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International Journal of Laboratory... Apr 2021In December 2019, a new type of coronavirus was detected for the first time in Wuhan, Hubei Province, China. According to the reported data, the emerging coronavirus has... (Review)
Review
In December 2019, a new type of coronavirus was detected for the first time in Wuhan, Hubei Province, China. According to the reported data, the emerging coronavirus has spread worldwide, infecting more than fifty-seven million individuals, leading to more than one million deaths. The current study aimed to review and discuss the hematological findings of COVID-19. Laboratory changes and hematologic abnormalities have been reported repeatedly in COVID-19 patients. WBC count and peripheral blood lymphocytes are normal or slightly reduced while these indicators may change with the progression of the disease. In addition, several studies demonstrated that decreased hemoglobin levels in COVID-19 patients were associated with the severity of the disease. Moreover, thrombocytopenia, which is reported in 5%-40% of patients, is known to be associated with poor prognosis of the disease. COVID-19 can present with various hematologic manifestations. In this regard, accurate evaluation of laboratory indicators at the beginning and during COVID-19 can help physicians to adjust appropriate treatment and provide special and prompt care for those in need.
Topics: Angiotensin-Converting Enzyme 2; Biomarkers; Blood Platelets; COVID-19; China; Erythrocytes; Hematology; Humans; Laboratories; Leukocytes; Pandemics; Receptors, Virus; SARS-CoV-2; Serine Endopeptidases; Severity of Illness Index; Spike Glycoprotein, Coronavirus; Virus Internalization
PubMed: 33264492
DOI: 10.1111/ijlh.13412 -
Stroke Jun 2018Rho-kinase, an effector of RhoA, is associated with various cardiovascular diseases in circulating blood cells. However, the role of RhoA/Rho-kinase in peripheral blood...
BACKGROUND AND PURPOSE
Rho-kinase, an effector of RhoA, is associated with various cardiovascular diseases in circulating blood cells. However, the role of RhoA/Rho-kinase in peripheral blood mononuclear cells from patients with spontaneous aneurysmal subarachnoid hemorrhage (aSAH) has not yet been studied in relation to the severity of this disease. Therefore, we analyzed the expression and activity of RhoA as a possible biomarker in aSAH.
METHODS
Twenty-four patients with aSAH and 15 healthy subjects were examined. Peripheral blood mononuclear cells were collected, and RhoA activity and expression were determined by RhoA activation assay kit (G-LISA) and enzyme-linked immunosorbent assay tests, respectively. The severity of aSAH was determined from the World Federation of Neurological Surgeon scale, and vasospasm was evaluated using clinical symptoms, arteriography, and sonography.
RESULTS
RhoA expression was significantly increased in peripheral blood mononuclear cells from patients on days 0, 2, and 4 after aSAH versus healthy subjects (=0.036, 0.010, and 0.018, respectively, by Mann-Whitney analysis). There was a significant correlation between RhoA expression and injury severity on days 2 and 4 (Spearman test, day 2: =0.682, n=14, =0.007; day 4: =0.721, n=14, =0.004). No significant correlation was observed on day 0 (day 0: =0.131, n=6, =0.805). Active RhoA was not significantly different in patients and healthy subjects on days 0, 2, and 4 (=0.243, 0.222, and 0.600, respectively) nor did it increase significantly on days 0 and 2 in patients with vasospasm versus patients without vasospasm (=0.064 and 0.519, respectively). In contrast, active RhoA was significantly higher on day 4 in patients who developed vasospasm versus patients without vasospasm (=0.028).
CONCLUSIONS
Our preliminary results indicate that RhoA expression and activity in peripheral blood mononuclear cells might be related with aSAH severity and cerebral vasospasm. RhoA is a potential biomarker of the risks associated with aSAH.
Topics: Biomarkers; Cerebral Angiography; Female; Humans; Leukocytes, Mononuclear; Male; Middle Aged; Risk Factors; Subarachnoid Hemorrhage; Vasospasm, Intracranial; rhoA GTP-Binding Protein
PubMed: 29735721
DOI: 10.1161/STROKEAHA.117.020311 -
American Family Physician Feb 2016Bleeding and bruising are common symptoms in the primary care setting. The patient history can help determine whether the bruising or bleeding is abnormal. The... (Review)
Review
Bleeding and bruising are common symptoms in the primary care setting. The patient history can help determine whether the bruising or bleeding is abnormal. The International Society on Thrombosis and Hemostasis has developed a bleeding assessment tool that can be used to indicate possible pathology. A family history of bleeding problems may suggest a hereditary coagulation defect. Such a history is especially important in children who may not have experienced a major bleeding episode. Medication review can identify pharmacologic causes of the bleeding or bruising. Physical examination findings such as mucocutaneous bleeding suggest that the underlying condition is caused by platelet dysfunction, whereas hemarthroses or hematomas are more common in coagulopathy. If the history and physical examination findings suggest a bleeding diathesis, initial laboratory testing includes a complete blood count, peripheral blood smear, prothrombin time (PT), and partial thromboplastin time (PTT). A normal PT and PTT indicate a platelet disorder, the most common of which is von Willebrand disease. A normal PT and prolonged PTT signal a deficit in the intrinsic pathway, and a mixing study should be performed. A vitamin K challenge is indicated in patients with an abnormal PT and normal PTT. A workup for liver failure is warranted in patients with prolonged PT and PTT. If initial testing does not reveal an etiology in a patient with a high suspicion for a bleeding disorder, the patient should be referred to a hematologist for additional evaluation.
Topics: Blood Coagulation Disorders; Blood Coagulation Tests; Child; Hemorrhage; Humans; Primary Health Care
PubMed: 26926815
DOI: No ID Found -
Acta Clinica Croatica Sep 2022Bleeding complications after peripheral nerve blocks (PNBs) in patients treated with an antiplatelet agent and/or an anticoagulant drug are rare, with estimated... (Review)
Review
Bleeding complications after peripheral nerve blocks (PNBs) in patients treated with an antiplatelet agent and/or an anticoagulant drug are rare, with estimated incidence of 0.67% (0.51-0.83%). However, they can result in significant patient morbidity and may require follow-up investigations and interventions. The evidence for bleeding risks and complications after PNB is very low or nonexistent, therefore, recommendations and guidelines are based on retrospective analyses, case reports, expert opinions and expert panel consensus. In the manuscript, an expert panel consensus on classification of PNBs according to the potential risk of serious bleeding complications is presented. The risks of bleeding depend on the location (vicinity of the vessels and critical structures at risk from the mass effect of a hematoma), block depth (which influences needle visibility), associated comorbidities and anticoagulation status, body habitus, site compressibility, whether the bleeding or hematoma are easy or not to assess and how easy or not an intervention may be applied to prevent or treat bleeding. Also, technical factors are considered: type and size of the used needle, technical difficulties, multiple attempts, needle passes and bloody tap, use of catheters and type of nerve location technique (USG versus techniques) and operator experience. In all patients on antithrombotic drugs, benefits vs. risks should be weighted. A bleeding risk should be minimized with the optimization of patient's coagulation: appropriate antithrombotic drug timing before PNB, dose of antithrombotic drug, indication for the drug and risk factors that may influence drug pharmacokinetics (bodyweight, age, renal and hepatic function). Superficial PNBs may be performed in the presence of antithrombotic drug. For deep PNBs, a recommendations for neuraxial procedures should be considered.
Topics: Humans; Fibrinolytic Agents; Retrospective Studies; Anesthesia, Conduction; Anticoagulants; Hematoma; Hemorrhage; Peripheral Nerves
PubMed: 36824631
DOI: 10.20471/acc.2022.61.s2.08 -
Clinical and Translational Medicine Sep 2023Peripheral immune cells play important roles in the maintenance of systemic and microenvironmental hemostasis. Measurements of circulating blood cells by single-cell RNA...
Peripheral immune cells play important roles in the maintenance of systemic and microenvironmental hemostasis. Measurements of circulating blood cells by single-cell RNA sequencing (scRNA-seq) were proposed as one of the routine measures in clinical biochemistry of hematology. Out of translational challenges, defining precise identities of cell subsets and states is more difficult, due to the complexity of immune cell development, location, regulation, function, and metabolism. It is also a challenge to precisely interpret clinical significance and impact of each cell identity marker gene panel (ciMGPs). ciMGPs have potential to advance the understanding of systemic responses of the disease, identify disease-specific biomarkers, and to define cell heterogeneity. Recently, a large number of peripheral cell subsets and expending/activating states have been identified and validated for use in the fast developments in clinical single cell biomedicine. Defining specificity, measurability, and repeatability of cell subsets/states is important for translation of peripheral scRNA-seq in clinical hematology and biochemistry. The development of standard operating procedure and performance of clinical trials in large populations at various ages, diseases, and therapies will promote the clinical translation of ciMGPs to measures. Thus, defining cell subset/state identities will provide the multi-dimensional and comprehensive readouts of systemic immune cells, the precision monitoring of immune dynamics, and deeper-understanding of the disease and response to therapy.
Topics: Cell Differentiation; Clinical Relevance; Hematology
PubMed: 37700496
DOI: 10.1002/ctm2.1401 -
Ginekologia Polska 2021Comparison of changes in peripheral blood venous morphology and the frequency of select complications in patients who underwent umbilical cord blood collection during...
Collection of umbilical cord blood and the risk of complications in postpartum women after natural labour in the context of the possibility of umbilical cord stem cells usage in clinical practice.
OBJECTIVES
Comparison of changes in peripheral blood venous morphology and the frequency of select complications in patients who underwent umbilical cord blood collection during the third stage of labour by in the utero method compared to patients who did not undergo this procedure. Presentation of current therapeutic possibilities of cord blood stem cells.
MATERIAL AND METHODS
The study involved 248 patients who had a vaginal delivery and had umbilical cord blood taken by in utero method during the third stage of labour. The control group consisted of the first 400 patients who gave vaginal delivery starting in 2019. Each patient had a venous peripheral blood count taken before delivery and 18 hours after delivery. Changes in the results of laboratory tests and the occurrence of adverse outcomes, such as postpartum curettage, postpartum haemorrhage and manual removal of placenta, in the 3rd and 4th stage delivery periods, were analysed.
RESULTS
In the blood donor group there were significantly lower haemoglobin (11.32 g/L vs 11.61 g/L, p = 0.004) and haematocrit (32.83% vs 33.82% p = 0.001) concentrations after delivery. Umbilical cord donors had a greater difference in haemoglobin (postpartum minus prepartum) (-1.4 g/L vs -0.9 g/L, p = 000), and haematocrit (-4.05% vs -2.5% , p = 0.000). The study group had a higher percentage of patients with postpartum anaemia (haemoglobin concentration < 10 g/L) (15.9% vs 10.64%, p = 0.05), but the result were borderline significant. The groups did not differ in terms of the percentage of postpartum curettage, PPH, manual removal of placenta, percentage of severe anaemia (Hb < 7g/L) or transfusion requirement.
CONCLUSION
Collection of umbilical cord blood during the 3rd stage of labour using the in utero method is associated with a statistically significant increase of blood loss and a higher probability of postpartum anaemia. The observed changes are minor and may have little clinical significance in otherwise healthy patients.
Topics: Female; Fetal Blood; Humans; Labor Stage, Third; Postpartum Hemorrhage; Postpartum Period; Pregnancy; Stem Cells; Umbilical Cord
PubMed: 33576474
DOI: 10.5603/GP.a2020.0179 -
Turkish Journal of Haematology :... Nov 2020
Topics: COVID-19; Hematology; Humans; Pandemics; Patients; SARS-CoV-2
PubMed: 32586086
DOI: 10.4274/tjh.galenos.2020.2020.0262 -
Malaria Journal Sep 2022Simple and accurate diagnosis is a key component of malaria control programmes. Microscopy is the current gold standard, however it requires extensive training and the...
BACKGROUND
Simple and accurate diagnosis is a key component of malaria control programmes. Microscopy is the current gold standard, however it requires extensive training and the results largely rely on the skill of the microscopists. Malaria rapid diagnostic tests (RDT) can be performed with minimal training and offer timely diagnosis, but results are not quantitative. Moreover, some Plasmodium falciparum parasites have evolved and can no longer be detected by existing RDT. Developed by the Sysmex Corporation, the XN-31 prototype (XN-31p) is an automated haematology analyser capable of detecting Plasmodium-infected erythrocytes and providing species differentiation and stage specific parasite counts in venous blood samples without any preparation in approximately one minute. However, factors such as stable electricity supply in a temperature-controlled room, cost of the instrument and its initial set-up, and need for proprietary reagents limit the utility of the XN-31p across rural settings. To overcome some of these limitations, a hub and spoke diagnosis model was designed, in which peripheral health facilities were linked to a central hospital where detection of Plasmodium infections by the XN-31p would take place. To explore the feasibility of this concept, the applicability of capillary blood samples with the XN-31p was evaluated with respect to the effect of sample storage time and temperature on the stability of results.
METHODS
Paired capillary and venous blood samples were collected from 169 malaria-suspected outpatients in Homa Bay County Referral Hospital, Kenya. Malaria infections were diagnosed with the XN-31p, microscopy, RDT, and PCR. Capillary blood samples were remeasured on the XN-31p after 24 h of storage at either room (15-25 °C) or chilled temperatures (2-8 °C).
RESULTS
Identical results in malaria diagnosis were observed between venous and capillary blood samples processed immediately after collection with the XN-31p. Relative to PCR, the sensitivity and specificity of the XN-31p with capillary blood samples were 0.857 and 1.000, respectively. Short-term storage of capillary blood samples at chilled temperatures had no adverse impact on parasitaemia and complete blood counts (CBC) measured by the XN-31p.
CONCLUSION
These results demonstrate the potential of the XN-31p to improve routine malaria diagnosis across remote settings using a hub and spoke model.
Topics: Diagnostic Tests, Routine; Hematology; Humans; Kenya; Malaria; Malaria, Falciparum; Plasmodium falciparum; Sensitivity and Specificity
PubMed: 36050757
DOI: 10.1186/s12936-022-04259-7 -
Medicina (Kaunas, Lithuania) Aug 2023Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a peripheral retinal vascular abnormality that is likely underreported. We review the differential... (Review)
Review
Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a peripheral retinal vascular abnormality that is likely underreported. We review the differential diagnoses, etiology, and treatment options for PEHCR. We present a case of an asymptomatic 72-year-old female referred following left eye fundus photography finding of the peripheral lesion. Fundus photography demonstrated a large temporal pigment epithelial detachment (PED) with adjacent fibrovascular membrane. Optical coherence tomography (OCT) confirmed the PED with trace subretinal fluid. Fluorescein angiography (FA) demonstrated early and late hypofluorescence of the PED with late leakage of the adjacent temporal fibrovascular membrane. Observation was elected, visual acuity remained unaffected, and the PED spontaneously resolved. Due to the peripheral location, patients often present as asymptomatic; however, vision loss can occur due to vitreous hemorrhage or extension of subretinal fluid, hemorrhage, or exudate to the macula. Commonly, these lesions are referred with concern for choroidal melanoma due to their large, dark, elevated presentation in the peripheral retina. Multimodal testing using B-scan, FA, and OCT is important in establishing the proper diagnosis. PEHCR lesions can often be observed without treatment, though intravitreal injection of anti-VEGF is increasingly used to prevent secondary causes of vision loss.
Topics: Female; Humans; Aged; Hemorrhage; Retina; Diagnosis, Differential; Exudates and Transudates; Fluorescein Angiography
PubMed: 37763626
DOI: 10.3390/medicina59091507 -
Annals of Clinical and Translational... Jul 2023The aim of this study was to examine the predictive value of the multiplication of neutrophil and monocyte counts (MNM) in peripheral blood, and develop a new predictive...
OBJECTIVE
The aim of this study was to examine the predictive value of the multiplication of neutrophil and monocyte counts (MNM) in peripheral blood, and develop a new predictive model for the prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH).
METHODS
This is a retrospective analysis that included 2 separate cohorts of patients undergoing endovascular coiling for aSAH. The training cohort consisted of 687 patients in the First Affiliated Hospital of Shantou University Medical College; the validation cohort consisted of 299 patients from Sun Yat-sen University's Affiliated Jieyang People's Hospital. The training cohort was used to develop 2 models to predict unfavorable prognosis (modified Rankin scale of 3-6 at 3 months): one was based on traditional factors (e.g., age, modified Fisher grade, NIHSS score, and blood glucose), and another model that included traditional factors as well as MNM on admission.
RESULTS
In the training cohort, MNM upon admission was independently associated with unfavorable prognosis (odds ratio after adjustment, 1.06; 95% confidence interval [CI], 1.03-1.10). In the validation cohort, the basic model that included only traditional factors had 70.99% sensitivity, 84.36% specificity, and 0.859 (95% CI, 0.817-0.901) area under the receiver operating characteristic curve (AUC). Adding MNM increased model sensitivity (from 70.99% to 76.48%), specificity (from 84.36% to 88.63%), and overall performance (AUC 0.859 [95% CI, 0.817-0.901] to 0.879 [95% CI, 0.841-0.917]).
INTERPRETATION
MNM upon admission is associated with unfavorable prognosis in patients undergoing endovascular embolization for aSAH. The nomogram including MNM is a user-friendly tool to help clinicians quickly predict the outcome of patients with aSAH.
Topics: Humans; Nomograms; Subarachnoid Hemorrhage; Retrospective Studies; Prognosis; Neutrophils
PubMed: 37198730
DOI: 10.1002/acn3.51789