Number Of Red Blood Cells Research Articles

Prediction of JENU-negative Phenotype by Genotyping among Thai Patients with Multiple Transfusions

Background: The MNS7 (Mia) is a low-prevalence antigen, associated with GP.Mur hybrid glycophorin is high in Thai populations. Consequently, anti-Mia, particularly anti-Mur caused by alloimmunisation is involved in transfusion medicine. In Thailand, before the first transfusion of transfusion-dependent patients with thalassemia, typing of Mia and Rh antigens is minimally required to provide phenotype-matched donors. A patient with Mia-positive phenotype encoded by GYP*Mur homozygote (do not express GPB, JENU-negative) receiving either Mia-negative or Mia-positive phenotype can produce anti-JENU, leading to difficulty in locating compatible donors. Genotyping for GYP*(B-A-B) hybrid alleles to predict the JENU-negative phenotype is alternatively implemented. This study aimed to predict the JENU-negative phenotype in multitransfused Thai patients using PCR-based coupled DNA sequencing. Methods: Blood samples from 861 multi-transfused Thai patients were included. Mia antigen testing was performed using serology and PCR-sequence-specific primer (PCR-SSP). GYP*(B-A-B) hybrid alleles were analyzed using Sanger DNA sequencing. Only 5 of 68 patients receiving more than 40 red cell units developed alloantibodies. The sequence analysis revealed that 60 of 68 patients carried the GYP*Mur allele, including GYP*Mur/GYPB heterozygotes (86.76%) and the GYP*Mur/GYP*Mur homozygote (1.47%). The remaining 8 patients were GYP*Thai/GYPB heterozygotes (10.29%) and GYP*ThaiII/GYPB heterozygotes (1.47%). The GYP*Bun, GYP*HF, GYP*Hop and GYP*Kip alleles were not observed. One female patient with JENU-negative phenotype received 24 red cell transfusions within one year without alloantibody production, which might be due to the number of red blood cell (RBC) units or her disease status. Conclusions: Concerning this study, multiple transfusions can induce alloantibody production. Therefore, phenotype-match transfusions are beneficial among patients with long-term transfusion therapy, and further investigation of the JENU-negative phenotype is suggested.

On the Intensity of the Microvascular Magnetic Field in Normal State and Septic Shock.

Background: Capillary tortuosity is a morphological variant of microcirculation. However, the mechanisms by which tortuous vessels meet metabolic requirements in health and disease remain unknown. We recently reported that capillary tortuosity score (CTS) is significantly higher in patients with septic shock than in steady-state individuals, and that CTS is significantly associated with alveolar-to-arterial oxygen (A-a O2) gradient and oxygen debt in septic shock patients. Objective: We aimed to investigate the characteristics of the magnetic fields in the sublingual microcirculation of individuals with normal physiology and patients with septic shock. Methods: Systemic hemodynamics were recorded, and sublingual microcirculation was monitored using sidestream dark field (SDF+) imaging. The number of capillary red blood cells (NRBC), the intensity of the magnetic field of a red blood cell (HRBC), the intensity of the magnetic field of each capillary (HCAP), and the intensity with which the magnetic field of a capillary acts on an RBC (FCAP) were calculated. Results: Significant differences in macro- and microhemodynamic variables were observed between the two groups. Although NRBC was significantly higher in individuals with steady-state physiology [87.4 (87.12) vs. 12.23 (6.9)], HRBC was significantly stronger in patients with septic shock [5.9 × 10-16 (6.9 × 10-16) A m-1 vs. 1.6 × 10-15 (1.4 × 10-15) A m-1]. No significant difference was observed in HCAP [2.16 × 10-14 (2.17 × 10-14) A m-1 vs. 1.34 × 10-14 (1.23 × 10-14) A m-1] and FCAP [1.66 × 10-24 (3.36 × 10-24) A m-1 vs. 6.44 × 10-25 (1.1 × 10-24) A m-1] between the two groups. In patients with septic shock, HRBC was associated with De Backer score (rho = -0.608) and venous-arterial carbon dioxide difference (rho = 0.569). In the same group, HCAP was associated with convective oxygen flow (rho = 0.790) and oxygen extraction ratio (rho = -0.596). Also, FCAP was significantly associated with base deficit (rho = 0.701), A-a O2 gradient (rho = 0.658), and oxygen debt (rho = -0.769). Conclusions: Despite the microcirculatory impairment in patients with septic shock, HRBC was significantly stronger in that group than in steady-state individuals. Also, HCAP and FCAP were comparable between the two groups. Tortuous vessels may function as biomagnetic coils that amplify RBC-induced magnetic fields, enhancing perfusion and oxygenation of adjacent tissues.

An In-Depth Assessment and Comparison of Learning Methods for Non-Invasive Anemia Identification

Anemia, caused by a reduced number of red blood cells or changes in cell structure, poses a significant health issue globally, particularly for children and pregnant women. Clinical diagnosis can be obstructed by patient hesitation, a lack of healthcare personnel in remote areas, and limited resources. However, due to its accessibility, affordability, and non-invasive nature, machine learning offers a compelling alternative. This paper methodically evaluates current applications of machine learning in the diagnosis of anemia. We analyze prominent algorithms, the characteristics of datasets, performance metrics, and techniques for image augmentation. Our findings illustrate the potential of non-invasive, machine learning-based methods for effective and cost-efficient screening of anemia. This paper highlights the capabilities of machine and deep learning in assessing clinical data and medical imagery to enhance anemia detection.

Determination of Cancerogenic Potentials Microplastic and recycled plastic on Oreochromis niloticus using Micronucleus Assay

Micronuclei (MN) play a fundamental role during cancer evolution and metastatic progression. Water pollution means that these bodies are polluted with harmful substances, resulting in serious health hazards. Microplastics are currently a significant source of global concern. Environmental exposures are known risk factors for cancer etiology. These carcinogens also accumulate in aquatic organisms consumed by humans, eventually entering our food chain. In our study, the effects of microplastic (MP) and recycled plastic (RP = plastic bottle caps) concentrations on the erythrocytes of the fish Oreochromis niloticus (Nile Tilapia) were investigated for their carcinogenic and hematological effects on red blood cells (RBCs) through MN testing and erythrocyte counting. The results indicated that, due to the effects of MP and RP concentrations, the frequency of MN in erythrocytes increased in a concentration- and time-dependent manner, leading to cancer in living organisms and causing a decrease in the number of red blood cells (anemia).

Addition of selenium nanoscale to high diets with wheat bran and its effect on Biochemical and characteristics blood and somatic cell count in milk in Awassi ewes

The study was conducted to investigate the effect of selenium nanoscale in improving the utilization of high wheat bran diet using 15 Awassi ewes weighing 51.58 ± 1.71 kg and their ages ranged between 3-4 years, the ewes were divided into three groups, each group included five ewes, the ewes were fed during the study period, which amounted to 72 days, and the amount of feed provided to ewes was equivalent to 1.5 kg of dry matter per ewe per day. The first group (control) was fed a diet high in barley grains with an ideal percentage of wheat bran, in the second group the ewes were fed a diet that contained less barley with a bran percentage raised to 35% of the components of the diet, while the third group was fed a diet similar to the second diet with daily doses of ewes with 0.3 mg / ewe of nano-selenium. The results indicated that there were no significant differences (P?0.05) for the biochemical blood traits, in Blood standards for a blood picture, there was no significant difference in the number of white blood cells, the percentage of lymphocytes, the mean corpuscular volume, the number of red blood cells, and blood hemoglobin. At the same time, the ratio of granulocytes increased for each of the second and third treatments, the platelet Counts decreased for each of the second and third treatments, and the number of somatic cells was much less in the second period of the study in Bran and selenium groups compared to control.

Effectiveness of liver transplant mortality scales in a Mexican population.

Effectiveness of liver transplant mortality scales in a Mexican population.

Transfusion quantities associated with 24-h mortality in trauma patients.

Data on the correlation between transfusion volumes and trauma mortality are limited. The association between the total number of red blood cell (RBC) and low titer group O whole blood (LTOWB) units, as well as the total volume of all transfused products that were administered up to 4-h after admission and 24-h mortality was determined. The Trauma Quality Improvement Program (TQIP) datasets from 2020 to 2022 were reviewed to identify patients aged ≥15 who received any volume of blood products. Receiver operating characteristic (ROC) were constructed along with the calculated area under the ROC curve (AUROC) to determine the association between the quantity of transfusion and 24-h mortality. There were 144,379 encounters that met inclusion, with 22,467 patients who died within the first 24 h. There was a 90% probability of 24-h mortality following the transfusion of 56 RBC/LTOWB units (AUROC 0.673), with the 90% specificity, Youden's index, and 90% sensitivity surrounding this probability occurring after the transfusion of 8, 4, and 2 units, respectively. In terms of the volume of transfusion, there was a 90% probability of 24-h mortality following the transfusion of 36,000 mL of all blood products combined (AUROC 0.662), with the 90% specificity, Youden's index, and 90% sensitivity surrounding this probability occurring after the transfusion of 4400, 2000, and 500 mL, respectively. Both the total number of RBC and LTOWB units transfused and the total volume of all blood products transfused demonstrated poor predictive association with the risk of 24-h mortality in the civilian trauma population.

Osseointegration Acceleration of Dental Implants by Weak Direct Current

It is possible to improve the quality of treatment of patients using dental implants by strengthening the bone–dental implant connection with a weak direct current. Titanium electrodes simulating dental implants were used in the in vitro experiment. The electrodes were placed in collected human venous blood. In the experimental group, physiotherapy procedures were performed for 10 minutes using the developed device at a current of 15–20 μA. In the control group, titanium plates were placed in blood without electric current for 10 minutes. In the studied samples, the adhesion density of blood clots to the titanium plates, the thickness of blood clots, the number of platelets and erythrocytes were studied. It was found that the effect of an electric current of 15–20 μA on a blood clot through titanium plates contributes to thickening and compaction of blood clots on the surface of the electrodes. The number of red blood cells and platelets in the blood clot increases, which can have a positive effect on the process of osseointegration.

ВЛИЯНИЕ СКАРМЛИВАНИЯ КОМПЛЕКСНОЙ МИНЕРАЛЬНОЙ КОРМОВОЙ ДОБАВКИ НА ГЕМАТОЛОГИЧЕСКИЕ ПОКАЗАТЕЛИ КРОВИ ЯРОК РОМАНОВСКОЙ ПОРОДЫ

The purpose of research is to study the effect of feeding a complex mineral-vitamin supplement on hematological blood parameters and the productivity of the Romanov breed young ewe. Objectives: to determine the deficiency of minerals in basic feed; taking into account the deficiency, complex mineral and vitamin feed supplement, (hereinafter referred to as CMVFS); establish feeding standards and techniques. To conduct scientific and economic experiments at the State Property Committee Yakupov D.N. of Birsk District of the Republic of Bashkortostan, 4 groups of young ewes of Romanov breeds were selected using the method of pair-analogues (by age, live weight) of 10 heads in each (1 control and three experimental). The duration of the experiment was 120 days. Three recipes for the production of CMVFS were developed with the introduction into their composition of local natural zeolite from the Kaltuban deposit of the Republic of Bashkortostan and sapropel, monocalcium phosphate and premix P81-1-89 and feed sulfur. The control group was fed the main diet; the daily norm of CMVFS was fed to the experimental groups as part of a grain mixture once a day. At the end of the experiment, compared with the indicators of the control group, the number of red blood cells in the experimental groups increased by 1.83 %, 6.39 and 10.16 %; leukocytes – by 4.00 %, 12.79 and 15.61 % and hemoglobin – by 3.00 %, 4.25 and 5.21 %. To assess the state of metabolism in the body of experimental animals using the CMVFS, biochemical blood parameters were studied before the experiment and during removal from the experiment. The additional introduction of CMVFS, which contains natural zeolite and sapropel in various proportions, into the diet of the animals, had a positive effect to varying degrees on the biochemical and hematological parameters of the blood, contributed to the improvement of the clinical condition of the animals, and also had a stimulating effect on protein and carbohydrate metabolism, hematopoietic functions organs and heart. All this creates the prerequisites for increasing animal productivity.

Acetylcholinesterase activity and hematological parameters in individuals exposed to pesticides in a Brazilian state: a cross-sectional study.

The use of pesticides has become a worldwide concern, and Brazil is one of the countries that release the most pesticides and is affected by them. These chemical substances, when in contact with the human body, can cause health problems such as nephrotoxicity, neurodegeneration, and even cancer. This study investigates how direct and indirect pesticide exposure interferes with acetylcholinesterase (AChE) and hematological parameters. This cross-sectional study was conducted in Sergipe, Brazil, and included 378 participants. The impact of pesticides on AChE and hematological parameters in individuals exposed to these agents was evaluated. Triazine (TZ) and Organochlorine (OC) classes combination generated the lowest AChE. A lower mean for AChE for individuals directly exposed to pesticides (p < 0.05) was observed. Men and younger individuals tended to have lower levels of AChE, as did individuals who declared themselves black or yellow or did not declare any ethnicity. As for hematological alterations, micronuclei (MN) were detected in 12.2% of farmers and 8.7% of families and neighborhoods. We found that AChE values tended to increase with the number of platelets and red blood cells (RBC). Still, we did not detect any other relationships between AChE and the type of exposure with hematological parameters. These findings contribute to evaluating the impact of pesticide exposure on human health. Thus, it allows us to infer that individuals directly exposed to pesticides tend to have lower levels of AChE, demonstrating the need to monitor these clinical parameters in individuals exposed to these agents and seek to identify the profile of this population.

Evaluation of the Effectiveness of Feeding Spirulina and Folic Acid on the Parameters of Complete Blood Count in Laboratory Rats with Induced Anemia

Abstract Anemia is a Problem with health are common around the world. defined as a deficiency-characterized condition in the red blood cell count or a deficiency in the percentage of hemoglobin distributed throughout the blood. It happens owing to disorders within the blood fluid content, the number and size of red blood cells are less than the normal level. The most important symptoms of this disease are stress, dyspnea, a feeling of fainting spell, increased tremors and thirst, paleness in the face where the color is abnormal. In the study, were used 25 rats, distributed randomly at a rate of 5 animals per group in plastic cages. The current study aimed at the benefits of folic acid and spirulina extracts in treating anemia caused by phenylhydrazone, as well as to investigate the biochemical and histological alterations of parameters of the blood in male albino rats. The findings indicated that PHZ injection caused A significant drop at the level (P≤ 0.05) in the number of (RBC) and Hb level compared to the control group, also resulted in an increase in WBC and PLT level. animals’ dosage orally folic acid and spirulina together produced a favorable outcome and improvement in CBC parameters, along with a notable rise in Hb and RBC at the level (P≤ 0.05) concentrations compared to the anemic rat group by PHZ. with a drop in WBC and PLT counts.

Anemia Pada Remaja Putri Di Desa Mattoangin

Anemia is a condition of decreasing the number of red blood cells in the blood circulation below normal limits and is also a condition when there is a deficiency in the size, number of erythrocytes or hemoglobin content which can cause symptoms often referred to as 5L (lethargic, tired, weak, tired, inattentive). There are several factors that can affect the occurrence of anemia, namely, low iron status due to infrequent consumption of iron food sources (heme and non-heme), poor nutritional status, history of infection and prolonged menstruation. The purpose of the study was to determine the incidence rate of anemia in adolescent females in Mattoangin Village based on (1) nutritional status (2) history of worm infection (3) length of menstruation (4) eating habits. This study was conducted on 99 adolescent females in Mattoangin Village, Bantimurung District, Maros Regency. The research method used in this study is quantitative research with descriptive observational research method with cross-sectional approach, using primary data in the form of interviews using questionnaires and examination of HB levels with Easytouch GCHB tool. Data analysis was processed using SPSS software. The results of this study showed the incidence of anemia and those at risk of anemia in adolescent females in Mattoangin Village: (1) based on the results of the examination of HB levels that fall into the anemia category, namely (33.3%) (2) The most nutritional status is the at-risk category (59.6%), (3) Based on a history of helminth infection at risk of anemia (9.1%), (4) Based on the length of menstruation at risk (14.1%) (5) Based on eating habits at risk (31.3%) The conclusion of the study is that many adolescent females in Mattoangin Village have poor nutritional status and are at risk of anemia.

The Relationship of Behavior Towards Nutrient Intake and the Incidence of Anemia in Pancar Bakti Middle School Students

Anemia is a condition characterized by a decrease in the number of red blood cells or a decrease in the amount of hemoglobin in the blood. Anemia is a significant health problem among adolescents. This study aims to determine the relationship between anemia behavior and iron intake in Pancar Bakti Middle School female students. This research used a cross-sectional approach which was carried out from January to February 2024. The research was conducted on female students at Pancar Bakti Middle School, Bogor with a sampling technique using total sampling, namely 41 female students. All female students had their knowledge, attitudes, and behavior measured using a questionnaire and Hb (Hemoglobin) was measured using the Easy Touch GCHb. Univariate analysis based on respondent characteristics showed that of the 41 female students, most were 17 years old (41.5%), mother's education was junior high school graduate (41.5%), the father's education was junior high school graduate (48.8%), mother's employment status was housewife (85.4%), the father's employment status is self-employed (85.4), the source of information about anemia is that most people get it from the family (39.0), then there are 35 female students (85.36%) experiencing anemia, while 6 female students (14.64%) did not experience anemia. Bivariate analysis using the chi-square statistical test showed insignificant results with a p-value&gt; 0.05 for the variable, namely the mother's level of knowledge regarding anemia (p = 0.646). Significant results with a p-value &lt;0.05 were obtained for the variables, namely attitudes regarding anemia (p = 0.024), and actions towards anemia (p = 0.000). Conclusion is the level of education, economy, and sources of information about anemia that influence the incidence of anemia in adolescents. There is a relationship between attitudes and actions and the incidence of anemia. There is no relationship between knowledge and the incidence of anemia. Keywords: anemia, teenagers, knowledge, attitudes, behavior

Human leukocyte antigen alloimmunization in a randomized trial of amustaline/glutathione pathogen-reduced red cells in complex cardiac surgery patients.

Although alloimmunization risk of pathogen-reduced (PR) platelets has been studied, the risk has not been reported with PR red blood cells (RBCs). In a Phase III, randomized, controlled trial (Red Cell Pathogen Inactivation), cardiac or thoracic-aorta surgery patients were randomized to transfusion with amustaline/glutathione PR versus conventional RBCs. Pre-transfusion and Day 28 samples were evaluated for Human leukocyte antigen (HLA) Class I and Class II antibodies at low, medium, and high cutoff values. The HLA alloimmunization analysis included 114 participants (53% female) in the PR and 113 (51% female) in the conventional RBC arms. In a modified intention-to-treat analysis, 13.7% (N = 29) and 7.2% (N = 15) developed new high-level HLA Class I or Class II antibodies, respectively; however, there was no signal that PR-RBCs affected the rate of HLA Class I (odds ratio (OR) 1.3 [95% confidence interval (CI) 0.62-2.9]) or Class II antibody formation (OR 0.99 [95% CI 0.35-2.8]). Female transfusion recipients had higher risk of developing new high-level HLA Class I antibodies (OR 12.0 [95% CI 3.5-40.9]) and Class II antibodies (OR 5.0 [95% CI 1.4-17]). The mean number of RBC (5.5 vs. 3.6 units, p = 0.018) and platelet (1.8 vs. 1.1 units, p = 0.043) transfusions was higher in subjects with new high-level HLA Class II antibodies. Receipt of amustaline/glutathione PR-RBC units did not affect HLA alloimmunization risk. Female sex and number of RBC and platelet transfusions were risk factors for the development of new high-level HLA Class I and Class II antibodies.

Determinants of anemia in school-going adolescents: a case study in Douala, Cameroon

ContextAnemia is a medical condition resulting from a reduction in the number of red blood cells below the reference range. It is a major public health problem, particularly among adolescents, as it can have negative effects on cognitive performance, growth and reproduction. This study aims to assess the determinants of anemia among adolescents in schools in the city of Douala.MethodsA cross-sectional study was carried out among 511 adolescents aged 10–15 years, selected by random sampling from four secondary schools in Douala. Data were collected using a structured questionnaire, including anthropometric measurements and hemoglobin tests to assess anemia. Anemia was defined according to specific thresholds (e.g. hemoglobin < 12 g/dL for girls and < 13 g/dL for boys). Severity was classified as mild, moderate and severe. Multiple logistic regression analysis was performed to identify determinants of anemia, controlling for confounding variables, and associations were established by calculating Odds ratios, Odds ratio adjusts, confidence intervals and P-value. Statistical significance was declared at P < 0.05.ResultsThe mean age of participants was 11.9 ± 1.30 years, with a slight predominance of girls (50.7%) over boys (49.3%). The prevalence of anemia was 40.3% (95% CI: 35.0–45.6%), including 15.7% mild anemia (95% CI: 12.0–19.4%), 23.9% moderate anemia (95% CI: 19.7–28.1%) and 0.7% severe anemia (95% CI: 0.1–2.7%). Independent determinants of anemia included rural residence [AOR = 8.39 (95% CI: 5.26–13.65); p < 0.001], status of parents divorced [OR = 2.60 (95% CI: 1.57- 4.34); p = 0.0001] or deceased [AOR = 7.73 (95% CI: 1.65- 41.90); p = 0.011], onset of first menstrual period [AOR = 6.59 (95% CI: 2.28–72.19); p = 0.001], the absence of iron supplementation [AOR = 1.68 (95% CI: 1.04–2.74; p = 0.034] and the occurrence of an illness in the previous three months (malaria, sickle cell disease, viral hepatitis, amoebiasis, typhoid fever, etc.) [AOR = 3.24 (95% CI: 1.14–22.37); p = 0.012].ConclusionsThis study highlights a worrying prevalence of anemia among adolescents in Douala, with clearly identified determinants. The results underline the importance of factors such as rural residence, parental status and menarche, which can inform public health policies. It is essential to integrate these elements into targeted intervention programs, particularly in nutrition and iron supplementation, especially in rural areas. Finally, longitudinal studies and intervention-based research are needed to better understand the causal mechanisms of adolescent anemia in this context.

Differential diagnosis of iron deficiency anemia from aplastic anemia using machine learning and explainable Artificial Intelligence utilizing blood attributes

As per world health organization, Anemia is a most prevalent blood disorder all over the world. Reduced number of Red Blood Cells or decrease in the number of healthy red blood cells is considered as Anemia. This condition also leads to the decrease in the oxygen carrying capacity of the blood. The main goal of this research is to develop a dependable method for diagnosing Aplastic Anemia and Iron Deficiency Anemia by examining the blood test attributes. As of today, there are no studies which use Interpretable Artificial Intelligence to perform the above differential diagnosis. The dataset used in this study is collected from Kasturba Medical College, Manipal. The dataset consisted of various blood test attributes such as Red Blood cell count, Hemoglobin level, Mean Corpuscular Volume, etc. One of the trending topics in Machine Learning is Explainable Artificial Intelligence. They are known to demystify the machine learning outputs to all its stakeholders. Hence, Five XAI tools including SHAP, LIME, Eli5, Qlattice and Anchor are used to understand the model’s predictions. The importance characteristics according to XAI models are PLT, PCT, MCV, PDW, HGB, ABS LYMP, WBC, MCH, and MCHC. are employed to train and test the data. The goal of using data analytic techniques is to give medical professionals a useful tool that improves decision-making, enhances resource management, and eventually raises the standard of patient care. By considering the unique qualities of each patient, medical professionals who must rely on AI-assisted diagnosis and treatment suggestions, XAI offers arguments to strengthen their faith in the model outcomes.

Association between betel nut (Areca catechu L.) consumption and hemoglobin levels and mid-upper arm circumference in pregnant women in Jayapura Regency, Papua

Anemia is a serious global public health problem that affects pregnant and postpartum women, where the number of red blood cells or hemoglobin concentration is lower than the normal levels. Betel nuts contain high levels of bioactive compounds including alkaloids and polyphenols which are believed to inhibit the absorption of nutrients including iron in the digestive tract. This research analyzes the correlation between betel nuts consumption, Hb levels, and MUAC. This research was conducted on 100 pregnant women using purposive sampling in three health center service areas within Jayapura Regency. Data on betel nut consumption was collected by questionnaire, Hb levels by Hemoglobinmeter, and MUAC by MUAC measuring tape. Data were analyzed using the Pearson correlation. This study's results show a significant negative association between the eating of betel nuts and hemoglobin levels (r=-0.359; p=0.001). Betel nut consumption is not significantly negatively correlated with MUAC (r=-0.022; p=0.830). It is recommended that pregnant women limit their consumption of betel nuts during pregnancy.

Cytochemical analysis of cerebrospinal fluid in tuberculous meningitis versus other etiologies.

Meningeal tuberculosis (TBM) is the most severe form of extrapulmonary tuberculosis due to its high mortality and long-term sequelae in survivors. A cross-sectional study of diagnostic tests was carried out in a private clinical laboratory in Lima, Peru. All cerebrospinal fluid (CSF) samples from patients with suspected meningitis were analyzed with cytochemical and biochemical studies, as well as smear microscopy, India ink, the FilmArray Meningitis/Encephalitis panel, Xpert® MTB/RIF or Xpert MTB/RIF Ultra, and culture for common bacterias, fungi or mycobacterial. 450 CSF samples were included. The main microorganisms detected were Mycobacterium tuberculosis (8.9%), Cryptococcus neoformans (6.0%), and Streptococcus pneumoniae (2.4%). 97.5% of patients with TBM presented positive Xpert MTB/RIF or Ultra. The median number of red blood cells, leukocytes, and percentage of mononuclear cells, glucose, and proteins in the CSF was 57.5 cells/μl, 91.5 cells/μl, 70%, 22.5 mg/dL and 218.3 mg/dL, respectively. Likewise, patients with TMB had the lowest glucose levels (median: 22.5, IQR: 11 - 35) compared to other etiologies of meningitis. While bacterial meningitis had the highest leukocyte (median: 173 μl; IQR: 17 - 520) and protein levels (median: 289.7; IQR: 92 - 556). The characteristics of the cytochemical study of CSF can guide the differential diagnosis by identifying general trends of tuberculous meningitis and other meningitis etiologies. However, it remains necessary to establish methods with greater precision to properly define the etiological agent causing meningitis.

Impact of implementing a nurse-led intraoperative cell saver service in reducing allogeneic red blood cell transfusions in Singapore General Hospital

IntroductionMajor perioperative blood loss often necessitates allogeneic blood transfusions, leading to adverse outcomes and straining healthcare resources. Intraoperative cell salvage (ICS) offers benefits like reduced adverse reactions, optimised blood resource...

Targeting Delivery of Dexamethasone to Inflamed Joints by Albumin-Binding Peptide Modified Liposomes for Rheumatoid Arthritis Therapy.

Delivering the anti-inflammatory dexamethasone in nanoformulations is important for reducing off-target effects when treating rheumatoid arthritis. Nanoformulations can be targeted to sites of inflammation by modifying the nanoparticles with albumin before administration, but such particles can be unstable in vivo. Here, we have developed and validated an alternative targeting in which dexamethasone-loaded liposomes were modified with a 46-residue peptide called "albumin-binding domain", such that the liposomes would adsorb endogenous albumin after administration. The resulting liposomes were small (90 nm diameter) and uniformly dispersed, and both X-ray diffraction and differential scanning calorimetry confirmed efficient dexamethasone encapsulation. Functionalizing the liposomes with albumin-binding peptide strongly increased not only their binding to albumin in vitro but also their uptake by RAW264.7 cells in culture. After injection into rats with adjuvant-induced arthritis, the liposomes accumulated and persisted at sites of inflammation, effectively inhibiting joint swelling and reducing the level of the inflammatory factors TNF-α and IL-1β in joints. The liposomes decorated with the albumin-binding peptide did not display obvious hepatotoxicity and did not reduce red and white blood cells number. Our results validate modifying liposomes with albumin-binding domain as a way to target them to sites of inflammation for efficient drug delivery against rheumatoid arthritis.