Results Of Hematological Tests Research Articles

Стабильность параметров гемоцитометрии при различных условиях хранения образцов

Sample stability is essential for reliable results in clinical laboratory practice. The aim of the work was to investigate the change in values of hematological indices in samples stored for up to 72 hours under different temperature regimes. A total of 60 whole blood samples stored under different conditions were analyzed: at room temperature (25°C), heated to 35°C and cooled to 4°C. Analysis was performed at different time points: immediately after blood sampling and then consecutively after 3, 6, 12, 24, 48 and 72 hours. K2EDTA anticoagulant tubes were used, and results were obtained using a UniCel DxH 800 hematology analyzer. The median shift of the parameters relative to baseline for each combination of time and temperature was assessed using the Wilcoxon matched pairs test. The shift in hemogram values obtained using Bland-Altman plots was compared with the maximum permissible error specified in the quality specification for the desirable error. Hemoglobin, erythrocyte count, mean erythrocyte hemoglobin content and platelet content were stable for at least 72 hours at all temperatures used in the experiment. For the other tested parameters, the first unacceptable changes in hemogram values were observed after 3 hours when the samples were stored at 25°C and 35°C. In samples cooled to 4°C, the first statistically significant differences were recorded after 6 hours. As a result, storage of samples for 72 hours at room temperature led to reliable unacceptable changes in 6 hemogram parameters of the 11 studied, at 4°C 5 parameters changed unacceptably, and at 35°C – 7 parameters. The obtained results, on the one hand, indicate that when analyzing the results of hematological tests is performed with a delay after sample collection, changes in hematological parameters should be considered; on the other hand, they provide information about the list of parameters subject to temperature-time changes, as well as about the intensity of these changes.

Efficiency of alfalfa granulated feed additive in balanced ration of Ukrainian Riding Horse

We established positive influence of granulated alfalfa feed on the growth, development intensity, and sport qualities of the race horses. We registered the increase in live weight of young horses, which consumed the full granulated alfalfa feed by 8.0-9.8%. These animals had a more pronounced constitutional breed type. Thus, at the age of 18 months, they outclassed their peers in main linear dimensions: they had higher values of thoracic development (by 4.6%), higher thoracic diameter (by 4.5%), higher body length (by 5.7%). At the age of 24 months, these advantages were 6.4, 8.2, and 6.0% respectively. We found that the colts and fillies in the experimental group at the age of 12 months outperformed the same year horses from the control group by 1.1% by the index of format. Further, at the age of 18 and 24 months, the animals of the experimental group outperformed their counterparts from the control group by 0.2 and 0.4%, respectively. In terms of breast circumference index, the advantage of the exerimentary group animals at the age of 12 months was 0.1%, at the age of 18 months - 1.7%, at the age of 24 months - 1.8%, respectively. Similar results were recorded for the compactness index, where the advantage at the age of 12 months was 1.2%, at 18 months - 1.9%, at 24 months - 2.3% respectively. The effective use of environmentally friendly feed is confirmed by the results of hematological blood tests. It was found that for the vast majority of indicators they correspond to the physiological norm. This blood composition naturally characterizes changes in horses during the whole period of research. The received hematological profile is the basic characteristic of the state of health of horses in the research enterprise.

Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery

BackgroundCardiopulmonary bypass (CPB) with high-priming volume can significantly activate the inflammatory response and increse the usage of packed red blood cells (PRBCs). As risks and complications related to transfusions are increasing, many cardiac centers are focusing on reducing the priming volume of CPB. In our center, efforts have also been made to reduce the priming volume, and the effects of CPB with low-priming volume on clinical outcomes in children undergoing congenital heart disease (CHD) surgery were investigated in this study to provide referential experiences for pediatric CPB.MethodsThe clinical case data of 158 children undergoing CHD surgery with CPB were collected. The children were divided into the low-priming-volume group (group A, n = 79) and the traditional group (group B, n = 79) according to the priming volume. The amount of PRBCs transfused, the postoperative hematological test results and the clinical outcomes of the two groups were compared by the independent sample t-test or the chi-square test.ResultsThe amount of PRBCs transfused during CPB and during the whole operation were significantly lower in group A than in group B (p < 0.01), but the hemoglobin (Hb) concentration was higher in group A on the first day after surgery (p < 0.01) and before hospital discharge. However, the latter showed no statistical significant difference. The lowest postoperative platelet count was higher in group A than in group B (p < 0.05). There was no statistical difference in the postoperative inflammatory markers and the main clinical outcomes between the two groups.ConclusionsThe usage of PRBCs in CPB with low-priming volume decreased significantly, but the postoperative Hb concentration and platelet count could still be maintained at a high level, improving the use efficiency of PRBCs. CPB with low-priming volume did not affect the postoperative recovery of patients, so it is worthy of continuous promotion and optimization.

A new way to treat proximal deep venous thrombosis using E-selectin inhibition

ObjectiveThere is an inter-relationship between thrombosis and inflammation. Previously, we have shown the importance of P-selectin in thrombogenesis and thrombus resolution in many preclinical animal models. The role of E-selectin has been explored in rodent models and in a small pilot study of clinical calf vein deep venous thrombosis. The purpose of this study was to determine the role of E-selectin in thrombosis in a primate model of proximal iliac vein thrombosis, a model close to the human condition. MethodsIliac vein thrombosis was induced with a well-characterized primate model. Through a transplant incision, the hypogastric vein and iliac vein branches were ligated. Thrombus was induced by balloon occlusion of the proximal and distal iliac vein for 6 hours. The balloons were then deflated, and the primates recovered. Starting on postocclusion day 2, animals were treated with the E-selectin inhibitor GMI-1271, 25 mg/kg subcutaneously, once daily until day 21 (n = 4). Nontreated control animals received no treatment (n = 5). All animals were evaluated by magnetic resonance venography (MRV); evaluation of vessel area by ultrasound, protein analysis, hematology (complete blood count), and coagulation tests (bleeding time, prothrombin time, activated partial thromboplastin time, fibrinogen, and thromboelastography) were performed at baseline, day 2, day 7, day 14, and day 21 with euthanasia. In addition, platelet function and CD44 expression on leukocytes were determined. ResultsE-selectin inhibition by GMI-1271 significantly increased vein recanalization by MRV vs control animals on day 14 (P < .05) and day 21 (P < .0001). GMI-1271 significantly decreased vein wall inflammation by MRV with gadolinium vein wall enhancement vs control also on day 14 (P < .0001) and day 21 (P < .0001). The thromboelastographic measure of clot strength (maximum amplitude) showed significant decreases in animals treated with GMI-1271 vs controls at day 2 (P < .05) and day 7 (P < .05). Animals treated with GMI-1271 had significant vessel area increase by day 21 vs controls (P < .05) by ultrasound. Vein wall intimal thickening (P < .001) and intimal fibrosis (P < .05) scores were significantly decreased in GMI-1271-treated animals vs controls. Importantly, no significant differences in hematology or coagulation test results were noted between all groups, suggesting that E-selectin inhibition carries no bleeding potential. GMI-1271 did not affect platelet function or aggregation or CD44 expression on leukocytes. In addition, no episodes of bleeding were noted in either group. ConclusionsThis study suggests that E-selectin modulates venous thrombus progression and that its inhibition will increase thrombus recanalization and decrease vein wall inflammation, without affecting coagulation. The use of an E-selectin inhibitor such as GMI-1271 could potentially change how we treat deep venous thrombosis.

Case 272.

History A 92-year-old bedridden woman presented to the emergency department from an assisted living facility with fever, cough, and swelling over the right lateral hip. She had baseline dementia and frailty and had been bedridden for 4 years. She did not have any recent falls or history of trauma at the site of swelling. She had a history of diffuse large B-cell lymphoma that had been diagnosed and treated 7 years ago, and thoracoabdominal CT at last follow-up 3 years ago did not show any recurrence. Physical examination findings were unremarkable except for a painful hard and fixed mass measuring approximately 5 × 5 × 10 cm (in the transverse, anteroposterior, and craniocaudal directions, respectively) located at the right lateral superior thigh. The overlying skin was intact, without any color changes. Pertinent blood test results showed an increased white blood cell count of 13 000/μL (13 ×109/L) (normal range, 3700-11 000/μL [3.7-11 ×109/L]). The remaining hematologic and biochemical test results were normal. Abdominal and pelvic CT performed at presentation did not show any abnormal lymph nodes. Because chest radiography showed consolidation in addition to typical clinical picture, the patient was diagnosed with pneumonia and underwent antibiotic treatment for 3 weeks. US ( Fig 1 ) and Doppler US ( Fig 2 ) of the mass were performed. MRI was not performed because the patient had a pacemaker; instead, CT of the lower extremity was performed ( Fig 3a , 3b ). Figure 1: US image of the mass at the level of the greater trochanter. Figure 2: Doppler US image of the caudal portion of the mass. Figure 3a: (a) Axial unenhanced CT image of the lesion at the level of the greater trochanter. (b) Coronal unenhanced CT image of the mass at the level of the greater trochanter. Figure 3b: (a) Axial unenhanced CT image of the lesion at the level of the greater trochanter. (b) Coronal unenhanced CT image of the mass at the level of the greater trochanter.

Effect of Perillaldehyde on Prophylaxis and Treatment of Vaginal Candidiasis in a Murine Model.

Vulvovaginal candidiasis is a common fungal infection afflicting women which is primarily caused by the yeast Candida albicans (C. albicans). It is imperative to introduce new drug classes to counter this threat due to the continuous emergence of drug-resistant cases in recent years. The purpose of this study was to clarify the in vivo antifungal activity of perillaldehyde (PAE) against C. albicans and to prove that PAE is a promising candidate for the control of vaginal candidiasis. An animal model of vaginitis was developed to demonstrate the therapeutic and preventive effects of PAE on vaginal candidiasis, and these were evaluated through fungal and histopathological examinations. In clarifying the mechanism of PAE, standard hematological test results indicated that white blood cells (WBC) were elevated abnormally in mice infected with C. albicans, whereas when the mice were treated with various concentrations of PAE, the number of WBC in the blood was reduced. Flow cytometry was used to detect the populations of neutrophils, macrophages and CD4 T cells in the vaginal tissue of the mice. PAE was found to reduce these immune cells, which all play a key role in the inflammatory response, and the related interleukin and pro-inflammatory cytokines, including IL-17, IL-22 and TNF-α. These were detected using ELISA. Finally, we detected the expression levels of E-cadherin in the PAE treatment mouse group and discovered that it had recovered to its normal levels, but in the infection mouse group, the E-cadherin expression was clearly suppressed by the presence of C. albicans. Our data demonstrated that PAE targets these cytokines and possesses the ability to fight the fungal infection while also reducing the levels of the inflammatory factors identified. Our results demonstrated that PAE has a significant preventative and therapeutic effect on vaginal candidiasis and is a potential candidate for the treatment of vaginal Candida infections.

Comparison of the Effects of Maropitant, Lidocaine, and Dextroketamine Administered by the Intratesticular Route in Dogs Undergoing Elective Orchiectomy

Background: Balanced anesthesia achieved with combinations of inhaled and injectable drugs administered systemically or in loco-regional anesthetic blocks, is widely used in veterinary medicine. The use of anesthesia and/or local analgesia has already demonstrated benefits in the performance of elective orchiectomy in different species, there is no literature that evaluates the use of the maropitant intratesticular route. The present study evaluated the cardiorespiratory variables and analgesia produced by intratesticular blockade with maropitant, lidocaine, or dextroketamine during the trans-operative period along with the discharge and anesthetic recovery of dogs that underwent elective orchiectomy. Materials, Methods &amp; Results: Used twenty-four dogs from routine elective orchiectomy, considered healthy based on the results of clinical and hematological tests. The animals were randomly divided into three groups and was applied intratesticularly 2% lidocaine at a dose of 1 mg/kg (GL), 5% dextrocetamina at a dose of 2.5 mg/kg (GC), or 1% maropitant at a dose of 1 mg/kg (GM). Anesthesia induction was performed with propofol (to effect), and stabilization of inhalational anesthesia was achieved with 1.7 V% of sevoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the animal's weight, being kept under spontaneous ventilation, After induction, we waited 10 min for stabilization of exhaled anesthetic concentration and then administered one of the treatments intratesticularly. After five min from the local block the surgical procedure was started during up to 15 min. Heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), oxygen saturation of hemoglobin (SatO2), end-tidal carbon dioxide partial pressure (EtCO2), end-tidal sevoflurane concentration (EtSevo) in exhaled air, and body temperature (T°C) were measured before intratesticular administration of the agent and at specific time points during surgery, in addition to assessments of analgesia and evaluation of discharge and anesthetic recovery. Statistical analysis was performed using the Kolmogorov-Smirnov test (P &gt; 0.10). The parameters HR, RR, SAP, DAP, MAP, T, EtCO2, and SatO2 were evaluated by analysis of variance (ANOVA), followed by the Scott-Knott test (Software R® 3.2.0 - 2013), considering a significance level of P &lt; 0.05. The results did not show inter-drug differences for the evaluated variables.Discussion: It was decided not to use premedication (MPA), so that we could accurately assess the analgesic effect of drugs, lidocaine, dextroketamine and maropitant, on intratesticular block during elective orchiectomy. In this study we demonstrated that these drugs promoted analgesia, because the trans-surgical values were relatively lower compared to baseline and within physiological limits for the species. In addition, it was noted that local analgesia used was efficient since even at the time of ligature and the incision spermatic cord which is described in the literature as the most painful part of the surgical procedure. The post-anesthetic recovery and discharge were quick in the absence of MPA, local analgesia without residual effects and the use of sevoflurane. The sevoflurane has a very low blood gas coefficient solubility, resulting in a recovery fast. Therefore, we can conclude that all of the drugs promoted analgesia and cardiorespiratory stability as well as rapid anesthetic recovery for elective orchiectomy in this species.

Next-generation reference intervals for pediatric hematology.

Background Interpreting hematology analytes in children is challenging due to the extensive changes in hematopoiesis that accompany physiological development and lead to pronounced sex- and age-specific dynamics. Continuous percentile charts from birth to adulthood allow accurate consideration of these dynamics. However, the ethical and practical challenges unique to pediatric reference intervals have restricted the creation of such percentile charts, and limitations in current approaches to laboratory test result displays restrict their use when guiding clinical decisions. Methods We employed an improved data-driven approach to create percentile charts from laboratory data collected during patient care in 10 German centers (9,576,910 samples from 358,292 patients, 412,905-1,278,987 samples per analyte). We demonstrate visualization of hematology test results using percentile charts and z-scores (www.pedref.org/hematology) and assess the potential of percentiles and z-scores to support diagnosis of different hematological diseases. Results We created percentile charts for hemoglobin, hematocrit, red cell indices, red cell count, red cell distribution width, white cell count and platelet count in girls and boys from birth to 18 years of age. Comparison of pediatricians evaluating complex clinical scenarios using percentile charts versus conventional/tabular representations shows that percentile charts can enhance physician assessment in selected example cases. Age-specific percentiles and z-scores, compared with absolute test results, improve the identification of children with blood count abnormalities and the discrimination between different hematological diseases. Conclusions The provided reference intervals enable precise assessment of pediatric hematology test results. Representation of test results using percentiles and z-scores facilitates their interpretation and demonstrates the potential of digital approaches to improve clinical decision-making.

E-Selectin Inhibition: A New Way to Treat Proximal Deep Venous Thrombosis

There is a close inter-relationship between thrombosis and inflammation. In previous studies, we have shown the importance of P-selectin in thrombogenesis and thrombus resolution in many preclinical animal models. The role of E-selectin has been explored in rodent models and in a small pilot study of clinical calf vein deep venous thrombosis. The purpose of this study was to determine the role of E-selectin in thrombosis in a primate model of proximal iliac vein thrombosis, a model close to the human condition. Iliac vein thrombosis was induced with a well-characterized primate model. Through a transplant incision, the hypogastric vein and iliac vein branches were ligated. Thrombus was induced by balloon occlusion of the proximal and distal iliac vein for 6 hours. The balloons were then deflated, and the primates recovered. Starting on postocclusion day 2, animals were treated with the E-selectin inhibitor GMI-1271, 25 mg/kg subcutaneously once daily (n = 4). Nontreated control (CTR) animals received no treatment (n = 5). All animals were evaluated by magnetic resonance venography (MRV), hematology (complete blood count), coagulation tests (bleeding time, partial thromboplastin time, activated partial thromboplastin time, fibrinogen, and thromboelastography) at baseline, day 2, day 7, day14, and day 21 with euthanasia. In addition, platelet function and CD44 expression on leukocytes were determined. E-selectin inhibition by GMI-1271 significantly increased vein recanalization by MRV vs CTR animals on day 14 (P < .05) and day 21 (P < .0001; Fig, A). GMI-1271 significantly decreased vein wall inflammation by MRV with gadolinium vein wall enhancement vs CTR also on day 14 (P < .0001) and day 21 (P < .0001; Fig, B). The thromboelastographic measure of clot strength showed significant decreases in animals treated with GMI-1271 vs CTRs at day 2 (P < .05) and day 7 (P < .05). Importantly, no significant differences in hematology or coagulation test results were noted between all groups, suggesting that E-selectin inhibition carries no bleeding potential. GMI-1271 did not affect platelet function or aggregation or CD44 expression on leukocytes. In addition, no episodes of bleeding were noted in either group. The study suggests that E-selectin modulates venous thrombus progression and that its inhibition will increase thrombus recanalization and decrease vein wall inflammation, without affecting coagulation. The use of an E-selectin inhibitor such as GMI-1271 could potentially change how we treat deep venous thrombosis.

Elevated blood basophil count may has a role in etiopathogenesis of isolated coronary artery ectasia

The pathophysiology of isolated coronary artery ectasia (CAE) takes in inflammation and atherosclerosis. It is clear that basophils have a critical role in endothelial dysfunction, atherosclerosis and inflammation. In this study, it was aimed to examine the association between isolated CAE and basophilia. All cases who underwent coronary angiography between January 2013 and April 2018 evaluated retrospectively. Of 10985 cases, 173 (107 males) with isolated CAE and 220 with normal coronary angiography (NCA) that age and gender matched subjects (119 males) were recorded. Hospital’s database was used to derive the biochemical and hematological test results, and baseline characteristics. White blood cell (WBC) count and basophil count were significantly elevated for the cases that have angiographic isolated CAE when compared to the subjects with NCA [ 7.87 (6.83-9.42)109/ L vs 7.48 (6.27-8.67) 109/ L, p=0.01; 0.04 (0.03-0.05) 109/ L vs 0.03 (0.02-0.05) 109/ L, p=0.03, respectively]. According to receiver operating characteristics curve analyses (ROC); the specificity of a basophil value > 0.037 109/ L (measured prior to coronary angiography) in predicting isolated CAE was 57,3% and the sensitivity was 57.2% (area under the curve [AUC] 0.562, 95% CI 0.505, 0.618; p=0.03). Patients with isolated CAE have higher blood basophil count. Elevated blood basophil count may have a substantial mission in the pathogenesis of isolated CAE.

Correlation between the values of circulating blood elements with the size of spleen in the presence of schistosomal splenomegaly.

To evaluate a possible relationship between the size of the spleen and values of circulating blood elements in patients with schistosomatic splenomegaly. ixty one patients with hepatosplenic schistosomiasis mansoni underwent a clinical exam and peripheral venous blood was collected for a hemogram. The erythrocyte, hemoglobin, hematocrit, leukocyte, and platelet values were determined. All patients underwent abdominal ultrasound to measure the spleen. The hematological test results were compared to the size of the spleen. The size of the spleen varied from 14.0 to 28.4 (19.9 ± 3.7) cm according to the ultrasound image. Thrombocytopenia was observed 58 (95%) patients, leukopenia in 55 (90%) patients, and anemia in 32 (52.4%) patients. Leukopenia was proportional to splenomegaly. Schistosomal splenomegaly leads to leukopenia in direct proportion to the size of the spleen.

Red blood cell distribution width is a independent prognostic indicator for mortality in patients with HBV related acute-on-chronic liver failure

To establish a model for predicting the short-term prognosis of patients with HBV-related acute-onchronic liver failure (HBV-ACLF) based on red blood cell distribution width (RDW) and the model for end-stage liver disease (MELD) scores. A total of 245 patients with HBV-ACLF were retrospectively analyzed for their clinical data and results of routine hematological tests, liver function, renal function, coagulation test, HBV-DNA, and other indicators at admission. Univariate analysis and binary logistic regression analysis were used to test the short-term risk factors for death of the patients, and the MELD-RDW model was established. The accuracy of each index and the established model was verified using the ROC curve. The surviving patients with HBV-ACLF had significantly decreased RDW (14.97 ± 1.38) and MELD score (23.54±4.35) compared with those in the patients dead within 90 days (17.05±2.92 and 28.95±5.99, respectively). Multivariate analysis indicated that RDW was a significant independent prognostic factor for mortality in patients with HBVACLF (OR=1.840, 95%CI: 1.47902.289, P &lt; 0.005). The risk assessment model was [logisticMELD-RDW]=-9.375+0.582×RDW- 0.091×ALB-0.05×PTA+0.186×MELD. The area under the ROC curve of MELD score combined with RDW was 0.878, which was higher than RDW (0.724) and MELD score (0.780) alone. RDW is an independent prognostic indicator for mortality in patients with HBV-ACLF. Compared with MELD score, the risk assessment model based on MELD and RDW has a greater value in predicting the short-term prognosis of patients with HBV-ACLF.

Bilateral Malignant Seminoma With Ventricular Metastasis in a Bald Eagle (Haliaeetus leucocephalus)

A 30-year-old bald eagle ( Haliaeetus leucocephalus) was presented with a history of hyporexia and lethargy. Results of initial hematologic testing, biochemical analysis, and fecal examination were unremarkable, and clinical signs did not resolve with supportive care and management changes. Results of echocardiography, based on auscultation of a murmur, and coelomic endoscopy, based on the presence of a soft tissue opacity on radiographs, as well as an aspergillosis panel were largely unsuccessful in determining a definitive diagnosis. Euthanasia was performed after the eagle did not recover from anesthesia after endoscopy. Necropsy results demonstrated bilateral testicular seminomas with metastases to the ventriculus. This case demonstrates an abnormal metastasis of a common reproductive tumor in an avian species.

Pediatric Crohn's Disease in Bahrain.

Our study aimed to report the epidemiology, clinical presentations, diagnostic and therapeutic approaches, and outcomes of Crohn's disease (CD) in pediatric patients in Bahrain. We conducted a retrospective review of the medical records of patients with CD diagnosed in the pediatric department, Salmaniya Medical Complex, Bahrain, between 1984 and 2017. We used the data to calculate the annual incidence and cumulative prevalence. Data about gender, nationality, clinical presentation, age at presentation and diagnosis, duration of illness, consanguinity, family history, contact with smokers, and comorbidities were gathered. Results of hematological, biochemical, and serological tests were also collected. All radiological, endoscopic, and histopathological findings were reviewed. Data about medical therapy, relapse episodes, hospital admissions, complications, and outcomes were collected. Of 108 pediatric patients diagnosed with inflammatory bowel disease (IBD), 51 (47.2%) patients had CD. The annual incidence was 1 in 100 000 per year (range = 0-5 patients/year) with significant rise on comparing the three decades (p = 0.0001). Prevalence was 9.32 patients per 100 000 pediatric populations. Thirty-four patients (66.7%) were males, and the median age was 18.5 years (range = 6.4-35.0). Common clinical presentations were recurrent abdominal pain and weight loss. Family history of IBD was found in 10 patients. One patient had positive antineutrophil cytoplasmic antibody. The terminal ileum was involved in 68.1%, colon in 63.8%, and perianal area in 17.0% patients. Biological therapy was used in five patients. Surgical intervention was required in six patients. The mean follow-up period was 9.2±5.6 years. The clinical characteristics of our population are comparable to that reported in neighboring countries and worldwide.

Risk factors in central retinal vein occlusion an activated protein C resistance.

Central retinal vein occlusion (CRVO) tends to be a disease of older individuals, with some known major risk factors, and activated protein C resistance seems to be one of the causes in younger patients. In this study, we reviewed risk factors including activated protein C resistance in a series of patients with CRVO. Twenty-four patients with a diagnosis of CRVO presenting either acutely or for a follow-up visit during the study period, were enrolled. Ages ranged between 31 and 83 years (mean 59.7). The risk factors, presence of ischemia, the results of biochemical serological and hematological tests, especially activated protein C resistance (APC-R), were analysed. RESULTS in 17 patients (71%) one or more of the following risk factors existed: hypertension, diabetes, oral contraceptive usage, family history of thrombosis, and previous operation. In 40% of the eyes, there were ischemic changes. Serum triglycerides were high in 4 of 21 patients (19%) and cholesterol and urea were high in 10 of 21 patients (19%). APC-R was found in 6 out of 24 patients (25%). Besides known predisposing factors like hypertension, diabetes, glaucoma and hyperlipidemia, APC-R seems to be a risk factor for CRVO at all ages. (Eur J Ophthalmol 1999; 9: 43-9).

Skrining za hepatitis B i C seroprevalencu i prevalenca HIV infekcije među avganistanskim izbeglicama koje su 2018. godine stigle u obalsko područje Turske - sistematska analiza

Introduction: Previous studies showed that refugee status have been associated with various deteriorated effects on human health including higher prevalence of hepatitis B, C and HIV infections. In this study we aim to bridge the gap between Afghan immigrants and naive Turkish population by identifying HBV, HCV and HIV profiles. In addition, a large number of laboratory parameters was collected for all participants, including hematologic and biochemical test results. Materials and Methods: We performed a retrospective review of laboratory records at a tertiary center in Northern Turkey from January 1, 2018, to April 15, 2018. Our population based study comprising hospital data of 403 Afghan refugees and 400 naive Turkish citizens. Results: Afghan refugees had higher anti-HIV seropositivity than Turkish citizens (p &lt; 0.05). There were no difference between the two groups according to HbsAg and anti-HCV seropositivity. Also Afghan refugees had statistically lower ALT levels, higher hemoglobin levels and higher mean TSH level (p &lt; 0.05). Mean T4 level did not show significant difference between the two groups. Conclusion: We need further investigations to find out the risk of infections that originated from immigration.

Anemia in Hospitalized Patients: A Cross-Sectional Study on Different Erythrocyte Indices and their Relationships

Background: The prevalence of anemia varies according to age, gender and ethnicity. Moreover, its occurrence in the significant proportions of hospitalized patients is a matter of concern for the healthcare practitioners. Objective: The objective of the study was to determine the prevalence of anemia in hospitalized patients in relation to age, gender, and ethnicity and to assess the relationships of different erythrocyte indices with hemoglobin. Materials and Methods: In a hospital-based, cross-sectional study, the hematological test results of 485 patients were analyzed. Participants were categorized according to gender, age and ethnicities and diagnosed as anemic based on hemoglobin levels <12.0 g/dL in females and <13.0 g/dL in males. Erythrocyte indices like hemoglobin, erythrocyte count, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration were compared between the anemic and normal participants apart from different subgroups. Results: The prevalence of anemia in the hospitalized patients was 65.8%. It was greater in females as compared to males. Likewise, it was the highest in the highest quartile of age and Indo-Aryan ethnic group. Hemoglobin concentration was significantly lower in the female participants than in the males (p<0.001); significantly different across different age groups (quartile of age) (p<0.001). Hemoglobin was found to be significantly and positively correlated with erythrocyte count, hematocrit, mean corpuscular volume and mean corpuscular hemoglobin (p<0.001). Hematocrit followed by erythrocyte count were the most efficient predictors of the diagnosis of anemia. Moreover, RBC count/HCT with MCV and MCH together could significantly explain the variance in hemoglobin levels, after controlling for age and gender (p<0.001). Conclusion: Anemia was found to be significantly prevalent in hospitalized patients. Moreover, the erythrocyte indices like erythrocyte count, hematocrit and hemoglobin concentration were effective in characterizing anemia.

Clinical, laboratory, and hemostatic findings in cats with naturally occurring sepsis.

OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables for associations with patient outcomes. DESIGN Prospective, observational, clinical study. ANIMALS 31 cats with sepsis and 33 healthy control cats. PROCEDURES Data collected included history; clinical signs; results of hematologic, serum biochemical, and hemostatic tests; diagnosis; and outcome (survival vs death during hospitalization or ≤ 30 days after hospital discharge). Differences between cats with and without sepsis and associations between variables of interest and death were analyzed statistically. RESULTS The sepsis group included cats with pyothorax (n = 10), septic peritonitis (7), panleukopenia virus infection (5), bite wounds (5), abscesses and diffuse cellulitis (3), and pyometra (1). Common clinical abnormalities included dehydration (21 cats), lethargy (21), anorexia (18), pale mucous membranes (15), and dullness (15). Numerous clinicopathologic abnormalities were identified in cats with sepsis; novel findings included metarubricytosis, hypertriglyceridemia, and high circulating muscle enzyme activities. Median activated partial thromboplastin time and plasma D-dimer concentrations were significantly higher, and total protein C and antithrombin activities were significantly lower, in the sepsis group than in healthy control cats. Disseminated intravascular coagulopathy was uncommon (4/22 [18%] cats with sepsis). None of the clinicopathologic abnormalities were significantly associated with death on multivariate analysis. CONCLUSIONS AND CLINICAL RELEVANCE Cats with sepsis had multiple hematologic, biochemical, and hemostatic abnormalities on hospital admission, including several findings suggestive of hemostatic derangement. Additional research including larger numbers of cats is needed to further investigate these findings and explore associations with outcome.

The pharmacokinetics, safety, and tolerability of single, high-strength doses of fluticasone propionate and fluticasone propionate/salmeterol delivered via a novel multidose dry powder inhaler in adolescents and adults with persistent asthma

ABSTRACTObjective: Characterize fluticasone propionate (Fp) and combination fluticasone propionate and salmeterol (FS) pharmacokinetic and safety profiles, delivered via a novel, inhalation-driven, multidose dry powder inhaler (MDPI). Methods: This multicenter, open-label, four-period crossover, single-dose study randomized patients aged ≥12 years with persistent asthma to Fp MDPI 200 mcg, FS MDPI 200/12.5 mcg, Fp dry powder inhaler (DPI) 500 mcg (250 mcg × 2 inhalations), or FS DPI 500/50 mcg. Blood samples for determination of Fp and salmeterol pharmacokinetic parameters including Cmax, AUC0–t, AUC0–inf, tmax, and t½ were collected predose through 36 h postdose (14 time points). Safety assessments comprised adverse events, vital signs, and physical examinations. The institutional review board approved the study protocol. Results: The pharmacokinetic analysis set and safety population each included 40 patients. Fp systemic exposure (Cmax, AUC0–t, and AUC0–inf) was highest for Fp DPI 500 mcg and similar for Fp MDPI 200 mcg, FS MDPI 200/12.5 mcg, and FS DPI 500/50 mcg. Fp geometric mean t½ values were similar across treatments. Salmeterol Cmax was 20% lower and AUC0–t and AUC0–inf were approximately 50% lower with FS MDPI versus FS DPI. Median tmax and geometric mean t½ were similar between FS MDPI and FS DPI. Adverse events were similar across treatments with no relevant changes in vital signs, physical examinations, or hematology test results. Conclusions: Fp MDPI and FS MDPI produced similar or lower systemic exposure to Fp and salmeterol, despite lower doses, versus conventional DPI devices, suggesting improved efficiency due to formulation and device differences.

Incidence of blood transfusion requirement and factors associated with transfusion following liver lobectomy in dogs and cats: 72 cases (2007-2015).

OBJECTIVE To determine the incidence of blood transfusion, mortality rate, and factors associated with transfusion in dogs and cats undergoing liver lobectomy. DESIGN Retrospective case series. ANIMALS 63 client-owned dogs and 9-client owned cats that underwent liver lobectomy at a specialty veterinary practice from August 2007 through June 2015. PROCEDURES Medical records were reviewed and data extracted regarding dog and cat signalment, hematologic test results before and after surgery, surgical method, number and identity of lobes removed, concurrent surgical procedures, hemoabdomen detected during surgery, incidence of blood transfusion, and survival to hospital discharge (for calculation of mortality rate). Variables were compared between patients that did and did not require transfusion. RESULTS 11 of 63 (17%) dogs and 4 of 9 cats required a blood transfusion. Mortality rate was 8% for dogs and 22% for cats. Pre- and postoperative PCV and plasma total solids concentration were significantly lower and mortality rate significantly higher in dogs requiring transfusion than in dogs not requiring transfusion. Postoperative PCV was significantly lower in cats requiring transfusion than in cats not requiring transfusion. No significant differences in any other variable were identified between dogs and cats requiring versus not requiring transfusion. CONCLUSIONS AND CLINICAL RELEVANCE Dogs and cats undergoing liver lobectomy had a high requirement for blood transfusion, and a higher requirement for transfusion should be anticipated in dogs with perioperative anemia and cats with postoperative anemia. Veterinarians performing liver lobectomies in dogs and cats should have blood products readily available.