were also collected. The consistency between CBC and NIHM was assessed by Pearson's Correlation, mean difference and linear regression. The study was reviewed by the Integrated REB at both St Joseph's Hospital, Hamilton and Mulago Hospital and Makerere University in Uganda. As a minimal risk study, the requirement for consent was waived at the Hamilton sites by the research ethics board. Consent was obtained from Ugandan participants. Results188 patients were recruited.a. ICU population. Seventy four patients were recruited with mean age of 61 years (range 16-89). The patients were of a medical (n=44; 69%), surgical (n=17; 23%), trauma (n=7; 18%) mixed population (n=6; 13%). The mean Hb on CBC was 97 g/L. Forty patients (53%) had an Hb less than 90 g/L. The mean absolute difference between the CBC and NIHM was 14.85 (range 0-53g/L). The overall Pearson correlation coefficient was 0.62 and the R2 value was 0.37.b. Ugandan population. Eighty-three patients were recruited (31 pediatric and 52 adult) with a mean age of 27 (range 2-80). The mean Hb value on CBC was 80 g/L and 43% percent of patients had Hb values than 70 g/L. Seventeen percent of patients had sickle cell disease. NIHM were not obtainable in over half (n=55 (65%) of the study population) and in 30 of the 31 pediatric patients. In those who could be tested the mean absolute difference between the CBC and NIHM was 24 g/L (range 0-72) with Pearson coefficient of 0.84 and R2 value of 0.71.c. Outpatient population. Thirty one patients were recruited with mean age of 66. The mean Hb value was 119 g/L with mean absolute difference between the CBC and NIHM of 14.6 g/L (range 1-43 g/L) with Pearson correlation coefficient of 0.69 and R2 of 0.47.Figure 1 shows the scatter plot for the three patient groups. In all three groups, the majority of data points fall to the right of the line of equal value between NIHM and CBC measurements, indicating a tendency of the device towards overestimation of the hemoglobin. [Display omitted] DiscussionThis is the first study of NIHM to target the patients with moderate to severe anemia and to include pediatric patients and those with hemoglobinopathy. There is only moderate degree of correlation between the NIHM and CBC measurements with the NIHM demonstrating a consistent positive bias. The positive bias was seen in all patient groups, and both the inpatient and outpatient setting. The device was unable to provide measurements in children though this may have been due the probe size available to the investigators. The discrepancy in values between NIHM and venipuncture CBC values suggests that the non-invasive hemoglobin monitor will be of limited utility in the patient groups evaluated in this study. Disclosures:Crowther:Asahi Kasai: Membership on an entity's Board of Directors or advisory committees; Baxter: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Boehringer Ingelheim: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; CSL Behring: Speakers Bureau; Leo Pharma: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Merck: Consultancy; Octapharma: Consultancy, Membership on an entity's Board of Directors or advisory committees; Pfizer: Consultancy, Honoraria, Research Funding; Sanofi-Aventis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Viropharma: Membership on an entity's Board of Directors or advisory committees.

Transcranial Color Doppler Sonography and Magnetic Resonance Imaging In Adult Patients With Sickle Cell Disease

▪ IntroductionStroke is a serious complication in Sickle Cell Disease (SCD) with an incidence of 11% by age 16 yrs and 24% by 45 yrs. In the Stroke Prevention Trial (STOP Trial) validity of the TransCranial Doppler (TCD) and threshold velocity ≥200 cm/sec were demonstrated to be useful in the prevention of stroke in pediatric patients with SCD. At present few data are available in adult patients. It is known that blood flow velocities detected with TransCranial Doppler (TCD) and TransCranial Color Doppler (TCCD) are comparable. AimTo compare transcranial blood flow velocities between SCD adult patients and healthy controls using TCCD with the insonation angle correction; to identify by TCCD the maximum mean Peak Systolic Velocity (PSV) in SCD adult patients as potential predictor of acute event or as an indicator of chronic progression of the disease; to evaluate Magnetic Resonance Imaging/Angiography (MRI/MRA) findings. Patients and MethodsFifty adult patients with SCD (aged >16 years) were enrolled, including14 Sickle Cell Anemia (SCA), 24 Sickle Cell Thalassemia (HbS-βThal) and 12 HbS/HbC. SCD adult patients and healthy subjects matched by gender, age and ethnicity (ratio of 2:1) were compared. SCD patients with epilepsy, pregnancy, HIV infection and bone marrow transplantation were excluded. The study was approved by Ethics Committee and all subjects gave written informed consent. Clinical evaluation, blood cell count, hemoglobin fractions by High Performance Liquid Chromatography (HPLC) and biochemical tests were evaluated. In both patients and controls Color and Duplex Doppler Sonography (CDDS) and TransCranial Color Doppler (TCCD) with angle correction were performed by the same physician to evaluate PSV, Pulsatility Index (PI) of the extracranial vessels (ICA and VA) and middle (MCA), anterior (ACA), posterior (PCA) cerebral arteries, carotid siphon (SIPH), vertebral (VA intracranial) and basilar (BAS) arteries following the STOP protocol. Furthermore, in all the patients 3.0T MRI/MRA was performed. ResultsSignificant differences in Hb levels, Hct%, WBC, RBC, MCV, HbA2% and HbF% (p<0.001) were found comparing SCD group and controls, with a mean Hb values of 9.9±1.8 and 13.8±1.4 g/dl respectively. No neurological signs were reported, despite history of sickle crisis. PSVs in MCA, ACA, SIPH, PCA, intracranial VA, BAS were higher in SCD patients (p<0.001), in particular the mean PSV in MCA was 129.89±21.22 cm/sec in SCD patients and 110.71±14.96 cm/sec in controls. In SCD patients MCA velocities were correlated with Hb values, Ht%, RBC and HbS% (p<0.01), but independent from MCV, HbA2%, HbF%, reticulocytes, erythroblasts, WBC, iron status and hemolysis indices. In SCA patients higher velocities compared to HbS-βThal and HbS/HbC patients (140.55±12.90 cm/sec vs 128.48±22.37, p=0.013 and 119.394±22.51, p<0.011 respectively) were found. PI was normal in both SCD patients and controls, but statistically lower in SCD patients, (MCA, ACA, PCA, SIPH, VA intra- and extracranial, p<0.01). No differences in PI between the 3 SCD subgroups were found. PSVs percentile were calculated, considering pathological those above the 95°: MCA>164.18 cm/s; ACA>135.20 cm/s, SIPH>170.75 cm/s; PCA>99.67 cm/s; VA>101.50 cm/s; BAS>116.12 cm/s. Eight out of 50 SCD patients were found above the 95° percentile in any district, showing a more severe clinical phenotype. No stenosis were found in ICA by CDDS. SCD patients underwent to MRI/MRA to evaluate cerebral parenchymal lesions and vessel abnormalities respectively. In 11 patients (22%) vascular lesions, in 17 patients (34%) white aspecific lesions and in 9 patients (18%) cerebral atrophy were found. In 2 patients (4%) mild focal stenosis were detected. ConclusionsTCCD velocities in adults SCD patients are lower than those provided by the STOP trial in children, confirming that the speeds disclose an age-related decline, however are higher than in healthy controls, in particular in SCA patients. According to our data, we could suggest as pathological cut off a MCA PSV value >160 cm/s. Moreover stenosis detected by MRA are not frequent as in young SCD patients. The peculiar alterations observed at MRI require further investigations. Disclosures:Cappellini:Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Shire: Membership on an entity's Board of Directors or advisory committees.