21 CFR 864.8165 - Calibrator for hemoglobin or hematocrit measurement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... hemoglobin or hematocrit measurement is a device that approximates whole blood, red blood cells, or a hemoglobin derivative and that is used to set instruments intended to measure hemoglobin, the hematocrit, or both. It is a material whose characteristics have been precisely and accurately determined. (b...

Histogram analysis for smartphone-based rapid hematocrit determination

PubMed Central

Jalal, Uddin M.; Kim, Sang C.; Shim, Joon S.

2017-01-01

A novel and rapid analysis technique using histogram has been proposed for the colorimetric quantification of blood hematocrits. A smartphone-based “Histogram” app for the detection of hematocrits has been developed integrating the smartphone embedded camera with a microfluidic chip via a custom-made optical platform. The developed histogram analysis shows its effectiveness in the automatic detection of sample channel including auto-calibration and can analyze the single-channel as well as multi-channel images. Furthermore, the analyzing method is advantageous to the quantification of blood-hematocrit both in the equal and varying optical conditions. The rapid determination of blood hematocrits carries enormous information regarding physiological disorders, and the use of such reproducible, cost-effective, and standard techniques may effectively help with the diagnosis and prevention of a number of human diseases. PMID:28717569

Increased hematocrit after applications of conducted energy weapons (including TASER(®) devices) to Sus scrofa.

PubMed

Jauchem, James R

2011-01-01

Conducted energy weapons (CEWs) are used by law enforcement personnel to incapacitate individuals quickly and effectively, without intending to cause lethality. CEWs have been deployed for relatively long or repeated exposures in some cases. In laboratory animal models, central venous hematocrit has increased significantly after CEW exposure. Even limited applications (e.g., three 5-sec applications) resulted in statistically significant increases in hematocrit. Preexposure hematocrit was significantly higher in nonsurvivors versus survivors after more extreme CEW applications. The purpose of this technical note is to address specific questions that may be generated when examining these results. Comparisons among results of CEW applications, other electrical muscle stimulation, and exercise/voluntary muscle contraction are included. The anesthetized swine appears to be an acceptable animal model for studying changes in hematocrit and associated red blood cell changes. Potential detrimental effects of increased hematocrit, and considerations during law enforcement use, are discussed. 2010 American Academy of Forensic Sciences. Published 2010. This article is a U.S. Government work and is in the public domain in the U.S.A.

Hematocrit is associated with carotid atherosclerosis in men but not in women.

PubMed

Irace, Concetta; Ciamei, Monica; Crivaro, Andrea; Fiaschi, Elio; Madia, Angela; Cortese, Claudio; Gnasso, Agostino

2003-06-01

It is known that blood and plasma viscosities are associated with clinical manifestations of atherosclerosis, though evidence is not conclusive particularly in women. To verify whether hematocrit and blood and plasma viscosities are independently associated with carotid atherosclerosis and whether their measurement can improve the definition of the global coronary heart disease (CHD) risk. Eight hundred and ninety-two participants in a cardiovascular disease prevention campaign were examined with regard to conventional CHD risk factors (age, blood pressure, lipids, glucose, body mass index, waist/hip ratio, cigarette smoking and diabetes), hematocrit and blood and plasma viscosities. According to the degree of carotid atherosclerosis, investigated by echo-Doppler, participants were divided in three groups: those without atherosclerosis, those with a low degree of atherosclerosis and those with a high degree of atherosclerosis. In men, age, blood pressure, intima-media thickness (IMT), hematocrit (47.4+/-3.7%, 47.8+/-3.7%, 48.4+/-3.7%, P<0.05) and blood viscosity (4.69+/-0.51 cP, 4.77+/-0.55 cP, 4.82+/-0.51 cP, P=0.05) increased with increasing degree of carotid atherosclerosis. In women, age, blood pressure, total cholesterol and low-density lipoprotein-cholesterol, IMT and plasma viscosity (1.42+/-0.12 cP, 1.44+/-0.11 cP, 1.46+/-0.13 cP, P<0.05) increased with increasing carotid score. Analysis of covariance (ANCOVA) showed that after adjusting for hematocrit, blood viscosity was no longer different in the three groups. In discriminant analysis, hematocrit, among the hemorheological variables investigated, was independently associated with carotid score in men (F=3.66, P<0.05). Neither hematocrit nor blood and plasma viscosities were significantly associated with carotid score in women. These findings suggest that in men, both hematocrit and blood viscosity are related to carotid atherosclerosis but hematocrit would appear to have an independent effect over and above that mediated by viscosity.

Plasma Skimming in a Spiral Groove Bearing of a Centrifugal Blood Pump.

PubMed

Murashige, Tomotaka; Sakota, Daisuke; Kosaka, Ryo; Nishida, Masahiro; Kawaguchi, Yasuo; Yamane, Takashi; Maruyama, Osamu

2016-09-01

Plasma skimming is a phenomenon in which discharge hematocrit is lower than feed hematocrit in microvessels. Plasma skimming has been investigated at a bearing gap in a spiral groove bearing (SGB), as this has the potential to prevent hemolysis in the SGB of a blood pump. However, it is not clear whether plasma skimming occurs in a blood pump with the SGB, because the hematocrit has not been obtained. The purpose of this study is to verify plasma skimming in an SGB of a centrifugal blood pump by developing a hematocrit measurement method in an SGB. Erythrocyte observation using a high-speed microscope and a bearing gap measurement using a laser confocal displacement meter was performed five times. In these tests, bovine blood as a working fluid was diluted with autologous plasma to adjust the hematocrit to 1.0%. A resistor was adjusted to achieve a pressure head of 100 mm Hg and a flow rate of 5.0 L/min at a rotational speed of 2800 rpm. Hematocrit on the ridge region in the SGB was measured using an image analysis based on motion image of erythrocytes, mean corpuscular volume, the measured bearing gap, and a cross-sectional area of erythrocyte. Mean hematocrit on the ridge region in the SGB was linearly reduced from 0.97 to 0.07% with the decreasing mean bearing gap from 38 to 21 μm when the rotational speed was changed from 2250 to 3000 rpm. A maximum plasma skimming efficiency of 93% was obtained with a gap of 21 μm. In conclusion, we succeeded in measuring the hematocrit on the ridge region in the SGB of the blood pump. Hematocrit decreased on the ridge region in the SGB and plasma skimming occurred with a bearing gap of less than 30 μm in the hydrodynamically levitated centrifugal blood pump. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Hematocrit and plasma osmolality values of young-of-year shortnose sturgeon following acute exposures to combinations of salinity and temperature

USGS Publications Warehouse

Ziegeweid, J.R.; Black, M.C.

2010-01-01

Little is known about the physiological capabilities of young-of-year (YOY) shortnose sturgeon. In this study, plasma osmolality and hematocrit values were measured for YOY shortnose sturgeon following 48-h exposures to 12 different combinations of salinity and temperature. Hematocrit levels varied significantly with temperature and age, and plasma osmolalities varied significantly with salinity and age. Plasma osmolality and hematocrit values were similar to previously published values for other sturgeons of similar age and size in similar treatment conditions. ?? 2010 Springer Science+Business Media B.V.

Randomized trial of hematocrit 25% versus 35% during hypothermic cardiopulmonary bypass in infant heart surgery.

PubMed

Newburger, Jane W; Jonas, Richard A; Soul, Janet; Kussman, Barry D; Bellinger, David C; Laussen, Peter C; Robertson, Richard; Mayer, John E; del Nido, Pedro J; Bacha, Emile A; Forbess, Joseph M; Pigula, Frank; Roth, Stephen J; Visconti, Karen J; du Plessis, Adre J; Farrell, David M; McGrath, Ellen; Rappaport, Leonard A; Wypij, David

2008-02-01

We previously reported that postoperative hemodynamics and developmental outcomes were better among infants randomized to a higher hematocrit value during hypothermic cardiopulmonary bypass. However, worse outcomes were concentrated in patients with hematocrit values of 20% or below, and the benefits of hematocrit values higher than 25% were uncertain. We compared perioperative hemodynamics and, at 1 year, developmental outcome and brain magnetic resonance imaging in a single-center, randomized trial of hemodilution to a hematocrit value of 25% versus 35% during hypothermic radiopulmonary bypass for reparative heart surgery in infants undergoing 2-ventricle repairs without aortic arch obstruction. Among 124 subjects, 56 were assigned to the lower-hematocrit strategy (24.8% +/- 3.1%, mean +/- SD) and 68 to the higher-hematocrit strategy (32.6% +/- 3.5%). Infants randomized to the 25% strategy, compared with the 35% strategy, had a more positive intraoperative fluid balance (P = .007) and lower regional cerebral oxygen saturation at 10 minutes after cooling (P = .04) and onset of low flow (P = .03). Infants with dextro-transposition of the great arteries in the 25% group had significantly longer hospital stay. Other postoperative outcomes, blood product usage, and adverse events were similar in the treatment groups. At age 1 year (n = 106), the treatment groups had similar scores on the Psychomotor and Mental Development Indexes of the Bayley Scales; both groups scored significantly worse than population norms. Hemodilution to hematocrit levels of 35% compared with those of 25% had no major benefits or risks overall among infants undergoing 2-ventricle repair. Developmental outcomes at age 1 year in both randomized groups were below those in the normative population.

The relative influence of hematocrit and red blood cell velocity on oxygen transport from capillaries to tissue.

PubMed

Lücker, Adrien; Secomb, Timothy W; Weber, Bruno; Jenny, Patrick

2017-04-01

Oxygen transport to parenchymal cells occurs mainly at the microvascular level and depends on convective RBC flux, which is proportional in an individual capillary to the product of capillary hematocrit and RBC velocity. This study investigates the relative influence of these two factors on tissue PO 2 . A simple analytical model is used to quantify the respective influences of hematocrit, RBC velocity, and RBC flow on tissue oxygenation around capillaries. Predicted tissue PO 2 levels are compared with a detailed computational model. Hematocrit is shown to have a larger influence on tissue PO 2 than RBC velocity. The effect of RBC velocity increases with distance from the arterioles. Good agreement between analytical and numerical results is obtained, and the discrepancies are explained. Significant dependence of MTCs on RBC velocity at low hematocrit is demonstrated. For a given RBC flux in a capillary, the PO 2 in the surrounding tissue increases with increasing hematocrit, as a consequence of decreasing IVR to diffusive oxygen transport from RBCs to tissue. These results contribute to understanding the effects of blood flow changes on oxygen transport, such as those that occur in functional hyperemia in the brain. © 2016 John Wiley & Sons Ltd.

Longitudinal changes in hematocrit in hypertensive chronic kidney disease: results from the African-American Study of Kidney Disease and Hypertension (AASK)

PubMed Central

Chen, Teresa K.; Estrella, Michelle M.; Astor, Brad C.; Greene, Tom; Wang, Xuelei; Grams, Morgan E.; Appel, Lawrence J.

2015-01-01

Background Anemia is common in chronic kidney disease (CKD) and associated with poor outcomes. In cross-sectional studies, lower estimated glomerular filtration rate (eGFR) has been associated with increased risk for anemia. The aim of this study was to determine how hematocrit changes as eGFR declines and what factors impact this longitudinal association. Methods We followed 1094 African-Americans with hypertensive nephropathy who participated in the African-American Study of Kidney Disease and Hypertension. Mixed effects models were used to determine longitudinal change in hematocrit as a function of eGFR. Interaction terms were used to assess for differential effects of age, gender, baseline eGFR, baseline proteinuria, malnutrition and inflammation on eGFR-associated declines in hematocrit. In sensitivity analyses, models were run using iGFR (by renal clearance of I125 iothalamate) in place of eGFR. Results At baseline, mean hematocrit was 39% and 441 (40%) individuals had anemia. The longitudinal relationship between eGFR and hematocrit differed by baseline eGFR and was steeper when baseline eGFR was <45 mL/min/1.73 m2. For example, the absolute decline in hematocrit per 10 mL/min/1.73 m2 decline in longitudinal eGFR was −3.7, −1.3 and −0.5% for baseline eGFR values of 20, 40 and 60 mL/min/1.73 m2, respectively (P < 0.001 comparing the longitudinal association between baseline eGFR = 40 or 60 versus baseline eGFR = 20 mL/min/1.73 m2). Similarly, male sex, younger age (<65 years) and higher baseline proteinuria (protein-to-creatinine ratio >0.22) were associated with greater hematocrit declines per unit decrease in longitudinal eGFR compared with female sex, older age and low baseline proteinuria, respectively (P-interaction <0.05 for each comparison). The longitudinal eGFR–hematocrit association did not differ by body mass index, serum albumin or C-reactive protein. Conclusions Men, younger individuals and those with low baseline eGFR (<45 mL/min/1.73 m2) or baseline proteinuria are particularly at risk for eGFR-related declines in hematocrit. PMID:25817226

Effects of varying hematocrit on intestinal oxygen uptake in neonatal lambs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holzman, I.R.; Tabata, B.; Edelstone, D.I.

1985-04-01

The authors chronically catheterized 15 newborn lambs (9.5 +/- 2.8 days) and measured intestinal blood flow (Qi) by the radionuclide microsphere technique at hematocrit levels ranging from 10 to 55%. Seven animals were made progressively anemic and eight polycythemic by means of exchange transfusions. Using the Fick principle, they calculated intestinal oxygen delivery (Di O/sub 2/), oxygen consumption (Vi O/sub 2/), and oxygen extraction. Initial base-line values were Qi = 195.5 ml . min-1 . 100 g intestine-1, Di O/sub 2/ = 22.1 ml . min-1 . 100 g-1, Vi O/sub 2/ = 4.8 ml . min-1 . 100 g-1,more » and O/sub 2/ extraction = 22.5%. As the hematocrit was lowered, Di O/sub 2/ decreased and O2 extraction increased and vice versa when the hematocrit was raised. Vi O/sub 2/ remained constant, but Qi did not correlate with changes in hematocrit. However, intestinal blood flow, as a percent distribution of total blood flow, decreased with lower hematocrit levels. At no time was there any evidence of anaerobic metabolism as measured by excess lactate production. The data indicate that the intestines of neonatal lambs are capable of maintaining their metabolic needs over a wide range of oxygen availability induced by a changing hematocrit. The primary mechanism is through alteration of oxygen extraction. Within the range of the experiments, no critically low oxygen availability was attained at which anaerobic metabolism became significant.« less

Fall in hematocrit per 1000 parasites cleared from peripheral blood: a simple method for estimating drug-related fall in hematocrit after treatment of malaria infections.

PubMed

Gbotosho, Grace Olusola; Okuboyejo, Titilope; Happi, Christian Tientcha; Sowunmi, Akintunde

2014-01-01

A simple method to estimate antimalarial drug-related fall in hematocrit (FIH) after treatment of Plasmodium falciparum infections in the field is described. The method involves numeric estimation of the relative difference in hematocrit at baseline (pretreatment) and the first 1 or 2 days after treatment begun as numerator and the corresponding relative difference in parasitemia as the denominator, and expressing it per 1000 parasites cleared from peripheral blood. Using the method showed that FIH/1000 parasites cleared from peripheral blood (cpb) at 24 or 48 hours were similar in artemether-lumefantrine and artesunate-amodiaquine-treated children (0.09; 95% confidence interval, 0.052-0.138 vs 0.10; 95% confidence interval, 0.069-0.139%; P = 0.75) FIH/1000 parasites cpb in patients with higher parasitemias were significantly (P < 0.0001) and five- to 10-fold lower than in patients with lower parasitemias suggesting conservation of hematocrit or red cells in patients with higher parasitemias treated with artesunate-amodiaquine or artemether-lumefantrine. FIH/1000 parasites cpb were similar in anemic and nonanemic children. Estimation of FIH/1000 parasites cpb is simple, allows estimation of relatively conserved hematocrit during treatment, and can be used in both observational studies and clinical trials involving antimalarial drugs.

The relative influence of hematocrit and red blood cell velocity on oxygen transport from capillaries to tissue

PubMed Central

Lücker, Adrien; Secomb, Timothy W.; Weber, Bruno; Jenny, Patrick

2016-01-01

Objective Oxygen transport to parenchymal cells occurs mainly at the microvascular level, and depends on convective red blood cell (RBC) flux, which is proportional in an individual capillary to the product of capillary hematocrit and red blood cell velocity. This study investigates the relative influence of these two factors on tissue oxygen partial pressure (Po2). Methods A simple analytical model is used to quantify the respective influences of hematocrit, RBC velocity and flow on tissue oxygenation around capillaries. Predicted tissue Po2 levels are compared with a detailed computational model. Results Hematocrit is shown to have a larger influence on tissue Po2 than RBC velocity. The effect of RBC velocity increases with distance from the arterioles. Good agreement between analytical and numerical results is obtained and the discrepancies are explained. Significant dependence of mass transfer coefficients on RBC velocity at low hematocrit is demonstrated. Conclusions For a given RBC flux in a capillary, the Po2 in the surrounding tissue increases with increasing hematocrit, as a consequence of decreasing intravascular resistance to diffusive oxygen transport from RBCs to tissue. These results contribute to understanding the effects of blood flow changes on oxygen transport, such as occur in functional hyperemia in the brain. PMID:27893186

The effect of differences in altitude location of an aquaculture on fish’s hematocrit and fish’s haemoglobin of Carp fish and resistance to bacterial attack

NASA Astrophysics Data System (ADS)

Rosidah; Rizal, A.; Rustikawati, I.; Octavia, F.

2018-04-01

The aim for this research is to analyze the relation between the height place of aquaculture and life directness towards Aeromonas hydrophila attack for hematocrit and hemoglobin degrees on Cyprinus carpio L. This research have been doing on February - March 2017 at UPT PTBP Kepanjen (as Group 1), Malang (332 amsl) and UPT PBAT Umbulan IBAT as Group 2 (955 amsl). The treatment that be used is Cyprinus carpio infected by Aeromonas hydrophila. Parameters was observed, are hematocrit, hemoglobin degrees, clinical symptom of fish and the quality of water. The result of this investigation, hematocrit and hemoglobin degrees of Cyprinus carpio in level low land (Group 1, 332 amsl) around 12.8 % and 9.58 g/dL, meanwhile hematocrit and hemoglobin degrees in level up land (Group 2, 955 amsl) around 24.19 % and 12.64 g/dL. Cyprinus carpio L. after infected by Aeromonas hydrophila, it shows the clinical symptoms : its mucus be left, bleeding, its scale get peeled off and dropsy. The life directness of that Cyprinus carpio L. maintaining in 15 days 0 %. The differences between the height level of aquaculture for hematocrit and hemoglobin degrees also life directness towards Aeromonas hydrophila attack on Cyprinus carpio L.

The performance of five different dried blood spot cards for the analysis of six immunosuppressants.

PubMed

Koster, Remco A; Botma, Rixt; Greijdanus, Ben; Uges, Donald R A; Kosterink, Jos G W; Touw, Daan J; Alffenaar, Jan-Willem C

2015-01-01

The relation between hematocrit, substance concentration, extraction recovery and spot formation of tacrolimus, sirolimus, everolimus, ascomycin, temsirolimus and cyclosporin A was investigated for Whatman 31 ET CHR, Whatman FTA DMPK-C, Whatman 903, Perkin Elmer 226 and Agilent Bond Elut DMS DBS cards. We found that all DBS cards showed the same hematocrit and concentration-dependent recovery patterns for sirolimus, everolimus and temsirolimus. At high concentrations, the total hematocrit effects were much more pronounced than at low concentrations for tacrolimus, sirolimus, everolimus, ascomycin and temsirolimus. The tested card types showed differences in performance, especially at extreme concentrations and hematocrit values. It may be useful to investigate the performance of different types of DBS cards prior to analytical method validation.

High-frequency attenuation and backscatter measurements of rat blood between 30 and 60 MHz.

PubMed

Huang, Chih-Chung

2010-10-07

There has recently been a great deal of interest in noninvasive high-frequency ultrasound imaging of small animals such as rats due to their being the preferred animal model for gene therapy and cancer research. Improving the interpretation of the obtained images and furthering the development of the imaging devices require a detailed knowledge of the ultrasound attenuation and backscattering of biological tissue (e.g. blood) at high frequencies. In the present study, the attenuation and backscattering coefficients of the rat red blood cell (RBC) suspensions and whole blood with hematocrits ranging from 6% to 40% were measured between 30 and 60 MHz using a modified substitution approach. The acoustic parameters of porcine blood under the same conditions were also measured in order to compare differences in the blood properties between these two animals. For porcine blood, both whole blood and RBC suspension were stirred at a rotation speed of 200 rpm. Three different rotation speeds of 100, 200 and 300 rpm were carried out for rat blood experiments. The attenuation coefficients of both rat and porcine blood were found to increase linearly with frequency and hematocrit (the values of coefficients of determination (r(2)) are around 0.82-0.97 for all cases). The average attenuation coefficient of rat whole blood with a hematocrit of 40% increased from 0.26 Nepers mm(-1) at 30 MHz to 0.47 Nepers mm(-1) at 60 MHz. The maximum backscattering coefficients of both rat and porcine RBC suspensions were between 10% and 15% hematocrits at all frequencies. The fourth-power dependence of backscatter on frequency was approximately valid for rat RBC suspensions with hematocrits between 6% and 40%. However, the frequency dependence of the backscatter estimate deviates from a fourth-power law for porcine RBC suspension with hematocrit higher than 20%. The backscattering coefficient plateaued for hematocrits higher than 15% in porcine blood, but for rat blood it was maximal around a hematocrit of 20% at the same rotation speed, and shifted to a hematocrit of 10% at a higher speed. The backscattering properties of rat RBCs in plasma are similar to those of RBCs in saline at a higher rotation speed. The differences in attenuation and backscattering between rat and porcine blood may be attributed to RBCs' being smaller and the RBC aggregation level being lower for rat blood than for porcine blood.

Microfluidic-Based Measurement Method of Red Blood Cell Aggregation under Hematocrit Variations

PubMed Central

2017-01-01

Red blood cell (RBC) aggregation and erythrocyte sedimentation rate (ESR) are considered to be promising biomarkers for effectively monitoring blood rheology at extremely low shear rates. In this study, a microfluidic-based measurement technique is suggested to evaluate RBC aggregation under hematocrit variations due to the continuous ESR. After the pipette tip is tightly fitted into an inlet port, a disposable suction pump is connected to the outlet port through a polyethylene tube. After dropping blood (approximately 0.2 mL) into the pipette tip, the blood flow can be started and stopped by periodically operating a pinch valve. To evaluate variations in RBC aggregation due to the continuous ESR, an EAI (Erythrocyte-sedimentation-rate Aggregation Index) is newly suggested, which uses temporal variations of image intensity. To demonstrate the proposed method, the dynamic characterization of the disposable suction pump is first quantitatively measured by varying the hematocrit levels and cavity volume of the suction pump. Next, variations in RBC aggregation and ESR are quantified by varying the hematocrit levels. The conventional aggregation index (AI) is maintained constant, unrelated to the hematocrit values. However, the EAI significantly decreased with respect to the hematocrit values. Thus, the EAI is more effective than the AI for monitoring variations in RBC aggregation due to the ESR. Lastly, the proposed method is employed to detect aggregated blood and thermally-induced blood. The EAI gradually increased as the concentration of a dextran solution increased. In addition, the EAI significantly decreased for thermally-induced blood. From this experimental demonstration, the proposed method is able to effectively measure variations in RBC aggregation due to continuous hematocrit variations, especially by quantifying the EAI. PMID:28878199

The use of regression analysis in determining reference intervals for low hematocrit and thrombocyte count in multiple electrode aggregometry and platelet function analyzer 100 testing of platelet function.

PubMed

Kuiper, Gerhardus J A J M; Houben, Rik; Wetzels, Rick J H; Verhezen, Paul W M; Oerle, Rene van; Ten Cate, Hugo; Henskens, Yvonne M C; Lancé, Marcus D

2017-11-01

Low platelet counts and hematocrit levels hinder whole blood point-of-care testing of platelet function. Thus far, no reference ranges for MEA (multiple electrode aggregometry) and PFA-100 (platelet function analyzer 100) devices exist for low ranges. Through dilution methods of volunteer whole blood, platelet function at low ranges of platelet count and hematocrit levels was assessed on MEA for four agonists and for PFA-100 in two cartridges. Using (multiple) regression analysis, 95% reference intervals were computed for these low ranges. Low platelet counts affected MEA in a positive correlation (all agonists showed r 2 ≥ 0.75) and PFA-100 in an inverse correlation (closure times were prolonged with lower platelet counts). Lowered hematocrit did not affect MEA testing, except for arachidonic acid activation (ASPI), which showed a weak positive correlation (r 2 = 0.14). Closure time on PFA-100 testing was inversely correlated with hematocrit for both cartridges. Regression analysis revealed different 95% reference intervals in comparison with originally established intervals for both MEA and PFA-100 in low platelet or hematocrit conditions. Multiple regression analysis of ASPI and both tests on the PFA-100 for combined low platelet and hematocrit conditions revealed that only PFA-100 testing should be adjusted for both thrombocytopenia and anemia. 95% reference intervals were calculated using multiple regression analysis. However, coefficients of determination of PFA-100 were poor, and some variance remained unexplained. Thus, in this pilot study using (multiple) regression analysis, we could establish reference intervals of platelet function in anemia and thrombocytopenia conditions on PFA-100 and in thrombocytopenia conditions on MEA.

Simultaneous determination of hemolysis and hematocrit in extracorporeal circulation by plasma surface reflectance spectroscopy.

PubMed

Sakota, Daisuke; Kani, Yuki; Kosaka, Ryo; Nishida, Masahiro; Maruyama, Osamu

2013-01-01

To achieve quantitative non-invasive optical diagnosis of blood abnormalities during extracorporeal circulation therapies, plasma surface reflectance spectroscopy was developed by implementing oblique-incidence optical fiber reflectometry on the surface of circulating blood. The reflected light in the wavelength range from 450 to 600 nm changed with respect to the plasma free hemoglobin level and could be used to quantify the free hemoglobin at an accuracy of 5.7 ± 3.5 mg/dL. In contrast, the spectrum did not changed by varying the hematocrit. In the wavelength range from 600 to 800 nm, the obtained spectrum was affected by both the hematocrit change and hemolysis. The linear correlation between the hematocrit value and the spectrum was confirmed at R(2) = 0.99. The feasibility of determining of the hematocrit of arbitrary hemolyzed blood was confirmed. The developed system permits the extraction of the optical characteristics of both plasma and red blood cells without centrifugation. The study establishes non-invasive optical diagnostics capable of analyzing the optical properties of both plasma and red blood cells.

METHOD FOR THE DETERMINATION OF THE HEMATOCRIT OF AN ORGAN IN VIVO (in Italian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cultrera, G.

1963-01-01

A method, based on the almost simuitaneous labeling of the plasma with Cl/sub 3/Cr/sup 51/ and of the red blood cells with Na/sub 2/Cr/sup 51/O/sub 4/, is described, by which the hematocrit can be measured in vivo. The patient's plasma is labeled, and the radioactivity is then almost simultaneously measured in vivo over the organ considered, e.g., the heart; the plasma radioactivity is measured in a sample of blood taken from a vein. The same procedure is then repeated considering the radioactivity of the red blood cells. By applying a formula, the hematocrit of the examined organ can then bemore » calculated. The results of measurements of the cardiac hematocrit were fairly satisfactory as compared with measurements of the venous hematocrit and showed that two factors are of fundamental importance in order to obtain accurate measurements. Highly sensitive counters must be used and relatively large doses of isotope must be employed. Unless these conditions are observed, results will be unsatisfactory on account of the high statistical error. (auth)« less

A simple method for the investigation of cell separation effects of blood with physiological hematocrit values.

PubMed

Gester, Kathrin; Jansen, Sebastian V; Stahl, Marion; Steinseifer, Ulrich

2015-05-01

Even though the separation of blood into erythrocyte-rich and erythrocyte-poor areas is well known in physiological setups such as small vessels, it has recently come into focus in small gaps in cardiovascular applications. Studies show that separation effects occur, for example, in gaps in hydrodynamic bearings, where they can have a positive effect on hemolysis. Separation effects depend on the hematocrit value, but due to visualization issues, studies in small gaps used very low hematocrit values. In this study, a test setup and an evaluation method for the investigation of separation effects of blood with hematocrit values of 30, 45, and 60% were developed. The erythrocyte distribution was evaluated by means of gray scale value distribution. This principle is based on the fact that an erythrocyte-rich region is more opaque than an erythrocyte-poor region. The experimental setup is designed in a way that no further processes (e.g., fluorescence labeling) need to be carried out which might change the properties of the membrane of the erythrocytes, and therefore their flow properties. Additionally, the method is executable with basic laboratory equipment, which makes it applicable for many laboratories. To validate the feasibility of the method, the influence of the diameter and the flow rate on the migration of erythrocytes were studied in micro channels for three different physiological hematocrit values. Even though no individual cells were traced, plasma layer and areas of high erythrocyte concentration could be identified. Dependencies of the erythrocyte distribution on flow rate and channel diameter were validated. The influence of the hematocrit value was demonstrated as well and showed the hematocrit value to be a crucial factor when investigating cell separation. The experimental results were consistent with findings in the literature. As the developed method is suitable for physiological hematocrit values and easy to handle, it provides an optimal basis for cell separation studies in gap models with whole blood, for example, hydrodynamic bearings, where it can be used to optimize these devices. Copyright © 2014 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Ferrokinetics in Patients on CAPD: Influence of CAPD on the Anemia of Uremia*

PubMed Central

Lee, Hi Bahl; Koh, Seong Won; Park, Hee Sook

1986-01-01

Ferrokinetic studies were performed with 59Fe-citrate to evaluate erythropoietic activity in CAPD patients and to investigate the mechanism(s) by which the hematocrit increases in CAPD patients. Plasma iron disappearance rate (PID), plasma iron turnover rate (PIT), red cell iron utilization (RCIU), red cell iron turnover rate (RCIT) and marrow transit time (MTT) were all “normal” in uremic patients not yet on dialysis (Hct 23.8±3.4%), CAPD patients with persistently low hematocrit (Hct 24.9±1.8%) and CAPD patients with improved hematocrit (Hct 32.4±3.1%). Compared to these uremic patients, patients with iron deficiency anemia and normal renal function (Hct 28.0±5.1 %) had significantly faster PID and MTT and significantly higher RCIU and RCIT. Plasma volume was significantly reduced (to normal level) in CAPD patients with improved hematocrits. The results of this study suggest that erythropoietic activity is inadequate for the degree of anemia in CAPD patients as well as uremic patients not on dialysis and further suggest that the hematocrit increases in CAPD as a result of decreased plasma volume. PMID:15759377

What can we learn from Einstein and Arrhenius about the optimal flow of our blood?

PubMed

Schuster, Stefan; Stark, Heiko

2014-01-01

The oxygen flow in humans and other higher animals depends on the erythrocyte-to-blood volume ratio, the hematocrit. Since it is physiologically favourable when the flow of oxygen transport is maximum it can be assumed that this situation has been achieved during evolution. If the hematocrit was too low, too few erythrocytes could transport oxygen. If it was too high, the blood would be very viscous, so that oxygen supply would again be reduced. The theoretical optimal hematocrit can be calculated by considering the dependence of blood viscosity on the hematocrit. Different approaches to expressing this dependence have been proposed in the literature. Here, we discuss early approaches in hydrodynamics proposed by Einstein and Arrhenius and show that especially the Arrhenius equation is very appropriate for this purpose. We show that despite considerable simplifications such as neglecting the deformation, orientation and aggregation of erythrocytes, realistic hematocrit values of about 40% can be derived based on optimality considerations. Also the prediction that the ratio between the viscosities of the blood and blood plasma at high shear rates nearly equals Euler's constant (2.718) is in good agreement with observed values. Finally, we discuss possible extensions of the theory. For example, we derive the theoretical optimal hematocrit for persevering divers among marine mammals to be 65%, in excellent agreement with the values observed in several species. These considerations are very important for human and animal physiology since oxygen transport is an important factor for medicine and physical performance. © 2013 Elsevier B.V. All rights reserved.

PATHOLOGIC SIGNIFICANCE OF BLOOD VOLUME CHANGES IN UNTREATED POLYCYTHEMIA VERA AND AFTER P$sup 32$ THERAPY (in Hungarian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burger, T.; Keszthelyi, B.; Peer, J.

1962-02-25

Ten patients suffering from polycythemia vera were divided into three groups for evaluation purposes. The first group (2 patients) consisted of the mildest cases in which the hematocrit values were 55% or less. The second group (2 patients) had a hematocrit values of 55% or higher, and the red cell and plasma voiumes were higher than normal. The third group consisted of the severest cases with hematocrit values of 70 to 80%, red cell counts of 6 to 8 million/ mm/sup 3, and red cell and plasma volumes two to four times normai. Blood volumes were determined with /sup 32/Pmore » or /sup 51/Cr. The patients showed clinical improvement after the first treatment with /sup 32/P and hematologic examination indicated that the red cell count dropped, while hemogiobin value, white cell count, thrombocyte count, and hematocrit decreased. After the second / sup 32/P treatment the blood volume did not decrease appreciably, but plasma volume increased, leading to improvement of the patient's condition. Venesection may still be used as a therapeutic means when an immediate reduction of the blood volume is desired. This can be achieved by /sup 32/P therapy only after severai treatments. The /sup 32/P dose varied with the severity of the illness from one treatment of five mC /sup 32/P in the patients with hematocrits of 55% to two doses of 4.2 mC in those with values of 58%, and three mC /sup 32/P in another patient with a hematocrit of 82%. (BBB)« less

Lead-induced anemia: Dose-response relationships and evidence for a threshold

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwartz, J.; Landrigan, P.J.; Baker, E.L. Jr.

1990-02-01

We conducted a cross-sectional epidemiologic study to assess the association between blood lead level and hematocrit in 579 one to five year-old children living near a primary lead smelter in 1974. Blood lead levels ranged from 0.53 to 7.91 mumol/L (11 to 164 micrograms/dl). To predict hematocrit as a function of blood lead level and age, we derived non-linear regression models and fit percentile curves. We used logistic regression to predict the probability of hematocrit values less than 35 per cent. We found a strong non-linear, dose-response relationship between blood lead level and hematocrit. This relationship was influenced by age,more » but (in this age group) not by sex; the effect was strongest in youngest children. In one year-olds, the age group most severely affected, the risk of an hematocrit value below 35 percent was 2 percent above background at blood lead levels between 0.97 and 1.88 mumol/L (20 and 39 micrograms/dl), 18 percent above background at lead levels of 1.93 to 2.85 mumol/L (40 to 59 micrograms/dl), and 40 percent above background at lead levels of 2.9 mumol/L (60 micrograms/dl) and greater; background was defined as a blood lead level below 1.88 mumol/L (20 micrograms/dl). This effect appeared independent of iron deficiency. These findings suggest that blood lead levels close to the currently recommended limit value of 1.21 mumol/L (25 micrograms/dl) are associated with dose-related depression of hematocrit in young children.« less

Correction for intravascular activity in the oxygen-15 steady-state technique is independent of the regional hematocrit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lammertsma, A.A.; Baron, J.C.; Jones, T.

1987-06-01

The oxygen-15 steady-state technique to measure the regional cerebral metabolic rate for oxygen requires a correction for the nonextracted intravascular molecular oxygen-15. To perform this correction, an additional procedure is carried out using RBCs labeled with /sup 11/CO or C/sup 15/O. The previously reported correction method, however, required knowledge of the regional cerebral to large vessel hematocrit ratio. A closer examination of the underlying model eliminated this ratio. Both molecular oxygen and carbon monoxide are carried by RBCs and are therefore similarly affected by a change in hematocrit.

Dissociation of local and global skeletal muscle oxygen transport metrics in type 2 diabetes.

PubMed

Mason McClatchey, P; Bauer, Timothy A; Regensteiner, Judith G; Schauer, Irene E; Huebschmann, Amy G; Reusch, Jane E B

2017-08-01

Exercise capacity is impaired in type 2 diabetes, and this impairment predicts excess morbidity and mortality. This defect appears to involve excess skeletal muscle deoxygenation, but the underlying mechanisms remain unclear. We hypothesized that reduced blood flow, reduced local recruitment of blood volume/hematocrit, or both contribute to excess skeletal muscle deoxygenation in type 2 diabetes. In patients with (n=23) and without (n=18) type 2 diabetes, we recorded maximal reactive hyperemic leg blood flow, peak oxygen utilization during cycling ergometer exercise (VO 2peak ), and near-infrared spectroscopy-derived measures of exercise-induced changes in skeletal muscle oxygenation and blood volume/hematocrit. We observed a significant increase (p<0.05) in skeletal muscle deoxygenation in type 2 diabetes despite similar blood flow and recruitment of local blood volume/hematocrit. Within the control group skeletal muscle deoxygenation, local recruitment of microvascular blood volume/hematocrit, blood flow, and VO 2peak are all mutually correlated. None of these correlations were preserved in type 2 diabetes. These results suggest that in type 2 diabetes 1) skeletal muscle oxygenation is impaired, 2) this impairment may occur independently of bulk blood flow or local recruitment of blood volume/hematocrit, and 3) local and global metrics of oxygen transport are dissociated. Copyright © 2017 Elsevier Inc. All rights reserved.

The hematocrit paradox--how does blood doping really work?

PubMed

Böning, D; Maassen, N; Pries, A

2011-04-01

The wide-spread assumption that doping with erythropoietin or blood transfusion is only effective by increasing arterial blood O2 content because of rising hematocrit is not self-evident. "Natural blood dopers" (horses, dogs) increase both hematocrit and circulating blood volume during exercise by releasing stored erythrocytes from the spleen. Improvement of aerobic performance by augmenting hemoglobin concentration may be expected until the optimal hematocrit is reached; above this value maximal cardiac output declines due to the steep increase of blood viscosity. Therefore an enlarged blood oxygen content might only be useful if the normal hematocrit of man during exercise is suboptimal. However, recent studies suggest that cardiac power rises after erythropoietin allowing an unchanged cardiac output in spite of increased viscosity. Other factors underlying improved performance after blood doping might be: augmented diffusion capacity for oxygen in lungs and tissues, increased percentage of young red cells with good functional properties (after erythropoietin), increased buffer capacity, increase of blood volume, vasoconstriction, reduced damage by radicals, mood improvement by cerebral effects of erythropoietin. Also the importance of placebo is unknown since double-blind studies are rare. It is suggested that blood doping has multifactorial effects not restricted to the increase in arterial oxygen content. © Georg Thieme Verlag KG Stuttgart · New York.

A computational simulation of the effect of hemodilution on oxygen transport in middle cerebral artery vasospasm

PubMed Central

Chittiboina, Prashant; Guthikonda, Bharat; Wollblad, Christian; Conrad, Steven A

2011-01-01

Cerebral vasospasm after aneurysmal subarachnoid hemorrhage is a potentially severe sequel. The induction of hypertension, hypervolemia, and hemodilution is advocated for vasospasm, but it is unclear whether hemodilution confers any benefit. A finite element model of oxygen transport in the proximal middle cerebral artery (MCA) was used to evaluate the complex relationship among hematocrit, viscosity, oxygen content, and blood flow in the setting of vasospasm. A single-phase non-Newtonian finite element model based on three-dimensional incompressible Navier–Stokes equations was constructed of the M1 segment. The model was solved at vessel stenoses ranging from 0% to 90% and hematocrit from 0.2 to 0.6. A small area of poststenotic recirculation was seen with mild (30%) stenosis. Poststenotic eddy formation was noted with more severe (60% to 90%) stenosis. Volumetric flow was inversely related to hematocrit at mild stenosis (0% to 30%). With near-complete stenosis (90%), a paradoxical increase in flow was seen with increasing hematocrit. Oxygen transport across the segment was related to hematocrit at all levels of stenosis with increasing oxygen transport despite a reduction in blood flow, suggesting that with clinically significant vasospasm in the MCA, hemodilution does not improve oxygen transport, but to the contrary, that ischemia may be worsened. PMID:21629259

Kinetics of red blood cell rouleaux formation studied by light scattering

NASA Astrophysics Data System (ADS)

Szołna-Chodór, Alicja; Bosek, Maciej; Grzegorzewski, Bronisław

2015-02-01

Red blood cell (RBC) rouleaux formation was experimentally studied using a light scattering technique. The suspensions of RBCs were obtained from the blood of healthy donors. Hematocrit of the samples was adjusted ranging from 1% to 4%. Measurements of the intensity of the coherent component of light scattered by the suspensions were performed and the scattering coefficient of the suspensions was determined. The number of RBCs per rouleaux was obtained using anomalous diffraction theory. The technique was used to show the effect of time, hematocrit, and sample thickness on the process. The number of cells per rouleaux first increases linearly, reaches a critical value at ˜3 cells per rouleaux, and then a further increase in the rouleaux size is observed. The kinetic constant of the rouleaux growth in the linear region is found to be independent of hematocrit. The aggregation rate increases as the sample thickness increases. The time at which the critical region appears strongly decreases as the hematocrit of the suspension increases.

The potential role of hematocrit control on symptom burden among polycythemia vera patients: Insights from the CYTO-PV and MPN-SAF patient cohorts.

PubMed

Scherber, Robyn Marie; Geyer, Holly Lynn; Dueck, Amylou C; Kosiorek, Heidi E; Finazzi, Guido; Cavazzina, Riccardo; Masciulli, Arianna; Scarano, Marco; Vannucchi, Alessandro M; Mesa, Ruben A; Barbui, Tiziano

2017-06-01

Current guidelines suggest that polycythemia vera (PV) patients maintain a strict hematocrit less than 45%. However, to date, little is known about the relationship between HCT control and PV- related symptom burden. In this study, PV patient data was analyzed from the CYTO PV trial (n = 224) and the MPN-SAF study cohort (n = 645). No significant differences in symptom burden were seen at the 6 and 12 month follow-up when evaluating prospective hematocrit control in the CYTO PV cohort. Patients in the MPN-SAF cohort with a worst item score of greater than 5/10 on the Myeloproliferative Neoplasm Symptom Total Symptom Score had a significantly lower mean hematocrit (p = .0376). These findings suggest a relationship between traditional aggressive therapy for PV and increased symptom burden with prolonged therapy. Thus, symptom burden should be considered when contemplating the choice of therapy in the second-line setting for PV.

Effects of nonlethal sea lamprey attack on the blood chemistry of lake trout

USGS Publications Warehouse

Edsall, Carol Cotant; Swink, William D.

2001-01-01

A laboratory study examined changes in the blood chemistry of field-caught and hatchery-reared lake trout Salvelinus namaycush subjected to a nonlethal attack by sea lampreys Petromyzon marinus. We measured glucose, total protein, amylase, alkaline phosphatase (ALKP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase, calcium, magnesium, triglycerides, sodium, and potassium with a Kodak Ektachem DT60 Analyzer, Ektachem DTSC Module, and the DTE Module. Mean levels of total protein, AST, ALKP, hematocrit, calcium, magnesium, and sodium decreased significantly (Pa?? 0.05), and mean levels of ALT and potassium increased significantly (Pa?? 0.05) after sea lamprey feeding. Lake trout condition (K) and hematocrit levels also decreased significantly (Pa?? 0.05) after the sea lamprey attack. Frequency distributions of eight lake trout blood chemistry variables and the hematocrit were significantly different before and after a sea lamprey attack. A second study that used hatchery lake trout broodstock measured changes in hematocrit before and after a sea lamprey attack.

Cyclic variation of ultrasonic backscattering from porcine whole blood under pulsatile flow

NASA Astrophysics Data System (ADS)

Lin, Yu-Hong

1997-10-01

The cyclic variation of ultrasonic backscattering from blood under pulsatile flow is believed to be related to the change of aggregation state of red cells and is only observed in whole blood. This study was to investigate the phenomenon by an invasive approach which was performed by inserting a 10 MHz catheter mounted transducer into a vessel. For ultrasonic measurement from blood, the most fundamental scheme is the hematocrit dependence. The backscatter maximum location was changed as the blood was stirred or stationary, as well as under steady laminar or turbulent flows. The same trend was also observed under pulsatile flow with 10% to 50% hematocrits in this study, as the backscattering to hematocrit curves were plotted at different times during a flow cycle. When the cyclic variation at 20 beats per minute (BPM) was interpreted in time domain, the enhanced aggregation at the beginning of shearing was observed. At 20 BPM with 40% hematocrit, the amplitude of cyclic variation was reduced when the shear rate was increased and the threshold of 150 s-1 was estimated. The results showed that there was no cyclic variation at 60 BPM. The backscattering was also plotted against the mean flow velocity, which demonstrated the hysteresis loops. The ultrasonic measurements showed that the relationship between the forward and backward paths of the loops were altered as beat rate, hematocrit, and shear rate were varied. Since the pulsatile flow was very complicated, a computational fluid dynamics package, FIDAPTM, was used to compute the shear rate based on the Power Law Model for non-Newtonian fluid viscosity. The non- Newtonian index and consistency in the model were computed from the viscosity to shear rate curves at 10% to 50% hematocrits measured by a cone-plate viscometer. For in vivo measurements, small pigs were used as models. Ultrasonic backscattering measurements were performed in the arteries and veins. The effect of stenosis was also investigated at the site below the renal branch in the artery. The results show that the cyclic variation from whole blood was mediated by the shear rate, hematocrit, beat rate, and fibrinogen concentration.

Substitution of Fingertip Blood for Venous Blood in the Measurement of Hematocrit and Hemoglobin Following Exercise

ERIC Educational Resources Information Center

Fahey, Thomas D.; And Others

1977-01-01

Results from comparative testing indicate that fingertip blood is a valid indicator of antecubital venous hematocrit (hct) and hemoglobin (hgb), and that hct ratios determined on the Coulter counter are comparable to those found by the microhematocrit method. (MB)

Kinetics of red blood cell rouleaux formation studied by light scattering.

PubMed

Szolna-Chodór, Alicja; Bosek, Maciej; Grzegorzewski, Bronislaw

2015-02-01

Red blood cell (RBC) rouleaux formation was experimentally studied using a light scattering technique. The suspensions of RBCs were obtained from the blood of healthy donors. Hematocrit of the samples was adjusted ranging from 1% to 4%. Measurements of the intensity of the coherent component of light scattered by the suspensions were performed and the scattering coefficient of the suspensions was determined. The number of RBCs per rouleaux was obtained using anomalous diffraction theory. The technique was used to show the effect of time, hematocrit, and sample thickness on the process. The number of cells per rouleaux first increases linearly, reaches a critical value at ∼3 cells per rouleaux, and then a further increase in the rouleaux size is observed. The kinetic constant of the rouleaux growth in the linear region is found to be independent of hematocrit. The aggregation rate increases as the sample thickness increases. The time at which the critical region appears strongly decreases as the hematocrit of the suspension increases. © 2015 Society of Photo-Optical Instrumentation Engineers (SPIE)

Effects of dietary and inhalative cadmium on hemoglobin and hematocrit in rats

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prigge, E.; Baumert, H.P.; Muhle, H.

1977-05-01

Th dfference of the effects of dietary and inhalative cadmium on hemoglobin and hematocrit was investigated using Wistar male rats. For the inhalation studies, rats were exposed to CdCl/sub 2/ aerosols (0.2 mg Cd/m/sup 3/) for 66 days. For the dietary experiments the rats received 25, 50 and 100 ppM cadmium as CdCl/sub 2/ in drinking water. The following parameters were measured: the body weights of the animals, hematocrit and hemoglobin in blood, and the Cd content of liver and kidney. The results showed a retardation of growth in the aerosol-exposed group and the group with 100 ppM oral Cdmore » intake. The relation of the Cd content of kidney to liver averaged 1.7 for the oral-exposed groups and 4.4 for the inhalation-exposed groups. The hematocrit and hemoglobin values for the inhalation-exposed rats showed no significant differences when compared to the controls, but the values for the dietary cadmium group showed a significant reduction.« less

Comparison of Pre- and Postoperative Hemoglobin and Hematocrit Levels in Hip Arthroscopy

PubMed Central

Seijas, Roberto; Espinosa, Wenceslao; Sallent, Andrea; Cuscó, Xavier; Cugat, Ramón; Ares, Oscar

2015-01-01

Purpose : to assess the loss in hematocrit and hemoglobin, if any, 24 hours after hip arthroscopy. Methods : thirty-five patients were included. Laboratory tests including complete blood count and white blood cells were performed one week prior to surgery and 24 hours after. Surgical time, volume of saline perfusion and pump perfusion was also recorded. Results : mean preoperative hematocrit was 42.01% (4.63 SD), whereas mean postoperative hematocrit at 24 h decreased to 36.78% (SD 5.11) (p <0.021.). Mean preoperative hemoglobin was 14.23 g/dL (1.73 SD), and mean postoperative hemoglobin at 24 h decreased to 12.40 g/dL (SD 1.92) (p =0.03.). Platelets and white blood cells, as well as the remaining biochemical parameters showed no significant difference between preoperative and postoperative samples. Lost blood volume worked out with the logarithmic method for estimated blood loss was which 0.78 liters (SD 0.45). Lost blood volume taking into account, the red blood cell mass was also 0.78 liters (SD 0.45). Conclusion : a significant decrease in hemoglobin and hematocrit after hip arthroscopy was observed. Although patients did not show clinical signs of anemia or bleeding, blood loss should be considered when planning a hip arthroscopy, especially in patients at risk of anemia. According to our results, we recommend a postoperative control analysis at 24 h. Level of Evidence : level II, Diagnostic Study. PMID:26401169

Surgery for lung adenocarcinoma with smokers' polycythemia: a case report.

PubMed

Sugiura, Yasoo; Nemoto, Etsuo; Shinoda, Hiromi; Nakamura, Naoya; Kaseda, Shizuka

2013-02-01

Smoking is a cause of cancer and polycythemia. Therefore, surgeons who treat patients with cancer may also encounter patients with polycythemia. However, few cases of surgical patients with polycythemia have been reported; in particular, a surgical case involving smokers' polycythemia has never been reported. We herein report a patient with lung cancer and smokers' polycythemia who successfully underwent lobectomy with control of hematocrit based on a modified formula in the perioperative period. A 67-year-old man underwent abdominoperineal resection for rectal carcinoma in June 2008. A ground glass opacity had been identified in the upper lobe of the right lung and was gradually enlarging. In March 2012, bronchoscopic cytology for investigation of the mass revealed non-small cell lung cancer, suggesting primary lung non-small cell carcinoma (T1bN0M0, Stage IA). When he was referred to our hospital for surgery, his complete blood count showed a red blood cell level of 6.50×106/μL, hemoglobin of 21.0 g/dL, and hematocrit of 60.1%. The hematologists' diagnosis was secondary polycythemia due to heavy smoking (smokers' polycythemia) because the white blood cell and platelet counts were within normal limits and the erythropoietin was not increased. We calculated the appropriate phlebotomy and infusion volumes based on a formula that we modified. After 550 g of blood was phlebotomized to reduce the hematocrit to approximately 55%, video-assisted right lung upper lobectomy with lymph node dissection was performed in April 2012. The hematocrit was maintained at <50% postoperatively, and the patient was uneventfully discharged on postoperative day 7. The predictive hematocrit and measured hematocrit were very closely approximated in this case. We experienced a patient with smokers' polycythemia who underwent right upper lobectomy for adenocarcinoma. The findings in this case report are meaningful for surgeons treating cancer patients because there are few reports discussing the perioperative care of surgical patients with polycythemia.

Surgery for lung adenocarcinoma with smokers’ polycythemia: a case report

PubMed Central

2013-01-01

Background Smoking is a cause of cancer and polycythemia. Therefore, surgeons who treat patients with cancer may also encounter patients with polycythemia. However, few cases of surgical patients with polycythemia have been reported; in particular, a surgical case involving smokers’ polycythemia has never been reported. We herein report a patient with lung cancer and smokers’ polycythemia who successfully underwent lobectomy with control of hematocrit based on a modified formula in the perioperative period. Case presentation A 67-year-old man underwent abdominoperineal resection for rectal carcinoma in June 2008. A ground glass opacity had been identified in the upper lobe of the right lung and was gradually enlarging. In March 2012, bronchoscopic cytology for investigation of the mass revealed non-small cell lung cancer, suggesting primary lung non-small cell carcinoma (T1bN0M0, Stage IA). When he was referred to our hospital for surgery, his complete blood count showed a red blood cell level of 6.50×106/μL, hemoglobin of 21.0 g/dL, and hematocrit of 60.1%. The hematologists’ diagnosis was secondary polycythemia due to heavy smoking (smokers’ polycythemia) because the white blood cell and platelet counts were within normal limits and the erythropoietin was not increased. We calculated the appropriate phlebotomy and infusion volumes based on a formula that we modified. After 550 g of blood was phlebotomized to reduce the hematocrit to approximately 55%, video-assisted right lung upper lobectomy with lymph node dissection was performed in April 2012. The hematocrit was maintained at <50% postoperatively, and the patient was uneventfully discharged on postoperative day 7. The predictive hematocrit and measured hematocrit were very closely approximated in this case. Conclusion We experienced a patient with smokers’ polycythemia who underwent right upper lobectomy for adenocarcinoma. The findings in this case report are meaningful for surgeons treating cancer patients because there are few reports discussing the perioperative care of surgical patients with polycythemia. PMID:23374961

Can middle cerebral artery peak systolic velocity predict polycythemia in monochorionic-diamniotic twins? Evidence from a prospective cohort study.

PubMed

Fishel-Bartal, M; Weisz, B; Mazaki-Tovi, S; Ashwal, E; Chayen, B; Lipitz, S; Yinon, Y

2016-10-01

The antenatal diagnosis of twin anemia-polycythemia sequence (TAPS) in monochorionic-diamniotic (MCDA) twin pregnancies is based on elevated peak systolic velocity in the middle cerebral artery (MCA-PSV) in the donor twin and decreased MCA-PSV in the recipient twin. However, the association between these parameters and polycythemia has not yet been established. The aim of this study was to determine whether MCA-PSV can predict polycythemia in MCDA pregnancies. This was a prospective cohort study of MCDA pregnancies recruited at 14-18 weeks' gestation from a single tertiary care center between January 2011 and June 2014. Fetal MCA Doppler waveforms were recorded every 2 weeks from 18 weeks' gestation until delivery. Only those with an MCA-PSV measurement within 1 week of delivery were included in the analysis. Neonatal hematocrit level was determined in all twins from venous blood obtained within 4 h of delivery. Polycythemia was defined as a hematocrit of > 65%, and anemia as a hematocrit of < 45%. TAPS was diagnosed when an intertwin hemoglobin difference of > 8 g/dL and reticulocyte count ratio of > 1.7 were observed. Of 162 MCDA pregnancies followed during the study period, 69 had an MCA-PSV measurement within 1 week of delivery and were included in the study. Twenty-five neonates were diagnosed with polycythemia and nine twin pairs met the criteria for TAPS. In a pooled analysis, MCA-PSV was negatively correlated with neonatal hematocrit (P = 0.017, r = -0.215) and was significantly higher in anemic fetuses than in normal controls (1.15 multiples of the median (MoM) vs 1.02 MoM, respectively; P = 0.001). However, MCA-PSV was similar among polycythemic and normal fetuses (0.95 MoM vs 1.02 MoM, respectively; P = 0.47). Intertwin difference in MCA-PSV (delta MCA-PSV) was positively correlated with intertwin hematocrit difference (P = 0.002, r = 0.394). Moreover, twin pregnancies with an intertwin hematocrit difference of > 24% had a significantly greater delta MCA-PSV than did those with an intertwin hematocrit difference of ≤ 24% (delta MCA-PSV, 19 vs 5 cm/s; P < 0.001). MCA-PSV is not significantly decreased in polycythemic MCDA twins. However, delta MCA-PSV is associated with a large intertwin difference in hematocrit, and its use may be better than conventional methods for the risk assessment of TAPS. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Tumor-associated erythrocytosis in a dog with nasal fibrosarcoma.

PubMed

Couto, C G; Boudrieau, R J; Zanjani, E D

1989-01-01

Erythrocytosis (hematocrit, 79%) was diagnosed in an 8-year-old, neutered female, mixed-breed dog with an intranasal fibrosarcoma. Both serum and tumor erythropoietin (Ep) activities were elevated, as determined by the polycythemic exhypoxic mouse model, and the Ep activity was neutralized in that model by rabbit anti-Ep antibodies. Tumor resection normalized the hematocrit.

Hematological changes in Eleginops maclovinus during an experimental Caligus rogercresseyi infestation.

PubMed

Peña-Rehbein, Patricio; Ruiz, Karin; Ortloff, Alexander; Pizarro, María Isabel; Navarrete, Carolina

2013-01-01

Eleginops maclovinus has been an important fishery resource in Chile since 1957. Caligus rogercresseyi is one of the most prevalent ectoparasite species found on E. maclovinus. Hematocrit, hemoglobin level, red blood cell count (RBC), white blood cell count (WBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and differential white blood cell count were determined before and after an experimental infestation with C. rogercresseyi. We found significant differences in the hemoglobin level, WBC, MCV, MCH, MCHC, hematocrit level and RBC between infested and uninfested fish. Furthermore correlations between number of C. rogercresseyi with hematocrit, MCHC, neutrophil, eosinophil and lymphocyte counts were found. Hematological reference ranges of E. maclovinus in captivity conditions were also established.

Validation of the harmless acute pancreatitis score in predicting nonsevere course of acute pancreatitis.

PubMed

Oskarsson, V; Mehrabi, M; Orsini, N; Hammarqvist, F; Segersvärd, R; Andrén-Sandberg, A; Sadr Azodi, O

2011-01-01

The Harmless Acute Pancreatitis Score (HAPS) is a scoring algorithm to identify patients with nonsevere acute pancreatitis. The aim of this study was to evaluate the reproducibility of HAPS outside its original study setting. Baseline information of all hospitalized patients with acute pancreatitis at Karolinska University Hospital, Stockholm, Sweden, between 2004 and 2009 was collected. The parameters constituting HAPS were signs of peritonitis, hematocrit and serum creatinine levels. Since hematocrit was not available in all patients, complete sample analysis was performed by replacing hematocrit with hemoglobin (strongly correlated with hematocrit; r = 0.86). In total, 531 patients with a first-time or a recurrent attack of acute pancreatitis were included. Among 353 patients with complete information on parameters constituting HAPS, 79 patients were predicted to have a nonsevere course, of whom 1 patient developed severe acute pancreatitis. The specificity of HAPS in predicting a nonsevere course of acute pancreatitis was 96.3% (95% CI: 81.0-99.9) with a corresponding positive predictive value of 98.7% (95% CI: 93.1-100). Complete sample analysis replacing hematocrit with hemoglobin level predicted a nonsevere course in 182 patients, of whom 2 patients had severe acute pancreatitis (94.3% specificity and 98.9% positive predictive value). HAPS is a highly specific scoring algorithm that predicts a nonsevere course of acute pancreatitis. Therefore, HAPS might be an additional tool in the clinical assessment of acute pancreatitis where early screening is important to treat the patients at an optimal level of care. Copyright © 2011 S. Karger AG, Basel.

Hematocrit Measurement with R2* and Quantitative Susceptibility Mapping in Postmortem Brain.

PubMed

Walsh, A J; Sun, H; Emery, D J; Wilman, A H

2018-05-24

Noninvasive venous oxygenation quantification with MR imaging will improve the neurophysiologic investigation and the understanding of the pathophysiology in neurologic diseases. Available MR imaging methods are limited by sensitivity to flow and often require assumptions of the hematocrit level. In situ postmortem imaging enables evaluation of methods in a fully deoxygenated environment without flow artifacts, allowing direct calculation of hematocrit. This study compares 2 venous oxygenation quantification methods in in situ postmortem subjects. Transverse relaxation (R2*) mapping and quantitative susceptibility mapping were performed on a whole-body 4.7T MR imaging system. Intravenous measurements in major draining intracranial veins were compared between the 2 methods in 3 postmortem subjects. The quantitative susceptibility mapping technique was also applied in 10 healthy control subjects and compared with reference venous oxygenation values. In 2 early postmortem subjects, R2* mapping and quantitative susceptibility mapping measurements within intracranial veins had a significant and strong correlation ( R 2 = 0.805, P = .004 and R 2 = 0.836, P = .02). Higher R2* and susceptibility values were consistently demonstrated within gravitationally dependent venous segments during the early postmortem period. Hematocrit ranged from 0.102 to 0.580 in postmortem subjects, with R2* and susceptibility as large as 291 seconds -1 and 1.75 ppm, respectively. Measurements of R2* and quantitative susceptibility mapping within large intracranial draining veins have a high correlation in early postmortem subjects. This study supports the use of quantitative susceptibility mapping for evaluation of in vivo venous oxygenation and postmortem hematocrit concentrations. © 2018 by American Journal of Neuroradiology.

Centrifuge apparatus

DOEpatents

Sartory, Walter K.; Eveleigh, John W.

1976-01-01

A method and apparatus for operating a continuous flow blood separation centrifuge are provided. The hematocrit of the entrant whole blood is continuously maintained at an optimum constant value by the addition of plasma to the entrant blood. The hematocrit of the separated red cells is monitored to indicate the degree of separation taking place, thereby providing a basis for regulating the flow through the centrifuge.

Is Aquatic Life Correlated with an Increased Hematocrit in Snakes?

PubMed Central

Brischoux, François; Gartner, Gabriel E. A.; Garland, Theodore; Bonnet, Xavier

2011-01-01

Background Physiological adaptations that allow air-breathing vertebrates to remain underwater for long periods mainly involve modifications of the respiratory system, essentially through increased oxygen reserves. Physiological constraints on dive duration tend to be less critical for ectotherms than for endotherms because the former have lower mass-specific metabolic rates. Moreover, comparative studies between marine and terrestrial ectotherms have yet to show overall distinct physiological differences specifically associated with oxygen reserves. Methodology/Principal Findings We used phylogenetically informed statistical models to test if habitat affects hematocrit (an indicator of blood oxygen stores) in snakes, a lineage that varies widely in habitat use. Our results indicate that both phylogenetic position (clade) and especially habitat are significant predictors of hematocrit. Our analysis also confirms the peculiar respiratory physiology of the marine Acrochordus granulatus. Conclusion/Significance Contrary to previous findings, marine snakes have significantly–albeit slightly–elevated hematocrit, which should facilitate increased aerobic dive times. Longer dives could have consequences for foraging, mate searching, and predation risks. Alternatively, but not exclusively, increased Hct in marine species might also help to fuel other oxygen-demanding physiological adaptations, such as those involved in osmoregulation. PMID:21359216

Carbonic anhydrase activity in the red blood cells of sea level and high altitude natives.

PubMed

Gamboa, J; Caceda, R; Gamboa, A; Monge-C, C

2000-01-01

Red blood cell carbonic anhydrase (CA) activity has not been studied in high altitude natives. Because CA is an intraerythocytic enzyme and high altitude natives are polycythemic, it is important to know if the activity of CA per red cell volume is different from that of their sea level counterparts. Blood was collected from healthy subjects living in Lima (150m) and from twelve subjects from Cerro de Pasco (4330m), and hematocrit and carbonic anhydrase activity were measured. As expected, the high altitude natives had significantly higher hematocrits than the sea level controls (p = 0.0002). No difference in the CA activity per milliliter of red cells was found between the two populations. There was no correlation between the hematocrit and CA activity.

Association of Preoperative Anemia With Postoperative Mortality in Neonates.

PubMed

Goobie, Susan M; Faraoni, David; Zurakowski, David; DiNardo, James A

2016-09-01

Neonates undergoing noncardiac surgery are at risk for adverse outcomes. Preoperative anemia is a strong independent risk factor for postoperative mortality in adults. To our knowledge, this association has not been investigated in the neonatal population. To assess the association between preoperative anemia and postoperative mortality in neonates undergoing noncardiac surgery in a large sample of US hospitals. Using data from the 2012 and 2013 pediatric databases of the American College of Surgeons National Surgical Quality Improvement Program, we conducted a retrospective study of neonates undergoing noncardiac surgery. Analysis of the data took place between June 2015 and December 2015. All neonates (0-30 days old) with a recorded preoperative hematocrit value were included. Anemia defined as hematocrit level of less than 40%. Receiver operating characteristics analysis was used to assess the association between preoperative hematocrit and mortality, and the Youden J Index was used to determine the specific hematocrit cutoff point to define anemia in the neonatal population. Demographic and postoperative outcomes variables were compared between anemic and nonanemic neonates. Univariate and multivariable logistic regression analyses were used to determine factors associated with postoperative neonatal mortality. An external validation was performed using the 2014 American College of Surgeons National Surgical Quality Improvement Program database. Neonates accounted for 2764 children (6%) in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program databases. Neonates inlcuded in the study were predominately male (64.5%), white (66.3%), and term (69.9% greater than 36 weeks' gestation) and weighed more than 2 kg (85.0%). Postoperative in-hospital mortality was 3.4% in neonates and 0.6% in all age groups (0-18 years). A preoperative hematocrit level of less than 40% was the optimal cutoff (Youden) to predict in-hospital mortality. Multivariable regression analysis demonstrated that preoperative anemia is an independent risk factor for mortality (OR, 2.62; 95% CI, 1.51-4.57) in neonates. The prevalence of postoperative in-hospital mortality was significantly higher in neonates with a preoperative hematocrit level less than 40%; being 7.5% (95% CI, 1%-10%) vs 1.4% (95% CI, 0%-4%) for preoperative hematocrit levels 40%, or greater. The relationship between anemia and in-hospital mortality was confirmed in our validation cohort (National Surgical Quality Improvement Program 2014). To our knowledge, this is the first study to define the incidence of preoperative anemia in neonates, the incidence of postoperative in-hospital mortality in neonates, and the association between preoperative anemia and postoperative mortality in US hospitals. Timely diagnosis, prevention, and appropriate treatment of preoperative anemia in neonates might improve survival.

Development and validation of an analytical method using UPLC-MS/MS to quantify everolimus in dried blood spots in the oncology setting.

PubMed

Knapen, Lotte M; Beer, Yvo de; Brüggemann, Roger J M; Stolk, Leo M; Vries, Frank de; Tjan-Heijnen, Vivianne C G; Erp, Nielka P van; Croes, Sander

2018-02-05

While the therapeutic drug monitoring (TDM) of everolimus has been routinely performed for over 10 years in solid organ transplantation medicine, in order to optimize the balance between effectiveness and toxicity, it is yet uncommon in the treatment of malignancies. The aim of this study was to develop and validate a bioanalytical method to quantify everolimus in dried blood spots (DBS) to facilitate TDM for the oncology outpatient setting. The hematocrit effect of everolimus was investigated. An 7.5mm disk from the central part of the DBS was punched, followed by the extraction of everolimus from the DBS by methanol/acetonitrile (80/20%) spiked with deuterium-labelled everolimus as internal standard. Subsequently, everolimus was separated and analyzed using ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The UPLC-MS/MS method was validated according to the European Medicine Agency (EMA) guideline. Everolimus concentrations could be quantified over the range of 3-75μg/L. The intra- and inter-assay precision and accuracy of the method were shown to be acceptable (coefficient of variation ≤10.7% and relative error ≤4.4%, respectively). The matrix effects appeared to be influenced by the hematocrit effect. The hematocrit effect was tested in a range of 0.20-0.50L/L, at which hematocrit accuracy and precision were satisfactory at values ≥0.25L/L. However, at 0.20L/L hematocrit in combination with high everolimus concentrations of 20 and 40μg/L, the precision was adequate (≤7.4%), but the accuracy was >15% of the nominal concentration. Everolimus was stable in DBS for at least 80days at 2-8°C. Given these results, the everolimus DBS method has been successfully developed and validated. Special attention is necessary for cancer patients with both a 0.20L/L hematocrit in combination with everolimus concentrations ≥20μg/L. A clinical validation for the use of everolimus DBS in cancer patients is currently being undertaken. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of the i-STAT Point-of-Care Analyzer in Critically Ill Adult Patients

PubMed Central

Steinfelder-Visscher, Jacoline; Teerenstra, Steven; Klein Gunnewiek, Jacqueline M.T.; Weerwind, Patrick W.

2008-01-01

Abstract: Point-of-care analyzers may benefit therapeutic decision making by reducing turn-around-time for samples. This is especially true when biochemical parameters exceed the clinical reference range, in which acute and effective treatment is essential. We therefore evaluated the analytical performance of the i-STAT point-of-care analyzer in two critically ill adult patient populations. During a 3-month period, 48 blood samples from patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and 42 blood samples from non-cardiac patients who needed intensive care treatment were analyzed on both the i-STAT analyzer (CPB and non-CPB mode, respectively) and our laboratory analyzers (RapidLab 865/Sysmex XE-2100 instrument). The agreement analysis for quantitative data was used to compare i-STAT to RapidLab for blood gas/electrolytes and for hematocrit with the Sysmex instrument. Point-of-care electrolytes and blood gases had constant deviation, except for pH, pO2, and hematocrit. A clear linear trend in deviation of i-STAT from RapidLab was noticed for pH during CPB (r = 0.32, p = .03) and for pO2 > 10 kPa during CPB (r = −0.59, p < .0001 when 10 < pO2 <30 kPa) and in the intensive care unit (r = −0.61, p < .001 when 10 < pO2 <30 kPa). In the normal pO2 range (10.6 < pO2 <13.3 kPa), the performance of the i-STAT was comparable to the RapidLab. In contrast to hematocrit measured during CPB, hematocrit using the non-CPB mode in the non-cardiac intensive care population showed an underestimation up to 2.2% (p < .0001) in the hematocrit range below 25% (n = 11) using the i-STAT. The i-STAT analyzer is suitable for point-of-care testing of electrolytes and blood gases in critically ill patients, except for high pO2. However, the discrepancy in hematocrit bias shows that accuracy established in one patient population cannot be automatically extrapolated to other patient populations, thus stressing the need for separate evaluation. PMID:18389666

Isovolemic hemodilution alters the ratio of whole-body to large-vessel hematocrit (F-cell ratio). A prospective, randomized study comparing the volume effects of hydroxyethyl starch 200,000/0.62 and albumin.

PubMed

Haller, M; Brechtelsbauer, H; Akbulut, C; Fett, W; Briegel, J; Finsterer, U

1995-04-01

To evaluate potential changes in the ratio of whole-body/large-vessel hematocrit (f-cell ratio) during isovolemic hemodilution and to compare the volume effects of 2 different plasma exchange solutions (hydroxyethyl starch 200,000/0.62 6% and human albumin 5%). Prospective, randomized, controlled trial. Operating theater in a university hospital. 24 gynecological patients scheduled for elective surgery. Isovolemic hemodilution was performed using 2 different plasma exchange solutions. Plasma volume was determined using dye dilution technique before and after hemodilution. The volume of withdrawn blood was measured from the change in weight of the blood bags taking into account the specific gravity of blood. The volume of administered plasma exchange solutions exceeded the amount of withdrawn blood by 80 +/- 47 ml (p < 0.001). Plasma volume was 3,067 +/- 327 ml before and 3,517 +/- 458 ml after hemodilution. Using red cell volumes calculated from measured plasma volumes and peripheral hematocrit, a deficit of 249 +/- 133 ml (p < 0.0001) in red cells after hemodilution appeared with the measured withdrawn red cell volumes taken into account. This finding can be explained by a change in the f-cell ratio during isovolemic hemodilution. The volume effect of the exchange solutions was 1.05 for hydroxyethyl starch and 0.95 for albumin. The results demonstrate that a change in the f-cell ratio occurs during isovolemic hemodilution. The estimation of red cell volume or plasma volume changes by using either the hematocrit or plasma or red cell volume determinations together with the hematocrit may lead to erroneous results.

Hematocrit correction does not improve glucose monitor accuracy in the assessment of neonatal hypoglycemia.

PubMed

Wang, Li; Sievenpiper, John L; de Souza, Russell J; Thomaz, Michele; Blatz, Susan; Grey, Vijaylaxmi; Fusch, Christoph; Balion, Cynthia

2013-08-01

The lack of accuracy of point of care (POC) glucose monitors has limited their use in the diagnosis of neonatal hypoglycemia. Hematocrit plays an important role in explaining discordant results. The objective of this study was to to assess the effect of hematocrit on the diagnostic performance of Abbott Precision Xceed Pro (PXP) and Nova StatStrip (StatStrip) monitors in neonates. All blood samples ordered for laboratory glucose measurement were analyzed using the PXP and StatStrip and compared with the laboratory analyzer (ABL 800 Blood Gas analyzer [ABL]). Acceptable error targets were ±15% for glucose monitoring and ±5% for diagnosis. A total of 307 samples from 176 neonates were analyzed. Overall, 90% of StatStrip and 75% of PXP values met the 15% error limit and 45% of StatStrip and 32% of PXP values met the 5% error limit. At glucose concentrations ≤4 mmol/L, 83% of StatStrip and 79% of PXP values met the 15% error limit, while 37% of StatStrip and 38% of PXP values met the 5% error limit. Hematocrit explained 7.4% of the difference between the PXP and ABL whereas it accounted for only 0.09% of the difference between the StatStrip and ABL. The ROC analysis showed the screening cut point with the best performance for identifying neonatal hypoglycemia was 3.2 mmol/L for StatStrip and 3.3 mmol/L for PXP. Despite a negligible hematocrit effect for the StatStrip, it did not achieve recommended error limits. The StatStrip and PXP glucose monitors remain suitable only for neonatal hypoglycemia screening with confirmation required from a laboratory analyzer.

Influence of plasma volume expansion with saline on the plasma levels of an ouabain-like factor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rauch, A.L.; Morris, M.; Buckalew, V.M. Jr.

1986-03-05

Plasma volume expansion with saline activates the cardiopulmonary baroreflex and causes the release of natriuretic factors(s). One putative natriuretic factor has ouabain-like activity (OLA). To examine the relationship between this factor and plasma volume expansion, the OLA of plasma was examined in rats that were volume expanded with 0.9% saline at a rate of 150..mu..l/min/100 g of rat for 15, 30, 60 and 120 minutes. Plasma OLA was quantitated with a radioreceptor assay utilizing /sup 3/H-ouabain and erythrocytes ghosts. The OLA and hematocrit of control rats were 18.2 +/- 2.93 pmoles of OLA/ml of plasma and 43.7 +/- 0.65. Aftermore » plasma volume expansion for 15 and 30 minutes, plasma OLA was not significantly altered (27.1 +/- 6.64 and 15.3 +/- 2.80, respectively). However, the hematocrit was reduced 13.9% (37.6 +/- 1.34, p < 0.05) and 33.6% (29.0 +/- 1.92, p < 0.01) for 15 and 30 minutes of volume expansion, respectively. After 60 minutes of volume expansion the hematocrit began to recover (33.7 +/- 2.16) although it was still significantly depressed (p < 0.01). At this time point the OLA was increased 248% to 63.4 +/- 22.7 pmoles of OLA/ml of plasma (p < 0.01). At 120 minutes of volume expansion the hematocrit was 38.3 +/- 1.24 and the OLA returned to control values (13.4 +/- 5.17). This data indicates that volume expansion causes an increase in plasma OLA and this increase in activity may contribute to the recovery of hematocrit that is seen with continued volume expansion.« less

Regional Tissue Oxygen Extraction and Severity of Anemia in Very Low Birth Weight Neonates: A Pilot NIRS Analysis.

PubMed

Mintzer, Jonathan P; Parvez, Boriana; La Gamma, Edmund F

2018-06-15

 Anemia causes blood flow redistribution and altered tissue metabolic behavior to sustain homeostatic oxygen consumption. We hypothesized that anemia severity would correlate with increased regional fractional tissue oxygen extraction among premature neonates.  Regional oxygen extraction was calculated using pulse oximetry and near-infrared spectroscopy data among neonates <1,250 g during their first 10 postnatal days. Oxygen extraction was assessed for correlations with raw hematocrit levels and following grouping into hematocrit quartiles.  Twenty-seven neonates with gestational age 27 ± 2 weeks and birth weight 966 ± 181 g underwent 116 hematocrit determinations. Cerebral and flank oxygen extraction inversely correlated with hematocrit (cerebral r  = -0.527, p  = 0.005; flank r  = -0.485, p  = 0.01). Increased cerebral oxygen extraction was observed for the lowest three hematocrit quartiles (Q1 0.26 ± 0.08, p  = 0.004; Q2 0.24 ± 0.09, p  = 0.01; Q3 0.25 ± 0.09, p  = 0.03; all compared with Q4 0.18 ± 0.10). Increased flank oxygen extraction occurred for the lowest two quartiles (Q1 0.36 ± 0.12, p  < 0.001; Q2 0.35 ± 0.11, p  < 0.001; compared with Q4 0.22 ± 0.13). Splanchnic oxygen extraction demonstrated no similar correlations.  Increases in tissue oxygen extraction may indicate early pathophysiologic responses to nascent anemia in premature neonates. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of perfusate hematocrit on urea permeability-surface area in isolated dog lung

DOE Office of Scientific and Technical Information (OSTI.GOV)

Parker, R.E.; Roselli, R.J.; Haselton, F.R.

1986-10-01

Seven dog lower left lung lobes were statically inflated and perfused at a constant rate for each lobe with a perfusate in which the hematocrit was altered over a wide range. The permeability-surface area of urea was calculated from multiple indicator dilution curves using two separate injectates for each hematocrit level. One injectate contained only /sup 125/I-albumin as the vascular reference tracer and the other contained both /sup 51/Cr-erythrocytes and /sup 125/I-albumin as the vascular reference tracers; both contained (/sup 14/C)urea as the permeating tracer. The results strongly indicate that the phenomenon of erythrocyte trapping of urea does not affectmore » the calculation of urea permeability-surface area product provided the appropriate albumin-erythrocyte composite reference tracer is utilized in its calculation.« less

Multiple diagnosis based on photoplethysmography: hematocrit, SpO2, pulse, and respiration

NASA Astrophysics Data System (ADS)

Yoon, Gilwon; Lee, Jong Y.; Jeon, Kye Jin; Park, Kun-Kook; Yeo, Hyung S.; Hwang, Hyun T.; Kim, Hong S.; Hwang, In-Duk

2002-09-01

Photo-plethysmography measures pulsatile blood flow in real-time and non-invasively. One of widely known applications of PPG is the measurement of saturated oxygen in arterial blood(SpO2). In our work, using several wavelengths more than those used in a pulse oximeter, an algorithm and instrument have been developed to measure hematocrit, saturated oxygen, pulse and respiratory rates simultaneously. To predict hematocrit, a dedicated algorithm is developed based on scattering of RBC and a protocol for detecting outlier signals is used to increase accuracy and reliability. Digital filtering techniques are used to extract respiratory rate signals. Utilization of wavelengths under 1000nm and a multi-wavelength LED array chip and digital-oriented electronics enable us to make a compact device. Our preliminary clinical trials show that the achieved percent errors are +/-8.2% for hematocrit when tested with 594 persons, R2 for SpO2 fitting is 0.99985 when tested with a Bi-Tek pulse oximeter simulator and the SpO2 error for in vivo test is +/-2.5% over the range of 75~100%. The error of pulse rates is less than +/-5%. We obtained a positive predictive value of 96% for respiratory rates in qualitative analysis.

Quantification of multiple elements in dried blood spot samples.

PubMed

Pedersen, Lise; Andersen-Ranberg, Karen; Hollergaard, Mads; Nybo, Mads

2017-08-01

Dried blood spots (DBS) is a unique matrix that offers advantages compared to conventional blood collection making it increasingly popular in large population studies. We here describe development and validation of a method to determine multiple elements in DBS. Elements were extracted from punches and analyzed using inductively coupled plasma-mass spectrometry (ICP-MS). The method was evaluated with quality controls with defined element concentration and blood spiked with elements to assess accuracy and imprecision. DBS element concentrations were compared with concentrations in venous blood. Samples with different hematocrit were spotted onto filter paper to assess hematocrit effect. The established method was precise and accurate for measurement of most elements in DBS. There was a significant but relatively weak correlation between measurement of the elements Mg, K, Fe, Cu, Zn, As and Se in DBS and venous whole blood. Hematocrit influenced the DBS element measurement, especially for K, Fe and Zn. Trace elements can be measured with high accuracy and low imprecision in DBS, but contribution of signal from the filter paper influences measurement of some elements present at low concentrations. Simultaneous measurement of K and Fe in DBS extracts may be used to estimate sample hematocrit. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Critical hematocrit and oxygen partial pressure in the beating heart of pigs.

PubMed

Hiebl, B; Mrowietz, C; Ploetze, K; Matschke, K; Jung, F

2010-12-01

In cardiac surgery the substitution of lost blood volume by plasma substitutes is a common therapeutical approach. None of the currently available blood substitutes has a sufficient oxygen transport capacity. This can limit the functional integrity of the myocardium known as highly oxygen consumptive. The study was aimed to get information about the minimal hematocrit, also known as critical hematocrit (cHct), which guarantees a stable and adequate oxygen partial pressure in the myocardium (pO2). In adult female pigs (n=7) the hematocrit was reduced by isovolemic blood dilution with an intravenous infusion of isotonic 4% gelatine polysuccinate solution, The substituted blood volume ranged between 3000ml and 7780ml (mean: 5254±1672ml). In all animals the pO2 of the myocardium of the beating heart and of the resting skeletal muscle increased until blood dilution resulted in a Hct decrease down to 15%. Further blood dilution resulted in a decrease of the pO2. Only after the Hct was <10% the pO2 was lower than before blood dilution and accompanied by a lethal ischemia of the myocardium. These data indicate a cHct of about 10% in the pig animal model. Copyright © 2010 Elsevier Inc. All rights reserved.

Tissue perfusion during normovolemic hemodilution investigated by a hydraulic model of the cardiovascular system.

PubMed

Mirhashemi, S; Messmer, K; Intaglietta, M

1987-01-01

Normovolemic hemodilution on a whole body basis is studied by means of a steady flow, hydraulic analogue simulation of the cardiovascular system, based on the Casson's model and current hemodynamic and rheological data. The vasculature is divided into serially connected compartments whose hydraulic resistance is characterized by the average diameter, length, number of vessels, and the corresponding rheological properties of blood formulated by Dintenfass (1971) and Lipowsky et al. (1980). This model computes the pressure distributions in all compartments, where the calculated venous pressure modulates the cardiac function according to the Starling mechanism for cardiac performance. The alterations of flow induced by the action of the heart are added to the effects due to changes in peripheral vascular resistance as a result of hematocrit variation. This model shows that when the response of heart to the changes of venous pressure is impaired, the maximum oxygen carrying capacity occurs at 40% hematocrit (H) where it is 1% higher than normal hematocrit (H = 44%). The normal cardiac response to the changes of venous pressure, causes the maximum oxygen carrying capacity to occur at 32% H where it is 12% greater than that at normal hematocrit. Mean arteriolar pressure and capillary pressure increase while venular pressure is slightly reduced during normovolemic hemodilution.

Different hematologic responses to hypoxia in Sherpas and Quechua Indians.

PubMed

Winslow, R M; Chapman, K W; Gibson, C C; Samaja, M; Monge, C C; Goldwasser, E; Sherpa, M; Blume, F D; Santolaya, R

1989-04-01

Previous studies of the erythropoietic response to hypoxia in high-altitude natives suggest that the hematocrit and hemoglobin values in Himalayan natives (Sherpas) are lower than expected for the altitude, perhaps because of a genetic adaptation. However, differences in sampling techniques and experimental methods make comparisons difficult. Our studies were carried out to compare the erythropoietic response with the same altitude in age-matched natives of the Himalayas and Andes by the same experimental techniques. Healthy male subjects were selected in Ollagüe, Chile (n = 29, 27.3 +/- 5.9 yr) and in Khunde, Nepal (n = 30, 24.7 +/- 3.8 yr). Both of these villages are located at 3,700 m above sea level. Hematologic measurements confirmed lower hematocrit values in Nepal (48.4 +/- 4.5%) than in Chile (52.2 +/- 4.6%) (P less than 0.003). When subjects were matched for hematocrit, erythropoietin concentrations in Chile were higher than in Nepal (P less than 0.01). Detailed measurements of blood O2 affinity in Nepal showed no differences in shape or position of the O2 equilibrium curve between Sherpas and Western sojourners. Our results indicate that although Quechua Indians have higher hematocrits than Sherpas living at the same altitude, nevertheless they may be functionally anemic.

The Relation of Erythropoietin Towards Hemoglobin and Hematocrit in Varying Degrees of Renal Insufficiency.

PubMed

Panjeta, Mirsad; Tahirovic, Ismet; Karamehic, Jasenko; Sofic, Emin; Ridic, Ognjen; Coric, Jozo

2015-06-01

Hypoxia is a basic stimulant in production of erythropoietin (EPO). The primary function of erythrocytes is the transport of oxygen to tissues. Erythropoietin stimulates erythropoiesis which leads to increased production of erythrocytes- their total mass. This increases the capacity of the blood to carry oxygen, reduces the hypoxic stimulus and provides a negative feedback of stopping EPO production. The aim of this study was to establish a quantitative relationship between the concentration of erythropoietin, hemoglobin and hematocrit in different values of renal insufficiency. The survey was conducted on 562 subjects divided into two groups: with and without renal insufficiency. EPO, hemoglobin, hematocrit, serum creatinine and additional parameters iron, vitamin B12, and folic acid were determined by using immunochemical and spectrophotometric methods and glomerular filtration rate (GFR) was calculated as well. EPO values (median) grow to the first degree of renal insufficiency, as compared to EPO values of healthy subjects, this increase is statistically significant, p=0.002. With further deterioration of renal function the values of EPO between all pathological groups are decreasing, and this decrease is statistically significant between first and second degree of renal insufficiency (RI) p<0.001. In the group of healthy subjects EPO is correlated rho = -0.532, p <0.0005 with hematocrit. The correlations are negative and strong and can be predicted by regression line (EP0 = 41.375- Hct * .649; EPO = 61.41-Hb * 0.355). In the group of subjects with the first degree of renal insufficiency EPO is in correlation with hematocrit rho=-0.574, p<0, 0005. It is also correlated with hemoglobin rho=-0.580, p< 0.0005. The correlation is negative (EP0= 42.168- Hct * 0.678). In the group of subjects with the third degree of renal insufficiency EPO is in correlation with hemoglobin rho=0.257, p=0.028. The correlation is medium strong and positive. In the group of subjects with third and fourth degree of renal insufficiency EPO is not in correlation with hemoglobin and hematocrit p>0.05. Renal dysfunction, depending on the level of RI effects differently on the biosynthesis of EPO in a diseased kidney, and consequently it also has a different effect on biosynthesis of HB in bone marrow and its content in the blood.

Colour oscillations in arterioarterial anastomoses reflect natural differences in donor and recipient oxygenation and hematocrit.

PubMed

de Vries, H R; Aalders, M C G; Faber, D J; van den Wijngaard, J P H M; Nikkels, P G J; van Gemert, M J C

2006-01-01

Our aim was to show that the colour difference between brighter and darker red, occasionally observed as an oscillating boundary in the recipient and donor parts of an arterioarterial anastomosis in severe twin-twin transfusion syndrome (TTTS), is a consequence of natural differences in blood oxygenation and hematocrit developing between donor and recipient twins. As method we defined a theoretical model of the placenta with dimensions from pathology examination. From literature we determined the optical absorption and scattering properties of all tissue components, and hematocrit and oxygen saturation values for donor and recipient twins. From our placental model we simulated the spectrum of back-scattered light by standard Monte Carlo photon propagation computations and calculated the colour of chorionic arterial and venous blood vessels by applying the physics theory of colour perception. Our computations demonstrate that recipient arterial blood is somewhat brighter red than donor arterial blood. The strong colour differences seen after laser coagulation of all anastomoses but the arterioarterial were explained from an angiotensin II cut-off in the recipient due to obliteration of arteriovenous anastomoses, causing a temporary increase in recipient placental perfusion and hence in blood oxygenation. In conclusion, natural differences in recipient versus donor blood oxygen saturation and hematocrit in severe TTTS explain the observed colour differences between brighter and darker red observed in the recipient and donor parts of arterioarterial anastomoses.

Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss.

PubMed

Vitello, Dominic J; Ripper, Richard M; Fettiplace, Michael R; Weinberg, Guy L; Vitello, Joseph M

2015-01-01

Purpose. The gravimetric method of weighing surgical sponges is used to quantify intraoperative blood loss. The dry mass minus the wet mass of the gauze equals the volume of blood lost. This method assumes that the density of blood is equivalent to water (1 gm/mL). This study's purpose was to validate the assumption that the density of blood is equivalent to water and to correlate density with hematocrit. Methods. 50 µL of whole blood was weighed from eighteen rats. A distilled water control was weighed for each blood sample. The averages of the blood and water were compared utilizing a Student's unpaired, one-tailed t-test. The masses of the blood samples and the hematocrits were compared using a linear regression. Results. The average mass of the eighteen blood samples was 0.0489 g and that of the distilled water controls was 0.0492 g. The t-test showed P = 0.2269 and R (2) = 0.03154. The hematocrit values ranged from 24% to 48%. The linear regression R (2) value was 0.1767. Conclusions. The R (2) value comparing the blood and distilled water masses suggests high correlation between the two populations. Linear regression showed the hematocrit was not proportional to the mass of the blood. The study confirmed that the measured density of blood is similar to water.

Optical measurement of isolated canine lung filtration coefficients at normal hematocrits.

PubMed

Klaesner, J W; Pou, N A; Parker, R E; Finney, C; Roselli, R J

1997-12-01

In this study, lung filtration coefficient (Kfc) values were measured in eight isolated canine lung preparations at normal hematocrit values using three methods: gravimetric, blood-corrected gravimetric, and optical. The lungs were kept in zone 3 conditions and subjected to an average venous pressure increase of 10.24 +/- 0.27 (SE) cmH2O. The resulting Kfc (ml . min-1 . cmH2O-1 . 100 g dry lung wt-1) measured with the gravimetric technique was 0.420 +/- 0.017, which was statistically different from the Kfc measured by the blood-corrected gravimetric method (0.273 +/- 0.018) or the product of the reflection coefficient (sigmaf) and Kfc measured optically (0. 272 +/- 0.018). The optical method involved the use of a Cellco filter cartridge to separate red blood cells from plasma, which allowed measurement of the concentration of the tracer in plasma at normal hematocrits (34 +/- 1.5). The permeability-surface area product was measured using radioactive multiple indicator-dilution methods before, during, and after venous pressure elevations. Results showed that the surface area of the lung did not change significantly during the measurement of Kfc. These studies suggest that sigmafKfc can be measured optically at normal hematocrits, that this measurement is not influenced by blood volume changes that occur during the measurement, and that the optical sigmafKfc agrees with the Kfc obtained via the blood-corrected gravimetric method.

Anesthesia with isoflurane and sevoflurane in the crested serpent eagle (Spilornis cheela hoya): minimum anesthetic concentration, physiological effects, hematocrit, plasma chemistry and behavioral effects.

PubMed

Chan, Fang-Tse; Chang, Geng-Ruei; Wang, Hsien-Chi; Hsu, Tien-Huan

2013-12-30

The initial goal of this study was to determine the minimum anesthetic concentration (MAC) for isoflurane (ISO) and sevoflurane (SEVO) for the crested serpent eagle. Next, we compared the anesthetic effects of each on the physiological effects, hematocrit, plasma chemistry values and behavior in spontaneously breathing captive adult crested serpent eagles. Sixteen eagles were randomly allocated to two groups for anesthesia with ISO (n=8) or SEVO (n=8). First, we measured the MAC values of ISO and SEVO, and four weeks later, we investigated the effect of each on the physiological effects, hematocrit (HCT) and plasma chemistry values. The MAC values of ISO and SEVO for crested serpent eagles were 1.46 ± 0.30 and 2.03 ± 0.32%, respectively. The results revealed no significant differences between the two anesthetics in induction time, while time of extubation to recovery was significantly shorter with SEVO. A time-related increase in end-tidal CO₂ and decreases in body temperature and respiratory rates were observed during anesthesia with each anesthetic. There were no significant differences between the effect of the two anesthetics on heart rate, hematocrit, plasma chemistry values or respiration, although each caused minor respiration depression. We concluded that SEVO is a more effective inhalant agent than ISO for use in eagles, showing the most rapidest induction and recovery from anesthesia.

Ruxolitinib is effective and safe in Japanese patients with hydroxyurea-resistant or hydroxyurea-intolerant polycythemia vera with splenomegaly.

PubMed

Kirito, Keita; Suzuki, Kenshi; Miyamura, Koichi; Takeuchi, Masahiro; Handa, Hiroshi; Okamoto, Shinichiro; Gadbaw, Brian; Yamauchi, Kyosuke; Amagasaki, Taro; Ito, Kazuo; Hino, Masayuki

2018-02-01

Ruxolitinib, a potent JAK1/JAK2 inhibitor, was found to be superior to the best available therapy (BAT) in controlling hematocrit, reducing splenomegaly, and improving symptoms in the phase 3 RESPONSE study of patients with polycythemia vera with splenomegaly who experienced an inadequate response to or adverse effects from hydroxyurea. We report findings from a subgroup analysis of Japanese patients in RESPONSE (n = 18). The composite response rate (hematocrit control and spleen response) was higher in patients receiving ruxolitinib (50.0%) than in those receiving BAT (8.3%). A total of 50.0% of patients randomized to ruxolitinib achieved a spleen response vs 8.3% of those receiving BAT; 100 and 33.3% of patients in the respective groups achieved hematocrit control, with mean hematocrit in ruxolitinib-treated patients remaining stable at < 45% throughout the study. Similarly, a higher proportion of ruxolitinib-treated patients achieved complete hematologic remission (33.3 vs 16.7%). Ruxolitinib also led to rapid improvements in pruritus. All responses with ruxolitinib were durable to week 80, and its safety profile was consistent with that in the overall study. These findings suggest that ruxolitinib is an effective and well-tolerated treatment option for Japanese patients with polycythemia vera with an inadequate response to or adverse effects from hydroxyurea.

Computational modeling of HHH therapy and impact of blood pressure and hematocrit.

PubMed

Robinson, Joe Sam; Walid, M Sami; Hyun, Sinjae; O'Connell, Robert; Menard, Chris; Bohleber, Brandi

2010-01-01

After an aneurysmal subarachnoid hemorrhage, cerebral microcirculatory changes occur as a result cerebral vasospasm. The objective of this study is to investigate, with a computational model, how various degrees of vasospasm are influenced by increasing the mean blood pressure and decreasing the blood viscosity. Using ANSYS CFX software, a computational model was constructed to simulate steady-state fully developed laminar blood flow through a rigid wall system consisting of the internal carotid artery (ICA), anterior cerebral artery, posterior cerebral artery, and middle cerebral artery (MCA). The MCA was selected for the site of a single acute vasospasm. Five severities of vasospasm were studied: 3 mm (normal), 2.5, 2, 1.5, and 1 mm. The ICA was assumed to have a constant inlet flow rate of 315 mL/min. The anterior cerebral artery and posterior cerebral artery were assumed to have constant outlet flow rates of 105 mL/min and 30 mL/min, respectively. The MCA was assumed to have a constant outlet pressure of 92 mL/min. Two different hematocrits, 45% and 32%, were simulated using the models. For a hematocrit of 45, the mean ICA inlet pressure required to pump blood through the system was 104 mm Hg for the 3-mm diameter MCA and 105, 108, 116, and 158 mm Hg for vasospasm diameters of 2.5, 2, 1.5, and 1 mm, respectively. For a hematocrit of 32, the mean ICA inlet pressure required was 102, 103, 105, 113, and 152 mm Hg, respectively. The MCA required a large increase in mean ICA inlet pressure for vasospasm diameters less than 1.5 mm, which suggests that for vasospasms more than 50% diameter reduction, the blood pressure must be increased dramatically. Decreasing the hematocrit had minimal impact on blood flow in a constricted vessel. Copyright © 2010 Elsevier Inc. All rights reserved.

A Randomized Clinical Trial of Red Blood Cell Transfusion Triggers in Cardiac Surgery.

PubMed

Koch, Colleen G; Sessler, Daniel I; Mascha, Edward J; Sabik, Joseph F; Li, Liang; Duncan, Andra I; Zimmerman, Nicole M; Blackstone, Eugene H

2017-10-01

Class I evidence supporting a threshold for transfusion in the cardiac surgical setting is scarce. We randomly allocated patients to a transfusion hematocrit trigger of 24% versus 28% to compare morbidity, mortality, and resource use. From March 2007 to August 2014, two centers randomly assigned 722 adults undergoing coronary artery bypass graft surgery or valve procedures to a 24% hematocrit trigger (n = 363, low group) or 28% trigger (n = 354, high group). One unit of red blood cells was transfused if the hematocrit fell below the designated threshold. The primary endpoint was a composite of postoperative morbidities and mortality. Treatment effect was primarily assessed using an average relative effect generalized estimating equation model. At the second planned interim analysis, the a priori futility boundary was crossed, and the study was stopped. There was no detected treatment effect on the composite outcome (average relative effect odds ratio, low versus high, 0.86, 95% confidence interval: 0.29 to 2.54, p = 0.71). However, the low group received fewer red blood cell transfusions than the high group (54% versus 75%, p < 0.001), mostly administered in the operating room (low group, 112 [31%]; high group, 208 [59%]), followed by intensive care unit (low, 105 [31%]; high, 115 [34%]) and floor (low, 41 [12%]; high, 42 [13%]). The low group was exposed to lower hematocrits: median before transfusion, 22% (Q1 = 21%, Q3 = 23%) versus 24% (Q1 = 22%, Q3 = 25%). Negative exposures differed between treatment groups, with lower hematocrit in the 24% trigger group and more red blood cells used in the 28% group, but adverse outcomes did not differ. Because red blood cell use was less with a 24% trigger without adverse effects, our randomized trial results support aggressive blood conservation efforts in cardiac surgery. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Measurement of Human Blood and Plasma Volumes

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Szalkay, H. G. H.

1987-01-01

Report reviews techniques for measuring blood-plasma volume in humans. Common technique of using radioactive iodine isotope to label plasma albumin involves unwarranted risks from low-level radiation. Report emphasizes techniques using Evans-blue-dye (T-1824) labeling of albumin, hematocrit or hemoglobin/hematocrit measurements, or blood densitometry. In Evans-blue-dye technique, plasma volume determined from decrease in dye concentration occurring after small amount of dye solution injected into circulatory system. Subjection of Evans blue dye to test for carcinogenicity gave negative results.

A hand-powered, portable, low-cost centrifuge for diagnosing anemia in low-resource settings.

PubMed

Brown, Jocelyn; Theis, Lauren; Kerr, Lila; Zakhidova, Nazima; O'Connor, Kelly; Uthman, Margaret; Oden, Z Maria; Richards-Kortum, Rebecca

2011-08-01

This report describes the development of a hand-powered centrifuge to determine hematocrit values in low-resource settings. A hand-powered centrifuge was constructed by using a salad spinner. Hematocrit values were measured by using the hand-powered device, and results were compared with those of a benchtop centrifuge. The packed cell volume (PCV) measured with the hand-powered device correlated linearly with results obtained with a benchtop centrifuge (r = 0.986, P < 0.001). The PCVs measured with the hand-powered centrifuge were consistently 1.14 times higher than those measured with the benchtop system. The 14% increase in PCV measured with the hand-powered centrifuge is caused by increased plasma trapped in the cell column. The reader card was adjusted to compensate for trapped plasma. A hand-powered centrifuge and calibrated reader card can be constructed for U.S. $35 and can accurately determine hematocrit values. It is suitable for use in low-resource settings because it is mechanically-powered, inexpensive, and accurate.

A Hand-Powered, Portable, Low-Cost Centrifuge for Diagnosing Anemia in Low-Resource Settings

PubMed Central

Brown, Jocelyn; Theis, Lauren; Kerr, Lila; Zakhidova, Nazima; O'Connor, Kelly; Uthman, Margaret; Oden, Z. Maria; Richards-Kortum, Rebecca

2011-01-01

This report describes the development of a hand-powered centrifuge to determine hematocrit values in low-resource settings. A hand-powered centrifuge was constructed by using a salad spinner. Hematocrit values were measured by using the hand-powered device, and results were compared with those of a benchtop centrifuge. The packed cell volume (PCV) measured with the hand-powered device correlated linearly with results obtained with a benchtop centrifuge (r = 0.986, P < 0.001). The PCVs measured with the hand-powered centrifuge were consistently 1.14 times higher than those measured with the benchtop system. The 14% increase in PCV measured with the hand-powered centrifuge is caused by increased plasma trapped in the cell column. The reader card was adjusted to compensate for trapped plasma. A hand-powered centrifuge and calibrated reader card can be constructed for U.S. $35 and can accurately determine hematocrit values. It is suitable for use in low-resource settings because it is mechanically-powered, inexpensive, and accurate. PMID:21813855

In-vitro model for evaluation of pulse oximetry

NASA Astrophysics Data System (ADS)

Vegfors, Magnus; Lindberg, Lars-Goeran; Lennmarken, Claes; Oberg, P. Ake

1991-06-01

An in vitro model with blood circulating in a silicon tubing system and including an artificial arterial bed is an important tool for evaluation of the pulse oximetry technique. The oxygen saturation was measured on an artificial finger using a pulse oximeter (SpO2) and on blood samples using a hemoximeter (SaO2). Measurements were performed at different blood flows and at different blood hematocrits. An increase in steady as well as in pulsatile blood flow was followed by an increase in pulse oximeter readings and a better agreement between SpO2 and SaO2 readings. After diluting the blood with normal saline (decreased hematocrit) the agreement was further improved. These results indicate that the pulse oximeter signal is related to blood hematocrit and the velocity of blood. The flow-related dependance of SpO2 was also evaluated in a human model. These results provided evidence that the pulse oximeter signal is dependent on vascular changes.

Association between red blood cell indices and CD4 count in HIV-positive reproductive women

NASA Astrophysics Data System (ADS)

Lumbanraja, S. N.; Siregar, D. I. S.

2018-03-01

Red blood cell indices, hemoglobin, and hematocrit reflect rapidity of HIV disease progression. This study aims to determine red blood cell indices and CD4 count in HIV-positive reproductive women. This study was a cross sectional study conducted at AIDS outpatient clinic at Haji Adam Malik General Hospital, Medan Indonesia. All seropositive reproductive women within antiretroviral therapy consented for blood count and CD4 examination. Data were collected and analyzed with SPSS 19. In subjects with CD4≤350 mm3, mean hemoglobin was 10.95 ± 2.01, hematocrit was 31.83 ± 5.04%, MCV was 84.17 ± 11.41, MCH was 25.98 ± 2.65, and MCHC was 32.18 ± 2.17. Mean hemoglobin, hematocrit, and MCH value was significantly lower in subjects with CD4 ≤350 mm3 (p=0.014; p=0.001; p=0.01; respectively). Lower Hb, Ht, and MCH associated with thelower CD4 count.

Management of a patient with dengue virus infection and tetralogy of Fallot

NASA Astrophysics Data System (ADS)

Arfijanto, M. V.; Oktiawan, E.; Purwati; Hadi, U.

2018-03-01

TOF belongs to cyanotic heart disease group, which has polycythemia and a high baseline hematocrit. A heart defect that features four problems:a hole between the lower chambers of the heart, an obstruction from the heart to the lungs, the aorta lies over the hole in the lower chambers, the muscle surrounding the lower right chamber becomes overly thickened. Dengue viral infection in patients with TOF would have a greater potential for the occurrence of heart failure because the baseline of hematocrit is already higher compare with non-congenital heart disease. A 22-year-old man complains offever and nausea since three days before hospitalized. The principal treatment is enough rest and rehydration to achieve normal range of hematocrit (around 65%) and to avoid drugs that may precipitate bleeding (like salicylic acid).In the management of this patient, we should be more careful because there wascomorbid with TOF. The focus of the management is to prevent dehydration during the critical phase and aware of overhydration in the recovery phase.

Effect of hematocrit and systolic blood pressure on cerebral blood flow in newborn infants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Younkin, D.P.; Reivich, M.; Jaggi, J.L.

1987-06-01

The effects of hematocrit and systolic blood pressure on cerebral blood flow were measured in 15 stable, low birth weight babies. CBF was measured with a modification of the xenon-133 (/sup 133/Xe) clearance technique, which uses an intravenous bolus of /sup 133/Xe, an external chest detector to estimate arterial /sup 133/Xe concentration, eight external cranial detectors to measure cephalic /sup 133/Xe clearance curves, and a two-compartmental analysis of the cephalic /sup 133/Xe clearance curves to estimate CBF. There was a significant inverse correlation between hematocrit and CBF, presumably due to alterations in arterial oxygen content and blood viscosity. Newborn CBFmore » varied independently of systolic blood pressure between 60 and 84 mm Hg, suggesting an intact cerebrovascular autoregulatory mechanism. These results indicate that at least two of the factors that affect newborn animal CBF are operational in human newborns and may have important clinical implications.« less

Comparison of immunohematological profile between endurance- and power-oriented elite athletes.

PubMed

Morgado, José P; Matias, Catarina N; Monteiro, Cristina P; Alves, Francisco; Reis, Joana F; Santos, Diana A; Silva, Analiza M; Martins, Fátima; Seixas, Maria T; Rocha-Pereira, Petronila; Sardinha, Luís B; Laires, Maria J

2017-03-01

There is general perception that elite athletes are highly susceptible to changes in immunohematological profile. The objective of this study was to compare immunohematological parameters of elite athletes of different aerobic and muscular strength sports and analyze changes over 2 months. Sixteen judoists and 14 swimmers were evaluated 2 months before (M1) and immediately prior to competition (M2). Hemogram and lymphocytes subpopulations were assessed with automatic counter and flow cytometry, respectively. Judoists had higher neutrophils and lower monocytes and eosinophils percentages than swimmers at M1 and M2. At M2 judoists had lower red blood cells (RBC), hemoglobin, and hematocrit than swimmers. At M2 judoists' hematocrit and CD16 decreased while swimmers' hemoglobin and hematocrit increased. In conclusion, neither sports characteristics nor intense training seem to displace the athletes' immunohematological profile out of the clinical range, despite the possibility of occurrence of microlesions that may stimulate production of leukocytes and reduction of RBC in judoists.

Thrombocytopenia in neonates with polycythemia: incidence, risk factors and clinical outcome.

PubMed

Vlug, Roos D; Lopriore, Enrico; Janssen, Marleen; Middeldorp, Johanna M; Rath, Mirjam E A; Smits-Wintjens, Vivianne E H J

2015-02-01

Polycythemia occurs in 1 to 5% of neonates and is associated with complications, including an increased risk of thrombocytopenia. To evaluate incidence, risk factors, management and outcome of thrombocytopenia in neonates with polycythemia. All neonates with polycythemia admitted to our neonatal intensive care unit between 2006 and 2013 were included in this retrospective study. We evaluated the incidence of thrombocytopenia (platelet count <150 × 10(9)/l) and severe thrombocytopenia (platelet count <50 × 10(9)/l) and the correlation between platelet counts and hematocrit values. The incidence of thrombocytopenia and severe thrombocytopenia was 51 (71/140) and 9% (13/140), respectively. Platelet count was negatively correlated with hematocrit (spearman correlation coefficient -0.233, p = 0.007). After multiple regression analysis, we found an independent association between thrombocytopenia and being small for gestational age (OR: 10.0; 95%; CI: 1.2-81.7; p = 0.031). Thrombocytopenia occurs in 51% of neonates with polycythemia and is independently associated with growth restriction. Increased hematocrit is associated with decreased platelet count.

The Effect of Pulsatile Versus Nonpulsatile Blood Flow on Viscoelasticity and Red Blood Cell Aggregation in Extracorporeal Circulation

PubMed Central

Ahn, Chi Bum; Kang, Yang Jun; Kim, Myoung Gon; Yang, Sung; Lim, Choon Hak; Son, Ho Sung; Kim, Ji Sung; Lee, So Young; Son, Kuk Hui; Sun, Kyung

2016-01-01

Background Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous O2 saturation, and lactate were measured. Results The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. Conclusion After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow. PMID:27298790

The Effect of Pulsatile Versus Nonpulsatile Blood Flow on Viscoelasticity and Red Blood Cell Aggregation in Extracorporeal Circulation.

PubMed

Ahn, Chi Bum; Kang, Yang Jun; Kim, Myoung Gon; Yang, Sung; Lim, Choon Hak; Son, Ho Sung; Kim, Ji Sung; Lee, So Young; Son, Kuk Hui; Sun, Kyung

2016-06-01

Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous O2 saturation, and lactate were measured. The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.

Anesthesia with Isoflurane and Sevoflurane in the Crested Serpent Eagle (Spilornis cheela hoya): Minimum Anesthetic Concentration, Physiological Effects, Hematocrit, Plasma Chemistry and Behavioral Effects

PubMed Central

CHAN, Fang-Tse; CHANG, Geng-Ruei; WANG, Hsien-Chi; HSU, Tien-Huan

2013-01-01

ABSTRACT The initial goal of this study was to determine the minimum anesthetic concentration (MAC) for isoflurane (ISO) and sevoflurane (SEVO) for the crested serpent eagle. Next, we compared the anesthetic effects of each on the physiological effects, hematocrit, plasma chemistry values and behavior in spontaneously breathing captive adult crested serpent eagles. Sixteen eagles were randomly allocated to two groups for anesthesia with ISO (n=8) or SEVO (n=8). First, we measured the MAC values of ISO and SEVO, and four weeks later, we investigated the effect of each on the physiological effects, hematocrit (HCT) and plasma chemistry values. The MAC values of ISO and SEVO for crested serpent eagles were 1.46 ± 0.30 and 2.03 ± 0.32%, respectively. The results revealed no significant differences between the two anesthetics in induction time, while time of extubation to recovery was significantly shorter with SEVO. A time-related increase in end-tidal CO2 and decreases in body temperature and respiratory rates were observed during anesthesia with each anesthetic. There were no significant differences between the effect of the two anesthetics on heart rate, hematocrit, plasma chemistry values or respiration, although each caused minor respiration depression. We concluded that SEVO is a more effective inhalant agent than ISO for use in eagles, showing the most rapidest induction and recovery from anesthesia. PMID:23955396

Blood Density Is Nearly Equal to Water Density: A Validation Study of the Gravimetric Method of Measuring Intraoperative Blood Loss

PubMed Central

Vitello, Dominic J.; Ripper, Richard M.; Fettiplace, Michael R.; Weinberg, Guy L.; Vitello, Joseph M.

2015-01-01

Purpose. The gravimetric method of weighing surgical sponges is used to quantify intraoperative blood loss. The dry mass minus the wet mass of the gauze equals the volume of blood lost. This method assumes that the density of blood is equivalent to water (1 gm/mL). This study's purpose was to validate the assumption that the density of blood is equivalent to water and to correlate density with hematocrit. Methods. 50 µL of whole blood was weighed from eighteen rats. A distilled water control was weighed for each blood sample. The averages of the blood and water were compared utilizing a Student's unpaired, one-tailed t-test. The masses of the blood samples and the hematocrits were compared using a linear regression. Results. The average mass of the eighteen blood samples was 0.0489 g and that of the distilled water controls was 0.0492 g. The t-test showed P = 0.2269 and R 2 = 0.03154. The hematocrit values ranged from 24% to 48%. The linear regression R 2 value was 0.1767. Conclusions. The R 2 value comparing the blood and distilled water masses suggests high correlation between the two populations. Linear regression showed the hematocrit was not proportional to the mass of the blood. The study confirmed that the measured density of blood is similar to water. PMID:26464949

Low central venous pressure versus acute normovolemic hemodilution versus conventional fluid management for reducing blood loss in radical retropubic prostatectomy: a randomized controlled trial.

PubMed

Habib, Ashraf S; Moul, Judd W; Polascik, Thomas J; Robertson, Cary N; Roche, Anthony M; White, William D; Hill, Stephen E; Nosnick, Israel; Gan, Tong J

2014-05-01

To compare acute normovolemic hemodilution versus low central venous pressure strategy versus conventional fluid management in reducing intraoperative estimated blood loss, hematocrit drop and need for blood transfusion in patients undergoing radical retropubic prostatectomy under general anesthesia. Patients undergoing radical retropubic prostatectomy under general anesthesia were randomized to conventional fluid management, acute normovolemic hemodilution or low central venous pressure (≤5 mmHg). Treatment effects on estimated blood loss and hematocrit change were tested in multivariable regression models accounting for surgeon, prostate size, and all two-way interactions. Ninety-two patients completed the study. Estimated blood loss (mean ± SD) was significantly lower with low central venous pressure (706 ± 362 ml) compared to acute normovolemic hemodilution (1103 ± 635 ml) and conventional (1051 ± 714 ml) groups (p = 0.0134). There was no difference between the groups in need for blood transfusion, or hematocrit drop from preoperative values. The multivariate model predicting estimated blood loss showed a significant effect of treatment (p = 0.0028) and prostate size (p = 0.0323), accounting for surgeon (p = 0.0013). In the model predicting hematocrit change, accounting for surgeon difference (p = 0.0037), the treatment effect depended on prostate size (p = 0.0007) with the slope of low central venous pressure differing from the other two groups. Hematocrit was predicted to drop more with increased prostate size in acute normovolemic hemodilution and conventional groups but not with low central venous pressure. Limitations include the inability to blind providers to group assignment, possible variability between providers in estimation of blood loss, and the relatively small sample size that was not powered to detect differences between the groups in need for blood transfusion. Maintaining low central venous pressure reduced estimated blood loss compared to conventional fluid management and acute normovolemic hemodilution in patients undergoing radical retropubic prostatectomy but there was no difference in allogeneic blood transfusion between the groups.

Detection and characterization of red blood cell (RBC) aggregation with photoacoustics

NASA Astrophysics Data System (ADS)

Hysi, Eno; Saha, Ratan K.; Rui, Min; Kolios, Michael C.

2012-02-01

Red blood cells (RBCs) aggregate in the presence of increased plasma fibrinogen and low shear forces during blood flow. RBC aggregation has been observed in deep vein thrombosis, sepsis and diabetes. We propose using photoacoustics (PA) as a non-invasive imaging modality to detect RBC aggregation. The theoretical and experimental feasibility of PA for detecting and characterizing aggregation was assessed. A simulation study was performed to generate PA signals from non-aggregated and aggregated RBCs using a frequency domain approach and to study the PA signals' dependence on hematocrit and aggregate size. The effect of the finite bandwidth nature of transducers on the PA power spectra was also investigated. Experimental confirmation of theoretical results was conducted using porcine RBC samples exposed to 1064 nm optical wavelength using the Imagio Small Animal PA imaging system (Seno Medical Instruments, Inc., San Antonio, TX). Aggregation was induced with Dextran-70 (Sigma-Aldrich, St. Louis, MO) and the effect of hematocrit and aggregation level was investigated. The theoretical and experimental PA signal amplitude increased linearly with increasing hematocrit. The theoretical dominant frequency content of PA signals shifted towards lower frequencies (<30 MHz) and 9 dB enhancements in spectral power were observed as the size of aggregates increased compared to non-aggregating RBCs. Calibration of the PA spectra with the transducer response obtained from a 200 nm gold film was performed to remove system dependencies. Analysis of the spectral parameters from the calibrated spectra suggested that PA can assess the degree of aggregation at multiple hematocrit and aggregation levels.

Variation in Red Blood Cell Transfusion Practices During Cardiac Operations Among Centers in Maryland: Results From a State Quality-Improvement Collaborative.

PubMed

Magruder, J Trent; Blasco-Colmenares, Elena; Crawford, Todd; Alejo, Diane; Conte, John V; Salenger, Rawn; Fonner, Clifford E; Kwon, Christopher C; Bobbitt, Jennifer; Brown, James M; Nelson, Mark G; Horvath, Keith A; Whitman, Glenn R

2017-01-01

Variation in red blood cell (RBC) transfusion practices exists at cardiac surgery centers across the nation. We tested the hypothesis that significant variation in RBC transfusion practices between centers in our state's cardiac surgery quality collaborative remains even after risk adjustment. Using a multiinstitutional statewide database created by the Maryland Cardiac Surgery Quality Initiative (MCSQI), we included patient-level data from 8,141 patients undergoing isolated coronary artery bypass (CAB) or aortic valve replacement at 1 of 10 centers. Risk-adjusted multivariable logistic regression models were constructed to predict the need for any intraoperative RBC transfusion, as well as for any postoperative RBC transfusion, with anonymized center number included as a factor variable. Unadjusted intraoperative RBC transfusion probabilities at the 10 centers ranged from 13% to 60%; postoperative RBC transfusion probabilities ranged from 16% to 41%. After risk adjustment with demographic, comorbidity, and operative data, significant intercenter variability was documented (intraoperative probability range, 4% -59%; postoperative probability range, 13%-39%). When stratifying patients by preoperative hematocrit quartiles, significant variability in intraoperative transfusion probability was seen among all quartiles (lowest quartile: mean hematocrit value, 30.5% ± 4.1%, probability range, 17%-89%; highest quartile: mean hematocrit value, 44.8% ± 2.5%; probability range, 1%-35%). Significant variation in intercenter RBC transfusion practices exists for both intraoperative and postoperative transfusions, even after risk adjustment, among our state's centers. Variability in intraoperative RBC transfusion persisted across quartiles of preoperative hematocrit values. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Hemodilution increases cerebral blood flow in acute ischemic stroke

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vorstrup, S.; Andersen, A.; Juhler, M.

1989-07-01

We measured cerebral blood flow in 10 consecutive, but selected, patients with acute ischemic stroke (less than 48 hours after onset) before and after hemodilution. Cerebral blood flow was measured by xenon-133 inhalation and emission tomography, and only patients with focal hypoperfusion in clinically relevant areas were included. Hemodilution was done according to the hematocrit level: for a hematocrit greater than or equal to 42%, 500 ml whole blood was drawn and replaced by the same volume of dextran 40; for a hematocrit between 37% and 42%, only 250 ml whole blood was drawn and replaced by 500 cc ofmore » dextran 40. Mean hematocrit was reduced by 16%, from 46 +/- 5% (SD) to 39 +/- 5% (SD) (p less than 0.001). Cerebral blood flow increased in both hemispheres by an average of 20.9% (p less than 0.001). Regional cerebral blood flow increased in the ischemic areas in all cases, on an average of 21.4 +/- 12.0% (SD) (p less than 0.001). In three patients, a significant redistribution of flow in favor of the hypoperfused areas was observed, and in six patients, the fractional cerebral blood flow increase in the hypoperfused areas was of the same magnitude as in the remainder of the brain. In the last patient, cerebral blood flow increased relatively less in the ischemic areas. Our findings show that cerebral blood flow increases in the ischemic areas after hemodilution therapy in stroke patients. The marked regional cerebral blood flow increase seen in some patients could imply an improved oxygen delivery to the ischemic tissue.« less

Blood parameters as biomarkers of cadmium and lead exposure and effects in wild wood mice (Apodemus sylvaticus) living along a pollution gradient.

PubMed

Tête, Nicolas; Afonso, Eve; Bouguerra, Ghada; Scheifler, Renaud

2015-11-01

Small mammal populations living on contaminated sites are exposed to various chemicals. Lead (Pb) and cadmium (Cd), two well-known nonessential trace metals, accumulate in different organs and are known to cause multiple adverse effects. To develop nonlethal markers in ecotoxicology, the present work aimed to study the relationships between blood parameters (hematocrit, leukocyte levels and granulated erythrocyte levels) and Cd and Pb concentrations in the soil and in the liver and kidneys of wood mice (Apodemus sylvaticus). Individuals were trapped along a pollution gradient with high levels of Cd, Pb and zinc (Zn) contamination. The results indicated that hematological parameters were independent of individual characteristics (age and gender). Blood parameters varied along the pollution gradient, following a pattern similar to the accumulation of Cd in the organs of the wood mice. No relationship was found between the blood parameters studied and Pb concentrations in the organs or in the environment. The hematocrit and leukocyte number decreased with increasing concentrations of Cd in the kidneys and/or in the liver. Moreover, the hematocrit was lower in the animals that were above the thresholds (LOAELs) for Cd concentrations in the liver. These responses were interpreted as a warning of potential negative effects of Cd exposure on the oxygen transport capacity of the blood (e.g., anemia). The present results suggest that blood parameters, notably hematocrit, may offer a minimally invasive biomarker for the evaluation of Cd exposure in further ecotoxicological studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Results of open heart surgery in Jehovah's Witness patients. Single centre experience.

PubMed

Juraszek, Andrzej; Kołsut, Piotr; Szymański, Jarosław; Kuriata, Jarosław; Kuśmierski, Krzysztof; Sitkowska-Rysiak, Ewa; Jasińska, Małgorzata; Kuśmierczyk, Mariusz

2017-09-01

Evaluation the results in patients from the religious community of Jehovah's Witness (JW) undergoing open heart surgery at our institution. Between September 2011 and March 2015, 21 patients with a religious background of the JW church underwent open heart surgery at our institution performed by the same surgical team. Mean age was 68.43 ±8.93 years. There were 13 (61.9%) female patients. Recombinant human erythropoietin was administered to every patient with a hemoglobin value < 12.0 g/dl. Nine patients undergoing isolated coronary artery revascularization were operated on without cardiopulmonary bypass. Seven patients underwent combined surgery and 5 patients underwent aortic valve replacement via ministernotomy. The mean follow-up time was 16.45 ±11.09 months (range: 1.67-44.3 months). Mean baseline hematocrit serum level was 40.15 ±3.34% (range: 34.5-46.1%). Perioperatively the hematocrit serum levels decreased to the mean level of 29.89 ±4.31% (range: 21.4-36.3%). The mean hematocrit value at discharge was 30.85 ±3.59% (range: 23.5-38.4%). One death was observed in the perioperative period. Five (24%) patients suffered from sternum wound infection requiring vacuum-assisted therapy. During the follow-up period 1 patient died due to a non-cardiac related cause. After careful preoperative preparation the results of open heart surgery in JW were very good, including combined procedures. The decrease of hematocrit serum levels significantly characterizing the postoperative period was highly acceptable in this series. Nevertheless, the number of sternum wound infections was a limiting factor for prompt postoperative recovery.

Alteration of chaotic advection in blood flow around partial blockage zone: Role of hematocrit concentration

NASA Astrophysics Data System (ADS)

Maiti, Soumyabrata; Chaudhury, Kaustav; DasGupta, Debabrata; Chakraborty, Suman

2013-01-01

Spatial distributions of particles carried by blood exhibit complex filamentary pattern under the combined effects of geometrical irregularities of the blood vessels and pulsating pumping by the heart. This signifies the existence of so called chaotic advection. In the present article, we argue that the understanding of such pathologically triggered chaotic advection is incomplete without giving due consideration to a major constituent of blood: abundant presence of red blood cells quantified by the hematocrit (HCT) concentration. We show that the hematocrit concentration in blood cells can alter the filamentary structures of the spatial distribution of advected particles in an intriguing manner. Our results reveal that there primarily are two major impacts of HCT concentrations towards dictating the chaotic dynamics of blood flow: changing the zone of influence of chaotic mixing and determining the enhancement of residence time of the advected particles away from the wall. This, in turn, may alter the extent of activation of platelets or other reactive biological entities, bearing immense consequence towards dictating the biophysical mechanisms behind possible life-threatening diseases originating in the circulatory system.

The Hematocrit Affects the Volume of Plasma Treated With Coupled Plasma Filtration and Adsorption With Predilution.

PubMed

Finazzi, Stefano; Garbero, Elena; Trussardi, Giampietro; Bertolini, Guido

2017-05-01

Coupled plasma filtration and adsorption (CPFA) is an extracorporeal blood purification technique proposed for the treatment of septic-shock. By removing pro- and anti-inflammatory mediators from plasma, CPFA is supposed to have a therapeutic effect on the abnormal inflammatory response seen in this condition. Recently, blood predilution with citrate solution has been adopted to prevent clotting in the CPFA circuit-one of the main problems of the technique. Taking into account the patient's hematocrit, we worked out a formula for the volume of plasma effectively treated by CPFA after predilution. Neglecting this effect, as is commonly done, introduces significant distortions in the estimation of the volume, possibly causing under-treatment. The distortion is stronger when the hematocrit and the predilution fraction are large and weaker when both values shrink. By correctly indicating the daily dose of plasma adsorption received by patients, this formula is essential for assessing the therapeutic efficacy of CPFA and, subsequently, establishing its optimal doses. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Continuous monitoring of blood volume changes in humans

NASA Technical Reports Server (NTRS)

Hinghofer-Szalkay, H.; Greenleaf, J. E.

1987-01-01

Use of on-line high-precision mass densitometry for the continuous monitoring of blood volume changes in humans was demonstrated by recording short-term blood volume alterations produced by changes in body position. The mass density of antecubital venous blood was measured continuously for 80 min per session with 0.1 g/l precision at a flow rate of 1.5 ml/min. Additional discrete plasma density and hematocrit measurements gave linear relations between all possible combinations of blood density, plasma density, and hematocrit. Transient filtration phenomena were revealed that are not amenable to discontinuous measurements.

Effects of activity, genetic selection and their interaction on muscle metabolic capacities and organ masses in mice.

PubMed

Kelly, Scott A; Gomes, Fernando R; Kolb, Erik M; Malisch, Jessica L; Garland, Theodore

2017-03-15

Chronic voluntary exercise elevates total daily energy expenditure and food consumption, potentially resulting in organ compensation supporting nutrient extraction/utilization. Additionally, species with naturally higher daily energy expenditure often have larger processing organs, which may represent genetic differences and/or phenotypic plasticity. We tested for possible adaptive changes in organ masses of four replicate lines of house mice selected (37 generations) for high running (HR) compared with four non-selected control (C) lines. Females were housed with or without wheel access for 13-14 weeks beginning at 53-60 days of age. In addition to organ compensation, chronic activity may also require an elevated aerobic capacity. Therefore, we also measured hematocrit and both citrate synthase activity and myoglobin concentration in heart and gastrocnemius. Both selection (HR versus C) and activity (wheels versus no wheels) significantly affected morphological and biochemical traits. For example, with body mass as a covariate, mice from HR lines had significantly higher hematocrit and larger ventricles, with more myoglobin. Wheel access lengthened the small intestine, increased relative ventricle and kidney size, and increased skeletal muscle citrate synthase activity and myoglobin concentration. As compared with C lines, HR mice had greater training effects for ventricle mass, hematocrit, large intestine length and gastrocnemius citrate synthase activity. For ventricle and gastrocnemius citrate synthase activity, the greater training was quantitatively explainable as a result of greater wheel running (i.e. 'more pain, more gain'). For hematocrit and large intestine length, differences were not related to amount of wheel running and instead indicate inherently greater adaptive plasticity in HR lines. © 2017. Published by The Company of Biologists Ltd.

The impact of maternal plasma volume expansion and antihypertensive treatment with intravenous dihydralazine on fetal and maternal hemodynamics during pre-eclampsia: a clinical, echo-Doppler and viscometric study.

PubMed

Boito, S M E; Struijk, P C; Pop, G A M; Visser, W; Steegers, E A P; Wladimiroff, J W

2004-04-01

To establish the effects of plasma volume expansion (PVE) followed by intravenous dihydralazine (DH) administration on maternal whole blood viscosity (WBV) and hematocrit, uteroplacental and fetoplacental downstream impedance and umbilical venous (UV) volume flow in pre-eclampsia. In 13 pre-eclamptic women maternal and fetal hemodynamics were established by means of combined measurement of maternal arterial blood pressure (BP), WBV, hematocrit and uterine artery (UtA) resistance index (RI) in addition to umbilical artery (UA) pulsatility index (PI) and UV volume flow obtained from UV vessel area and UV time-averaged flow velocity. In each woman all parameters were measured four times at baseline, after PVE, after DH and 24 h after the start of treatment. Maternal diastolic BP, hematocrit and WBV display a significant reduction after PVE. In the fetus UA PI decreases significantly whereas a significant increase in UV cross-sectional area was detected. After maternal DH administration, arterial systolic and diastolic BP and UA PI show a significant decrease compared with the measurements following PVE. At 24 h, only maternal systolic and diastolic BP display a significant further decrease. No significant changes were established for the UtA RI, UV time-averaged velocity and UV volume flow during the entire study period. During pre-eclampsia, maternal PVE followed by DH administration results in a significant reduction in maternal diastolic BP, maternal hematocrit and WBV. Maternal PVE is associated with a significant increase in UV cross-sectional area and a non-significant rise of 11% in UV volume flow. Maternal DH administration does not result in any change in UV cross-sectional area. However, UA PI decreases significantly after both PVE and DH treatment. Copyright 2004 ISUOG.

Blood viscosity monitoring during cardiopulmonary bypass based on pressure-flow characteristics of a Newtonian fluid.

PubMed

Okahara, Shigeyuki; Zu Soh; Takahashi, Shinya; Sueda, Taijiro; Tsuji, Toshio

2016-08-01

We proposed a blood viscosity estimation method based on pressure-flow characteristics of oxygenators used during cardiopulmonary bypass (CPB) in a previous study that showed the estimated viscosity to correlate well with the measured viscosity. However, the determination of the parameters included in the method required the use of blood, thereby leading to high cost of calibration. Therefore, in this study we propose a new method to monitor blood viscosity, which approximates the pressure-flow characteristics of blood considered as a non-Newtonian fluid with characteristics of a Newtonian fluid by using the parameters derived from glycerin solution to enable ease of acquisition. Because parameters used in the estimation method are based on fluid types, bovine blood parameters were used to calculate estimated viscosity (ηe), and glycerin parameters were used to estimate deemed viscosity (ηdeem). Three samples of whole bovine blood with different hematocrit levels (21.8%, 31.0%, and 39.8%) were prepared and perfused into the oxygenator. As the temperature changed from 37 °C to 27 °C, the oxygenator mean inlet pressure and outlet pressure were recorded for flows of 2 L/min and 4 L/min, and the viscosity was estimated. The value of deemed viscosity calculated with the glycerin parameters was lower than estimated viscosity calculated with bovine blood parameters by 20-33% at 21.8% hematocrit, 12-27% at 31.0% hematocrit, and 10-15% at 39.8% hematocrit. Furthermore, deemed viscosity was lower than estimated viscosity by 10-30% at 2 L/min and 30-40% at 4 L/min. Nevertheless, estimated and deemed viscosities varied with a similar slope. Therefore, this shows that deemed viscosity achieved using glycerin parameters may be capable of successfully monitoring relative viscosity changes of blood in a perfusing oxygenator.

DELAYING BLOOD TRANSFUSION IN EXPERIMENTAL ACUTE ANEMIA WITH A PERFLUOROCARBON EMULSION

PubMed Central

Cabrales, Pedro; Briceño, Juan Carlos

2011-01-01

Background To avoid unnecessary blood transfusions, physiologic transfusion triggers, rather than exclusively hemoglobin-based transfusion triggers have been suggested. The objective of this study was to determine systemic and microvascular effects of using a perfluorocarbon-based oxygen carrier (PFCOC) to maintaining perfusion and oxygenation during extreme anemia. Methods The hamster (weight 55-65 g) window chamber model was used. Two isovolemic hemodilution steps were performed using 10% hydroxyethyl starch at normoxic conditions to hematocrit of 19% (5.5 gHb/dl), point where the transfusion trigger was reached. Two additional hemodilution exchanges using the PFCOC (Oxycyte™, Synthetic Blood International, Inc. Costa Mesa, CA) and increasing fraction of inspired oxygen to 1.0 were performed to reduce hematocrit to 11% (3.8 gHb/dl) and 6% (2.0 gHb/dl), respectively. No control group was used in the study, as this level of hemodilution is lethal with conventional plasma expanders. Systemic parameters, microvascular perfusion, functional capillary density and oxygen tensions across the microvascular network were measured. Results At 6% hematocrit, the PFCOC maintained mean arterial pressure, cardiac output, systemic oxygen delivery and consumption. As hematocrit was lowered from 11% to 6%, functional capillary density, calculated microvascular oxygen delivery and consumption decreased, and oxygen extraction ratio was close to 100%. Peripheral tissue oxygenation was not predicted by systemic oxygenation. Conclusions PFCOC in conjunction with hyperoxia was able to sustain organ function, and partially provide systemic oxygenation during extreme anemia over the observation period. The PFCOC can work as a bridge until red blood cells are available for transfusion, or where additional oxygen is required, notwithstanding possible limitations in peripheral tissue oxygenation. PMID:21326091

Effects of endotoxemia on systemic plasma loss and hematocrit in rats

DOE Office of Scientific and Technical Information (OSTI.GOV)

van Lambalgen, A.A.; Rasker, M.T.; van den Bos, G.C.

1988-11-01

Endotoxemia in rats increases plasma extravasation but does not result in continuously rising hematocrit. These contradictory observations led us to design a study in anesthetized rats (C, control rats, n = 10; E, endotoxin rats, n = 10) in which we continuously measured in blood hematocrit (conductivity cell) and changes in concentration of 125I-HSA (human serum albumin) and 51Cr-labeled red cell (51Cr-RBC; multichannel analyzer) in an extracorporeal circuit. In two additional series of experiments we measured in blood samples changes in protein concentration (series II, C: n = 7, E: n = 7) and uptake of intraperitoneally injected 125I-HSA andmore » 51Cr-RBC (reflecting lymph flow rate; series III, C: n = 6, E: n = 7). Endotoxemia was induced by infusion (iv, 0.2 ml/100 g.hr) of Escherichia coli endotoxin (20 mg/kg) from t = 0 to t = 60 min; controls received saline. Experiments ended at t = 120 (series I and II) or 150 min (series III). The endotoxemia resulted in a marked rise of serum lactate (by ca 500% at t = 120); heart rate increased and central venous pressure decreased (by ca 20 and -95% at t = 120, respectively). All rats showed characteristic changes in hematocrit during endotoxemia: an increase from t = 20 to t = 45 (by ca 9%) followed by a decrease to preshock values or less at t = 120. The 51Cr activity per microliter blood cells did not change, indicating that there was no red cell mobilization. Protein concentration and 125I-HSA activity also showed a temporary increase during endotoxemia, but 125I-HSA activity per gram protein was decreased. Peritoneal uptake of 125I-HSA and 51Cr-RBC was significantly increased during endotoxemia (by 200%).« less

Results of open heart surgery in Jehovah’s Witness patients. Single centre experience

PubMed Central

Kołsut, Piotr; Szymański, Jarosław; Kuriata, Jarosław; Kuśmierski, Krzysztof; Sitkowska-Rysiak, Ewa; Jasińska, Małgorzata; Kuśmierczyk, Mariusz

2017-01-01

Aim Evaluation the results in patients from the religious community of Jehovah’s Witness (JW) undergoing open heart surgery at our institution. Material and methods Between September 2011 and March 2015, 21 patients with a religious background of the JW church underwent open heart surgery at our institution performed by the same surgical team. Mean age was 68.43 ±8.93 years. There were 13 (61.9%) female patients. Recombinant human erythropoietin was administered to every patient with a hemoglobin value < 12.0 g/dl. Nine patients undergoing isolated coronary artery revascularization were operated on without cardiopulmonary bypass. Seven patients underwent combined surgery and 5 patients underwent aortic valve replacement via ministernotomy. The mean follow-up time was 16.45 ±11.09 months (range: 1.67–44.3 months). Results Mean baseline hematocrit serum level was 40.15 ±3.34% (range: 34.5–46.1%). Perioperatively the hematocrit serum levels decreased to the mean level of 29.89 ±4.31% (range: 21.4–36.3%). The mean hematocrit value at discharge was 30.85 ±3.59% (range: 23.5–38.4%). One death was observed in the perioperative period. Five (24%) patients suffered from sternum wound infection requiring vacuum-assisted therapy. During the follow-up period 1 patient died due to a non-cardiac related cause. Conclusions After careful preoperative preparation the results of open heart surgery in JW were very good, including combined procedures. The decrease of hematocrit serum levels significantly characterizing the postoperative period was highly acceptable in this series. Nevertheless, the number of sternum wound infections was a limiting factor for prompt postoperative recovery. PMID:29181043

The Use of Dried Blood Spots for Pharmacokinetic Monitoring of Vemurafenib Treatment in Melanoma Patients.

PubMed

Nijenhuis, Cynthia M; Huitema, Alwin D R; Marchetti, Serena; Blank, Christian; Haanen, John B A G; van Thienen, Johannes V; Rosing, Hilde; Schellens, Jan H M; Beijnen, Jos H

2016-10-01

Pharmacokinetic monitoring is increasingly becoming an important part of clinical care of tyrosine kinase inhibitor treatment. Vemurafenib is an oral tyrosine kinase inhibitor that inhibits mutated serine/threonine protein kinase B-Raf (BRAF) and is approved for the treatment of adult patients with BRAF V600 mutation-positive unresectable or metastatic melanoma. The aim of this study was to establish the relationship between dried blood spot (DBS) and plasma concentrations of vemurafenib to enable the use of DBS sampling, which is a minimally invasive form of sample collection. In total, 43 paired plasma and DBS samples (in duplicate) were obtained from 8 melanoma patients on vemurafenib therapy and were analyzed using high-performance liquid chromatography-tandem mass spectrometry. Plasma concentrations were predicted from the DBS concentrations using 2 methods: (1) individual hematocrit correction and blood cell-to-plasma partitioning and (2) the calculated slope explaining the relationship between DBS and plasma concentrations (without individual hematocrit correction). Vemurafenib DBS concentrations and plasma concentrations showed a strong correlation (r = 0.964), and the relationship could be described by ([vemurafenib]plasma = [vemurafenib]DBS /0.64). The predicted plasma concentrations were within ±20% of the analyzed plasma concentrations in 97% and 100% of the samples for the methods with and without hematocrit correction, respectively. In conclusion, DBS concentrations and plasma concentrations of vemurafenib are highly correlated. Plasma concentrations can be predicted from DBS concentration using the blood cell-to-plasma partition and the average hematocrit value of this cohort (0.40 L/L). DBS sampling for pharmacokinetic monitoring of vemurafenib treatment can be used in clinical practice. © 2016, The American College of Clinical Pharmacology.

Effect of dehydration on erythropoiesis in mice - Relevance to the 'anemia' of space flight

NASA Technical Reports Server (NTRS)

Dunn, C. D. R.

1978-01-01

Mice deprived of water for 24 h showed an increase in hematocrit and loss of body weight comparable to that seen in men during space flight. The increase in hematocrit was entirely due to a decrease in plasma volume and was associated with suppression of erythropoiesis, but with no significant change in the serum titer of a presumptive humoral regulator of erythropoiesis, Erythroid Stimulating Activity (ESA). Mice deprived of water for 24 h may be a useful model for the study of the early hematological effects of space flight. The suppression of erythropoiesis due to a relative erythrocytosis appears to be independent of ESA.

INCREASED BLOOD VOLUME IN POLYCYTHEMIA VERA AND THE EFFECT ON IT OF TREATMENT WITH P$sup 3$$sup 2$

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burger, T.; Keszthelyi, B.; Peer, J.

1961-01-01

The effect of this treatment was studied in 3 patients with polycythemia vera having hematocrits of 70-80% and red cell counts of 6-8 x 10/sup 6/. Plasma volume was also elevated and the red cell volume was decreased to 80-5 mu m/sup 3/ from a normal mean of 87. After a single injection of 3-10 mc inorganic P/sup 32/O/sub 4/, subjective symptoms improved as well as the hematologic values. Hematocrit, hemoglobin, and counts of erythrocytes, leukocytes, and thrombocytes fell. Blood volume and viscosity also declined. (H.H.D.)

User's instructions for the erythropoiesis regulatory model

NASA Technical Reports Server (NTRS)

1978-01-01

The purpose of the model provides a method to analyze some of the events that could account for the decrease in red cell mass observed in crewmen returning from space missions. The model is based on the premise that erythrocyte production is governed by the balance between oxygen supply and demand at a renal sensing site. Oxygen supply is taken to be a function of arterial oxygen tension, mean corpuscular hemoglobin concentration, oxy-hemoglobin carrying capacity, hematocrit, and blood flow. Erythrocyte destruction is based on the law of mass action. The instantaneous hematocrit value is derived by integrating changes in production and destruction rates and accounting for the degree of plasma dilution.

Simultaneous, noninvasive, in vivo, continuous monitoring of hematocrit, vascular volume, hemoglobin oxygen saturation, pulse rate and breathing rate in humans and other animal models using a single light source

NASA Astrophysics Data System (ADS)

Dent, Paul; Tun, Sai Han; Fillioe, Seth; Deng, Bin; Satalin, Josh; Nieman, Gary; Wilcox, Kailyn; Searles, Quinn; Narsipur, Sri; Peterson, Charles M.; Goodisman, Jerry; Mostrom, James; Steinmann, Richard; Chaiken, J.

2018-02-01

We previously reported a new algorithm "PV[O]H" for continuous, noninvasive, in vivo monitoring of hematocrit changes in blood and have since shown its utility for monitoring in humans during 1) hemodialysis, 2) orthostatic perturbations and 3) during blood loss and fluid replacement in a rat model. We now show that the algorithm is sensitive to changes in hemoglobin oxygen saturation. We document the phenomenology of the effect and explain the effect using new results obtained from humans and rat models. The oxygen sensitivity derives from the differential absorption of autofluorescence originating in the static tissues by oxy and deoxy hemoglobin. Using this approach we show how to perform simultaneous, noninvasive, in vivo, continuous monitoring of hematocrit, vascular volume, hemoglobin oxygen saturation, pulse rate and breathing rate in mammals using a single light source. We suspect that monitoring of changes in this suite of vital signs can be provided with improved time response, sensitivity and precision compared to existing methodologies. Initial results also offer a more detailed glimpse into the systemic oxygen transport in the circulatory system of humans.

Real-Time Electrical Impedimetric Monitoring of Blood Coagulation Process under Temperature and Hematocrit Variations Conducted in a Microfluidic Chip

PubMed Central

Lei, Kin Fong; Chen, Kuan-Hao; Tsui, Po-Hsiang; Tsang, Ngan-Ming

2013-01-01

Blood coagulation is an extremely complicated and dynamic physiological process. Monitoring of blood coagulation is essential to predict the risk of hemorrhage and thrombosis during cardiac surgical procedures. In this study, a high throughput microfluidic chip has been developed for the investigation of the blood coagulation process under temperature and hematocrit variations. Electrical impedance of the whole blood was continuously recorded by on-chip electrodes in contact with the blood sample during coagulation. Analysis of the impedance change of the blood was conducted to investigate the characteristics of blood coagulation process and the starting time of blood coagulation was defined. The study of blood coagulation time under temperature and hematocrit variations was shown a good agreement with results in the previous clinical reports. The electrical impedance measurement for the definition of blood coagulation process provides a fast and easy measurement technique. The microfluidic chip was shown to be a sensitive and promising device for monitoring blood coagulation process even in a variety of conditions. It is found valuable for the development of point-of-care coagulation testing devices that utilizes whole blood sample in microliter quantity. PMID:24116099

Effect of long-term exercise training on blood viscosity during endurance exercise at an anaerobic threshold intensity.

PubMed

Adachi, H; Sakurai, S; Tanehata, M; Oshima, S; Taniguchi, K

2000-11-01

Blood viscosity (etaB) is low in athletes, but the effect of exercise training on etaB during endurance exercise at an anaerobic threshold (AT) intensity in non-athletes is not well known, although it is known that exercise training sometimes induces the hyperviscosity syndrome. Fourteen subjects were recruited and divided into 2 groups: those who trained at an AT intensity for 30 min/day, 3 times weekly for 1 year (Group T, n=8), and sedentary subjects (Group C, n=6). The test protocol consisted of a single 30-min treadmill exercise at each individual's AT intensity, which was determined in advance. The etaB, plasma viscosity (etaP), and hematocrit were measured just before and at the end of the treadmill exercise. The subjects were not allowed to drink any water before exercise. In the Group C subjects, the hematocrit and etaP increased significantly and the etaB tended to increase. However, in the Group T subjects, the hematocrit and etaP did not increase and the etaB decreased significantly. These data indicate that long-term exercise training attenuates the increase in blood viscosity during exercise.

Evaluation of two glucose meters and interference corrections for screening neonatal hypoglycemia.

PubMed

Wada, Yuka; Nakamura, Tomoo; Kaneshige, Masao; Takahashi, Shigehiro; Fujinaga, Hideshi; Tsukamoto, Keiko; Ito, Yushi; Sago, Haruhiko

2015-08-01

Many neonatal intensive care and maternal units still use self-monitoring of blood glucose (SMBG) devices as a tool to aid diagnosis despite the introduction of point-of-care testing (POCT) devices, which are known to have higher accuracy. We evaluated the performance of two glucose meters, the StatStrip (Nova Biomedical), a POCT device, and the Medisafe Mini (Terumo), an SMBG device, to detect hypoglycemia in neonates. In addition, we evaluated the interference of hematocrit, acetaminophen and ascorbic acid. Whole blood samples were drawn from neonates who were at risk of hypoglycemia and analyzed with the StatStrip and Medisafe Mini. The results were further confirmed with blood gas analyzers ABL825 and BM6050. To evaluate the interference of hematocrit, acetaminophen and ascorbic acid, concentrated solutions of glucose and interfering substances were gravimetrically prepared and analyzed. Among the 222 blood samples analyzed, results from the StatStrip were more closely aligned to those of the ABL825 at all levels of glucose than the Medisafe Mini. StatStrip appears to be unaffected by hematocrit, ascorbic acid or acetaminophen. We recommend its use in neonates in hospital. Further studies are required to identify other interference effects. © 2014 Japan Pediatric Society.

The effects of erythrocyte deformability upon hematocrit assessed by the conductance method.

PubMed

Hayashi, Yoshihito; Katsumoto, Yoichi; Oshige, Ikuya; Omori, Shinji; Yasuda, Akio; Asami, Koji

2009-04-21

A comparative study of centrifugation and conductance methods for the estimation of cell volume fraction (phi) was performed to examine whether the strong forces exerted upon erythrocytes during centrifugation affect their volume, and the results are discussed in terms of erythrocyte deformability. Rabbit erythrocytes of four shapes (spherocytes, echinocytes, stomatocyte-like enlarged erythrocytes and discocytes) were prepared by controlling the pH of the suspending media. The packed cell volumes of the suspensions were measured by standard hematocrit determination methods using centrifugation in capillary tubes. Simultaneously, the same suspensions and their supernatants were used in dielectric spectroscopy measurements, and the low-frequency limits of their conductivities were used for the numerical estimation of phi. The hematocrit values of spherocytes and echinocytes were markedly less than the volume fractions obtained by the conductance method. Namely, the centrifugation reduced the cell volume. For enlarged erythrocytes and discocytes, however, the reduction of cell volume was not observed. These findings showed that phi obtained by the centrifugation method can be greatly affected by the deformability of the cells, but the level of the effect depends on the cell types. Consequently, phi obtained by the centrifugation method should be carefully interpreted.

Polycythemia Vera Management and Challenges in the Community Health Setting

PubMed Central

Gerds, Aaron T.; Dao, Kim-Hien

2017-01-01

Patients with polycythemia vera (PV) experience shortened survival, increased risk of thromboembolic and hemorrhagic events, and burdensome symptoms. For all patients with PV, treatment with aspirin and hematocrit control with phlebotomy are recommended. In addition, patients with high-risk status or poor hematocrit control benefit from cytoreductive therapy with hydroxyurea, although approximately 1 in 4 patients develops resistance or intolerance. For patients who are resistant to or intolerant of hydroxyurea, studies have shown that ruxolitinib, a Janus kinase 1/2 inhibitor, provides hematocrit control, reduces spleen size, normalizes blood counts, and improves PV-related symptoms. For many patients, PV is managed in a community health setting, and it is important that community hematologists, oncologists, and internists are familiar with the contemporary management of PV to improve patient outcomes, including management for patients who present with unique health-care needs. This review provides an overview of current treatment options for patients with PV and discusses challenging circumstances encountered by community providers in the management of PV, including symptom assessment, identification of hydroxyurea resistance/intolerance, pregnancy, elective surgeries, concomitant immunosuppressants, and managing patients in areas with limited access to specialized hematologic care. PMID:28095380

Comparison of three methods of sampling trout blood for measurements of hematocrit

USGS Publications Warehouse

Steucke, Erwin W.; Schoettger, Richard A.

1967-01-01

Trout blood is frequently collected for hematocrit measurements by excising the caudal fin (Snieszko, 1960), but this technique is impractical if valuable fish are to be sampled or if repeated observations are desired. Schiffman (1959) and Snieszko (1960) collected blood from the dorsal aorta and the heart, but these methods are relatively slow and require the preparation of needles and syringes. The use of pointed capillary tubes for cardiac punctures increases the speed of sampling, but body fluids may dilute the blood (Perkins, 1957; Larsen and Snieszko, 1961; and Normandau, 1962). There is need for methods of sampling which are rapid and which neither influence hematological determinations nor harm the fish.

Blood values of the canvasback duck by age, sex and season

USGS Publications Warehouse

Kocan, R.M.; Pitts, S.M.

1976-01-01

Blood samples were obtained from canvasback ducklings from Manitoba and Saskatchewan and from immature and adult canvasbacks on the Mississippi River near LaCrosse, Wisconsin and the Chesapeake Bay. These samples were used to determine baseline data on red cell counts, hematocrit, total protein, glucose, cholesterol, hemoglobin and distribution of plasma proteins. Calculations were also made to determine mean corpuscular volume, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. The major differences noted were between ducklings and adults. The former having higher total protein and lower hematocrit, glucose and cholesterol values. These hematologic values were collected in order to provide baseline information on apparently healthy canvasbacks, thereby providing disease investigators with a standard of comparison

Red cell volume with changes in plasma osmolarity during maximal exercise.

NASA Technical Reports Server (NTRS)

Van Beaumont, W.

1973-01-01

The volume of the red cell in vivo was measured during acute changes in plasma osmolarity evoked through short (6 to 8 min) maximal exercise in six male volunteer subjects. Simultaneous measurements of mean corpuscular red cell volume (MCV), hematocrit, blood hemoglobin, mean corpuscular hemoglobin concentration (MCHC), and plasma osmolarity showed that there was no change in the MCV or MCHC with a concomitant rise of nearly 6% in plasma osmolarity. Apparently, in vivo, the volume of the red cell in exercising healthy human subjects does not change measurably, in spite of significant changes in osmotic pressure of the surrounding medium. Consequently, it is not justified to correct postexercise hematocrit measurements for changes in plasma osmolarity.

Validation of a model for investigating red cell mass changes during weightlessness

NASA Technical Reports Server (NTRS)

Leonard, J. I.

1976-01-01

The model, both the conceptual model and simulation model, provided a convenient framework on which to demonstrate the commonality between such diverse stresses as descent from altitude, red cell infusions, bed rest, and weightlessness. The results suggest that all of these stresses induce an increased blood hematocrit leading to tissue hyperoxia and eventual inhibition of the erythyocyte producing circuit until the hyperoxic condition is relieved. The erythropoietic system was acting, in these situations, as if it were an hematocrit sensor and regulator. In these terms the decreases in red cell mass during Skylab may be explained in terms of normal feedback regulation of the erythropoietic system in the face of sustained decreases in plasma colume.

Education on fluid management and encouraging critical thinking skills.

PubMed

Dale, Willette

2012-01-01

The unit is currently utilizing hematocrit-based blood volume monitoring on each patient, resulting in improved monitoring in patients achieving their target weight. The nurses expressed confidence in their understanding of the use of hematocrit-based blood volume monitoring. This learning experience provided a vivid look at the importance of fluid management in nephrology nursing. This area should always be included in nephrology nurse competencies and represented in a way that it ignites critical thinking within the nursing professional. It is the responsibility of a professional nurse to stay current in evidence-based practice and continuing education. Professional pride stimulates nephrology nurses to seek new learning experiences to enhance their practice.

Ruxolitinib for the treatment of inadequately controlled polycythemia vera without splenomegaly: 80-week follow-up from the RESPONSE-2 trial.

PubMed

Griesshammer, Martin; Saydam, Guray; Palandri, Francesca; Benevolo, Giulia; Egyed, Miklos; Callum, Jeannie; Devos, Timothy; Sivgin, Serdar; Guglielmelli, Paola; Bensasson, Caroline; Khan, Mahmudul; Ronco, Julian Perez; Passamonti, Francesco

2018-05-27

RESPONSE-2 is a phase 3 study comparing the efficacy and safety of ruxolitinib with the best available therapy (BAT) in hydroxyurea-resistant/hydroxyurea-intolerant polycythemia vera (PV) patients without palpable splenomegaly. This analysis evaluated the durability of the efficacy and safety of ruxolitinib after patients completed the visit at week 80 or discontinued the study. Endpoints included proportion of patients achieving hematocrit control (< 45%), proportion of patients achieving complete hematologic remission (CHR) at week 28, and the durability of hematocrit control and CHR. At the time of analysis, 93% (69/74) of patients randomized to ruxolitinib were receiving ruxolitinib; while in the BAT arm, 77% (58/75) of patients crossed over to ruxolitinib after week 28. No patient remained on BAT by week 80. Among patients who achieved a hematocrit response at week 28, the probability of maintaining response up to week 80 was 78% in the ruxolitinib arm. At week 80, durable CHR was achieved in 18 patients (24%) in the ruxolitinib arm versus 2 patients (3%) in the BAT arm. The safety profile of ruxolitinib was consistent with previous reports. These data support that ruxolitinib treatment should be considered also as a standard of care for hydroxyurea-resistant/hydroxyurea-intolerant PV patients without palpable splenomegaly.

Red Blood Cell Hematocrit Influences Platelet Adhesion Rate in a Microchannel

NASA Astrophysics Data System (ADS)

Spann, Andrew; Campbell, James; Fitzgibbon, Sean; Rodriguez, Armando; Shaqfeh, Eric

2014-11-01

The creation of a blood clot to stop bleeding involves platelets forming a plug at the site of injury. Red blood cells indirectly play a role in ensuring that the distribution of platelets across the height of the channel is not uniform - the contrast in deformability and size between platelets and red blood cells allows the platelets to preferentially marginate close to the walls. We perform 3D boundary integral simulations of a suspension of platelets and red blood cells in a periodic channel with a model that allows for platelet binding at the walls. The relative rate of platelet activity with varying hematocrit (volume fraction of red blood cells) is compared to experiments in which red blood cells and platelets flow through a channel coated with von Willebrand factor. In the simulations as well as the experiments, a decrease in hematocrit of red blood cells is found to reduce the rate at which platelets adhere to the channel wall in a manner that is both qualitatively and quantitatively similar. We conclude with a discussion of the tumbling and wobbling motions of platelets in 3D leading up to the time at which the platelets bind to the wall. Funded by Stanford Army High Performance Computing Research Center, experiments by US Army Institute of Surgical Research.

Point-of-care blood gases, electrolytes, chemistries, hemoglobin, and hematocrit measurement in venous samples from pet rabbits.

PubMed

Selleri, Paolo; Di Girolamo, Nicola

2014-01-01

Point-of-care testing is an attractive option in rabbit medicine, because it permits rapid analysis of a panel of electrolytes, chemistries, blood gases, hemoglobin, and hematocrit, requiring only 65 μL of blood. The purpose of this study was to evaluate the performance of a portable clinical analyzer for measurement of pH, partial pressure of CO2, Na, chloride, potassium, blood urea nitrogen, glucose, hematocrit, and hemoglobin in healthy and diseased rabbits. Blood samples obtained from 30 pet rabbits were analyzed immediately after collection by the portable clinical analyzer (PCA) and immediately thereafter (time <20 sec) by a reference analyzer. Bland-Altman plots and Passing-Bablok regression analysis were used to compare the results. Limits of agreement were wide for all the variables studied, with the exception of pH. Most variables presented significant proportional and/or constant bias. The current study provides sufficient evidence that the PCA presents reliability for pH, although its low agreement with a reference analyzer for the other variables does not support their interchangeability. Limits of agreement provided for each variable allow researchers to evaluate if the PCA is reliable enough for their scope. To the authors' knowledge, the present is the first report evaluating a PCA in the rabbit.

Measurement of lung fluid volumes and albumin exclusion in sheep

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pou, N.A.; Roselli, R.J.; Parker, R.E.

1989-10-01

A radioactive tracer technique was used to determine interstitial diethylenetriaminepentaacetic acid (DTPA) and albumin distribution volume in sheep lungs. {sup 125}I- and/or {sup 131}I-labeled albumin were injected intravenously and allowed to equilibrate for 24 h. {sup 99m}Tc-labeled DTPA and {sup 51}Cr-labeled erythrocytes were injected and allowed to equilibrate (2 h and 15 min, respectively) before a lethal dose of thiamylal sodium. Two biopsies (1-3 g) were taken from each lung and the remaining tissue was homogenized for wet-to-dry lung weight and volume calculations. Estimates of distribution volumes from whole lung homogenized samples were statistically smaller than biopsy samples for extravascularmore » water, interstitial {sup 99m}Tc-DTPA, and interstitial albumin. The mean fraction of the interstitium (Fe), which excludes albumin, was 0.68 +/- 0.04 for whole lung samples compared with 0.62 +/- 0.03 for biopsy samples. Hematocrit may explain the consistent difference. To make the Fe for biopsy samples match that for homogenized samples, a mean hematocrit, which was 82% of large vessel hematocrit, was required. Excluded volume fraction for exogenous sheep albumin was compared with that of exogenous human albumin in two sheep, and no difference was found at 24 h.« less

Non-invasive prediction of hematocrit levels by portable visible and near-infrared spectrophotometer.

PubMed

Sakudo, Akikazu; Kato, Yukiko Hakariya; Kuratsune, Hirohiko; Ikuta, Kazuyoshi

2009-10-01

After blood donation, in some individuals having polycythemia, dehydration causes anemia. Although the hematocrit (Ht) level is closely related to anemia, the current method of measuring Ht is performed after blood drawing. Furthermore, the monitoring of Ht levels contributes to a healthy life. Therefore, a non-invasive test for Ht is warranted for the safe donation of blood and good quality of life. A non-invasive procedure for the prediction of hematocrit levels was developed on the basis of a chemometric analysis of visible and near-infrared (Vis-NIR) spectra of the thumbs using portable spectrophotometer. Transmittance spectra in the 600- to 1100-nm region from thumbs of Japanese volunteers were subjected to a partial least squares regression (PLSR) analysis and leave-out cross-validation to develop chemometric models for predicting Ht levels. Ht levels of masked samples predicted by this model from Vis-NIR spectra provided a coefficient of determination in prediction of 0.6349 with a standard error of prediction of 3.704% and a detection limit in prediction of 17.14%, indicating that the model is applicable for normal and abnormal value in Ht level. These results suggest portable Vis-NIR spectrophotometer to have potential for the non-invasive measurement of Ht levels with a combination of PLSR analysis.

Blood rheology and 2,3-diphosphoglycerate levels after erythropoietin treatment.

PubMed

Crowley, J P; Chazan, J A; Metzger, J B; Pono, L; Valeri, C R

1993-01-01

Twenty-seven transfusion dependent patients with end-stage renal disease on long-term dialysis had blood cell counts, serum chemistries, blood pressure, and whole blood viscosity measured, as well as having transfusion requirements assessed. Three months after the institution of recombinant human erythropoietin (rHU-EPO) (75 u per kg per wk), there was an 88 percent fall in transfusion requirement. After four months, the hematocrit increased from 24 +/- 3.8 to 25.6 +/- 4.2 percent, mean corpuscular volume from 93 +/- 4.9 to 97 +/- 6.6 fl, 2-3-diphosphoglycerate (2,3-DPG) from 13.2 +/- 3.2 to 15.6 +/- 4.3 microM per g of Hb. Whole blood viscosity fell from 14.1 +/- 2.1 to 12.7 +/- 2.3 seconds, and ferritin levels fell from 3282 +/- 3889 to 2131 +/- 2441 ng per ml. In eight patients in whom the dose of rHU-EPO was further increased by up to 50 units per kg three times weekly for three months, the hematocrit rose further to 29.3 +/- 3.0 percent and the rise in hematocrit was accompanied by a further increase in 2,3-DPG to 17.9 +/- 2.8 microM per g of Hb (p < 0.03). There were no major side effects or vascular complications.

Evaluation of hematocrit interference with MyStar extra and seven competitive devices.

PubMed

Demircik, Filiz; Ramljak, Sanja; Hermanns, Iris; Pfützner, Anke; Pfützner, Andreas

2015-03-01

In previous studies, meters employing dynamic electrochemistry (DE), have been shown to correct for hematocrit (HCT) interference. This laboratory investigation assessed the HCT stability of MyStar Extra (Sanofi) in comparison to 7 competitive devices (Accu-Chek Aviva Nano & Accu-Chek Performa, Roche Diagnostics; Contour XT and Contour Link, Bayer; FreeStyle Freedom Lite, Abbott; MyLife Pura, Ypsomed; OneTouch Verio Pro, LifeScan). Venous heparinized blood was freshly drawn, immediately aliquoted, and manipulated to contain 3 different blood glucose concentrations (50-80 mg/dL, 150-180 mg/dL, and 350-400 mg/dL) and 5 different HCT levels (20-25%, 30-35%, 40-45%, 50-55%, and 60-65%). After careful oxygenation to normal blood oxygen pressure, each of the 15 different samples was measured 8 times with 2 devices and 2 strip lots of each meter (32 measurements/meter/sample). YSI Stat 2300 served as laboratory reference method. Next to determination of the mean absolute relative deviation (MARD), stability to HCT influence was assumed, when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT over all tested glucose ranges (HIF: hematocrit interference factor). Four of the devices showed stable performance: Contour XT (MARD: 1.3%/HIF: 6.1%), MyStar Extra (4.7%/7.1%), OneTouch Verio Pro (4.5%/7.3%), and Contour Link (6.3%/9.3%). The 4 other meters were influenced by HCT (Accu-Chek Performa: 4.7%/20.9%, Accu-Chek Aviva Nano: 4.5%/22.4%, FreeStyle Freedom Lite: 4.8%/24.5%; MyLife Pura: 6.4%/28.7%). In this study, all meters showed a good accuracy, but only 50% of them, including MyStar Extra, were shown to reliably correct for potential hematocrit influence on the meter results. © 2014 Diabetes Technology Society.

Evaluation of Hematocrit Interference With MyStar Extra and Seven Competitive Devices

PubMed Central

Demircik, Filiz; Ramljak, Sanja; Hermanns, Iris; Pfützner, Anke; Pfützner, Andreas

2014-01-01

Background: In previous studies, meters employing dynamic electrochemistry (DE), have been shown to correct for hematocrit (HCT) interference. This laboratory investigation assessed the HCT stability of MyStar Extra (Sanofi) in comparison to 7 competitive devices (Accu-Chek Aviva Nano & Accu-Chek Performa, Roche Diagnostics; Contour XT and Contour Link, Bayer; FreeStyle Freedom Lite, Abbott; MyLife Pura, Ypsomed; OneTouch Verio Pro, LifeScan). Method: Venous heparinized blood was freshly drawn, immediately aliquoted, and manipulated to contain 3 different blood glucose concentrations (50-80 mg/dL, 150-180 mg/dL, and 350-400 mg/dL) and 5 different HCT levels (20-25%, 30-35%, 40-45%, 50-55%, and 60-65%). After careful oxygenation to normal blood oxygen pressure, each of the 15 different samples was measured 8 times with 2 devices and 2 strip lots of each meter (32 measurements/meter/sample). YSI Stat 2300 served as laboratory reference method. Next to determination of the mean absolute relative deviation (MARD), stability to HCT influence was assumed, when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT over all tested glucose ranges (HIF: hematocrit interference factor). Results: Four of the devices showed stable performance: Contour XT (MARD: 1.3%/HIF: 6.1%), MyStar Extra (4.7%/7.1%), OneTouch Verio Pro (4.5%/7.3%), and Contour Link (6.3%/9.3%). The 4 other meters were influenced by HCT (Accu-Chek Performa: 4.7%/20.9%, Accu-Chek Aviva Nano: 4.5%/22.4%, FreeStyle Freedom Lite: 4.8%/24.5%; MyLife Pura: 6.4%/28.7%). Conclusions: In this study, all meters showed a good accuracy, but only 50% of them, including MyStar Extra, were shown to reliably correct for potential hematocrit influence on the meter results. PMID:25549636

Endothelin ETA Receptor Blockade, by Activating ETB Receptors, Increases Vascular Permeability and Induces Exaggerated Fluid Retention.

PubMed

Vercauteren, Magali; Trensz, Frederic; Pasquali, Anne; Cattaneo, Christophe; Strasser, Daniel S; Hess, Patrick; Iglarz, Marc; Clozel, Martine

2017-05-01

Endothelin (ET) receptor antagonists have been associated with fluid retention. It has been suggested that, of the two endothelin receptor subtypes, ET B receptors should not be blocked, because of their involvement in natriuresis and diuresis. Surprisingly, clinical data suggest that ET A -selective antagonists pose a greater risk of fluid overload than dual antagonists. The purpose of this study was to evaluate the contribution of each endothelin receptor to fluid retention and vascular permeability in rats. Sitaxentan and ambrisentan as ET A -selective antagonists and bosentan and macitentan as dual antagonists were used as representatives of each class, respectively. ET A -selective antagonism caused a dose-dependent hematocrit/hemoglobin decrease that was prevented by ET B -selective receptor antagonism. ET A -selective antagonism led to a significant blood pressure reduction, plasma volume expansion, and a greater increase in vascular permeability than dual antagonism. Isolated vessel experiments showed that ET A -selective antagonism increased vascular permeability via ET B receptor overstimulation. Acutely, ET A -selective but not dual antagonism activated sympathetic activity and increased plasma arginine vasopressin and aldosterone concentrations. The hematocrit/hemoglobin decrease induced by ET A -selective antagonism was reduced in Brattleboro rats and in Wistar rats treated with an arginine vasopressin receptor antagonist. Finally, the decrease in hematocrit/hemoglobin was larger in the venous than in the arterial side, suggesting fluid redistribution. In conclusion, by activating ET B receptors, endothelin receptor antagonists (particularly ET A -selective antagonists) favor edema formation by causing: 1) fluid retention resulting from arginine vasopressin and aldosterone activation secondary to vasodilation, and 2) increased vascular permeability. Plasma volume redistribution may explain the clinical observation of a hematocrit/hemoglobin decrease even in the absence of signs of fluid retention. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

Effect of Spironolactone and Amiloride on Thiazolidinedione-Induced Fluid Retention in South Indian Patients with Type 2 Diabetes

PubMed Central

Viswanathan, Vijay; Mohan, Viswanathan; Subramani, Poongothai; Parthasarathy, Nandakumar; Subramaniyam, Gayathri; Manoharan, Deepa; Sundaramoorthy, Chandru; Gnudi, Luigi; Viberti, Giancarlo

2013-01-01

Summary Background and objectives Thiazolidinediones (pioglitazone and rosiglitazone) induce renal epithelial sodium channel (ENaC)–mediated sodium reabsorption, resulting in plasma volume (PV) expansion. Incidence and long-term management of fluid retention induced by thiazolidinediones remain unclear. Design, setting, participants, & measurements In a 4-week run-in period, rosiglitazone, 4 mg twice daily, was added to a background anti-diabetic therapy in 260 South Indian patients with type 2 diabetes mellitus. Patients with PV expansion (absolute reduction in hematocrit in run-in, ≥1.5 percentage points) entered a randomized, placebo-controlled study to evaluate effects of amiloride and spironolactone on attenuating rosiglitazone-induced fluid retention. Primary endpoint was change in hematocrit in each diuretic group versus placebo (control group). Results Of the 260 patients, 70% (n=180) had PV expansion. These 180 patients (70% male; mean age, 47.8 years [range, 30–80 years]) were randomly assigned to rosiglitazone, 4 mg twice daily, plus spironolactone, 50 mg once daily; rosiglitazone, 4 mg twice daily, plus amiloride, 10 mg once daily; or rosiglitazone, 4 mg twice daily, plus placebo for 24 weeks. Hematocrit continued to decrease significantly in control and spironolactone groups (mean absolute change, −1.2 [P=0.01] and −0.7 [P=0.02] percentage points, respectively), suggesting continued PV expansion. No change occurred with amiloride (mean change, 0.0 percentage points). Amiloride, but not spironolactone, was superior to control (mean hematocrit difference [95% confidence interval] relative to control, 1.27 [0.21–2.55] and 0.49 [−0.79–1.77] percentage points [P=0.04 and P=0.61], respectively). Conclusions Prevalence of rosiglitazone-induced fluid retention in South Indian patients with type 2 diabetes is high. Amiloride, a direct ENaC blocker, but not spironolactone, prevented protracted fluid retention in these patients. PMID:23184569

Endotoxin-induced shock in the rat. A role for C5a.

PubMed Central

Smedegård, G.; Cui, L. X.; Hugli, T. E.

1989-01-01

Administration of endotoxin from gram-negative bacteria to rats results in systemic hypotension, an increased hematocrit, and decreased numbers of circulating leukocytes (polymorphonuclear), monocytes, and platelets. These potentially lethal physiologic changes may be partially attributed to complement activation and generation of anaphylatoxins by the endotoxin (LPS). We demonstrated an elevation in the plasma levels of both C3a and C5a in LPS-treated rats. Injection of 5 micrograms C5ades Arg (rat) into rats produced effects similar to those induced by LPS, including decreased mean arterial pressure (systemic hypotension) and decreased numbers of circulating polymorphonuclear leukocytes, monocytes, and platelets. Unlike the response to LPS, C5a did not increase the hematocrit, indicating little effect on vascular permeability at the doses used. When LPS-treated animals were pretreated with F(ab')2 fragments of rabbit anti-rat C5a, no changes were measured in the circulating cell counts compared with LPS alone; however a significant improvement in the mean arterial pressure and a decrease in hematocrit was observed. We conclude that LPS-induced (septic) shock in the rat may result, in part, from the effects of complement activation and particularly from the generation of C5a. The influence of C5a on the LPS effect in the rat appears to enhance both the hypotensive (mean arterial pressure) and vascular permeability (hematocrit) responses. These results appear to support and confirm earlier observations that anti-human C5a increased survival in a septic-shock monkey model by eliminating circulating C5a and presumably thereby reducing the effects of endotoxin on blood pressure. Our results demonstrate that C5a plays a significant role in the hemodynamic changes associated with endotoxin-induced shock. Neutralization of C5a with specific antibodies may reduce the hypotensive response to endotoxin sufficiently to prevent lethal septic shock both in animals and in man. PMID:2789475

Modeling of the blood rheology in steady-state shear flows

DOE Office of Scientific and Technical Information (OSTI.GOV)

Apostolidis, Alex J.; Beris, Antony N., E-mail: beris@udel.edu

We undertake here a systematic study of the rheology of blood in steady-state shear flows. As blood is a complex fluid, the first question that we try to answer is whether, even in steady-state shear flows, we can model it as a rheologically simple fluid, i.e., we can describe its behavior through a constitutive model that involves only local kinematic quantities. Having answered that question positively, we then probe as to which non-Newtonian model best fits available shear stress vs shear-rate literature data. We show that under physiological conditions blood is typically viscoplastic, i.e., it exhibits a yield stress thatmore » acts as a minimum threshold for flow. We further show that the Casson model emerges naturally as the best approximation, at least for low and moderate shear-rates. We then develop systematically a parametric dependence of the rheological parameters entering the Casson model on key physiological quantities, such as the red blood cell volume fraction (hematocrit). For the yield stress, we base our description on its critical, percolation-originated nature. Thus, we first determine onset conditions, i.e., the critical threshold value that the hematocrit has to have in order for yield stress to appear. It is shown that this is a function of the concentration of a key red blood cell binding protein, fibrinogen. Then, we establish a parametric dependence as a function of the fibrinogen and the square of the difference of the hematocrit from its critical onset value. Similarly, we provide an expression for the Casson viscosity, in terms of the hematocrit and the temperature. A successful validation of the proposed formula is performed against additional experimental literature data. The proposed expression is anticipated to be useful not only for steady-state blood flow modeling but also as providing the starting point for transient shear, or more general flow modeling.« less

Liver enzymes in patients with chronic kidney disease undergoing peritoneal dialysis and hemodialysis.

PubMed

Liberato, Isabella Ramos de Oliveira; Lopes, Edmundo Pessoa de Almeida; Cavalcante, Maria Alina Gomes de Mattos; Pinto, Tiago Costa; Moura, Izolda Fernades; Loureiro Júnior, Luiz

2012-01-01

The present study was designed to analyze the serum levels of aspartate and alanine aminotransferases, gamma-glutamyl transferase, and the hematocrit in patients with chronic kidney disease who were undergoing peritoneal dialysis or hemodialysis. Twenty patients on peritoneal dialysis and 40 on hemodialysis were assessed, and the patients were matched according to the length of time that they had been on dialysis. Blood samples were collected (both before and after the session for those on hemodialysis) to measure the enzymes and the hematocrit. In the samples from the patients who were undergoing peritoneal dialysis, the aspartate and alanine aminotransferase levels were slightly higher compared with the samples collected from the patients before the hemodialysis session and slightly lower compared with the samples collected after the hemodialysis session. The levels of gamma-glutamyl transferase in the hemodialysis patients were slightly higher than the levels in the patients who were undergoing peritoneal dialysis. In addition, the levels of aminotransferases and gamma-glutamyl transferase that were collected before the hemodialysis session were significantly lower than the values collected after the session. The hematocrit levels were significantly lower in the patients who were on peritoneal dialysis compared with the patients on hemodialysis (both before and after the hemodialysis session), and the levels were also significantly lower before hemodialysis compared with after hemodialysis. The aminotransferase levels in the patients who were undergoing peritoneal dialysis were slightly higher compared with the samples collected before the hemodialysis session, whereas the aminotransferase levels were slightly lower compared with the samples collected after the session. The hematocrits and the aminotransferase and gamma-glutamyl transferase levels of the samples collected after the hemodialysis session were significantly higher than the samples collected before the session. Taken together, the present data suggest that hemodilution could alter the serum levels of liver enzymes.

Diagnosis of hypogonadism: clinical assessments and laboratory tests.

PubMed

Carnegie, Christina

2004-01-01

Hypogonadism can be of hypothalamic-pituitary origin or of testicular origin, or a combination of both, which is increasingly common in the aging male population. In the postpubertal male, testosterone replacement therapy can be used to treat the signs and symptoms of low testosterone, which include loss of libido, erectile dysfunction, diminished intellectual capacity, depression, lethargy, osteoporosis, loss of muscle mass and strength, and some regression of secondary sexual characteristics. Before initiation of testosterone replacement therapy, an examination of the prostate and assessment of prostate symptoms should be performed, and both the hematocrit and lipid profile should be measured. Absolute contraindications to testosterone replacement therapy are prostate or breast cancer, a hematocrit of 55% or greater, or sensitivity to the testosterone formulation.

Hemoglobin and hematocrit values in the fish Oreochromis mossambicus (Peters) after short term exposure to copper and mercury

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cyriac, P.J.; Antony, A.; Nambisan, P.N.K.

1989-08-01

Hematology is used as an index of health status in a number of fish species. Hematological changes have been detected following different types of stress conditions like exposure to pollutants, diseases, hypoxia, etc. Copper and mercury are two known aquatic pollutants. Though copper is an essential micro-nutrient, it is highly toxic at high concentrations. Mercury has no biological function to serve and causes serious impairment in the metabolic and physiological functions of the body. In this paper hematocrit and hemoglobin (Hb) values in the fish Oreochromis mossambicus separately exposed to two different sublethal concentrations of copper and mercury for amore » period of 168 h are reported.« less

DBS-LC-MS/MS assay for caffeine: validation and neonatal application.

PubMed

Bruschettini, Matteo; Barco, Sebastiano; Romantsik, Olga; Risso, Francesco; Gennai, Iulian; Chinea, Benito; Ramenghi, Luca A; Tripodi, Gino; Cangemi, Giuliana

2016-09-01

DBS might be an appropriate microsampling technique for therapeutic drug monitoring of caffeine in infants. Nevertheless, its application presents several issues that still limit its use. This paper describes a validated DBS-LC-MS/MS method for caffeine. The results of the method validation showed an hematocrit dependence. In the analysis of 96 paired plasma and DBS clinical samples, caffeine levels measured in DBS were statistically significantly lower than in plasma but the observed differences were independent from hematocrit. These results clearly showed the need for extensive validation with real-life samples for DBS-based methods. DBS-LC-MS/MS can be considered to be a good alternative to traditional methods for therapeutic drug monitoring or PK studies in preterm infants.

Evaluation of erythrocyte flow at a bearing gap in a hydrodynamically levitated centrifugal blood pump.

PubMed

Murashige, Tomotaka; Kosaka, Ryo; Sakota, Daisuke; Nishida, Masahiro; Kawaguchi, Yasuo; Yamane, Takashi; Maruyama, Osamu

2015-01-01

We have developed a hydrodynamically levitated centrifugal blood pump for extracorporeal circulatory support. In the blood pump, a spiral groove bearing was adopted for a thrust bearing. In the spiral groove bearing, separation of erythrocytes and plasma by plasma skimming has been postulated to occur. However, it is not clarified that plasma skimming occurs in a spiral groove bearing. The purpose of this study is to verify whether plasma skimming occurs in the spiral groove bearing of a hydrodynamically levitated centrifugal blood pump. For evaluation of plasma skimming in the spiral groove bearing, an impeller levitation performance test using a laser focus displacement meter and a microscopic visualization test of erythrocyte flow using a high-speed microscope were conducted. Bovine blood diluted with autologous plasma to adjust hematocrit to 1.0% was used as a working fluid. Hematocrit on the ridge region in the spiral groove bearing was estimated using image analysis. As a result, hematocrits on the ridge region with gaps of 45 μm, 31 μm, and 25 μm were calculated as 1.0%, 0.6%, and 0.3%, respectively. Maximum skimming efficiency in this study was calculated as 70% with a gap of 25 μm. We confirmed that separation of erythrocyte and plasma occurred in the spiral groove bearing with decrease in bearing gap in a hydrodynamically levitated centrifugal blood pump.

Hematologic Profile and Semen Quality of Male Timor Deer (Rusa timorensis) at Various Hierarchies

NASA Astrophysics Data System (ADS)

Samsudewa, D.; Capitan, S. S.; Sevilla, C. C.; Vega, R. S. A.; Ocampo, P. P.

2018-02-01

The aim of this research was to observe hematologic profile i.e. erythrocyte count, hemoglobin and hematocrit and semen quality, i.e. semen volume, sperm motility and sperm abnormality of α-male, β-male and subordinate male Timor deer raised under captivity. Twelve males (51 ± 6 months old; 68.29 ± 8.41kg body weight) at similar antler stages were use in this study. Before and after 43 days of establishment of dominance hierarchy blood were sampled after sedation for erythrocyte count, hemoglobin (mg/dL), and hematocrit (%). Likewise, semen was collected using electroejaculator and were analyzed for semen volume (ml), sperm motility (%) and sperm abnormality (%) to compare male deer at various heirarchies. Wilcoxon signed ranks test and Kruskal-Wallis H test of non-parametric analysis was done. Significant difference was tested with Mann-Whitney U test. The results showed that highest count of erythrocyte shown on α and β-male (1.60 million per µL). The highest increase in hematocrit was observed in β-male (5%) and then followed by S2-male (4%). S2-male had the highest increase in hemoglobin (0.13 g/dL). The highest increase in semen volume was observed in α -male (0.75 ml). Social stress affected negatively the sperm motility and abnormality (P<0.05). The highest decrease was observed in S2-male.

The effect of blood cell count on coronary flow in patients with coronary slow flow phenomenon.

PubMed

Soylu, Korhan; Gulel, Okan; Yucel, Huriye; Yuksel, Serkan; Aksan, Gokhan; Soylu, Ayşegül İdil; Demircan, Sabri; Yılmaz, Ozcan; Sahin, Mahmut

2014-09-01

The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course, but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates. Selective coronary angiographies of 3368 patients were analyzed to assess Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) values. Seventy eight of them had CSFP, and their demographic and laboratory findings were compared with 61 patients with normal coronary flow. Patients' demographic characteristics were similar in both groups. Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (p<0.001). Furthermore, hematocrit and hemoglobin values, and eosinophil and basophil counts of the CSFP patients were significantly elevated compared to the values obtained in the control group (p=0.005, p=0.047, p=0.001 and p=0.002, respectively). The increase observed in hematocrit and eosinophil levels showed significant correlations with increased TFC values (r=0.288 and r=0.217, respectively). Significant changes have been observed in the cellular composition of blood in patients diagnosed with CSFP as compared to the patients with normal coronary blood flow. The increases in hematocrit levels and in the eosinophil and basophil counts may have direct or indirect effects on the rate of coronary blood flow.

Cerebral oximetry during infant cardiac surgery: evaluation and relationship to early postoperative outcome.

PubMed

Kussman, Barry D; Wypij, David; DiNardo, James A; Newburger, Jane W; Mayer, John E; del Nido, Pedro J; Bacha, Emile A; Pigula, Frank; McGrath, Ellen; Laussen, Peter C

2009-04-01

We examined changes in cerebral oxygen saturation during infant heart surgery and its relationship to anatomic diagnosis and early outcome. Regional cerebral oxygen saturation (rSO(2)) was measured by near-infrared spectroscopy in 104 infants undergoing biventricular repair without aortic arch obstruction as part of a randomized trial of hemodilution to a hematocrit of 25% vs 35%. Before cardiopulmonary bypass (CPB), infants with tetralogy of Fallot had higher rSO(2) values compared to those with D-transposition of the great arteries (D-TGA) or ventricular septal defect (P < 0.001). During CPB cooling, low flow, and at the termination of CPB, D-TGA subjects had the highest rSO(2) values (P < 0.001). There were no significant associations between intraoperative rSO(2) and early postoperative outcomes after adjustment for diagnosis. In 39 D-TGA subjects with > or =5 min of deep hypothermic circulatory arrest (DHCA), there was no correlation between the rSO(2) (91% +/- 6%) or hematocrit (29.2% +/- 5.5%) at the onset of arrest and the rate of decline in rSO(2) during arrest. Intraoperative rSO(2) varies according to anatomic diagnosis but accounts for very little of the variance in early outcome. As measured by frontal near-infrared spectroscopy, higher levels of hematocrit and current perfusion techniques appear to provide an adequate oxygen reservoir prior to relatively short periods of DHCA.

Pulsatile plasma filtration and cell-free DNA amplification using a water-head-driven point-of-care testing chip.

PubMed

Lee, Yonghun; Kim, Dong-Min; Li, Zhenglin; Kim, Dong-Eun; Kim, Sung-Jin

2018-03-13

We demonstrate a microfiltration chip that separates blood plasma by using water-head-driven pulsatile pressures rather than any external equipment and use it for on-chip amplification of nucleic acids. The chip generates pulsatile pressures to significantly reduce filter clogging without hemolysis, and consists of an oscillator, a plasma-extraction pump, and filter units. The oscillator autonomously converts constant water-head pressure to pulsatile pressure, and the pump uses the pulsatile pressure to extract plasma through the filter. Because the pulsatile pressure can periodically clear blood cells from the filter surface, filter clogging can be effectively reduced. In this way, we achieve plasma extraction with 100% purity and 90% plasma recovery at 15% hematocrit. During a 10 min period, the volume of plasma extracted was 43 μL out of a 243 μL extraction volume at 15% hematocrit. We also studied the influence of the pore size and diameter of the filter, blood loading volume, oscillation period, and hematocrit level on the filtration performance. To demonstrate the utility of our chip for point-of-care testing (POCT) applications, we successfully implemented on-chip amplification of a nucleic acid (miDNA21) in plasma filtered from blood. We expect our chip to be useful not only for POCT applications but also for other bench-top analysis tools using blood plasma.

Patterns of Hand Grip Strength and Detection of Strength Loss in Patients Undergoing Bone Marrow Transplantation: A Feasibility Study.

PubMed

Sayre, Cindy A; Belza, Basia; Shannon Dorcy, Kathleen; Phelan, Elizabeth; Whitney, JoAnne D

2017-09-01

To determine the feasibility of measuring hand grip strength (HGS) daily in a population of recipients of bone marrow transplantation (BMT), to describe changes in strength measured by HGS, and to describe relationships between laboratory values (hematocrit, hemoglobin, and absolute neutrophil count) and HGS.
. Prospective, longitudinal, repeated measures, within subject.
. Inpatient units at the University of Washington Medical Center in Seattle.
. 33 patients admitted in preparation for BMT or for complications from BMT.
. HGS measured on admission and daily.
. HGS, absolute neutrophil count, hemoglobin, and hematocrit.
. Participants found HGS testing to be relatively easy. Average time to complete testing was 7.2 minutes (SD = 1.95). Nineteen experienced 20% or greater decline in HGS during hospitalization, with nine experiencing decline during the conditioning phase. Age, gender, and hemoglobin correlated with HGS. Strength loss was more likely in those undergoing allogeneic compared to autologous BMT.
. A majority of patients experienced strength decline during BMT, with a subgroup declining during conditioning. A positive relationship existed between HGS and hemoglobin and hematocrit in participants admitted for conditioning for BMT.
. Weakness increases risk for falls. Patients may experience as much as 50% strength loss during the course of hospitalization for BMT. Strength loss occurs in the conditioning phase for some patients.

A Mountain or a Plateau? Hematological Traits Vary Nonlinearly with Altitude in a Highland Lizard.

PubMed

González-Morales, Juan Carlos; Beamonte-Barrientos, Rene; Bastiaans, Elizabeth; Guevara-Fiore, Palestina; Quintana, Erendira; Fajardo, Victor

High-altitude organisms exhibit hematological adaptations to augment blood transport of oxygen. One common mechanism is through increased values of blood traits such as erythrocyte count, hematocrit, and hemoglobin concentration. However, a positive relationship between altitude and blood traits is not observed in all high-altitude systems. To understand how organisms adapt to high altitudes, it is important to document physiological patterns related to hypoxia gradients from a greater variety of species. Here, we present an extensive hematological description for three populations of Sceloporus grammicus living at 2,500, 3,400, and 4,300 m. We did not find a linear increase with altitude for any of the blood traits we measured. Instead, we found nonlinear relationships between altitude and the blood traits erythrocyte number, erythrocyte size, hematocrit, and hemoglobin concentration. Erythrocyte number and hematocrit leveled off as altitude increased, whereas hemoglobin concentration and erythrocyte size were highest at intermediate altitude. Additionally, lizards from our three study populations are similar in blood pH, serum electrolytes, glucose, and lactate. Given that the highest-altitude population did not show the highest levels of the variables we measured, we suggest these lizards may be using different adaptations to cope with hypoxia than lizards at low or intermediate altitudes. We discuss future directions that research could take to investigate such potential adaptations.

Hematocrit

MedlinePlus

... of the heart Too little water in the body ( dehydration ) Low levels of oxygen in the blood Scarring or thickening of the lungs Bone marrow disease that causes abnormal increase in red blood cells

CBC

MedlinePlus

... count results, such as chronic kidney disease Normal Results Blood counts may vary with altitude. In general, ... meaning of your specific test results. What Abnormal Results Mean High RBC, hemoglobin, or hematocrit may be ...

Hyperviscosity - newborn

MedlinePlus

... called a hematocrit . Other tests may include: Blood gases to check oxygen level in the blood Blood ... 2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM ...

Immune hemolytic anemia

MedlinePlus

... Absolute reticulocyte count Direct or indirect Coombs test Hemoglobin in the urine LDH (level of this enzyme ... of tissue damage) Red blood cell count (RBC), hemoglobin, and hematocrit Serum bilirubin level Serum free hemoglobin ...

Efficacy of iron-supplement bars to reduce anemia in urban Indian women: a cluster-randomized controlled trial.

PubMed

Mehta, Rajvi; Platt, Alyssa C; Sun, Xizi; Desai, Mukesh; Clements, Dennis; Turner, Elizabeth L

2017-03-01

Background: India's high prevalence of iron-deficiency anemia has largely been attributed to the local diet consisting of nonheme iron, which has lower absorption than that of heme iron. Objective: We assessed the efficacy of the consumption of iron-supplement bars in raising hemoglobin concentrations and hematocrit percentages in anemic (hemoglobin concentration <12 g/dL) Indian women of reproductive age. Design: The Let's be Well Red study was a 90-d, pair-matched, cluster-randomized controlled trial. A total of 361 nonpregnant women (age 18-35 y) were recruited from 10 sites within Mumbai and Navi Mumbai, India. All participants received anemia education and a complete blood count (CBC). Random assignment of anemic participants to intervention and control arms occurred within 5 matched site-pairs. Intervention participants received 1 iron-supplement bar (containing 14 mg Fe)/d for 90 d, whereas control subjects received nothing. CBC tests were given at days 15, 45, and 90. Primary outcomes were 90-d changes from baseline in hemoglobin concentrations and hematocrit percentages. Linear mixed models and generalized estimating equations were used to model continuous and binary outcomes, respectively. Results: Of 179 anemic participants, 136 (76.0%) completed all follow-up assessments (65 intervention and 71 control participants). Baseline characteristics were comparable by arm. Mean hemoglobin and hematocrit increases after 90 d were greater for intervention than for control participants [1.4 g/dL (95% CI: 1.3, 1.6 g/dL) and 2.7% (95% CI: 2.2%, 3.2%), respectively]. The anemia prevalence at 90 d was lower for intervention (29.2%) than for control participants (98.6%) (OR: 0.007; 95% CI: 0.001, 0.04). Conclusions: The daily consumption of an iron-supplement bar leads to increased hemoglobin concentrations and hematocrit percentages and to a lower anemia prevalence in the target population with no reported side effects. This intervention is an attractive option to combat anemia in India. This trial was registered at clinicaltrials.gov as NCT02032615. © 2017 American Society for Nutrition.

Efficacy and safety of new complementary feeding guidelines with an emphasis on red meat consumption: a randomized trial in Bogota, Colombia.

PubMed

Olaya, Gilma A; Lawson, Margaret; Fewtrell, Mary S

2013-10-01

Iron deficiency and poor linear growth are common in infants from deprived socioeconomic backgrounds and may be associated with inadequate complementary feeding (CF) practices. We tested the hypothesis that new CF guidelines emphasizing meat as a source of iron and zinc would improve linear growth, iron, and zinc status in infants living in poor socioeconomic circumstances in Bogota, Colombia. A total of 85 term infants who were exclusively breastfed for ≥4 mo were randomly assigned at 6 mo of age to a control group [CG (n = 43); current advice] or intervention group (new guidelines group [NGG (n = 42); with counseling to 1) continue breastfeeding, 2) offer red meat ≥3 d/wk, and 3) offer fruit and vegetables daily]). Main outcomes were 1) linear growth from 6 to 12 mo of age; 2) hemoglobin, hematocrit, iron [serum ferritin (SF)], and zinc status at 12 mo of age; and 3) meat intake at 12 mo of age (by using a food-frequency questionnaire). A total of 38 infants/group provided data at 12 mo of age. NGG infants had significantly higher red meat intake [mean ± SD: 5.4 ± 1.8 compared with 3.5 ± 1.7 d/wk at 12 mo of age; P < 0.001), higher hemoglobin and hematocrit at 12 mo of age, and a significantly greater increase in hemoglobin (mean ± SD change: 0.41 ± 0.8 compared with -0.13 ± 1.0; P = 0.01) and hematocrit (1.04 ± 2.2 compared with -0.15 ± 2.4; P = 0.03) from 6 to 12 mo of age than those in CG infants. There were no significant differences in linear growth from 6 to 12 mo of age or in SF or zinc. The new guidelines showed efficacy with higher red meat intake and positive effects on hemoglobin and hematocrit. The intervention was acceptable and affordable for most mothers. These preliminary results suggest that the intervention merits investigation in a larger cohort with longer-term follow-up. This trial was registered at http://isrctn.org as ISRCTN57733004.

TIBC, UIBC and Transferrin

MedlinePlus

... 28 weeks to delivery) Primary Aldosteronism (Conn Syndrome) Prostate Cancer Protein in Urine (Proteinuria) Reactive Arthritis Rheumatoid Arthritis ... Blood Count (CBC) Hemoglobin Hematocrit Reticulocytes Soluble Transferrin Receptor Conditions Anemia Hemochromatosis Elsewhere On The Web American ...

Macular hemorrhages associated with neonatal polycythemia and thrombocytopenia: A case report.

PubMed

Cui, Z; Zhang, Y; Liang, L; Li, Z; Hao, Q

2017-02-01

Thrombocytopenia occurs in 51% of neonates with polycythemia and is independently associated with growth restriction. Increased hematocrit is associated with decreased platelet count. The possibility of a hemorrhage should be noted. A Chinese male newborn presented with elevated hemoglobin and hematocrit levels. The platelet count decreased to 10×10 9 /L during the 1st week after birth and remained abnormal at day 12. Vitreous turbidity of the right eye was detected 2 days later and was suspected of stemming from endophthalmitis or ocular inflammation. Two weeks later, vitreous turbidity decreased and a macular hemorrhage became visible. Optical coherence tomography confirmed the diagnosis of a retinal hemorrhage. Thrombocytopenia associated with polycythemia can induce a vitreous hemorrhage, which may be confused with ocular infection or inflammation. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The hounsfield unit value calculated with the aid of non-contrast computed tomography and its effect on the outcome of percutaneous nephrolithotomy.

PubMed

Gok, Alper; Polat, Haci; Cift, Ali; Yucel, Mehmet Ozgur; Gok, Bahri; Sirik, Mehmet; Benlioglu, Can; Kalyenci, Bedreddin

2015-06-01

To evaluate the effect of the Hounsfield unit (HU) value, calculated with the aid of non-contrast computed tomography, on the outcome of percutaneous nephrolithotomy (PCNL). Data for 83 patients evaluated in our clinic between November 2011 and February 2014 that had similar stone sizes, localizations, and radio opacities were retrospectively reviewed. The patients were grouped according to their HU value, in a low HU group (HU ≤ 1000) or a high HU group (HU > 1000). The two groups were compared based on their PCNL success rates, complications, duration of surgery, duration of fluoroscopy, and decrease in the hematocrit. There were no significant differences in terms of mean age, female-male ratio, or mean body mass index between the two groups (p > 0.05). The stone size and stone surface area did not differ significantly between the groups (p = 0.820 and p = 0.394, respectively). The unsuccessful PCNL rate and the prevalence of complications did not differ significantly between the two groups (p > 0.05). The duration of surgery, duration of fluoroscopy, and decrease in the hematocrit were significantly greater in the high HU group compared to the low HU group (p < 0.001). Calculating the HU value using this imaging method may predict cases with longer surgery durations, longer fluoroscopy durations, and greater decreases in hematocrite levels, but this value is not related to the success rate of PCNL.

Diet and iron status of nonpregnant women in rural Central Mexico.

PubMed

Backstrand, Jeffrey R; Allen, Lindsay H; Black, Anne K; de Mata, Margarita; Pelto, Gretel H

2002-07-01

Few studies have examined the relation of iron status to diet in populations from developing countries with high levels of iron deficiency and diets of poor quality. The objective was to identify nutrients, dietary constituents, and foods that are associated with better iron status in a rural Mexican population. A prospective cohort study was conducted in rural central Mexico. The subjects were 125 nonpregnant women aged 16-44 y. During the 12 mo before blood collection, food intakes were assessed repeatedly by a combination of dietary recalls, food weighing, and food diaries [mean (+/-SD) days of food intake data: 18.8 +/- 5.9 d]. Hemoglobin, hematocrit, and plasma ferritin were measured at the end of the study. Higher plasma ferritin concentrations were associated with greater intakes of nonheme iron and ascorbic acid after control for age, BMI, breast-feeding, season, and the time since the birth of the last child. Higher ascorbic acid intakes, but not higher intakes of heme and nonheme iron, predicted a lower risk of low hemoglobin and hematocrit values after control for the background variables. Consumption of the alcoholic beverage pulque predicted a lower risk of low ferritin and low hemoglobin values. Seasonal variation in ferritin, hemoglobin, and hematocrit values was observed. Better iron status was associated with greater intakes of foods containing nonheme iron and ascorbic acid. PULQUE:a beverage containing iron, ascorbic acid, and alcohol-may influence the iron status of women in rural central Mexico.

The use of body mass changes as a practical measure of dehydration in team sports.

PubMed

Harvey, Gemma; Meir, Rudi; Brooks, Lyndon; Holloway, Kate

2008-11-01

Body mass changes, hematocrit, specific gravity and urine colour were recorded during two games of soccer to determine which of these methods was the most practical in a field setting for monitoring dehydration. Members (n=13) of a premiership soccer team with a mean age of 22.6 (+/-4.9) years old, height of 177.8 (+/-7.1)cm and sum of skinfolds (four sites) of 37 (+/-12.8) were invited to participate in this study with 11 participating in each game. Players had weight, hematocrit, specific gravity and urine colour recorded pre- and post-game. Players were allowed to ingest fluid ad libitum throughout the matches with the amount consumed recorded. Urine excretion was also recorded and included in the calculation of final body mass loss (kg). A mean ambient temperature of 21 degrees C and relative humidity 77% was recorded for both games. Pre- and post-game body mass, sweat loss, hematocrit, urine specific gravity and colour were significantly different (p<0.01) for both games. Linear mixed effects models were fitted to the data in order to identify an optimal prediction equation for sweat loss. The model predicting from mass change was clearly the best fitting. The results demonstrate that a change in body mass during a game of soccer is an effective method of monitoring dehydration due to sweat loss when compared to other known methods that may be invasive and inappropriate in the field.

The effect of blood cell count on coronary flow in patients with coronary slow flow phenomenon

PubMed Central

Soylu, Korhan; Gulel, Okan; Yucel, Huriye; Yuksel, Serkan; Aksan, Gokhan; Soylu, Ayşegül İdil; Demircan, Sabri; Yılmaz, Özcan; Sahin, Mahmut

2014-01-01

Background and Objective: The coronary slow flow phenomenon (CSFP) is a coronary artery disease with a benign course, but its pathological mechanisms are not yet fully understood.The purpose of this controlled study was to investigate the cellular content of blood in patients diagnosed with CSFP and the relationship of this with coronary flow rates. Methods: Selective coronary angiographies of 3368 patients were analyzed to assess Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) values. Seventy eight of them had CSFP, and their demographic and laboratory findings were compared with 61 patients with normal coronary flow. Results: Patients’ demographic characteristics were similar in both groups. Mean corrected TFC (cTFC) values were significantly elevated in CSFP patients (p<0.001). Furthermore, hematocrit and hemoglobin values, and eosinophil and basophil counts of the CSFP patients were significantly elevated compared to the values obtained in the control group (p=0.005, p=0.047, p=0.001 and p=0.002, respectively). The increase observed in hematocrit and eosinophil levels showed significant correlations with increased TFC values (r=0.288 and r=0.217, respectively). Conclusion: Significant changes have been observed in the cellular composition of blood in patients diagnosed with CSFP as compared to the patients with normal coronary blood flow. The increases in hematocrit levels and in the eosinophil and basophil counts may have direct or indirect effects on the rate of coronary blood flow. PMID:25225502

Cerebral Oximetry During Infant Cardiac Surgery: Evaluation of and Relationship to Early Postoperative Outcome

PubMed Central

Kussman, Barry D.; Wypij, David; DiNardo, James A.; Newburger, Jane W.; Mayer, John E.; del Nido, Pedro J.; Bacha, Emile A.; Pigula, Frank; McGrath, Ellen; Laussen, Peter C.

2009-01-01

Background We examined changes in cerebral oxygen saturation during infant heart surgery and its relationship to anatomic diagnosis and early outcome Methods Regional cerebral oxygen saturation (rSO2) was measured by near-infrared spectroscopy in 104 infants undergoing biventricular repair without aortic arch obstruction as part of a randomized trial of hemodilution to a hematocrit of 25% versus 35%. Results Prior to cardiopulmonary bypass (CPB), infants with tetralogy of Fallot had higher rSO2 values compared to those with D-transposition of the great arteries (D-TGA) or ventricular septal defect (P < 0.001). During CPB cooling, low flow and at the termination of CPB, D-TGA subjects had the highest rSO2 values (P < 0.001). There were no significant associations between intraoperative rSO2 and early postoperative outcomes after adjustment for diagnosis. In 39 D-TGA subjects with ≥5 minutes of deep hypothermic circulatory arrest, there was no correlation between the rSO2 (91 ± 6%) or hematocrit (29.2 ± 5.5%) at the onset of arrest and the rate of decline in rSO2 during arrest. Conclusions Intraoperative rSO2 varies according to anatomic diagnosis but accounts for very little of the variance in early outcome. As measured by frontal near-infrared spectroscopy, higher levels of hematocrit and current perfusion techniques appear to provide an adequate oxygen reservoir prior to relatively short periods of deep hypothermic circulatory arrest. PMID:19299774

Intravascular volume in cirrhosis. Reassessment using improved methodology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rector, W.G. Jr.; Ibarra, F.

1988-04-01

Previous studies of blood volume (BV) in cirrhosis have either not adjusted BV properly for body size; determined plasma volume from the dilution of labeled albumin 10-20 min postinjection, when some extravascular redistribution has already occurred; and/or not used the correct whole body-peripheral hematocrit ratio (0.82) in calculating whole BV from plasma volume and the peripheral hematocrit. We measured BV with attention to these considerations in 19 patients with cirrhosis and reexamined the determinants of vascular volume and the relationship between vascular volume and sodium retention. BV was calculated as plasma volume (determined from extrapolated plasma activity of intravenously injectedmore » (/sup 131/I)+albumin at time 0) divided by (peripheral hematocrit X 0.82). The result was expressed per kilogram dry body weight, determined by subtracting the mass of ascites (measured by isotope dilution; 1 liter = 1 kg) from the actual body weight of nonedematous patients. Measured and expressed in this way, BV correlated strongly with esophageal variceal size (r = 0.87, P less than 0.05), although not with net portal, right atrial, inferior vena caval, or arterial pressure, and was significantly greater in patients with sodium retention as compared to patients without sodium retention. The principal modifier of vascular volume in cirrhosis is vascular capacity, which is probably mainly determined by the extent of the portasystemic collateral circulation. Increased vascular volume in patients with sodium retention as compared to patients without sodium retention supports the overflow theory of ascites formation.« less

Single-Pass Percutaneous Liver Biopsy for Diffuse Liver Disease Using an Automated Device: Experience in 154 Procedures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rivera-Sanfeliz, Gerant, E-mail: gerantrivera@ucsd.edu; Kinney, Thomas B.; Rose, Steven C.

2005-06-15

Purpose: To describe our experience with ultrasound (US)-guided percutaneous liver biopsies using the INRAD 18G Express core needle biopsy system.Methods: One hundred and fifty-four consecutive percutaneous core liver biopsy procedures were performed in 153 men in a single institution over 37 months. The medical charts, pathology reports, and radiology files were retrospectively reviewed. The number of needle passes, type of guidance, change in hematocrit level, and adequacy of specimens for histologic analysis were evaluated.Results: All biopsies were performed for histologic staging of chronic liver diseases. The majority of patients had hepatitis C (134/153, 90.2%). All patients were discharged to homemore » after 4 hr of postprocedural observation. In 145 of 154 (94%) biopsies, a single needle pass was sufficient for diagnosis. US guidance was utilized in all but one of the procedures (153/154, 99.4%). The mean hematocrit decrease was 1.2% (44.1-42.9%). Pain requiring narcotic analgesia, the most frequent complication, occurred in 28 of 154 procedures (18.2%). No major complications occurred. The specimens were diagnostic in 152 of 154 procedures (98.7%).Conclusions: Single-pass percutaneous US-guided liver biopsy with the INRAD 18G Express core needle biopsy system is safe and provides definitive pathologic diagnosis of chronic liver disease. It can be performed on an outpatient basis. Routine post-biopsy monitoring of hematocrit level in stable, asymptomatic patients is probably not warranted.« less

Atrial natriuretic peptide decreases blood volume in intact and anephric rats

DOE Office of Scientific and Technical Information (OSTI.GOV)

Trippodo, N.C.; Chien, Y.W.; Pegram, B.L.

1986-03-05

Atrial natriuretic peptide (ANP) reportedly lowers atrial pressure and increases hematocrit, suggesting venodilation and/or decreased blood volume (BV). To examine these possibilities, rat ANP (99-126) was administered to Inactinanesthetized rats (313 +/- 9 g, +/- SE) at 0.5 ..mu..g/kg/min for 30 minutes. Urine flow increased by 0.05 ml/min (p < 0.001) during the last 15 minutes of infusion. Mean arterial pressure (MAP) and thoracic central venous pressure (CVP) decreased (p < 0.001) by 12 and 0.5 mmHg, respectively; hematocrit increased by 4.1 units (p < 0.001) and BV (/sup 51/Cr-RBC) decreased by 3.4 ml/kg (p < 0.001). Mean circulatory fillingmore » pressure, measured by inflating an intracardiac balloon to briefly stop the circulation, did not change. Distribution of BV between the thoracic and spanchnic organs (whole-animal freezing in liquid nitrogen) was not measurably altered. The results suggest that the decrease in CVP was related more to decreased BV than to venodilation. To investigate possible mechanisms for the decreased BV, the same dose of ANP was administered to anephric rats. MAP decreased by 8 mmHg (p < 0.001); hematocrit increased by 2.4 units (p < 0.001) and BV decreased by 1.7 ml/kg (p < 0.05). The results indicate that short-term administration of ANP decreases blood volume by causing intravascular fluid to shift into the interstitium as well as by inducing diuresis.« less

Analyzing near infrared scattering from human skin to monitor changes in hematocrit

NASA Astrophysics Data System (ADS)

Chaiken, Joseph; Deng, Bin; Goodisman, Jerry; Shaheen, George; Bussjager, R. J.

2012-01-01

The leading preventable cause of death, world-wide, civilian or military, for all people between the ages of 18-45 is undetected internal hemorrhage. Autonomic compensation mechanisms mask changes such as e.g. hematocrit fluctuations that could give early warning if only they could be monitored continuously with reasonable degrees of precision and relative accuracy. Probing tissue with near infrared radiation (NIR) simultaneously produces remitted fluorescence and Raman scattering (IE) plus Rayleigh/Mie light scattering (EE) that noninvasively give chemical and physical information about the materials and objects within. We model tissue as a three-phase system: plasma and red blood cell (RBC) phases that are mobile and a static tissue phase. In vivo, any volume of tissue naturally experiences spatial and temporal fluctuations of blood plasma and RBC content. Plasma and RBC fractions may be discriminated from each other on the basis of their physical, chemical and optical properties. Thus IE and EE from NIR probing yield information about these fractions. Assuming there is no void volume in viable tissue, or that void volume is constant, changes in plasma and RBC volume fractions may be calculated from simultaneous measurements of the two observables, EE and IE. In a previously published analysis we showed the underlying phenomenology but did not provide an algorithm for calculating volume fractions from experimental data. Here we present a simple analysis that allows continuous monitoring of fluid fraction and hematocrit (Hct) changes by measuring IE and EE, and apply it to some experimental in vivo measurements.

Hematocrit and plasma chemistry values in adult collared scops owls (Otus lettia) and crested serpent eagles (Spilornis cheela hoya).

PubMed

Chan, Fang-Tse; Lin, Pei-I; Chang, Geng-Ruei; Wang, Hsien-Chi; Hsu, Tien-Huan

2012-07-01

In this study, we report hematocrit and plasma chemistry values for adult captive collared scops owls (Otus lettia) and crested serpent eagles (Spilornis cheela hoya). In particular, we address the gender-specific differences within these values. We measured hematocrit (HCT) and plasma chemistry values for uric acid (UA), plasma urea nitrogen (BUN), total protein (TP), albumin (ALB), glucose (GLU), cholesterol (CHO), triglyceride (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), total bilirubin (TBIL), creatine (CRE), creatine phosphokinase (CPK), amylase (AMY), calcium (CA), ionic phosphorous (IP) and sodium (NA), potassium (K) and chloride ions (CL) in 37 adult captive collared scops owls and 39 adult captive crested serpent eagles. Significant differences between the sexes were found for UA, GLU and CPK in the collared scope owls. UA and GLU concentrations were significantly higher (P<0.01 and P<0.05) among males than females, while the CPK concentration was significantly lower (P<0.05) in males. There were no significant differences in of all of the measured parameters between male and female eagles. These finding suggested that HCT and plasma chemistry values of raptors vary individually according to species and sex. Our results provide the 1st available reference data for ranges of plasma values in adult captive collared scops owls and crested serpent eagles, making them a potentially useful complementary diagnostic tool for veterinary care of individuals for both species in captivity.

Cerebral Hemodynamics in Patients with Hemolytic Uremic Syndrome Assessed by Susceptibility Weighted Imaging and Four-Dimensional Non-Contrast MR Angiography.

PubMed

Löbel, Ulrike; Forkert, Nils Daniel; Schmitt, Peter; Dohrmann, Thorsten; Schroeder, Maria; Magnus, Tim; Kluge, Stefan; Weiler-Normann, Christina; Bi, Xiaoming; Fiehler, Jens; Sedlacik, Jan

2016-01-01

Conventional magnetic resonance imaging (MRI) of patients with hemolytic uremic syndrome (HUS) and neurological symptoms performed during an epidemic outbreak of Escherichia coli O104:H4 in Northern Europe has previously shown pathological changes in only approximately 50% of patients. In contrast, susceptibility-weighted imaging (SWI) revealed a loss of venous contrast in a large number of patients. We hypothesized that this observation may be due to an increase in cerebral blood flow (CBF) and aimed to identify a plausible cause. Baseline 1.5T MRI scans of 36 patients (female, 26; male, 10; mean age, 38.2±19.3 years) were evaluated. Venous contrast was rated on standard SWI minimum intensity projections. A prototype four-dimensional (time resolved) magnetic resonance angiography (4D MRA) assessed cerebral hemodynamics by global time-to-peak (TTP), as a surrogate marker for CBF. Clinical parameters studied were hemoglobin, hematocrit, creatinine, urea levels, blood pressure, heart rate, and end-tidal CO2. SWI venous contrast was abnormally low in 33 of 36 patients. TTP ranged from 3.7 to 10.2 frames (mean, 7.9 ± 1.4). Hemoglobin at the time of MRI (n = 35) was decreased in all patients (range, 5.0 to 12.6 g/dL; mean, 8.2 ± 1.4); hematocrit (n = 33) was abnormally low in all but a single patient (range, 14.3 to 37.2%; mean, 23.7 ± 4.2). Creatinine was abnormally high in 30 of 36 patients (83%) (range, 0.8 to 9.7; mean, 3.7 ± 2.2). SWI venous contrast correlated significantly with hemoglobin (r = 0.52, P = 0.0015), hematocrit (r = 0.65, P < 0.001), and TTP (r = 0.35, P = 0.036). No correlation of SWI with blood pressure, heart rate, end-tidal CO2, creatinine, and urea level was observed. Findings suggest that the loss of venous contrast is related to an increase in CBF secondary to severe anemia related to HUS. SWI contrast of patients with pathological conventional MRI findings was significantly lower compared to patients with normal MRI (mean SWI score, 1.41 and 2.05, respectively; P = 0.04). In patients with abnormal conventional MRI, mean TTP (7.45), mean hemoglobin (7.65), and mean hematocrit (22.0) were lower compared to patients with normal conventional MRI scans (mean TTP = 8.28, mean hemoglobin = 8.63, mean hematocrit = 25.23). In contrast to conventional MRI, almost all patients showed pathological changes in cerebral hemodynamics assessed by SWI and 4D MRA. Loss of venous contrast on SWI is most likely the result of an increase in CBF and may be related to the acute onset of anemia. Future studies will be needed to assess a possible therapeutic effect of blood transfusions in patients with HUS and neurological symptoms.

Hemograms for and nutritional condition of migrant bald eagles tested for exposure to lead.

PubMed

Miller, M J; Wayland, M E; Bortolotti, G R

2001-07-01

Plasma proteins, hematocrit, differential blood counts were examined and nutritional condition was estimated for bald eagles (Haliaeetus leucocephalus) trapped (n = 66) during antumn migration, 1994-95 at Galloway Bay (Saskatchewan, Canada), for the purposes of estimating prevalence of exposure to lead. Sex and age differences in hematocrit and plasma proteins were not observed; however, female eagles exhibited larger median absolute heterophil counts than males. Hematologic values were similar to those previously reported from eagles in captivity. Departures from expected hematological values from a healthy population of eagles were not observed in birds with elevated levels of blood lead (> or =0.200 microg/ml). Similarly, nutritional condition was not related to blood-lead concentrations. Therefore, it appears that lead exposure in this population was below a threshold required to indicate toxicological alteration in the hematological values and index of nutritional condition that we measured.

Effect of chronic altitude hypoxia on hematologic and glycolytic parameters.

PubMed

Clench, J; Ferrell, R E; Schull, W J

1982-05-01

The physiological effect of chronic exposure to altitude hypoxia on the glycolytic intermediates, adenosine triphosphate and 2,3-diphosphoglyceric acid, and the hematologic parameters, hemoglobin, hematocrit, and mean cell hemoglobin concentration, has been examined in an indigenous population, the Aymara, of the Departamento de Arica, Chile. This population normally resides at three altitudes: the coast (0-500 m), the sierra (2,500-3,500 m), and the altiplano (above 4,200 m). After isolation of altitude from other environmental factors (age, sex, body build, ethnicity, smoking, and residential permanence), an increase in 2,3-diphosphoglycerate and a decrease in adenosine triphosphate was observed. Both hemoglobin and hematocrit increased as expected, but mean cell hemoglobin concentration declined. It is proposed that a decline in the activity of a single enzyme, pyruvate kinase, can account for these observed changes and suggests a pivotal role for pyruvate kinase in the physiological adaptation to altitude hypoxia.

Fluid shifts and erythropoiesis - Relevance to the 'anemia' of space flight

NASA Technical Reports Server (NTRS)

Dunn, C. D. R.; Johnson, P. C.; Leach, C. S.

1982-01-01

To model the fluid shifts thought to occur in man during space flight, cephalic fluid shifts have been induced in man subjected to horizontal or headdown bedrest, in squirrel monkeys exposed to lower body positive pressure, and in rats subjected to antiorthostatic hypokinesia. The influence on erythropoiesis of such fluid redistribution has been studied. Only in man did a cephalic fluid shift consistently and significantly lead to a plasma volume reduction and an increased hematocrit. Although there was evidence for erythrosuppression and the subjects were 'anemic' at the end of the study, serum erythropoietin titers remained normal throughout bedrest. The erythrosuppression probably did not arise due to the increased hematocrit but may have been related to P50 shifts or the loss of body weight. Each model appeared to reproduce different parts of man's physiological response to weightlessness and promises to be useful in unraveling the etiology of the 'anemia' of space flight.

Dried blood spots analysis with mass spectrometry: Potentials and pitfalls in therapeutic drug monitoring.

PubMed

Antunes, Marina Venzon; Charão, Mariele Feiffer; Linden, Rafael

2016-09-01

Therapeutic drug monitoring (TDM) relays in the availability of specialized laboratory assays, usually available in reference centers that are not accessible to all patients. In this context, there is a growing interest in the use of dried blood spot (DBS) sampling, usually obtained from finger pricks, which allows simple and cost-effective logistics in many settings, particularly in Developing Countries. The use of DBS assays to estimate plasma concentrations is highly dependent on the hematocrit of the blood, as well as the particular characteristics of the measured analyte. DBS assays require specific validation assays, most of them are related to hematocrit effects. In the present manuscript, the application of mass spectrometric assays for determination of drugs for TDM purposes in the last ten years is reviewed, as well as the particular validation assays for new DBS methods. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Blood indicators of seasonal metabolic patterns in captive adult gray wolves

USGS Publications Warehouse

Seal, U.S.; Mech, L.D.

1983-01-01

Blood samples and physical data were collected weekly from a colony of gray wolves (Canis lupus) maintained under natural weather arid light conditions. Sampling over 33 continuous months indicated that hemoglobin, hematocrit, red blood cells, mean corpuscular hemoglobin concentration (MCHC), and thyroxine exhibited consistent circannual patterns of variation in both males and females. Hemoglobin levels peaked at 15-16 g/dl in January in females and at 16-17 g/dl in February in males, and were lowest in August at 10.5-11.5 g/dl (P < 0.00001). The cyclic patterns of hematocrit, red blood cells, and MCHC were similarly timed. Females also had a cyclic pattern of white blood cell counts and body weight; their weight peaked in early February and was lowest in August (P < 0.001). Body temperature, urea nitrogen, mean corpuscular volume (MCV), serum glucose, and cortisol did not follow a consistent seasonal pattern.

A new method for culturing Plasmodium falciparum shows replication at the highest erythrocyte densities

NASA Technical Reports Server (NTRS)

Li, Tao; Glushakova, Svetlana; Zimmerberg, Joshua

2003-01-01

Plasmodium falciparum replicates poorly in erythrocyte densities greater than a hematocrit of 20%. A new method to culture the major malaria parasite was developed by using a hollow fiber bioreactor that preserves healthy erythrocytes at hematocrit up to 100%. P. falciparum replicated equally well at all densities studied. This method proved advantageous for large-scale preparation of parasitized erythrocytes (and potentially immunogens thereof), because high yields ( approximately 10(10) in 4 days) could be prepared with less cost and labor. Concomitantly, secreted proteins were concentrated by molecular sieving during culture, perhaps contributing to the parasitemic limit of 8%-12% with the 3D7 strain. The finding that P. falciparum can replicate at packed erythrocyte densities suggests that this system may be useful for study of the pathogenesis of fatal cerebral malaria, of which one feature is densely packed blood cells in brain microvasculature.

Hematology of the Pascagoula map turtle (Graptemys gibbonsi) and the southeast Asian box turtle (Cuora amboinensis).

PubMed

Perpiñán, David; Hernandez-Divers, Sonia M; Latimer, Kenneth S; Akre, Thomas; Hagen, Chris; Buhlmann, Kurt A; Hernandez-Divers, Stephen J

2008-09-01

Turtle populations are decreasing dramatically due to habitat loss and collection for the food and pet market. This study sought to determine hematologic values in two species of turtles to help assess health status of captive and wild populations. Blood samples were collected from 12 individuals of the Pascagoula map turtle (Graptemys gibbonsi) and seven individuals of the southeast Asian box turtle (Cuora amboinensis) from the Savannah River Ecology Laboratory (South Carolina, USA). The hematologic data included hematocrit, total solids, erythrocyte count, leukocyte count, and differential and percentage leukocyte counts. Low hematocrit values and high basophil counts were found in both species. The basophil was the most abundant leukocyte in the Pascagoula map turtle (median = 0.80 x 10(9)/L), whereas in the Southeast Asian box turtle the most abundant leukocyte was the heterophil (median = 2.06 x 10(9)/L).

Is there really a clinical benefit of using minimized extracorporeal circulation for coronary artery bypass grafting?

PubMed

Schöttler, J; Lutter, G; Böning, A; Soltau, D; Bein, B; Caliebe, D; Haake, N; Schoeneich, F; Cremer, J

2008-03-01

Minimized extracorporeal circulation is intended to reduce the negative effects associated with cardiopulmonary bypass. This prospective study was performed to evaluate whether minimized extracorporeal circulation has a clinical benefit for coronary artery surgery patients compared to standard extracorporeal circulation. Sixty patients were randomized into two study groups: 30 patients underwent coronary artery bypass grafting using minimized extracorporeal circulation and 30 patients were operated using standard extracorporeal circulation. Baseline characteristics, intraoperative details, postoperative data, perioperative blood chemistry determinations of hematocrit, platelets, muscle-brain fraction of the creatine kinase, cardiac troponin T and colloid osmotic pressure as measurements of intrathoracic blood volume index and extravascular lung water index were compared. Baseline characteristics and intraoperative details of both groups were similar. Patients who underwent minimized extracorporeal circulation showed more short-term dependency on norepinephrine ( P < 0.01). Their maximal postoperative muscle-brain fraction of the creatine kinase was lower ( P < 0.05) and their hematocrit on arrival in the intensive care unit was higher ( P < 0.01). No other significant differences were found. In both collectives, values for hematocrit ( P < 0.001), platelets ( P < 0.001), colloid osmotic pressure ( P < 0.001) and intrathoracic blood volume index ( P < 0.05) decreased, while the extravascular lung water index did not change significantly during cardiopulmonary bypass. A clinical advantage of minimized over standard extracorporeal circulation was not found. Furthermore, a higher number of patients in the minimized extracorporeal circulation group required postoperative norepinephrine infusions for hemodynamic stabilization. In summary, the presumed superiority of minimized extracorporeal circulation for coronary artery bypass grafting in standard patients could not be confirmed.

Equiosmolar Solutions of Hypertonic Saline and Mannitol Do Not Impair Blood Coagulation During Elective Intracranial Surgery.

PubMed

Hernández-Palazón, Joaquín; Fuentes-García, Diego; Doménech-Asensi, Paloma; Piqueras-Pérez, Claudio; Falcón-Araña, Luis; Burguillos-López, Sebastián

2017-01-01

The authors investigated the effect of equiosmolar, equivolemic solutions of 3% hypertonic saline (HS) and 20% mannitol on blood coagulation assessed by rotational thromboelastometry (ROTEM) and standard coagulation tests during elective craniotomy. In a prospective, randomized, double-blind trial, 40 patients undergoing elective craniotomy were randomized to receive 5 mL/kg of either 20% mannitol or 3% HS for intraoperative brain relaxation. Fibrinogen, activated partial thromboplastin time, prothrombin time, hemoglobin, hematocrit, and platelet count were simultaneously measured intraoperatively with ROTEM for EXTEM, INTEM, and FIBTEM analysis. ROTEM parameters were: clotting time (CT), clot formation time (CFT), maximum clot firmness (MCF), and α-angle. No significant differences between groups were found in ROTEM variables CT, CFT, MCF, α-angle (EXTEM and INTEM), and MCF (FIBTEM) nor standard coagulation tests. ROTEM parameters did not show changes after administration of hyperosmolar solutions relating to basal values, except for an increase of CFT EXTEM (118±28 vs. 128±26 s) and decrease of CT INTEM (160±18 vs. 148±15 s) with values within normal range. Significant decreases from baseline levels were observed for hematocrit (-7%), platelet count (-10%), and fibrinogen (-13%) after HS infusion, and hematocrit (-9%), platelet count (-13%), and fibrinogen (-9%) after mannitol infusion, but remaining normal. The use of 5 mL/kg of equiosmolar solutions of 3% HS and 20% mannitol applied to reach a brain relaxation during elective craniotomy does not induce coagulation impairment as evidenced by ROTEM and standard coagulation tests.

Continuous and Pulsatile Pediatric Ventricular Assist Device Hemodynamics with a Viscoelastic Blood Model

PubMed Central

Good, Bryan C.; Deutsch, Steven; Manning, Keefe B.

2015-01-01

Purpose To investigate the effects of pulsatile and continuous pediatric ventricular assist (PVAD) flow and pediatric blood viscoelasticity on hemodynamics in a pediatric aortic graft model. Methods Hemodynamic parameters of pulsatility, along with velocity and wall shear stress (WSS), are analyzed and compared between Newtonian and viscoelastic blood models at a range of physiological pediatric hematocrits using computational fluid dynamics. Results Both pulsatile and continuous PVAD flow lead to a decrease in pulsatility (surplus hemodynamic energy (SHE), ergs/cm3) compared to healthy aortic flow but with continuous PVAD pulsatility up to 2.4 times lower than pulsatile PVAD pulsatility at each aortic outlet. Significant differences are also seen between the two flow modes in velocity and WSS. The higher velocity jet during systole with pulsatile flow leads to higher WSSs at the anastomotic toe and at the aortic branch bifurcations. The lower velocity but continuous flow jet leads to a much different flow field and higher WSSs into diastole. Under a range of physiological pediatric hematocrit (20-60%), both velocity and WSS can vary significantly with the higher hematocrit blood model generally leading to higher peak WSSs but also lower WSSs in regions of flow separation. Conclusions The large decrease in pulsatility seen from continuous PVAD flow could lead to complications in pediatric vascular development while the high WSSs during peak systole from pulsatile PVAD flow could lead to blood damage. Both flow modes lead to similar regions prone to intimal hyperplasia (IH) resulting from low time-averaged WSS (TAWSS) and high oscillatory shear index (OSI). PMID:26643646

Colorimetric device for measurement of transvascular fluid flux in blood-perfused organs.

PubMed

Oppenheimer, L; Richardson, W N; Bilan, D; Hoppensack, M

1987-01-01

The aim of this study was to develop a device capable of measuring transvascular fluid flux in blood-perfused organs. For any given blood flow through the organ (QT), transvascular flux (QF) can be considered as the fraction of QT exchange. Presumably, QF would change the background concentration of an impermeable tracer residing in the perfusate. Thus QF could be calculated from the relative changes in tracer concentration for any given QT. We have used Blue Dextran (1 g/l of blood) as the reference tracer. Because the minimum molecular weight of Blue Dextran is 2 X 10(6), we anticipated it to behave as an impermeable tracer in most organs. QF was simulated with continuous infusions of plasma, normal saline solution, and a 50% mixture of both. Changes in Blue Dextran concentration were continuously followed colorimetrically by changes in transmission of specific light at a wavelength of 632 nm. Because 632-nm light is affected by hematocrit and O2 saturation changes, two additional wavelengths were used: 815-nm, which is not affected by saturation or Blue Dextran concentration changes, was used to account for changes in hematocrit, and 887-nm specific light, which is not affected by Blue Dextran, served to correct for saturation changes. Red cells could not be used as the reference tracer because of the possibility of hematocrit changes independent of fluid flux (Fahraeus effect). The device so constructed proved capable of measuring rates of fluid infusion in the order of 0.1% of QT with a variability of 10% around the mean.

Population Pharmacokinetics of Intravenous Methotrexate in Patients with Hematological Malignancies: Utilization of Routine Clinical Monitoring Parameters.

PubMed

Nader, Ahmed; Zahran, Noran; Alshammaa, Aya; Altaweel, Heba; Kassem, Nancy; Wilby, Kyle John

2017-04-01

Clinical response to methotrexate in cancer is variable and depends on several factors including serum drug exposure. This study aimed to develop a population pharmacokinetic model describing methotrexate disposition in cancer patients using retrospective chart review data available from routine clinical practice. A retrospective review of medical records was conducted for cancer patients in Qatar. Relevant data (methotrexate dosing/concentrations from multiple occasions, patient history, and laboratory values) were extracted and analyzed using NONMEM VII ® . A population pharmacokinetic model was developed and used to estimate inter-individual and inter-occasion variability terms on methotrexate pharmacokinetic parameters, as well as patient factors affecting methotrexate pharmacokinetics. Methotrexate disposition was described by a two-compartment model with clearance (CL) of 15.7 L/h and central volume of distribution (V c ) of 79.2 L. Patient weight and hematocrit levels were significant covariates on methotrexate V c and CL, respectively. Methotrexate CL changed by 50 % with changes in hematocrit levels from 23 to 50 %. Inter-occasion variability in methotrexate CL was estimated for patients administered the drug on multiple occasions (48 and 31 % for 2nd and 3rd visits, respectively). Therapeutic drug monitoring data collected during routine clinical practice can provide a useful tool for understanding factors affecting methotrexate pharmacokinetics. Patient weight and hematocrit levels may play a clinically important role in determining methotrexate serum exposure and dosing requirements. Future prospective studies are needed to validate results of the developed model and evaluate its usefulness to predict methotrexate exposure and optimize dosing regimens.

Correlates of N-Terminal Prohormone Brain Natriuretic Peptides in African Americans with Hypertensive Chronic Kidney Disease: The African American Study of Kidney Disease and Hypertension

PubMed Central

Yi, S.; Contreras, G.; Miller, E.R.; Appel, L.J.; Astor, B.C.

2009-01-01

Background/Aims The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. Methods The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20–65 ml/min/1.73 m2) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. Results In unadjusted analyses, GFR (r = −0.39; p < 0.001), hematocrit (r = −0.21; p < 0.001) and body mass index (BMI; r = −0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p < 0.001) and log UPCR (r = 0.32; p < 0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. Conclusion Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure. PMID:18824845

78 FR 65565 - Fomesafen; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... identified and discussed later in this document. Interregional Research Project Number 4 (IR-4) requested..., hemoglobin, or hematocrit). In the developmental studies, post-implantation loss was noted but no quantitative or qualitative evidence of increased susceptibility to fomesafen [[Page 65567

42 CFR 494.90 - Condition: Patient plan of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-based professionally-accepted clinical nutrition indicators may be monitored, as appropriate. (3... achieve and sustain the clinically appropriate hemoglobin/hematocrit level. The patient's hemoglobin... is a change in transplant candidate status. (d) Standard: Patient education and training. The patient...

Proceedings of the 2010 AFMS Medical Research Symposium. Volume 5. Nursing Track: Abstracts and Presentations

DTIC Science & Technology

2011-03-15

management, toxicology/health risks (e.g., particulates nanomaterials, radiation, etc.), monitoring disease trends , other areas of preventive medicine...will include hematocrit, hemoglobin, mean corpuscle volume, iron, total iron binding capacity, Ferritin , and soluble transferring receptor. The

21 CFR 864.8625 - Hematology quality control mixture.

Code of Federal Regulations, 2011 CFR

2011-04-01

... parameters such as white cell count (WBC), red cell count (RBC), platelet count (PLT), hemoglobin, hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). (b) Classification. Class II (performance standards). [45 FR 60637, Sept. 12...

Nutritional Supplementation of Disadvantaged Elementary-School Children

ERIC Educational Resources Information Center

Paige, David M.; And Others

1976-01-01

Examined with 177 disadvantaged elementary school students (5-9 years old, 99 percent Blacks) were the effects of the provision of a nutritionally fortified low-lactose food supplement on hematocrit values (volume percentage of erythrocytes in whole blood), growth, absenteeism, and lunch consumption. (IM)

Non-invasive evaluation of blood oxygen saturation and hematocrit from T1 and T2 relaxation times: In-vitro validation in fetal blood.

PubMed

Portnoy, Sharon; Seed, Mike; Sled, John G; Macgowan, Christopher K

2017-12-01

We propose an analytical method for calculating blood hematocrit (Hct) and oxygen saturation (sO 2 ) from measurements of its T 1 and T 2 relaxation times. Through algebraic substitution, established two-compartment relationships describing R1=T1-1 and R2=T2-1 as a function of hematocrit and oxygen saturation were rearranged to solve for Hct and sO 2 in terms of R 1 and R 2 . Resulting solutions for Hct and sO 2 are the roots of cubic polynomials. Feasibility of the method was established by comparison of Hct and sO 2 estimates obtained from relaxometry measurements (at 1.5 Tesla) in cord blood specimens to ground-truth values obtained by blood gas analysis. Monte Carlo simulations were also conducted to assess the effect of T 1 , T 2 measurement uncertainty on precision of Hct and sO 2 estimates. Good agreement was observed between estimated and ground-truth blood properties (bias = 0.01; 95% limits of agreement = ±0.13 for Hct and sO 2 ). Considering the combined effects of biological variability and random measurement noise, we estimate a typical uncertainty of ±0.1 for Hct, sO 2 estimates. Results demonstrate accurate quantification of Hct and sO 2 from T 1 and T 2 . This method is applicable to noninvasive fetal vessel oximetry-an application where existing oximetry devices are unusable or require risky blood-sampling procedures. Magn Reson Med 78:2352-2359, 2017. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Effect of scaling and root planing on erythrocyte count, hemoglobin and hematocrit in patients with chronic periodontal disease.

PubMed

Malhotra, Ranjan; Kapoor, Anoop; Grover, Vishakha; Grover, Deepak; Kaur, Aaswin

2012-01-01

Anemia of chronic disease, a cytokine-mediated anemia, is a frequent complication of many chronic inflammatory conditions. The present clinical trial was aimed to evaluate the effect of chronic periodontal disease on erythrocyte count, hemoglobin and hematocrit and the changes produced in these parameters after the provision of periodontal therapy. 40 systemically healthy non-smoker male subjects in the age group of 25 to 50 years suffering with chronic periodontal disease were selected and categorized into 2 groups. Group A was categorized as chronic generalized gingivitis, and Group B was categorized as chronic generalized periodontitis on the basis of clinical findings. The clinical parameters Gingival Index (GI), Probing Pock et Depth (PPD) and Relative Attachment Level (RAL) and laboratory blood investigations viz erythrocyte count (EC), hemoglobin (Hb), hematocrit (HCT) and red cell indices (MCV, MCH, MCHC) were recorded at baseline. Complete oral prophylaxis was performed for all patients. Patients were recalled after 3 weeks and 3 months. The clinical and hematological parameters were re-evaluated to analyze the changes after provision of phase I therapy. The mean values of EC, Hb and HCT were significantly lower in Group B in comparison to Group A, and showed a significantly greater increase at 3 months of observation. However, the values of MCV, MCH and MCHC showed a non significant change during the same observation period in both the groups. Lower values of EC, Hb and HCT in Group B showed that mild anemia is associated with chronic generalized periodontitis, which tends to improve after provision of periodontal therapy. Minimal changes in MCV, MCH and MCHC indicated that the lower values are not due to any vitamin and mineral deficiencies, but secondary to the chronic inflammatory changes associated with chronic periodontal disease.

Prenatal cigarette smoke exposure: Pregnancy outcome and gestational changes in plasma nicotine concentration, hematocrit, and carboxyhemoglobin in a newly standardized rat model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farkas, Svetlana; Hussein, Jabeen; Ariano, Robert E.

Epidemiological studies support an association between perinatal cigarette smoke (CS) exposure and a number of severe pre- and postnatal complications. However, the mechanisms through which CS enhances such risks largely remain unknown. One of the reasons for our inability to discover such mechanisms has been the unavailability of a clinically relevant and physiologically concordant animal model. A number of studies have previously used nicotine (Nic) as surrogate for CS. We sought to (1) establish the amount of CS exposure to achieve plasma Nic concentrations observed among moderate to heavy smokers (20-60 ng/ml) (2) investigate the temporal changes in plasma Nicmore » concentrations, carboxyhemoglobin, and hematocrit with advancing pregnancy, and (3) elucidate the effects of CS exposure on pregnancy outcome. Pregnant Sprague-Dawley rats were exposed to various doses of CS or room air (Sham) from days 6 to 21 of gestation. Exposure to 6000 ml/day of CS led to very high plasma Nic concentrations and increased maternal and fetal mortality (P < 0.001). The plasma Nic concentrations remained higher than those observed in moderate smokers until the CS dose was reduced to 1000 ml/day and showed dose-dependent temporal changes with advancing gestational age. Significant increases in carboxyhemoglobin and hematocrit were observed in the CS group as compared with the Sham group (P < 0.001). In addition, prenatally CS exposed fetuses had lower birth weight as compared with the Sham group (P = 0.04). Our current study establishes a newly standardized and physiologically relevant model to investigate the mechanisms of CS-mediated adverse effects during the critical period of fetal development.« less

New Insights into the Microvascular Mechanisms of Drag Reducing Polymers: Effect on the Cell-Free Layer

PubMed Central

Brands, Judith; Kliner, Dustin; Lipowsky, Herbert H.; Kameneva, Marina V.; Villanueva, Flordeliza S.; Pacella, John J.

2013-01-01

Drag-reducing polymers (DRPs) significantly increase blood flow, tissue perfusion, and tissue oxygenation in various animal models. In rectangular channel microfluidic systems, DRPs were found to significantly reduce the near-wall cell-free layer (CFL) as well as modify traffic of red blood cells (RBC) into microchannel branches. In the current study we further investigated the mechanism by which DRP enhances microvascular perfusion. We studied the effect of various concentrations of DRP on RBC distribution in more relevant round microchannels and the effect of DRP on CFL in the rat cremaster muscle in vivo. In round microchannels hematocrit was measured in parent and daughter branch at baseline and after addition of DRP. At DRP concentrations of 5 and 10 ppm, the plasma skimming effect in the daughter branch was eliminated, as parent and daughter branch hematocrit were equivalent, compared to a significantly lowered hematocrit in the daughter branch without DRPs. In anesthetized rats (N=11) CFL was measured in the cremaster muscle tissue in arterioles with a diameter of 32.6 ± 1.7 µm. In the control group (saline, N=6) there was a significant increase in CFL in time compared to corresponding baseline. Addition of DRP at 1 ppm (N=5) reduced CFL significantly compared to corresponding baseline and the control group. After DRP administration the CFL reduced to about 85% of baseline at 5, 15, 25 and 35 minutes after DRP infusion was complete. These in vivo and in vitro findings demonstrate that DRPs induce a reduction in CFL width and plasma skimming in the microvasculature. This may lead to an increase of RBC flux into the capillary bed, and thus explain previous observations of a DRP mediated enhancement of capillary perfusion. PMID:24124610

New insights into the microvascular mechanisms of drag reducing polymers: effect on the cell-free layer.

PubMed

Brands, Judith; Kliner, Dustin; Lipowsky, Herbert H; Kameneva, Marina V; Villanueva, Flordeliza S; Pacella, John J

2013-01-01

Drag-reducing polymers (DRPs) significantly increase blood flow, tissue perfusion, and tissue oxygenation in various animal models. In rectangular channel microfluidic systems, DRPs were found to significantly reduce the near-wall cell-free layer (CFL) as well as modify traffic of red blood cells (RBC) into microchannel branches. In the current study we further investigated the mechanism by which DRP enhances microvascular perfusion. We studied the effect of various concentrations of DRP on RBC distribution in more relevant round microchannels and the effect of DRP on CFL in the rat cremaster muscle in vivo. In round microchannels hematocrit was measured in parent and daughter branch at baseline and after addition of DRP. At DRP concentrations of 5 and 10 ppm, the plasma skimming effect in the daughter branch was eliminated, as parent and daughter branch hematocrit were equivalent, compared to a significantly lowered hematocrit in the daughter branch without DRPs. In anesthetized rats (N=11) CFL was measured in the cremaster muscle tissue in arterioles with a diameter of 32.6 ± 1.7 µm. In the control group (saline, N=6) there was a significant increase in CFL in time compared to corresponding baseline. Addition of DRP at 1 ppm (N=5) reduced CFL significantly compared to corresponding baseline and the control group. After DRP administration the CFL reduced to about 85% of baseline at 5, 15, 25 and 35 minutes after DRP infusion was complete. These in vivo and in vitro findings demonstrate that DRPs induce a reduction in CFL width and plasma skimming in the microvasculature. This may lead to an increase of RBC flux into the capillary bed, and thus explain previous observations of a DRP mediated enhancement of capillary perfusion.

Factors interfering with the accuracy of five blood glucose meters used in Chinese hospitals.

PubMed

Lv, Hong; Zhang, Guo-jun; Kang, Xi-xiong; Yuan, Hui; Lv, Yan-wei; Wang, Wen-wen; Randall, Rollins

2013-09-01

The prevalence of diabetes is increasing in China. Glucose control is very important in diabetic patients. The aim of this study was to compare the accuracy of five glucose meters used in Chinese hospitals with a reference method, in the absence and presence of various factors that may interfere with the meters. Within-run precision of the meters was evaluated include Roche Accu-Chek Inform®, Abbott Precision PCx FreeStyle®, Bayer Contour®, J&J LifeScan SureStep Flexx®, and Nova Biomedical StatStrip®. The interference of hematocrit level, maltose, ascorbic acid, acetaminophen, galactose, dopamine, and uric acid were tested in three levels of blood glucose, namely low, medium, and high concentrations. Accuracy (bias) of the meters and analytical interference by various factors were evaluated by comparing results obtained in whole blood specimens with those in plasma samples of the whole blood specimens run on the reference method. Impact of oxygen tension on above five blood glucose meters was detected. Precision was acceptable and slightly different between meters. There were no significant differences in the measurements between the meters and the reference method. The hematocrit level significantly interfered with all meters, except StatStrip. Measurements were affected to varying degrees by different substances at different glucose levels, e.g. acetaminophen and ascorbic acid (Freestyle), maltose and galactose (FreeStyle, Accu-Chek), uric acid (FreeStyle, Bayer Contour), and dopamine (Bayer Contour). The measurements with the five meters showed a good correlation with the plasma hexokinase reference method, but most were affected by the hematocrit level. Some meters also showed marked interference by other substances. © 2013 Wiley Periodicals, Inc.

Noninvasive in vivo plasma volume and hematocrit in humans: observing long-term baseline behavior to establish homeostasis for intravascular volume and composition

NASA Astrophysics Data System (ADS)

Dent, Paul; Deng, Bin; Goodisman, Jerry; Peterson, Charles M.; Narsipur, Sriram; Chaiken, J.

2016-04-01

A new device incorporating a new algorithm and measurement process allows simultaneous noninvasive in vivo monitoring of intravascular plasma volume and red blood cell volume. The purely optical technique involves probing fingertip skin with near infrared laser light and collecting the wavelength shifted light, that is, the inelastic emission (IE) which includes the unresolved Raman and fluorescence, and the un-shifted emission, that is, the elastic emission (EE) which includes both the Rayleigh and Mie scattered light. Our excitation and detection geometry is designed so that from these two simultaneous measurements we can calculate two parameters within the single scattering regime using radiation transfer theory, the intravascular plasma volume fraction and the red blood cell volume fraction. Previously calibrated against a gold standard FDA approved device, 2 hour monitoring sessions on three separate occasions over a three week span for a specific, motionless, and mostly sleeping individual produced 3 records containing a total of 5706 paired measurements of hematocrit and plasma volume. The average over the three runs, relative to the initial plasma volume taken as 100%, of the plasma volume±1σ was 97.56+/-0.55 or 0.56%.For the same three runs, the average relative hematocrit (Hct), referenced to an assumed initial value of 28.35 was 29.37+/-0.12 or stable to +/-0.4%.We observe local deterministic circulation effects apparently associated with the pressure applied by the finger probe as well as longer timescale behavior due to normal ebb and flow of internal fluids due to posture changes and tilt table induced gravity gradients.

Evaluation of Oral Anticoagulant-Associated Intracranial Parenchymal Hematomas Using CT Findings.

PubMed

Gökçe, E; Beyhan, M; Acu, B

2015-06-01

Intracranial hemorrhage (ICH) is one of the most serious and lethal complications of anticoagulants with a reported incidence of 5-18.5 %. Computed tomographic (CT) findings, should be carefully studied because early diagnosis and treatment of oral anticoagulant use-associated hematomas are vitally important. In the present study, CT findings of intraparenchymal hematomas associated with anticoagulant and antihypertensive use are presented. This study included 45 patients (25 men, 20 women) under anticoagulant (21 patients) or antihypertensive (24 patients) treatment who had brain CT examinations due to complaints and findings suggesting cerebrovascular disease during July 2010-October 2013 period. CT examinations were performed to determine hematoma volumes and presence of swirl sign, hematocrit effect, mid-line shift effect, and intraventricular extension. The patients were 40-89 years of age. In four cases, a total of 51 intraparenchymal hematomas (42 cerebral, 7 cerebellar and 2 brain stem) were detected in multiple foci. Hematoma volumes varied from 0.09 to 284.00 ml. Swirl sign was observed in 87.5 and 63.0 % of OAC-associated ICHs and non-OAC-associated ICHs, respectively. In addition, hematocrit effect was observed in 41.6 % of OAC-associated and in 3.7 % of non-OAC-associated ICHs. Volume increases were observed in all 19 hematomas where swirl sign was detected, and follow-up CT scanning was conducted. Mortality of OAC-associated ICHs was correlated with initial volumes of hematoma, mid-line shift amount, and intraventricular extension. Detection of hematocrit effect by CT scanning of intracranial hematomas should be cautionary in oral anticoagulant use, while detection of swirl sign should be suggestive of active hemorrhage.

Comparative performance assessment of point-of-care testing devices for measuring glucose and ketones at the patient bedside.

PubMed

Ceriotti, Ferruccio; Kaczmarek, Ewa; Guerra, Elena; Mastrantonio, Fabrizio; Lucarelli, Fausto; Valgimigli, Francesco; Mosca, Andrea

2015-03-01

Point-of-care (POC) testing devices for monitoring glucose and ketones can play a key role in the management of dysglycemia in hospitalized diabetes patients. The accuracy of glucose devices can be influenced by biochemical changes that commonly occur in critically ill hospital patients and by the medication prescribed. Little is known about the influence of these factors on ketone POC measurements. The aim of this study was to assess the analytical performance of POC hospital whole-blood glucose and ketone meters and the extent of glucose interference factors on the design and accuracy of ketone results. StatStrip glucose/ketone, Optium FreeStyle glucose/ketone, and Accu-Chek Performa glucose were also assessed and results compared to a central laboratory reference method. The analytical evaluation was performed according to Clinical and Laboratory Standards Institute (CLSI) protocols for precision, linearity, method comparison, and interference. The interferences assessed included acetoacetate, acetaminophen, ascorbic acid, galactose, maltose, uric acid, and sodium. The accuracies of both Optium ketone and glucose measurements were significantly influenced by varying levels of hematocrit and ascorbic acid. StatStrip ketone and glucose measurements were unaffected by the interferences tested with exception of ascorbic acid, which reduced the higher level ketone value. The accuracy of Accu-Chek glucose measurements was affected by hematocrit, by ascorbic acid, and significantly by galactose. The method correlation assessment indicated differences between the meters in compliance to ISO 15197 and CLSI 12-A3 performance criteria. Combined POC glucose/ketone methods are now available. The use of these devices in a hospital setting requires careful consideration with regard to the selection of instruments not sensitive to hematocrit variation and presence of interfering substances. © 2014 Diabetes Technology Society.

Locally Sustainable School Lunch Intervention Improves Hemoglobin and Hematocrit Levels and Body Mass Index among Elementary Schoolchildren in Rural West Java, Indonesia

PubMed Central

Sekiyama, Makiko; Roosita, Katrin; Ohtsuka, Ryutaro

2017-01-01

School lunch is not provided in public elementary schools in Indonesia, and students frequently buy and eat snacks at school. We hypothesized that providing a traditional Sundanese meal as school lunch would be beneficial for children in rural West Java. To test this hypothesis, we evaluated the effect of a 1-month school lunch intervention aiming at sustainability and based on children’s nutritional intake, hemoglobin and hematocrit levels, and body mass index (BMI). A lunch (including rice, vegetable dish, animal protein dish, plant protein dish, and fruit) containing one-third of the recommended daily allowance of energy was offered every school day for 1 month, targeting 68 fourth-grade elementary schoolchildren. At baseline, the prevalence of anemia was 33.3%. The prevalence of stunting and underweight were 32.4% and 2.9%, respectively, whereas that of overweight and obesity combined was 17.6%, indicating a double burden of malnutrition among the subjects. During the intervention, intakes of protein (p < 0.05), calcium (p < 0.05), and vitamin C (p < 0.001) significantly increased, while that of fat significantly decreased (p < 0.001). After the intervention, hemoglobin (p < 0.05) and hematocrit (p < 0.05) levels were significantly improved, thereby almost halving the rate of anemia. These changes were significantly larger in the baseline anemic group than the non-anemic group (p < 0.01). BMI significantly increased in the baseline underweight/normal group (p < 0.001) but not in the overweight/obese group. The school lunch intervention significantly improved nutritional intakes and health statuses, implying its potential for reducing anemia and resolving the double burden of malnutrition among rural Indonesian schoolchildren. PMID:28805668

Blood gases, biochemistry, and hematology of Galapagos green turtles (Chelonia mydas).

PubMed

Lewbart, Gregory A; Hirschfeld, Maximilian; Denkinger, Judith; Vasco, Karla; Guevara, Nataly; García, Juan; Muñoz, Juanpablo; Lohmann, Kenneth J

2014-01-01

The green turtle, Chelonia mydas, is an endangered marine chelonian with a circum-global distribution. Reference blood parameter intervals have been published for some chelonian species, but baseline hematology, biochemical, and blood gas values are lacking from the Galapagos sea turtles. Analyses were done on blood samples drawn from 28 green turtles captured in two foraging locations on San Cristóbal Island (14 from each site). Of these turtles, 20 were immature and of unknown sex; the other eight were males (five mature, three immature). A portable blood analyzer (iSTAT) was used to obtain near immediate field results for pH, lactate, pO2, pCO2, HCO3-, Hct, Hb, Na, K, iCa, and Glu. Parameter values affected by temperature were corrected in two ways: (1) with standard formulas; and (2) with auto-corrections made by the iSTAT. The two methods yielded clinically equivalent results. Standard laboratory hematology techniques were employed for the red and white blood cell counts and the hematocrit determination, which was also compared to the hematocrit values generated by the iSTAT. Of all blood analytes, only lactate concentrations were positively correlated with body size. All other values showed no significant difference between the two sample locations nor were they correlated with body size or internal temperature. For hematocrit count, the iSTAT blood analyzer yielded results indistinguishable from those obtained with high-speed centrifugation. The values reported in this study provide baseline data that may be useful in comparisons among populations and in detecting changes in health status among Galapagos sea turtles. The findings might also be helpful in future efforts to demonstrate associations between specific biochemical parameters and disease.

Blood Gases, Biochemistry, and Hematology of Galapagos Green Turtles (Chelonia Mydas)

PubMed Central

Lewbart, Gregory A.; Hirschfeld, Maximilian; Denkinger, Judith; Vasco, Karla; Guevara, Nataly; García, Juan; Muñoz, Juanpablo; Lohmann, Kenneth J.

2014-01-01

The green turtle, Chelonia mydas, is an endangered marine chelonian with a circum-global distribution. Reference blood parameter intervals have been published for some chelonian species, but baseline hematology, biochemical, and blood gas values are lacking from the Galapagos sea turtles. Analyses were done on blood samples drawn from 28 green turtles captured in two foraging locations on San Cristóbal Island (14 from each site). Of these turtles, 20 were immature and of unknown sex; the other eight were males (five mature, three immature). A portable blood analyzer (iSTAT) was used to obtain near immediate field results for pH, lactate, pO2, pCO2, HCO3 −, Hct, Hb, Na, K, iCa, and Glu. Parameter values affected by temperature were corrected in two ways: (1) with standard formulas; and (2) with auto-corrections made by the iSTAT. The two methods yielded clinically equivalent results. Standard laboratory hematology techniques were employed for the red and white blood cell counts and the hematocrit determination, which was also compared to the hematocrit values generated by the iSTAT. Of all blood analytes, only lactate concentrations were positively correlated with body size. All other values showed no significant difference between the two sample locations nor were they correlated with body size or internal temperature. For hematocrit count, the iSTAT blood analyzer yielded results indistinguishable from those obtained with high-speed centrifugation. The values reported in this study provide baseline data that may be useful in comparisons among populations and in detecting changes in health status among Galapagos sea turtles. The findings might also be helpful in future efforts to demonstrate associations between specific biochemical parameters and disease. PMID:24824065

Clinical impact of sepsis at admission to the ICU of a private hospital in Salvador, Brazil.

PubMed

Juncal, Verena Ribeiro; Britto Neto, Lelivaldo Antonio de; Camelier, Aquiles Assunção; Messeder, Octavio Henrique Coelho; Farias, Augusto Manoel de Carvalho

2011-01-01

To describe the clinical characteristics, laboratory data, and clinical outcomes of patients with and without sepsis admitted to the ICU of a private hospital in the city of Salvador, Brazil, and to identify clinical variables related to a worse prognosis in those with sepsis. This was a longitudinal study including all patients admitted to the general ICU of the Hospital Português, in the city of Salvador, Brazil, between June of 2008 and March of 2009. At ICU admission, two groups of patients were identified: with sepsis and without sepsis. Epidemiological, clinical and laboratory data were collected, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score was calculated. Of the 144 patients in the study, 29 (20.1%) had sepsis. Among the patients with sepsis, males accounted for 55.2%, the mean age was 73.1 ± 14.6 years, and the mean APACHE II score was 23.8 ± 9.1, compared with 36.3%, 68.7 ± 17.7 years, and 18.4 ± 9.5, respectively, among those without sepsis. There were significant associations between a diagnosis of sepsis and the following variables: APACHE II score; in-hospital mortality; ICU mortality; HR; mean arterial pressure; hematocrit level; white blood cell count; and antibiotic use. The use of life support measures and lower hematocrit levels were associated with a worse prognosis in the patients with sepsis. The patients diagnosed with sepsis presented worse clinical outcomes, probably due to their greater severity. Hematocrit level was the only variable that was a predictor of mortality risk in the patients with sepsis.

Relationship of Blood Mercury Levels to Health Parameters in the Loggerhead Sea Turtle (Caretta caretta)

PubMed Central

Day, Rusty D.; Segars, Al L.; Arendt, Michael D.; Lee, A. Michelle; Peden-Adams, Margie M.

2007-01-01

Background Mercury is a pervasive environmental pollutant whose toxic effects have not been studied in sea turtles in spite of their threatened status and evidence of immunosuppression in diseased populations. Objectives In the present study we investigate mercury toxicity in loggerhead sea turtles (Caretta caretta) by examining trends between blood mercury concentrations and various health parameters. Methods Blood was collected from free-ranging turtles, and correlations between blood mercury concentrations and plasma chemistries, complete blood counts, lysozyme, and lymphocyte proliferation were examined. Lymphocytes were also harvested from free-ranging turtles and exposed in vitro to methylmercury to assess proliferative responses. Results Blood mercury concentrations were positively correlated with hematocrit and creatine phosphokinase activity, and negatively correlated with lymphocyte cell counts and aspartate amino-transferase. Ex vivo negative correlations between blood mercury concentrations and B-cell proliferation were observed in 2001 and 2003 under optimal assay conditions. In vitro exposure of peripheral blood leukocytes to methylmercury resulted in suppression of proliferative responses for B cells (0.1 μg/g and 0.35 μg/g) and T cells (0.7 μg/g). Conclusions The positive correlation between blood mercury concentration and hematocrit reflects the higher affinity of mercury species for erythrocytes than plasma, and demonstrates the importance of measuring hematocrit when analyzing whole blood for mercury. In vitro immunosuppression occurred at methylmercury concentrations that correspond to approximately 5% of the individuals captured in the wild. This observation and the negative correlation found ex vivo between mercury and lymphocyte numbers and mercury and B-cell proliferative responses suggests that subtle negative impacts of mercury on sea turtle immune function are possible at concentrations observed in the wild. PMID:17938730

Does Preoperative Platelet Function Predict Bleeding in Patients Undergoing Off Pump Coronary Artery Bypass Surgery?

PubMed

Berger, Peter B; Kirchner, H Lester; Wagner, Eric S; Ismail-Sayed, Ibrahim; Yahya, Salma; Benoit, Charles; Blankenship, James C; Carter, Russell; Casale, Alfred S; Green, Sandy M; Scott, Thomas D; Skelding, Kimberly A; Woods, Edward; Henry, Yvette M

2015-06-01

We sought to examine the relationship between preoperative platelet function and perioperative bleeding in patients undergoing CABG. There are many ways to measure platelet aggregability. Little is known about their correlations with one another, or with bleeding. We prospectively studied 50 patients undergoing a first isolated off-pump CABG. Thirty-four were exposed to a thienopyridine prior to surgery; 16 were not. Preoperative platelet function was measured by VerifyNow®, TEG®, AggreGuide™, Plateletworks®, vasodilator-stimulated phosphoprotein (VASP) phosphorylation, and light transmission aggregometry. Bleeding was assessed 2 ways: drop from pre- to nadir postoperative hematocrit, and chest tube drainage. Correlation coefficients were calculated using Spearman's rank-order correlation. Mean age was 62 years. Patient characteristics and surgical details were similar between the thienopyridine-exposed and non-exposed patients. The correlation coefficients between the 4 point-of-care platelet function measurements and hematocrit change ranged from -0.2274 to 0.2882. Only Plateletworks® correlated with drop in hematocrit (r = 0.2882, P = 0.0470). The correlation coefficients between each of the 4 point-of-care platelet function tests and the chest tube drainage were also poor, ranging from -0.3073 to 0.2272. Both AggreGuide™ (r = -0.3073, P = 0.0317) and VASP (r = -0.3187, P = 0.0272) were weakly but significantly correlated with chest tube drainage. The correlation among the 4 point-of-care platelet function measurements was poor, with coefficients ranging from -0.2504 to 0.1968. We observed little correlation among 4 platelet function tests, and between those assays and perioperative bleeding defined 2 different ways. Whether any of these assays should be used to guide decision making in individual patients is unclear. © 2015, Wiley Periodicals, Inc.

Adhesive blood microsampling systems for steroid measurement via LC-MS/MS in the rat.

PubMed

Heussner, Kirsten; Rauh, Manfred; Cordasic, Nada; Menendez-Castro, Carlos; Huebner, Hanna; Ruebner, Matthias; Schmidt, Marius; Hartner, Andrea; Rascher, Wolfgang; Fahlbusch, Fabian B

2017-04-01

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) allows for the direct analysis of multiple hormones in a single probe with minimal sample volume. Rodent-based animal studies strongly rely on microsampling, such as the dry blood spot (DBS) method. However, DBS suffers the drawback of hematocrit-dependence (non-volumetric). Hence, novel volumetric microsampling techniques were introduced recently, allowing sampling of fixed accurate volumes. We compared these methods for steroid analysis in the rat to improve inter-system comparability. We analyzed steroid levels in blood using the absorptive microsampling devices Whatman® 903 Protein Saver Cards, Noviplex™ Plasma Prep Cards and the Mitra™ Microsampling device and compared the obtained results to the respective EDTA plasma levels. Quantitative steroid analysis was performed via LC-MS/MS. For the determination of the plasma volume factor for each steroid, their levels in pooled blood samples from each human adults and rats (18weeks) were compared and the transferability of these factors was evaluated in a new set of juvenile (21days) and adult (18weeks) rats. Hematocrit was determined concomitantly. Using these approaches, we were unable to apply one single volume factor for each steroid. Instead, plasma volume factors had to be adjusted for the recovery rate of each steroid and device individually. The tested microsampling systems did not allow the use of one single volume factor for adult and juvenile rats based on an unexpectedly strong hematocrit-dependency and other steroid specific (pre-analytic) factors. Our study provides correction factors for LC-MS/MS steroid analysis of volumetric and non-volumetric microsampling systems in comparison to plasma. It argues for thorough analysis of chromatographic effects before the use of novel volumetric systems for steroid analysis. Copyright © 2017 Elsevier Inc. All rights reserved.

The effects of nandrolone decanoate on nutritional parameters in hemodialysis patients.

PubMed

Barton Pai, A; Chretien, C; Lau, A H

2002-07-01

Malnutrition with hypoalbuminemia is an independent predictor of mortality in end-stage renal disease patients. Anabolic steroids reduce protein catabolism and therefore may improve nutritional parameters. This study was undertaken to determine the effects of the anabolic steroid nandrolone decanoate on the nutritional status of hemodialysis patients. Secondary endpoints were to examine the effects of androgen therapy on hematocrit and erythropoietin (EPO) dose. Medical records of chronic hemodialysis patients who received nandrolone decanoate for greater than 30 days were reviewed. Data collected included: demographics, dose, frequency, duration of treatment and cumulative dose of nandrolone. Baseline albumin, transferrin, dry weight, phosphorus, creatinine, hematocrit and erythropoietin dose were obtained for comparison with values after treatment. Of the 9 patients evaluated (mean +/- SD: age 55+/-28 years, 4/9 male), 2 patients received nandrolone doses of 25 mg intramuscularly (i.m.) every week, while the remaining 7 patients received 100 mg i.m. every 2 weeks. The mean +/- SD duration of treatment was 96+/-43 days, with a mean +/- SD cumulative dose of 656+/-371 mg. The mean +/- SD baseline albumin was 2.9+/-0.6 mg/dl which increased to 3.3+/-0.4 mg/dl after treatment (p = 0.045). Dry weight increased from a mean +/- SD of 64.4+/-11.7 kg to 66.0+/-10.9 kg after nandrolone therapy (p = 0.028). Mean +/- SD hematocrit at baseline was 28.2+/-4.5% and increased to 33.2+/-5.1% (p = 0.033). The dose of EPO was reduced in 4 patients (44%) during nandrolone therapy. Nandrolone significantly improved markers of nutritional status in our hemodialysis patients. This therapy may also enhance the hematopoietic effects of EPO.

Are overall adiposity and abdominal adiposity separate or redundant determinants of blood viscosity?

PubMed

Varlet-Marie, Emmanuelle; Raynaud de Mauverger, Eric; Brun, Jean-Frédéric

2015-01-01

In line with recent literature showing that both general adiposity and abdominal adiposity are independently associated with the risk of death, we recently reported that body mass index (BMI) and waist-to hip ratio (WHR) were independent predictors of blood viscosity, related to different determinants of viscosity (for BMI: plasma viscosity and red cell aggregation; for WHR: hematocrit). Since this report was challenged by a study showing that abdominal adiposity (as measured with waist circumference WC and not WHR) is the only independent determinant of viscosity, we re-assessed on our previous database correlations among viscosity factors, BMI, WHR and WC. Blood viscosity was correlated to BMI (r = 0.155 p = 0.004), WHR (r = 0.364; p = 0.027) and WC (r = 0.094; p = 0.05). Hematocrit was correlated to WHR (r = 0.524) but neither to BMI (r =-0.021) nor waist circumference (r = 0.053). WC was correlated with plasma viscosity (r = 0.154; p = 0.002) while WHR was not (r =-0.0102 NS). A stepwise regression analysis selected two determinants of whole blood viscosity at high shear rate: BMI (p = 0.0167) and WC (p = 0.0003) excluding WHR. Therefore, in this sample, abdominal fatness expressed by WC and whole body adiposity remain independent determinants of blood viscosity. WHR and WC have not the same meaning, WC measuring the size of abdominal fat while WHR measuring the shape of body distribution regardless the degree of fat excess. Interestingly, hematocrit is rather related to shape (even within a normal range of body size) than the extent of abdominal fatness, and is not related to whole body adiposity.

Nutritional and metabolic determinants of blood rheology differ between trained and sedentary individuals.

PubMed

Varlet-Marie, Emmanuelle; Guiraudou, Marie; Fédou, Christine; Raynaud de Mauverger, Eric; Durand, Fabienne; Brun, Jean-Frédéric

2013-01-01

Body composition and nutrition have been reported to be correlated with blood rheology. However, in sedentary and in physically active individuals these relationships seem to be not exactly similar. This study investigated whether exercise training status influences these relationships. 32 athletes (ATH) (age: 25 ± 0.7 yr; body mass index (BMI): 23.75 ± 0.23 kg/m2) were compared to 21 sedentary subjects (SED) (age: 45.19 ± 2.90; BMI = 33.41 ± 1.33) with nutritional assessment (autoquestionnaire), bioelectrical impedancemetry, viscometry at high shear rate (MT90) and Myrenne aggregometer. Subjects differ according to age, weight and adiposity parameters. Their eating behavior is different: ATH eat a higher percentage of protein (p < 0.005), a lower percentage of lipid (p < 0.05), and a higher total amount of carbohydrate (+31% p < 0.02). Their viscosity factors are similar except plasma viscosity which is higher in SED than ATH (1.51 ± 0.03 vs 1.43 ± 0.02 mPa.s, p < 0.05). In both ATH and SED, abdominal obesity (waist-to-hip ratio or WHR) is associated with impairments in blood rheology, but not exactly the same. In ATH, WHR is associated with an increase in hematocrit (r = 0.647; p = 0.009), plasma viscosity (r = 0.723; p = 0.002), and caloric (and CHO) intake moderately increase RBC rigidity (r = 0.5405; p = 0.0251) and aggregability (r = 0.3366 p = 0.0596). In SED the picture is different, adiposity increases hematocrit (r = 0.460; p = 0.048), abdominal fatness increases blood viscosity independent of hematocrit, and CHO intake is associated with lower RBC aggregability (r = -0.493; p = 0.0319).

Locally Sustainable School Lunch Intervention Improves Hemoglobin and Hematocrit Levels and Body Mass Index among Elementary Schoolchildren in Rural West Java, Indonesia.

PubMed

Sekiyama, Makiko; Roosita, Katrin; Ohtsuka, Ryutaro

2017-08-12

School lunch is not provided in public elementary schools in Indonesia, and students frequently buy and eat snacks at school. We hypothesized that providing a traditional Sundanese meal as school lunch would be beneficial for children in rural West Java. To test this hypothesis, we evaluated the effect of a 1-month school lunch intervention aiming at sustainability and based on children's nutritional intake, hemoglobin and hematocrit levels, and body mass index (BMI). A lunch (including rice, vegetable dish, animal protein dish, plant protein dish, and fruit) containing one-third of the recommended daily allowance of energy was offered every school day for 1 month, targeting 68 fourth-grade elementary schoolchildren. At baseline, the prevalence of anemia was 33.3%. The prevalence of stunting and underweight were 32.4% and 2.9%, respectively, whereas that of overweight and obesity combined was 17.6%, indicating a double burden of malnutrition among the subjects. During the intervention, intakes of protein ( p < 0.05), calcium ( p < 0.05), and vitamin C ( p < 0.001) significantly increased, while that of fat significantly decreased ( p < 0.001). After the intervention, hemoglobin ( p < 0.05) and hematocrit ( p < 0.05) levels were significantly improved, thereby almost halving the rate of anemia. These changes were significantly larger in the baseline anemic group than the non-anemic group ( p < 0.01). BMI significantly increased in the baseline underweight/normal group ( p < 0.001) but not in the overweight/obese group. The school lunch intervention significantly improved nutritional intakes and health statuses, implying its potential for reducing anemia and resolving the double burden of malnutrition among rural Indonesian schoolchildren.

Numerical Simulation of Unsteady Blood Flow through Capillary Networks.

PubMed

Davis, J M; Pozrikidis, C

2011-08-01

A numerical method is implemented for computing unsteady blood flow through a branching capillary network. The evolution of the discharge hematocrit along each capillary segment is computed by integrating in time a one-dimensional convection equation using a finite-difference method. The convection velocity is determined by the local and instantaneous effective capillary blood viscosity, while the tube to discharge hematocrit ratio is deduced from available correlations. Boundary conditions for the discharge hematocrit at divergent bifurcations arise from the partitioning law proposed by Klitzman and Johnson involving a dimensionless exponent, q≥1. When q=1, the cells are partitioned in proportion to the flow rate; as q tends to infinity, the cells are channeled into the branch with the highest flow rate. Simulations are performed for a tree-like, perfectly symmetric or randomly perturbed capillary network with m generations. When the tree involves more than a few generations, a supercritical Hopf bifurcation occurs at a critical value of q, yielding spontaneous self-sustained oscillations in the absence of external forcing. A phase diagram in the m-q plane is presented to establish conditions for unsteady flow, and the effect of various geometrical and physical parameters is examined. For a given network tree order, m, oscillations can be induced for a sufficiently high value of q by increasing the apparent intrinsic viscosity, decreasing the ratio of the vessel diameter from one generation to the next, or by decreasing the diameter of the terminal vessels. With other parameters fixed, oscillations are inhibited by increasing m. The results of the continuum model are in excellent agreement with the predictions of a discrete model where the motion of individual cells is followed from inlet to outlet.

Exploring the Role of Polycythemia in Patients With Cyanosis After Palliative Congenital Heart Surgery.

PubMed

Siehr, Stephanie L; Shi, Shenghui; Hao, Shiying; Hu, Zhongkai; Jin, Bo; Hanley, Frank; Reddy, Vadiyala Mohan; McElhinney, Doff B; Ling, Xuefeng Bruce; Shin, Andrew Y

2016-03-01

To understand the relationship between polycythemia and clinical outcome in patients with hypoplastic left heart syndrome following the Norwood operation. A retrospective, single-center cohort study. Pediatric cardiovascular ICU, university-affiliated children's hospital. Infants with hypoplastic left heart syndrome admitted to our medical center from September 2009 to December 2012 undergoing stage 1/Norwood operation. None. Baseline demographic and clinical information including first recorded postoperative hematocrit and subsequent mean, median, and nadir hematocrits during the first 72 hours postoperatively were recorded. The primary outcomes were in-hospital mortality and length of hospitalization. Thirty-two patients were included in the analysis. Patients did not differ by operative factors (cardiopulmonary bypass time and cross-clamp time) or traditional markers of severity of illness (vasoactive inotrope score, lactate, saturation, and PaO2/FIO2 ratio). Early polycythemia (hematocrit value > 49%) was associated with longer cardiovascular ICU stay (51.0 [± 38.6] vs 21.4 [± 16.2] d; p < 0.01) and total hospital length of stay (65.0 [± 46.5] vs 36.1 [± 20.0] d; p = 0.03). In a multivariable analysis, polycythemia remained independently associated with the length of hospitalization after controlling for the amount of RBC transfusion (weight, 4.36 [95% CI, 1.35-7.37]; p < 0.01). No difference in in-hospital mortality rates was detected between the two groups (17.6% vs 20%). Early polycythemia following the Norwood operation is associated with longer length of hospitalization even after controlling for blood cell transfusion practices. We hypothesize that polycythemia may be caused by hemoconcentration and used as an early marker of capillary leak syndrome.

Complete Blood Count: MedlinePlus Lab Test Information

MedlinePlus

... your lungs and to the rest of your body Hematocrit , a measurement of how much of your blood is made ... Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Your Guide to Anemia; [cited ... MedlinePlus Health Topics Bleeding Disorders Blood Count ...

The Manufacture and Study of Hemoglobin-Saline Solution.

DTIC Science & Technology

1981-02-25

hemoglobin, methemoglobin, and carboxyhemoglobin ; with a Damon IEC MB centrifuge for hematocrit; and with the Hem-O-Scan for a dissociation curve. I F...The saturation, as measured with the Co-oximeter, was corrected for the proportion of methemoglobin and carboxyhemoglobin , to reflect the per

Temperature dependence of blood viscosity in frogs and turtles: effect on heat exchange with environment.

PubMed

Langille, B L; Crisp, B

1980-09-01

The temperature dependence of the viscosity of blood from frogs and turtles has been assessed for temperatures between 5 and 40 degrees C. Viscosity of turtles' blood was, on average, reduced from 3.50 +/- 0.16 to 2.13 +/- 0.10 cP between 10 and 30 degrees C, a decline of 39%. Even larger changes in viscosity were observed for frogs' blood with viscosity falling from 4.55 +/- 0.32 to 2.55 +/- 0.25 cP over the same temperature range, a change of 44%. Blood viscosity was highly correlated with hematocrit in both species at all temperatures. Viscosity of blood from both frogs and turtles showed a large standard deviation at all temperatures and this was attributed to large individual-to-individual variations in hematocrit. Turtles heat faster than they cool, regardless of whether tests are performed at temperatures above or below the range of thermal preference. The effect of temperature dependence of blood viscosity on heating and cooling rates is demonstrated.

Regulation of hematopoiesis in the suspended rat as a model for space flight

NASA Technical Reports Server (NTRS)

Dunn, C. D. R.; Johnson, P. C.

1984-01-01

A series of studies was completed in which a variety of routine hematological and other parameters were obtained from sequential sampling of control and suspended rats. These data showed that, during suspension, the rats failed to gain weight at the same rate as the controls, ate and drank significantly less, demonstrated a transient increase in peripheral hematocrit and RBC count, a transient decrease in MCH, suppressed reticulocyte counts and a progressive decrease in MCV but no change in RBC shape. Leukocyte counts were variably decreased but no significant changes in platelet numbers were noted. Post-suspension, evidence of anemia was present from a reduced RBC count, hemoglobin, hematocrit, and MCV. A leukocytosis was also noted. Efforts directed to the collection of data aimed at understanding changes in blood volume during suspension are also discussed. As part of these studies the following parameters were investigated; RBC survival, in vitro leukocyte reactivity to PHA, bone marrow and spleen cellularity and morphology, ferrokinetics, and the hematopoietic inductive microenvironment.

Active Brazilian crack cocaine users: nutritional, anthropometric, and drug use profiles.

PubMed

Escobar, Mariana; Scherer, Juliana N; Soares, Cassia M; Guimarães, Luciano S P; Hagen, Martine E; von Diemen, Lisia; Pechansky, Flavio

2018-02-15

To evaluate the nutritional status of crack users and to analyze its correlation with drug use profiles. Cross-sectional study with 108 crack users. Anthropometric data were assessed through body mass index (BMI) and bioimpedance (BIA) measurements. A blood test to analyze hematocrit, hemoglobin, glucose, and lipid profiles was also performed. Crack use was determined through a standardized interview. Based on BMI and BIA, most individuals were eutrophic (about 70%). Regarding hematological parameters, we found that hemoglobin and hematocrit levels were below normal for 32.4 and 30.6% of patients, respectively. Considering normal parameters, a large part of the sample (60.2%) had low levels of HDL cholesterol and high levels of triglycerides (38%). There were no significant correlations between drug profile and nutritional variables. This is a pioneering study that examines the nutritional status of crack users. Our results showed that most crack users present normal anthropometric findings and the prevalence of underweight is low. However, blood analysis showed changes and a specific type of malnutrition.

A comprehensive evaluation of strip performance in multiple blood glucose monitoring systems.

PubMed

Katz, Laurence B; Macleod, Kirsty; Grady, Mike; Cameron, Hilary; Pfützner, Andreas; Setford, Steven

2015-05-01

Accurate self-monitoring of blood glucose is a key component of effective self-management of glycemic control. Accurate self-monitoring of blood glucose results are required for optimal insulin dosing and detection of hypoglycemia. However, blood glucose monitoring systems may be susceptible to error from test strip, user, environmental and pharmacological factors. This report evaluated 5 blood glucose monitoring systems that each use Verio glucose test strips for precision, effect of hematocrit and interferences in laboratory testing, and lay user and system accuracy in clinical testing according to the guidelines in ISO15197:2013(E). Performance of OneTouch(®) VerioVue™ met or exceeded standards described in ISO15197:2013 for precision, hematocrit performance and interference testing in a laboratory setting. Performance of OneTouch(®) Verio IQ™, OneTouch(®) Verio Pro™, OneTouch(®) Verio™, OneTouch(®) VerioVue™ and Omni Pod each met or exceeded accuracy standards for user performance and system accuracy in a clinical setting set forth in ISO15197:2013(E).

Association of necrotizing enterocolitis with anemia and packed red blood cell transfusions in preterm infants

PubMed Central

Singh, Rachana; Visintainer, Paul F.; Frantz, Ivan D.; Shah, Bhavesh L.; Meyer, Kathleen M.; Favila, Sarah A.; Thomas, Meredith S.; Kent, David M.

2011-01-01

Objective To determine association of anemia and RBC transfusions with NEC in preterm infants. Study Design 111 preterm infants with NEC ≥ Stage 2a were compared with 222 matched controls. 28 clinical variables, including hematocrit and RBC transfusions were recorded. Propensity scores and multivariate logistic regression models were created to examine effects on the risk of NEC. Results Controlling for other factors, lower hematocrit was associated with increased odds of NEC [OR 1.10, p =0.01]. RBC transfusion has a temporal relationship with NEC onset. Transfusion within 24h (OR=7.60, p=0.001) and 48h (OR=5.55, p=0.001) has a higher odds of developing NEC but this association is not significant by 96h (OR= 2.13, p =0.07), post transfusion Conclusions Anemia may increase the risk of developing NEC in preterm infants. RBC transfusions are temporally related to NEC. Prospective studies are needed to better evaluate the potential influence of transfusions on the development of NEC. PMID:21273983

Term babies with delayed cord clamping: an approach in preventing anemia (.).

PubMed

Ertekin, Arif Aktug; Nihan Ozdemir, Nilufer; Sahinoglu, Zeki; Gursoy, Tugba; Erbil, Nazan; Kaya, Erdal

2016-09-01

We investigated the effects of delayed and early clamping of the cord on the hematologic status of the baby at birth and at the end of second month. Umbilical cord of 74 babies were clamped in the first 30 s (Group 1) and 76 were clamped at 90-120 s (Group 2). Levels of hemoglobin, hematocrit, iron and ferritin were analyzed from the umbilical cord blood at birth and from the venous samples at the end of second month. Hemoglobin, hematocrit, iron and ferritin levels of cord blood were similar in both groups. However, their levels other than ferritin were higher in Group 2 at the end of second month. Two babies had respiratory distress and twelve neonates received phototherapy in Group 2 whereas only five neonates received phototherapy in Group 1. Term babies to whom delayed cord clamping was performed had improved hematological parameters at the end of second month. Therefore, delaying cord clamping in these babies may be a favorible approach in preventing anemia.

Snapping turtles (Chelydra serpentina) as biomonitors of lead contamination of the Big River in Missouri`s Old Lead Belt

DOE Office of Scientific and Technical Information (OSTI.GOV)

Overmann, S.R.; Krajicek, J.J.

1995-04-01

The usefulness of common snapping turtles (Chelydra serpentina) as biomonitors of lead (Pb) contamination of aquatic ecosystems was assessed. Thirty-seven snapping turtles were collected from three sites on the Big River, an Ozarkian stream contaminated with Pb mine tailings. Morphometric measurements, tissue Pb concentrations (muscle, blood, bone, carapace, brain, and liver), {delta}-aminolevulinic acid dehydratase ({delta}-ALAD) activity, hematocrit, hemoglobin, plasma glucose, osmolality, and chloride ion content were measured. The data showed no effects of Pb contamination on capture success or morphological measurements. Tissue Pb concentrations were related to capture location. Hematocrit, plasma osmolality, plasma glucose, and plasma chloride ion content weremore » not significantly different with respect to capture location. The {delta}-ALAD activity levels were decreased in turtles taken from contaminated sites. Lead levels in the Big River do not appear to be adversely affecting the snapping turtles of the river. Chelydra serpentina is a useful species for biomonitoring of Pb-contaminated aquatic environments.« less

The influence of water versus carbohydrate-electrolyte hydration on blood components during a 16-km military march.

PubMed

de Carvalho, Moisés Vieira; Marins, João Carlos Bouzas; Silami-Garcia, Emerson

2007-01-01

The purpose of this study was to identify and to compare the effects of ingesting liquids during a 16-km military march under moderate environmental conditions. Twenty-six volunteer male subjects were randomly divided into two groups. Group GW received water (n=12), and group GP received an electrolytic carbohydrate solution (n=14). Blood and urine samples were obtained immediately before and after the march. No significant differences between the drinks were found for any of the measured variables. However, important results (p < 0.05) were observed by comparing variables before and after exercise. The variables included sodium, hematocrit, red blood cell, hemoglobin, and lactic acid levels and body weight (group GW) and sodium, potassium, hematocrit, red blood cell, hemoglobin, and lactic acid levels (group GP). Under the environmental conditions and hydration procedures applied, the results of this study showed similarities in the behavior of the variables, regardless of the kind of beverage consumed.

Vitamin D pathway gene polymorphisms affecting daclatasvir plasma concentration at 2 weeks and 1 month of therapy.

PubMed

Cusato, Jessica; Nicolò, Amedeo De; Boglione, Lucio; Favata, Fabio; Ariaudo, Alessandra; Pinna, Simone Mornese; Carcieri, Chiara; Guido, Federica; Cariti, Giuseppe; Perri, Giovanni Di; D'Avolio, Antonio

2018-06-01

Vitamin D (VD) influences genetic expression through its receptor (VDR). VD pathway gene polymorphisms seem to influence antiviral drug pharmacokinetics and therapeutic outcome/toxicity. We investigated the association between daclatasvir (DCV) plasma concentrations and genetic variants (SNPs) associated with the VD pathway. Chronic hepatitis C patients treated with DCV from 2014 to 2016 were included. Genotypes were assessed through real-time PCR and plasma concentrations through liquid chromatography. A total of 52 patients were analyzed. DCV levels were influenced by CYP24A1 rs2248359T>C polymorphism at 2 weeks and VDR Cdx2 A>G at 1 month of treatment. Linear regression analysis showed baseline BMI, alanine aminotransferase and hematocrit as significant predictors of DCV concentrations at 2 weeks, BMI and hematocrit at baseline, VDR Cdx2 AG/GG and FokI TC/CC at 1 month. These results showed a possible role of VD pathway gene polymorphisms in influencing DCV plasma concentrations, but further studies are required.

Access thrombosis, hospitalization, and hematocrit level in hemodialysis patients.

PubMed

Heard, K A; Russell, T A

2000-12-01

Are occurrences of vascular access thrombosis and hospitalization higher in hemodialysis patients with hematocrits (Hcts) > 36% compared to those < 36%? This 12-month retrospective study included 30 male hemodialysis patients who received erythropoietin (rHuEPO) for at least 6 months. Sixty percent (n = 18) had arteriovenous fistulas and 40% (n = 12) had polytetrafluoroethylene grafts. The mean age was 59.6 years. Twenty patients during 216 patient months had a mean Hct < 36% with five thromboses (2.3%). Ten patients during 118 patient months had a mean Hct > 36% with four thromboses (3.4%). There was no statistically significant difference between the thrombosis rates in the two groups. There were four hospitalizations in 118 patient months in the > 36% group (3.4%). There were 33 hospitalizations in 216 patient months in the < 36% group (15.3%). This is 4.5 times higher than the > 36% group. Our data suggest that Hcts > 36% are not associated with increased thrombosis and are associated with lower hospitalization rates.

The Chronic and Acute Effects of Exercise Upon Selected Blood Measures.

ERIC Educational Resources Information Center

Roitman, J. L.; Brewer, J. P.

This study investigated the effects of chronic and acute exercise upon selected blood measures and indices. Nine male cross-country runners were studied. Red blood count, hemoglobin, and hematocrit were measured using standard laboratory techniques; mean corpuscular volume (MCV), mean corpuscular hemoglobin, and mean corpuscular hemoglobin…

Chelation and effectiveness of salicylate related compounds on pyresis, sedimentation rate and hematocrit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schubert, J.; Rosenthal, M.W.; Fried, J.F.

1984-01-01

The mechanism of action and identification of sites of salicylates and related compounds in antipyresis were studied. Structure-activity investigations of antipyresis were made using Sprague-Dawley rats. Results showed copper was chelated by the salicylate, passes through the cell membrane, and repairs the lesion. 13 references, 2 figures. (ACR)

21 CFR 864.6400 - Hematocrit measuring device.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., racks, and a sealer and a holder. The device is used to measure the packed red cell volume in blood to determine whether the patient's total red cell volume is normal or abnormal. Abnormal states include anemia...). The packed red cell volume is produced by centrifuging a given volume of blood. (b) Classification...

21 CFR 864.6400 - Hematocrit measuring device.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., racks, and a sealer and a holder. The device is used to measure the packed red cell volume in blood to determine whether the patient's total red cell volume is normal or abnormal. Abnormal states include anemia...). The packed red cell volume is produced by centrifuging a given volume of blood. (b) Classification...

21 CFR 864.6400 - Hematocrit measuring device.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., racks, and a sealer and a holder. The device is used to measure the packed red cell volume in blood to determine whether the patient's total red cell volume is normal or abnormal. Abnormal states include anemia...). The packed red cell volume is produced by centrifuging a given volume of blood. (b) Classification...

21 CFR 864.6400 - Hematocrit measuring device.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., racks, and a sealer and a holder. The device is used to measure the packed red cell volume in blood to determine whether the patient's total red cell volume is normal or abnormal. Abnormal states include anemia...). The packed red cell volume is produced by centrifuging a given volume of blood. (b) Classification...

21 CFR 864.6400 - Hematocrit measuring device.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., racks, and a sealer and a holder. The device is used to measure the packed red cell volume in blood to determine whether the patient's total red cell volume is normal or abnormal. Abnormal states include anemia...). The packed red cell volume is produced by centrifuging a given volume of blood. (b) Classification...

Glucose Tolerance and Hyperkinesis.

ERIC Educational Resources Information Center

Langseth, Lillian; Dowd, Judith

Examined were medical records of 265 hyperkinetic children (7-9 years old). Clinical blood chemistries, hematology, and 5-hour glucose tolerance test (GTT) results indicated that hematocrit levels were low in 27% of the Ss, eosinophil levels were abnormally high in 86% of the Ss, and GTT results were abnormal in a maority of Ss. (CL)

Adenosine triphosphate and diphosphoglycerate levels in red blood cells from patients with Down's syndrome.

PubMed

Knull, H R; Bronstein, W W; Porter, P J

1978-09-15

The levels of ATP and ATP plus DPG were significantly elevated in erythrocytes from Down's syndrome patients when compared to erythrocytes from age matched controls. The hemoglobin content and hematocrit values were significantly reduced. The resultant tendency towards anemia probably explains the elevation in metabolite levels.

Blood Perfusion in Microfluidic Models of Pulmonary Capillary Networks: Role of Geometry and Hematocrit

NASA Astrophysics Data System (ADS)

Stauber, Hagit; Waisman, Dan; Sznitman, Josue; Technion-IIT Team; Department of Neonatology Carmel Medical Center; Faculty of Medicine-Technion IIT Collaboration

2015-11-01

Microfluidic platforms are increasingly used to study blood microflows at true physiological scale due to their ability to overcome manufacturing obstacle of complex anatomical morphologies, such as the organ-specific architectures of the microcirculation. In the present work, we utilize microfluidic platforms to devise in vitro models of the underlying pulmonary capillary networks (PCN), where capillary lengths and diameters are similar to the size of RBCs (~ 5-10 μm). To better understand flow characteristics and dispersion of red blood cells (RBCs) in PCNs, we have designed microfluidic models of alveolar capillary beds inspired by the seminal ``sheet flow'' model of Fung and Sobin (1969). Our microfluidic PCNs feature confined arrays of staggered pillars with diameters of ~ 5,7 and 10 μm, mimicking the dense structure of pulmonary capillary meshes. The devices are perfused with suspensions of RBCs at varying hematocrit levels under different flow rates. Whole-field velocity patterns using micro-PIV and single-cell tracking using PTV are obtained with fluorescently-labelled RBCs and discussed. Our experiments deliver a real-scale quantitative description of RBC perfusion characteristics across the pulmonary capillary microcirculation.

Atrial natriuretic factor increases vascular permeability

NASA Technical Reports Server (NTRS)

Lockette, Warren; Brennaman, Bruce

1990-01-01

An increase in central blood volume in microgravity may result in increased plasma levels of atrial natriuretic factor (ANF). In this study, it was determined whether ANF increases capillary permeability to plasma protein. Conscious, bilaterally nephrectomized male rats were infused with either saline, ANF + saline, or hexamethonium + saline over 2 h following bolus injections of (I-125)-albumin and (C-14)-dextran of similar molecular size. Blood pressure was monitored, and serial determinations of hematocrits were made. Animals infused with 1.0 microg/kg per min ANF had significantly higher hematocrits than animals infused with saline vehicle. Infusion of ANF increased the extravasation of (I-125)-albumin, but not (C-14)-dextran from the intravascular compartment. ANF also induced a depressor response in rats, but the change in blood pressure did not account for changes in capillary permeability to albumin; similar depressor responses induced by hexamethonium were not accompanied by increased extravasation of albumin from the intravascular compartment. ANF may decrease plasma volume by increasing permeability to albumin, and this effect of ANF may account for some of the signs and symptoms of space motion sickness.

Effect of an allostatic modulator on stress blood indicators and meat quality of commercial young bulls in Mexico.

PubMed

Rubio Lozano, M S; Méndez Medina, R D; Reyes Mayorga, K; Rubio García, M E; Ovando, M A; Ngapo, T M; Galindo Maldonado, F A

2015-07-01

To assess the effect of an allostatic modulator (AM) on stress blood indicators and meat quality traits, the feed of 80 non-castrated 18-20 month-old bulls was supplemented with 10 g/day of an AM for 30 days before slaughter. Another 80 bulls served as control animals. The AM was comprised of ascorbic acid, acetoxybenzoic acid and sodium and potassium chloride. Blood samples were taken at slaughter for analyses of hematocrit value, erythrocyte and leukocyte counts, and glucose, lactate and cortisol concentrations. Post-mortem measures of meat color and pH were made at 24h and color, shear force and cooking loss on meat from 20 animals at 28 days. The AM supplementation resulted in lower hematocrit value, erythrocyte count and glucose level (P<0.05), higher a* (P<0.0001) and b* (P<0.0001) at 24h and lower b* (P<0.05) at 28 days. Thus AM treatment improved some stress blood indicators and meat color and therefore merits further investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Bloodless surgery in a pediatric Jehovah's Witness.

PubMed

Allen, Jerry; Berrios, Lindsay; Solimine, Mike; Knott-Craig, Christopher J

2013-12-01

Pediatric cardiac surgery in Jehovah's Witness patients who refuse the use of blood products remains a challenge because of the extreme hemodilution caused by priming the circuit and subsequent cardiopulmonary bypass. We report our successful strategy for reducing the prime volume for a 2-year-old Jehovah's Witness patient who required open heart surgery. We modified our conventional bypass circuit requirements for this size child by incorporating a lower prime oxygenator and reducing the size of the venous line and circuit, which decreased the circuit prime volume. We managed to reduce our initial sanguineous prime volume from 315 to 210 mL. The prime was further reduced to 160 mL by minimizing circuit length at the field and with venous prime sequestration prebypass. The postbypass hematocrit was 31%. Bloodless pediatric cardiac surgery in Jehovah's Witness patients can be performed safely. Incorporating a lower prime oxygenator into a revised circuit alleviated the need for blood transfusion and allowed us to achieve our calculated flow rate of 2.6 L/min/m2 while maintaining a hematocrit of 31%.

Phlebotomy-induced anemia alters hippocampal neurochemistry in neonatal mice

PubMed Central

Wallin, Diana J.; Tkac, Ivan; Stucker, Sara; Ennis, Kathleen M.; Sola-Visner, Martha; Rao, Raghavendra; Georgieff, Michael K.

2015-01-01

Background Phlebotomy-induced anemia (PIA) is common in preterm infants. The hippocampus undergoes rapid differentiation during late fetal/early neonatal life and relies on adequate oxygen and iron to support oxidative metabolism necessary for development. Anemia shortchanges these two critical substrates, potentially altering hippocampal development and function. Methods PIA (hematocrit <25%) was induced in neonatal mice pups from postnatal day (P)3 to P14. Neurochemical concentrations in the hippocampus were determined using in vivo 1H NMR spectroscopy at 9.4T and compared with control animals at P14. Gene expression was assessed using qRT-PCR. Results PIA decreased brain iron concentration, increased hippocampal lactate and creatine concentrations, and decreased phosphoethanolamine (PE) concentration and the phosphocreatine/creatine ratio. Hippocampal transferrin receptor (Tfrc) gene expression was increased, while the expression of calcium/calmodulin-dependent protein kinase type II alpha (CamKIIα) was decreased in PIA mice. Conclusion This clinically relevant model of neonatal anemia alters hippocampal energy and phospholipid metabolism and gene expression during a critical developmental period. Low target hematocrits for preterm neonates in the NICU may have potential adverse neural implications. PMID:25734245

Stress response of lead-exposed rainbow trout (Oncorhynchus mykiss) during swimming performance and hypoxia challenges

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phillips, K.A.; Caldwell, C.A.; Sandheinrich, M.B.

1995-12-31

Contaminants often invoke a stress response in aquatic organisms, and may compromise their capacity to respond to secondary stressors. This may reduce growth, reproduction and survival. The authors objectives were to assess the effects of lead and secondary stressors on hematology and blood chemistry of rainbow trout. After a 7 to 8-week aqueous exposure to Pb(100{micro}g/L), rainbow trout were challenged with forced swimming or hypoxia. Lead significantly reduced concentrations of 5-aminolevulinic acid dehydratase (ALAD), but not other constituents in the blood. Lead did not affect the swimming endurance of the fish. Hematocrit, mean cell hemoglobin content, and mean cell volumemore » were significantly lower in Pb-exposed trout following the swimming challenge. Although hypoxia resulted in increased hematocrit and plasma glucose concentrations, there were no significant differences between the Pb and control groups. Hypoxia did not affect plasma chloride concentrations, although concentrations increased in Pb-exposed trout. There was no difference in lactic acid concentrations between Pb-exposed and control fish after forced swimming or hypoxia.« less

Body and organ weights of rats exposed to carbon monoxide at high altitude

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGrath, J.J.

1988-01-01

Male, laboratory rats were exposed for 6 wk in steel barometric chambers to (1) 100 ppm CO, (2) 15,000 ft simulated high altitude (SHA), and (3) CO at SHA. Altitude was simulated by a system of gate valves and a vacuum pump, and measured by an altimeter. CO, from high-pressure cylinders, was introduced into the air supplying each chamber through a mass flow controller and measured by a nondispersive infrared (NDIR) analyzer. Although SHA had no affect on left ventricle plus septum (LV + S), adrenal, spleen, or kidney weights, SHA decreased body weights, and increased hematocrit ratios, as wellmore » as right ventricle (RV), total heart (HT), and pituitary weights. CO had no affect on body weights, RV, HT, adrenal, spleen, or kidney weights, but CO increased hematocrit ratios and LV + S weights. There was no significant interaction between SHA and CO on any parameter except kidney weight. These results indicate that, in general, the effects produced by 15,000 ft SHA are not intensified by exposure to 100 ppm CO.« less

Dimethylthiourea inhibits heart weight and hematocrit changes caused by dietary copper deficiency

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saari, J.T.

1991-03-11

Feeding antioxidants to rats in a copper (Cu)-deficient diet can partially inhibit the cardiac enlargement and anemia caused by Cu deficiency. This study was done to determine whether an antioxidant which bypassed the gastrointestinal tract was also protective and whether an agent more potent than previously used was more effective in this inhibition. Male, weanling rats were fed diets deficient or sufficient in Cu for 4 wks. Dimethylthiourea (DMTU) or saline was injected (ip) 4 times a week; minimum amount of DMTU retained during the experiment was estimated to be 250 mg/kg. Unlike other antioxidants, DMTU completely prevented the increasemore » in heart wt/body wt ratio; like the other agents, it only partially inhibited the anemia of Cu deficiency. DMTU did not affect plasma or liver Cu content of CuD rats; however, heart copper of CuD rats was significantly increased by DMTU. The effects of DMTU on heart size and hematocrit (Hct) may be attributed to its antioxidant function, but the possibility of altered mineral status must also be considered.« less

Hyperkalemia after irradiation of packed red blood cells: Possible effects with intravascular fetal transfusion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thorp, J.A.; Plapp, F.V.; Cohen, G.R.

1990-08-01

Plasma potassium, calcium, and albumin concentrations in irradiated blood, and in fetal blood before and after transfusion, were measured. Dangerously high plasma potassium levels were observed in some units of irradiated packed red blood cells (range, 13.9 to 66.5 mEq/L; mean, 44.7 mEq/L) and could be one possible explanation for the high incidence of fetal arrhythmia associated with fetal intravascular transfusion. There are many factors operative in the preparation of irradiated packed red blood cells that may predispose to high potassium levels: the age of the red blood cells, the number of procedures used to concentrate the blood, the durationmore » of time elapsed from concentration, the duration of time elapsed from irradiation, and the hematocrit. Use of fresh blood, avoidance of multiple packing procedures, limiting the hematocrit in the donor unit to less than or equal to 80%, and minimizing the time between concentration, irradiation and transfusion may minimize the potassium levels, and therefore making an additional washing procedure unnecessary.« less

Iron, copper, and zinc status: response to supplementation with zinc or zinc and iron in adult females.

PubMed

Yadrick, M K; Kenney, M A; Winterfeldt, E A

1989-01-01

Response of iron, copper, and zinc status to supplementation with Zn or a combination of Zn and Fe was assessed in adult females in a 10-wk study. Group Z received 50 mg Zn/d as Zn gluconate; group F-Z received 50 mg Fe as ferrous sulfate monohydrate in addition to the Zn. For Group Z, serum ferritin, hematocrit, and erythrocyte Cu,Zn-superoxide dismutase (ESOD) were significantly lower (p less than 0.05) after 10 wk supplementation compared with pretreatment levels. Serum Zn increased (p less than 0.01) but no change occurred in serum ceruloplasmin, hemoglobin, or salivary sediment Zn with treatment. For Group F-Z ESOD decreased with treatment as did salivary sediment Zn (p less than 0.05). Serum ferritin and serum Zn increased significantly, but hemoglobin, hematocrit, and ceruloplasmin were not affected by this treatment. Supplementation with Zn poses a risk to Fe and Cu status. Inclusion of Fe with Zn ameliorates the effect on Fe but not on Cu status.

Inhibition of plasma vasopressin after drinking in dehydrated humans

NASA Technical Reports Server (NTRS)

Geelen, G.; Keil, L. C.; Kravik, S. E.; Wade, C. E.; Thrasher, T. N.; Barnes, P. R.; Pyka, G.; Nesvig, C.; Greenleaf, J. E.

1984-01-01

The effects of nonosmotic and nonvolumetric factors on vasopressin secretion in dehydrated humans has been investigated experimentally, before and after drinking. The subjects of the experiment were five adult men and three adult women weighing 69-77 kg. In order to determine the influence of nonosmotic and nonvolumetric factors on vasopressin secretion, measurements were obtained of the following blood hematological indices: serum Na(+) content; serum K(+) content; osmolality; and hemoglobin. Measurements of hematocrit, plasma arginine vasopressin (AVP), aldosterone, and renin activity were also obtained. It is found that dehydration increased mean serum Na(+) content, osmolality,and AVP. No significant changes were observed in renin activity, hemoglobin, hematocrit, or plasma volume, while plasma aldosterone increased from 11.1 ng/dl after dehydration to 15.6 ng/dl between 30 and 60 min after drinking. A rapid fall of AVP content following rehydration occurred in the absence of changes in the primary regulators of AVP osmolality and plasma volume, with no change in blood pressure. On the basis of the experimental results, it is suggested that oropharyngeal factors may be the mechanism, for the observed decrease in AVP following rehydration.

Hemodynamic and ADH responses to central blood volume shifts in cardiac-denervated humans

NASA Technical Reports Server (NTRS)

Convertino, V. A.; Thompson, C. A.; Benjamin, B. A.; Keil, L. C.; Savin, W. M.; Gordon, E. P.; Haskell, W. L.; Schroeder, J. S.; Sandler, H.

1990-01-01

Hemodynamic responses and antidiuretic hormone (ADH) were measured during body position changes designed to induce blood volume shifts in ten cardiac transplant recipients to assess the contribution of cardiac and vascular volume receptors in the control of ADH secretion. Each subject underwent 15 min of a control period in the seated posture, then assumed a lying posture for 30 min at 6 deg head down tilt (HDT) followed by 20 min of seated recovery. Venous blood samples and cardiac dimensions (echocardiography) were taken at 0 and 15 min before HDT, 5, 15, and 30 min of HDT, and 5, 15, and 30 min of seated recovery. Blood samples were analyzed for hematocrit, plasma osmolality, plasma renin activity (PRA), and ADH. Resting plasma volume (PV) was measured by Evans blue dye and percent changes in PV during posture changes were calculated from changes in hematocrit. Heart rate (HR) and blood pressure (BP) were recorded every 2 min. Results indicate that cardiac volume receptors are not the only mechanism for the control of ADH release during acute blood volume shifts in man.

Effects of the fungicide azoxystrobin on Atlantic salmon (Salmo salar L.) smolt.

PubMed

Olsvik, Pål A; Kroglund, Frode; Finstad, Bengt; Kristensen, Torstein

2010-11-01

Atlantic salmon smolts were exposed to three doses of the fungicide azoxystrobin for 4 days, and physiological blood parameters and transcriptional effects in liver and muscle were evaluated in search for potential negative effects. Azoxystrobin exposure mediated up-regulation of catalase, MAPK1 and IGFBP1 in liver tissue. Catalase, transferrin, IGFBP1 and TNFR were up-regulated and CYP1A down-regulated in muscle tissue. Blood parameters glucose, hematocrit, pCO(2), HCO(3) and pH grouped together with transcripts levels of MnSOD, MAPK1, IGFBP1, MAP3K7 and GPx4 in liver of fish exposed to the highest azoxystrobin concentration (352 μgL(-1)) using principal component analysis (PCA). In muscle, the blood parameters glucose, hematocrit, pCO(2), HCO(3) and pH grouped together with transcript levels of heme oxygenase, thioredoxin, MnSOD, TNFR and MMP9. These results suggest that the fungicide azoxystrobin affects mitochondrial respiration and mechanisms controlling cell growth and proliferation in fish and may have negative effects on juvenile Atlantic salmon. Copyright © 2010 Elsevier Inc. All rights reserved.

A clinical analysis of erythrocytapheresis for the treatment of polycythemia.

PubMed

Liu, Huasheng; Liu, Haibo; Shen, Jingzhi; Sun, Chunhong; Guo, Caili; Lin, Huan; Yao, Jianna; Ma, Rui; Zhang, Mei

2013-04-01

To evaluate the efficacy and safety of erythrocytapheresis (ECP) in the treatment of polycythemia. Patients diagnosed with polycythemia were included in this retrospective analysis and treated with ECP (n=20) or conventional treatments (exsanguination; n=20). Blood laboratory values and adverse effects were recorded. In ECP-treated patients mean red blood cell (RBC) collection time was 25.7±4.5min (range: 19-37min), with a mean collection volume of 773.5±129.3mL (range: 600-1002mL). From baseline, ECP reduced the mean number of RBCs (0.6×10(12)/L [7.6%]), mean hemoglobin (31.1g/L [14.8%]), and mean hematocrit (13.1% [20.2%]) (P<0.001 for each). After ECP, a marked reduction in symptoms associated with polycythemia was also observed. Treatment of patients with polycythemia using ECP reduces RBC count, hemoglobin, and hematocrit. The advantages associated with ECP over conventional therapy should be considered when choosing a treatment plan for patients with polycythemia. Copyright © 2013. Published by Elsevier Ltd.

Blood glucose meters employing dynamic electrochemistry are stable against hematocrit interference in a laboratory setting.

PubMed

Pfützner, Andreas; Musholt, Petra B; Schipper, Christina; Demircik, Filiz; Hengesbach, Carina; Flacke, Frank; Sieber, Jochen; Forst, Thomas

2013-11-01

Hematocrit (HCT) is known to be a confounding factor that interferes with many blood glucose (BG) measurement technologies, resulting in wrong readings. Dynamic electrochemistry has been identified as one possible way to correct for these potential deviations. The purpose of this laboratory investigation was to assess the HCT stability of four BG meters known to employ dynamic electrochemistry (BGStar and iBGStar, Sanofi; Wavesense Jazz, AgaMatrix; Wellion Linus, MedTrust) in comparison with three other devices (GlucoDock, Medisana; OneTouch Verio Pro, LifeScan; FreeStyle Freedom InsuLinx, Abbott-Medisense). Venous heparinized blood was immediately aliquoted after draw and manipulated to contain three different BG concentrations (60-90, 130-160, and 280-320 mg/dl) and five different HCT levels (25%, 35%, 45%, 55%, and 60%). After careful oxygenation to normal blood oxygen pressure, each of the resulting 15 different samples was measured six times with three devices and three strip lots of each meter. The YSI Stat 2300 served as laboratory reference method. Stability to HCT influence was assumed when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT concentrations [hematocrit interference factor (HIF)]. Five of the investigated self-test meters showed a stable performance with the different HCT levels tested in this investigation: BGStar (HIF 4.6%), iBGStar (6.6%), Wavesense Jazz (4.1%), Wellion Linus (8.5%), and OneTouch Verio Pro (6.2%). The two other meters were influenced by HCT (FreeStyle InsuLinx 17.8%; GlucoDock 46.5%). In this study, meters employing dynamic electrochemistry, as used in the BGStar and iBGStar devices, were shown to correct for potential HCT influence on the meter results. Dynamic electrochemistry appears to be an effective way to handle this interfering condition. © 2013 Diabetes Technology Society.

Interference studies with two hospital-grade and two home-grade glucose meters.

PubMed

Lyon, Martha E; Baskin, Leland B; Braakman, Sandy; Presti, Steven; Dubois, Jeffrey; Shirey, Terry

2009-10-01

Interference studies of four glucose meters (Nova Biomedical [Waltham, MA] StatStrip [hospital grade], Roche Diagnostics [Indianapolis, IN] Accu-Chek Aviva [home grade], Abbott Diabetes Care [Alameda, CA] Precision FreeStyle Freedom [home grade], and LifeScan [Milpitas, CA] SureStep Flexx [hospital grade]) were evaluated and compared to the clinical laboratory plasma hexokinase reference method (Roche Hitachi 912 chemistry analyzer). These meters were chosen to reflect the continuum of care from hospital to home grade meters commonly seen in North America. Within-run precision was determined using a freshly prepared whole blood sample spiked with concentrated glucose to give three glucose concentrations. Day-to-day precision was evaluated using aqueous control materials supplied by each vendor. Common interferences, including hematocrit, maltose, and ascorbate, were tested alone and in combination with one another on each of the four glucose testing devices at three blood glucose concentrations. Within-run precision for all glucose meters was <5% except for the FreeStyle (up to 7.6%). Between-day precision was <6% for all glucose meters. Ascorbate caused differences (percentage change from a sample without added interfering substances) of >5% with pyrroloquinolinequinone (PQQ)-glucose dehydrogenase-based technologies (Aviva and Freestyle) and the glucose oxidase-based Flexx meter. Maltose strongly affected the PQQ-glucose dehydrogenase-based meter systems. When combinations of interferences (ascorbate, maltose, and hematocrit mixtures) were tested, the extent of the interference was up to 193% (Aviva), 179% (FreeStyle), 25.1% (Flexx), and 5.9% (StatStrip). The interference was most pronounced at low glucose (3.9-4.4 mmol/L). All evaluated glucose meter systems demonstrated varying degrees of interference by hematocrit, ascorbate, and maltose mixtures. PQQ-glucose dehydrogenase-based technologies showed greater susceptibility than glucose oxidase-based systems. However, the modified glucose oxidase-based amperometric method (Nova StatStrip) was less affected in comparison with the glucose oxidase-based photometric method (LifeScan SureStep Flexx).

Interrupted intracarotid artery cold saline infusion as an alternative method for neuroprotection after ischemic stroke.

PubMed

Ji, Ya-Bin; Wu, Yong-Ming; Ji, Zhong; Song, Wei; Xu, Sui-Yi; Wang, Yao; Pan, Su-Yue

2012-07-01

Intracarotid artery cold saline infusion (ICSI) is an effective method for protecting brain tissue, but its use is limited because of undesirable secondary effects, such as severe decreases in hematocrit levels, as well as its relatively brief duration. In this study, the authors describe and investigate the effects of a novel ICSI pattern (interrupted ICSI) relative to the traditional method (uninterrupted ICSI). Ischemic strokes were induced in 85 male Sprague-Dawley rats by occluding the middle cerebral artery for 3 hours using an intraluminal filament. Uninterrupted infusion groups received an infusion at 15 ml/hour for 30 minutes continuously. The same infusion speed was used in the interrupted infusion groups, but the whole duration was divided into trisections, and there was a 20-minute interval without infusion between sections. Forty-eight hours after reperfusion, H & E and silver nitrate staining were utilized for morphological assessment. Infarct sizes and brain water contents were determined using H & E staining and the dry-wet weight method, respectively. Levels of neuron-specific enolase (NSE), S100β protein, and matrix metalloproteinase 9 (MMP-9) in the serum were determined using enzyme-linked immunosorbent assay. Neurological deficits were also evaluated. Histology showed that interrupted ICSI did not affect neurons or fibers in rat brains, which suggests that this method is safe for brain tissues with ischemia. The duration of hypothermia induced by interrupted ICSI was longer than that induced via the traditional method, and the decrease in hematocrit levels was less pronounced. There were no differences in infarct size or brain water content between uninterrupted and interrupted ICSI groups, but neuron-specific enolase and matrix metalloproteinase 9 serum levels were more reduced after interrupted ICSI than after the traditional method. Interrupted ICSI is a safe method. Compared with traditional ICSI, the interrupted method has a longer duration of hypothermia and less effect on hematocrit and offers more potentially improved neuroprotection, thereby making it more attractive as an infusion technique in the clinic.

Combined effect of short-term dehydration and sublethal acute oral dicrotophos exposure confounds the diagnosis of anticholinesterase exposure in common quail (Coturnix coturnix) using plasma cholinesterase activity.

PubMed

Heffernan, James; Mineau, Pierre; Falk, Ramona; Wickstrom, Mark

2012-07-01

Common Quail (Coturnix coturnix) were subjected to controlled and replicated experiments in the summer of 2008 to investigate the effects of short-term dehydration on cholinesterase activity in brain and plasma and the interaction between dehydration and exposure to the organophosphorus pesticide dicrotophos in these same tissues. Our objective was to determine if dehydration could confound the diagnosis of anticholinesterase exposure using inhibition of cholinesterase activity in quail tissues. The effect of dehydration was quantified using measures of plasma osmolality and hematocrit. Dicrotophos exposure caused significant inhibition of cholinesterase activity in brain, while the effects of dehydration and interaction were not significant. Dehydration caused significant duration-dependent increases in plasma osmolality and hematocrit. Dehydration also caused a significant increase in plasma cholinesterase activity. Variation in the change in plasma cholinesterase activity in response to dehydration was significantly and positively correlated with dehydration-induced variation in both the change in plasma osmolality and the change in hematocrit. These correlations suggest that plasma cholinesterase activity in quail is not limited to plasma but occupies some larger pool of the extracellular fluid volume, and we suggest lymph is part of that pool. The effects of dehydration on plasma cholinesterase activity masked the inhibitory effects of dicrotophos. Here, the combination of dehydration and dicrotophos exposure produced plasma cholinesterase activity that was not significantly different from reference and pre-exposure values, confounding the diagnosis of anticholinesterase exposure in dehydrated, dicrotophos-exposed quail. A method to adjust plasma cholinesterase activities for the confounding effects of dehydration and enable the diagnosis of anticholinesterase exposure in dehydrated, dicrotophos-exposed quail was developed. Clinicians and practitioners responsible for the diagnosis of anticholinesterase exposure in birds are cautioned that dehydration, commonly observed in sick wildlife, may mask the effect of anticholinesterases on plasma cholinesterase activity.

Point-of-Care Versus Central Laboratory Measurements of Hemoglobin, Hematocrit, Glucose, Bicarbonate and Electrolytes: A Prospective Observational Study in Critically Ill Patients.

PubMed

Allardet-Servent, Jérôme; Lebsir, Melissa; Dubroca, Christian; Fabrigoule, Martine; Jordana, Sylvie; Signouret, Thomas; Castanier, Matthias; Thomas, Guillemette; Soundaravelou, Rettinavelou; Lepidi, Anne; Delapierre, Laurence; Penaranda, Guillaume; Halfon, Philippe; Seghboyan, Jean-Marie

2017-01-01

Rapid detection of abnormal biological values using point-of-care (POC) testing allows clinicians to promptly initiate therapy; however, there are concerns regarding the reliability of POC measurements. We investigated the agreement between the latest generation blood gas analyzer and central laboratory measurements of electrolytes, bicarbonate, hemoglobin, hematocrit, and glucose. 314 paired samples were collected prospectively from 51 critically ill patients. All samples were drawn simultaneously in the morning from an arterial line. BD Vacutainer tubes were analyzed in the central laboratory using Beckman Coulter analyzers (AU 5800 and DxH 800). BD Preset 3 ml heparinized-syringes were analyzed immediately in the ICU using the POC Siemens RAPIDPoint 500 blood gas system. We used CLIA proficiency testing criteria to define acceptable analytical performance and interchangeability. Biases, limits of agreement (±1.96 SD) and coefficients of correlation were respectively: 1.3 (-2.2 to 4.8 mmol/L, r = 0.936) for sodium; 0.2 (-0.2 to 0.6 mmol/L, r = 0.944) for potassium; -0.9 (-3.7 to 2 mmol/L, r = 0.967) for chloride; 0.8 (-1.9 to 3.4 mmol/L, r = 0.968) for bicarbonate; -11 (-30 to 9 mg/dL, r = 0.972) for glucose; -0.8 (-1.4 to -0.2 g/dL, r = 0.985) for hemoglobin; and -1.1 (-2.9 to 0.7%, r = 0.981) for hematocrit. All differences were below CLIA cut-off values, except for hemoglobin. Compared to central Laboratory analyzers, the POC Siemens RAPIDPoint 500 blood gas system satisfied the CLIA criteria of interchangeability for all tested parameters, except for hemoglobin. These results are warranted for our own procedures and devices. Bearing these restrictions, we recommend clinicians to initiate an appropriate therapy based on POC testing without awaiting a control measurement.

Point-of-Care Versus Central Laboratory Measurements of Hemoglobin, Hematocrit, Glucose, Bicarbonate and Electrolytes: A Prospective Observational Study in Critically Ill Patients

PubMed Central

Lebsir, Melissa; Dubroca, Christian; Fabrigoule, Martine; Jordana, Sylvie; Signouret, Thomas; Castanier, Matthias; Thomas, Guillemette; Soundaravelou, Rettinavelou; Lepidi, Anne; Delapierre, Laurence; Penaranda, Guillaume; Halfon, Philippe; Seghboyan, Jean-Marie

2017-01-01

Introduction Rapid detection of abnormal biological values using point-of-care (POC) testing allows clinicians to promptly initiate therapy; however, there are concerns regarding the reliability of POC measurements. We investigated the agreement between the latest generation blood gas analyzer and central laboratory measurements of electrolytes, bicarbonate, hemoglobin, hematocrit, and glucose. Methods 314 paired samples were collected prospectively from 51 critically ill patients. All samples were drawn simultaneously in the morning from an arterial line. BD Vacutainer tubes were analyzed in the central laboratory using Beckman Coulter analyzers (AU 5800 and DxH 800). BD Preset 3 ml heparinized-syringes were analyzed immediately in the ICU using the POC Siemens RAPIDPoint 500 blood gas system. We used CLIA proficiency testing criteria to define acceptable analytical performance and interchangeability. Results Biases, limits of agreement (±1.96 SD) and coefficients of correlation were respectively: 1.3 (-2.2 to 4.8 mmol/L, r = 0.936) for sodium; 0.2 (-0.2 to 0.6 mmol/L, r = 0.944) for potassium; -0.9 (-3.7 to 2 mmol/L, r = 0.967) for chloride; 0.8 (-1.9 to 3.4 mmol/L, r = 0.968) for bicarbonate; -11 (-30 to 9 mg/dL, r = 0.972) for glucose; -0.8 (-1.4 to -0.2 g/dL, r = 0.985) for hemoglobin; and -1.1 (-2.9 to 0.7%, r = 0.981) for hematocrit. All differences were below CLIA cut-off values, except for hemoglobin. Conclusions Compared to central Laboratory analyzers, the POC Siemens RAPIDPoint 500 blood gas system satisfied the CLIA criteria of interchangeability for all tested parameters, except for hemoglobin. These results are warranted for our own procedures and devices. Bearing these restrictions, we recommend clinicians to initiate an appropriate therapy based on POC testing without awaiting a control measurement. PMID:28072822

Factors influencing immediate post-release survival of spectacled eiders following surgical implantation of transmitters with percutaneous antennae

USGS Publications Warehouse

Sexson, Matthew G.; Mulcahy, Daniel M.; Spriggs, Maria; Myers, Gwen E.

2014-01-01

Surgically implanted transmitters are a common method for tracking animal movements. Immediately following surgical implantation, animals pass through a critical recovery phase when behaviors may deviate from normal and the likelihood of individual survival may be reduced. Therefore, data collected during this period may be censored to minimize bias introduced by surgery-related behaviors or mortality. However, immediate post-release mortalities negate a sampling effort and reduce the amount of data potentially collected after the censoring period. Wildlife biologists should employ methods to support an animal’s survival through this period, but factors contributing to immediate post-release survival have not been formally assessed. We evaluated factors that potentially influenced the immediate post-release survival of 56 spectacled eiders (Somateria fischeri) marked with coelomically implanted satellite transmitters with percutaneous antennae in northern Alaska in 2010 and 2011. We modeled survival through the first 14 days following release and assessed the relative importance and effect of 15 covariates hypothesized to influence survival during this immediate post-release period. Estimated daily survival rate increased over the duration of the immediate post-release period; the probability of mortality was greatest within the first 5 days following release. Our top-ranking model included the effect of 2 blood analytes, pH and hematocrit, measured prior to surgical implantation of a transmitter. We found a positive response to pH; eiders exhibiting acidemia (low pH) prior to surgery were less likely to survive the immediate post-release period. We found a curvilinear response to hematocrit; eiders exhibiting extremely low or high pre-surgery hematocrit were also less likely to survive the immediate post-release period. In the interest of maximizing the survival of marked birds following release, hematological data obtained prior to surgical implantation of telemetry equipment may be useful when screening for optimal surgical candidates or informing appropriate response to mitigate potentially deleterious disorders such as acidemia.

Blood Glucose Meters Employing Dynamic Electrochemistry Are Stable against Hematocrit Interference in a Laboratory Setting

PubMed Central

Pfützner, Andreas; Musholt, Petra B.; Schipper, Christina; Demircik, Filiz; Hengesbach, Carina; Flacke, Frank; Sieber, Jochen; Forst, Thomas

2013-01-01

Background Hematocrit (HCT) is known to be a confounding factor that interferes with many blood glucose (BG) measurement technologies, resulting in wrong readings. Dynamic electrochemistry has been identified as one possible way to correct for these potential deviations. The purpose of this laboratory investigation was to assess the HCT stability of four BG meters known to employ dynamic electrochemistry (BGStar and iBGStar, Sanofi; Wavesense Jazz, AgaMatrix; Wellion Linus, MedTrust) in comparison with three other devices (GlucoDock, Medisana; OneTouch Verio Pro, LifeScan; FreeStyle Freedom InsuLinx, Abbott-Medisense). Methods Venous heparinized blood was immediately aliquoted after draw and manipulated to contain three different BG concentrations (60–90, 130–160, and 280–320 mg/dl) and five different HCT levels (25%, 35%, 45%, 55%, and 60%). After careful oxygenation to normal blood oxygen pressure, each of the resulting 15 different samples was measured six times with three devices and three strip lots of each meter. The YSI Stat 2300 served as laboratory reference method. Stability to HCT influence was assumed when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT concentrations [hematocrit interference factor (HIF)]. Results Five of the investigated self-test meters showed a stable performance with the different HCT levels tested in this investigation: BGStar (HIF 4.6%), iBGStar (6.6%), Wavesense Jazz (4.1%), Wellion Linus (8.5%), and OneTouch Verio Pro (6.2%). The two other meters were influenced by HCT (FreeStyle InsuLinx 17.8%; GlucoDock 46.5%). Conclusions In this study, meters employing dynamic electrochemistry, as used in the BGStar and iBGStar devices, were shown to correct for potential HCT influence on the meter results. Dynamic electrochemistry appears to be an effective way to handle this interfering condition. PMID:24351179

Density increment and decreased survival of rat red blood cells induced by cadmium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kunimoto, M.; Miura, T.

1986-01-01

Male Wistar rats were injected with CdCl/sub 2/ subcutaneously to examine in vivo effects of Cd on density and survival of red blood cells. During the 7 days after administration of 1.0 mg Cd/kg, the following sequence of events occurred: (1) a progressive increase in the amount of more dense red blood cells concomitant with a decrease in that of light red blood cells from the first to the third day; (2) an increase in the spleen weight at the third day; (3) a decrease in the hematocrit value and an increase in the amount of light red blood cellsmore » at the fifth day; and (4) a recovery of the hematocrit value at the seventh day. Five days after administration, the hematocrit value decreased in a dose-dependent mode and the decrease was significant at the 1% level at 1.0 and 1.5 mg Cd/kg. A highly significant splenomegaly was also observed at 0.5 to 1.5 mg Cd/kg. In order to label red blood cells in vivo, (/sup 3/H) diisopropylfluorophosphate ((/sup 3/H)DFP) was injected into rats. At Day 11, Cd at either 0.5 or 1.0 mg/kg was administered to (/sup 3/H)DFP-prelabeled animals. Cd administration accelerated /sup 3/H-labeled red cell clearance from the blood. Six days after Cd administration, the radioactivity of red blood cells was 76 and 68% of the control at 0.5 and 1.0 mg Cd/kg, respectively. In vitro treatment of rat red density and accelerated in vivo clearance of red blood cells from the recipient circulation. These results show that Cd at low dose can cause anemia by increasing red cell density and by accelerating red cell sequestration, presumably in the spleen.« less

The impact of bowl size, program setup, and blood hematocrit on the performance of a discontinuous autotransfusion system.

PubMed

Seyfried, Timo F; Gruber, Michael; Streithoff, Fabian; Mandle, Robert J; Pawlik, Michael T; Busse, Hendrik; Hansen, Ernil

2017-03-01

Cell salvage is an essential element in the concept of blood management. Modern devices provide different bowl sizes and sensor-directed programs to optimally adjust to varying clinical situations. In an experimental performance study, the discontinuous autotransfusion device XTRA (LivaNova/Sorin) was evaluated using fresh donor blood anticoagulated with heparin 5 U/mL and adjusted to a hematocrit of 10% or 25%, representing orthopedic or cardiac surgery. Test blood was processed with the autotransfusion device XTRA in four different bowls (55 mL, 125 mL, 175 mL, and 225 mL) and in three different program modes (a standard program, an optimized program, and an emergency program). Processing speed increased with bowl size and with the emergency program (range, 6.4-29.8 mL red blood cells [RBCs]/min). The RBC recovery rate exceeded 90% for all bowls and programs except the 55-mL bowl with the emergency program. Plasma elimination exceeded 95% for all bowls and programs except the 225-mL bowl with the emergency and standard programs. Maximal RBC recovery (range, 94.7%-97.6%) and plasma elimination (range, 98.7%-99.5%) were obtained with the medium-sized bowls (125 mL and 175 mL) and the optimized program. Elimination rates for potassium or plasma free hemoglobin were consistently lower than for protein or albumin and were highest for heparin. Increased hematocrit and RBC recovery rates are obtained with the optimized program Popt with the discontinuous autotransfusion device. The emergency program Pem speeds up the process but leads to RBC loss and reduced plasma elimination rates; therefore, it should be restricted to emergency situations. All four different sized bowls have high performance. Plasma elimination is represented best by protein or albumin elimination rates. © 2017 AABB.

Does antenatal care attendance prevent anemia in pregnancy at term?

PubMed

Ikeanyi, E M; Ibrahim, A I

2015-01-01

Anemia in pregnancy is one of the public health problems in the developed and developing world. If uncontrolled it is a major indirect cause of maternal and perinatal morbidity and mortality. This is worst in settings with poor prenatal practices. Quality prenatal interventions therefore are expected to prevent or ameliorate this disorder in pregnancy. Nigerian scientific literatures are full of data on anemia in pregnancy, but few of them are on the influence of prenatal care on maternal anemia. This study, therefore, sought to appraise the role of antenatal care (ANC) services in the prevention of anemia in pregnancy at term in Nigerian women. The aim was to estimate the prevalence of anemia at first antenatal visit and determine if antenatal attendance prevents anemia at term among prenatal Nigerian women. To measure the hematocrit levels at booking and at term respectively and compare the proportion anemic at booking with the proportion anemic at term. A retrospective cross-sectional comparative study of 3442 prenatal women in a mission hospital in South-South Nigeria from 2009 to 2013. Venous blood hematocrit was estimated from each woman at booking and at term, and the prevalence of anemia for the two periods were compared. There were 1205 subjects with hematocrit of below 33% at booking, an anemia prevalence of 32.2% at booking in this population. At term or delivery at term 736 (21.4% odds ratio [OR] =2.3, P < 0.0001) of the 1052 subjects that fulfilled the study criteria had their anemia corrected, a 69.9% prevention, while 316 (9.2%, OR = 0.43, P < 0.0001) persisted despite their antenatal attendance. The subjects were similar in most of the confounding factors like parity, social class, mean age, body mass index and gestational age at delivery (P value: all > 0.05). The prevalence of anemia in pregnancy is still high in our setting. Quality ANC appeared a valuable preventive intervention that should be made widely available, accessible and affordable to all pregnant women.

Leukocyte, red blood cell and morphological adaptation to moderate physical training in rats undernourished in the neonatal period

PubMed Central

Viana, Marcelo Tavares; Perez, Manuella Cavalcanti; Ribas, Valdenilson Ribeiro; Martins, Gilberto de Freire; de Castro, Célia Maria Machado Barbosa

2012-01-01

Objective To analyze the impact of moderate physical exercise on the total and differential leukocyte counts and red blood cell count of 36 sixty-day-old adult male Wistar rats subjected to early malnourishment. Methods The rats were divided in nourished (N - casein 17%) and malnourished groups (M - casein 8%) and thesegroups were then subdivided in trained (T) untrained (U) creating four groups NT, NU, MT and MU. The NT and MTgroups were submitted to moderate physical exercise using a treadmill (60 min/day, 5 days/week for 8 weeks). Onthe 1st day, before the training started T0 and 24 hours after the last training day of the week (T1 until T8), a 1 mLaliquot of blood was collected from the animals' tails for analysis. The total leukocyte count was evaluated in a cellcounter with an electronic microscope. The cyanmethemoglobin technique was used to measure the hemoglobin level. The hematocrit values were determined as a percentage using the micro-hematocrit technique with a microcapillaryreader and a cell counter was used to determine the red blood cell count. The t-test was used for statistical analysis and a p-value < 0.05 was considered significant. Data are expressed as means ± standard deviation. Results There was a significant difference in the total leukocyte count between the NT (9.1 ± 0.1) and MT groups (8.0 ± 0.1) from T1 and in neutrophils between the NT (22.1 ± 0.6) and MT groups (24.6 ± 1.8) from T7 (p < 0.05). There was no statistical significance in the hemoglobin, hematocrit and red blood cell count from T1. Conclusions According to the results of this study, moderate physical exercise seems to have induced physiologic adaptation in adult rats from T1. PMID:23049442

Successful Performance of Laboratory Investigations with Blood Glucose Meters Employing a Dynamic Electrochemistry-Based Correction Algorithm Is Dependent on Careful Sample Handling.

PubMed

Demircik, Filiz; Klonoff, David; Musholt, Petra B; Ramljak, Sanja; Pfützner, Andreas

2016-10-01

Devices employing electrochemistry-based correction algorithms (EBCAs) are optimized for patient use and require special handling procedures when tested in the laboratory. This study investigated the impact of sample handling on the results of an accuracy and hematocrit interference test performed with BG*Star, iBG*Star; OneTouch Verio Pro and Accu-Chek Aviva versus YSI Stat 2300. Venous heparinized whole blood was manipulated to contain three different blood glucose concentrations (64-74, 147-163, and 313-335 mg/dL) and three different hematocrit levels (30%, 45%, and 60%). Sample preparation was done by either a very EBCA-experienced laboratory testing team (A), a group experienced with other meters but not EBCAs (B), or a team inexperienced with meter testing (C). Team A ensured physiological pO 2 and specific sample handling requirements, whereas teams B and C did not consider pO 2 . Each sample was tested four times with each device. In a separate experiment, a different group similar to group B performed the experiment before (D1) and after (D2) appropriate sample handling training. Mean absolute deviation from YSI was calculated as a metrix for all groups and devices. Mean absolute relative difference was 4.3% with team A (B: 9.2%, C: 5.2%). Team B had much higher readings and team C produced 100% of "sample composition" errors with high hematocrit levels. In a separate experiment, group D showed a result similar to group B before the training and improved significantly when considering the sample handling requirements (D1: 9.4%, D2: 4.5%, P < 0.05). Laboratory performance testing of EBCA devices should only be performed by trained staff considering specific sample handling requirements. The results suggest that healthcare centers should evaluate EBCA-based devices with capillary blood from patients in accordance with the instructions for use to achieve reliable results.

Vacuum-assisted venous return reduces blood usage.

PubMed

Banbury, Michael K; White, Jennifer A; Blackstone, Eugene H; Cosgrove, Delos M

2003-09-01

To determine whether vacuum-assisted venous return has clinical advantages over conventional gravity drainage apart from allowing the use of smaller cannulas and shorter tubing. A total of 150 valve operations were performed at our institution between February and July 1999 using vacuum-assisted venous return with small venous cannulas connected to short tubing. These were compared with (1) 83 valve operations performed between April 1997 and January 1998 using the initial version of vacuum-assisted venous return, and (2) 124 valve operations performed between January and April of 1997 using conventional gravity drainage. Priming volume, hematocrit value, red blood cell usage, and total blood product usage were compared multivariably. These comparisons were covariate and propensity adjusted for dissimilarities between the groups and confirmed by propensity-matched pairs analysis. Priming volume was 1.4 +/- 0.4 L for small-cannula vacuum-assisted venous return, 1.7 +/- 0.4 L for initial vacuum-assisted venous return, and 2.0 +/- 0.4 L for gravity drainage (P <.0001). Smaller priming resulted in higher hematocrit values both at the beginning of cardiopulmonary bypass (27% +/- 5% compared with 26% +/- 4% and 25% +/- 4%, respectively, P <.0001) and at the end (30% +/- 4% compared with 28% +/- 4% and 27% +/- 4%, respectively, P <.0001). Red cell transfusions were used in 17% of the patients having small-cannula vacuum-assisted venous return, 27% of the initial patients having vacuum-assisted venous return, and 37% of the patients having gravity drainage (P =.001); total blood product usage was 19%, 27%, and 39%, respectively (P =.002). Although ministernotomy also was associated with reduced blood product usage (P <.004), propensity matching on type of sternotomy confirmed the association of vacuum-assisted venous return with lowered blood product usage. Vacuum-assisted venous return results in (1) higher hematocrit values during cardiopulmonary bypass and (2) decreased red cell and total blood product usage.

Tighter accuracy standards within point-of-care blood glucose monitoring: how six commonly used systems compare.

PubMed

Robinson, Charlotte S; Sharp, Patrick

2012-05-01

Blood glucose monitoring systems (BGMS) are used in the hospital environment to manage blood glucose levels in patients at the bedside. The International Organization for Standardization (ISO) 15197:2003 standard is currently used by regulatory bodies as a minimum requirement for the performance of BGMS, specific to self-testing. There are calls for the tightening of accuracy requirements and implementation of a standard specifically for point-of-care (POC) BGMS. The accuracy of six commonly used BGMS was assessed in a clinical setting, with 108 patients' finger stick capillary samples. Using the accuracy criteria from the existing standard and a range of tightened accuracy criteria, system performance was compared. Other contributors to system performance have been measured, including hematocrit sensitivity and meter error rates encountered in the clinical setting. Five of the six BGMS evaluated met current accuracy criteria within the ISO 15197 standard. Only the Optium Xceed system had >95% of all readings within a tightened criteria of ±12.5% from the reference at glucose levels ≥72 mg/dl (4 mmol/liter) and ±9 mg/dl (0.5 mmol/liter) at glucose levels <72 mg/dl (4 mmol/liter). The Nova StatStrip Xpress had the greatest number of error messages observed; Optium Xceed the least. OneTouch Ultra2, Nova StatStrip Xpress, Accu-Chek Performa, and Contour TS products were all significantly influenced by blood hematocrit levels. From evidence obtained during this clinical evaluation, the Optium Xceed system is most likely to meet future anticipated accuracy standards for POC BGMS. In this clinical study, the results demonstrated the Optium Xceed product to have the highest level of accuracy, to have the lowest occurrence of error messages, and to be least influenced by blood hematocrit levels. © 2012 Diabetes Technology Society.

The Prevalence of Anemia in Head Start Children. Nutrition Evaluation, 1968-69.

ERIC Educational Resources Information Center

Mickelsen, Olaf; And Others

Concern over the nutritional status of the disadvantaged in America led to this study describing the prevalence of anemia among Head Start children in Pontiac, Michigan. Hemoglobin and hematocrit determinations, along with measurements of height and weight, were performed on 77 children, 4 to 6 years old, enrolled in Head Start classes. These…

76 FR 51041 - Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-17

... Donors.'' The purpose of this public workshop is to discuss blood donor hemoglobin and hematocrit... that prospective blood donors, particularly women, are deferred. Allogeneic donors of a unit of red blood cells generally may not donate more than once in an 8 week period to ensure recovery of their red...

Lead Toxicity and Iron Deficiency in Utah Migrant Children.

ERIC Educational Resources Information Center

Ratcliffe, Stephen D.; And Others

1989-01-01

Determines the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, aged 9-72 months. There were no confirmed cases of lead toxicity. Thirteen percent of all children tested, and 30 percent of those aged 9-23 months, were iron deficient. Hematocrit determination is an insensitive screen for iron deficiency.…

EFFECTS OF BROILER REARING ENVIRONMENT ON TRANSMISSION OF F-STRAIN MYCOPLASMA GALLISEPTICUM FROM COMMERCIAL LAYER HENS TO BROILER CHICKENS: ROLE OF ACID-BASE BALANCE

USDA-ARS?s Scientific Manuscript database

Two trials were conducted concurrently to determine and compare, blood pH, blood gases, hematocrit, and hemoglobin in mycoplasma-free, F-strain Mycoplasma gallisepticum (FMG) inoculation layers, and FMG contact-infected broilers. FMG-inoculated layers had the highest partial pressure of O2 and the l...

Health Risk Assessment of Women in Submarines: Reproductive and Developmental Toxicity Evaluation of Major Submarine Atmosphere Components (CO, CO2 and O2) in Rats (Rattus norvegicus) - Phase II (Neurological and Reproductive Performance Study)

DTIC Science & Technology

2011-10-11

exposed parents. Statistically significant increases in hematopoietic activity (mild polycythemia , leukocytosis and thrombocytosis) were...Tables 25 & 26). Polycythemia (increased red blood cells, with expected increases in hemoglobin and hematocrit) is an established effect of

Short term effects of reduced exposure to cigarette smoke on white blood cells, platelets and red blood cells in adult cigarette smokers.

PubMed

Roethig, Hans J; Koval, Tamara; Muhammad-Kah, Raheema; Jin, Yan; Mendes, Paul; Unverdorben, Martin

2010-01-01

Previous studies indicate that cigarette smokers have a 5-30% higher white blood cell counts (WBC) compared to non-smokers and higher red blood cell counts. This study was to pool hematology data from three similar studies and analyze the data for effects on WBC, its subpopulations, platelets, red blood cell count (RBC) and hematocrit in adult cigarette smokers three days after using an electrically heated cigarette smoking system (EHCSS) as a potential reduced exposure product (PREP) or no-smoking compared to smoking a conventional cigarette. Lower exposure to cigarette smoke in adult, long term smokers, by using an EHCSS or stopping smoking, leads to statistically significant decreases of up to 9% in WBC, neutrophils, lymphocytes, platelets, RBC and hematocrit within three days. Switching from CC-smoking to EHCSS-smoking or no-smoking resulted in lower WBC and vice versa within 3 days. This clinical model may be used as a screening tool to find new technologies that could provide insights on changes in inflammation resulting from the change in cigarette smoke. Copyright 2010 Elsevier Inc. All rights reserved.

Dietary status of trained female cyclists.

PubMed

Keith, R E; O'Keeffe, K A; Alt, L A; Young, K L

1989-11-01

Dietary status was evaluated in eight highly trained female cyclists. Each cyclist kept a 3-day weighed food record. Diets were analyzed for nutrient content using a computerized software package. Blood was also obtained and evaluated for hemoglobin, hematocrit, and albumin. For an athletic group, the cyclists' diets were found to be low in energy (85% RDA) and carbohydrate (4.4 gm/kg body weight per day). Mean daily dietary intakes were well below the RDAs for folacin (76% RDA), magnesium (81%), iron (59%), and zinc (48%). In addition, more than one-third of the cyclists failed to consume 67% of the RDA for the following micronutrients: pyridoxine, folacin, cobalamin, vitamin E, magnesium, iron, and zinc. Hemoglobin (135 gm/L), hematocrit (0.39), and albumin (45 gm/L) values were all normal, although most hemoglobin values were in the lower 50% of normal range. Foods such as meats, poultry, fish, beans, peas, and nuts were low or absent from the diets of most athletes. Dietary quality in this group of female cyclists could have been greatly improved with the addition of more of those foods. These athletes could benefit from nutrition education and diet counseling.

Estimation of polydispersity in aggregating red blood cells by quantitative ultrasound backscatter analysis.

PubMed

de Monchy, Romain; Rouyer, Julien; Destrempes, François; Chayer, Boris; Cloutier, Guy; Franceschini, Emilie

2018-04-01

Quantitative ultrasound techniques based on the backscatter coefficient (BSC) have been commonly used to characterize red blood cell (RBC) aggregation. Specifically, a scattering model is fitted to measured BSC and estimated parameters can provide a meaningful description of the RBC aggregates' structure (i.e., aggregate size and compactness). In most cases, scattering models assumed monodisperse RBC aggregates. This study proposes the Effective Medium Theory combined with the polydisperse Structure Factor Model (EMTSFM) to incorporate the polydispersity of aggregate size. From the measured BSC, this model allows estimating three structural parameters: the mean radius of the aggregate size distribution, the width of the distribution, and the compactness of the aggregates. Two successive experiments were conducted: a first experiment on blood sheared in a Couette flow device coupled with an ultrasonic probe, and a second experiment, on the same blood sample, sheared in a plane-plane rheometer coupled to a light microscope. Results demonstrated that the polydisperse EMTSFM provided the best fit to the BSC data when compared to the classical monodisperse models for the higher levels of aggregation at hematocrits between 10% and 40%. Fitting the polydisperse model yielded aggregate size distributions that were consistent with direct light microscope observations at low hematocrits.

Base-line O sub 2 extraction influences cerebral blood flow response to hematocrit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hudak, M.L.; Tang, Yuilin; Massik, J.

1988-01-01

The authors have shown that the fall in cerebral blood flow (CBF) as hematocrit (Hct) rises is due to the independent effects of increasing red blood cell (RBC) concentration and arterial O{sub 2} content (Ca{sub O{sub 2}}). In the present study, they tested the hypothesis that the magnitude of the effect of RBC concentration depends on the base-line cerebral fractional oxygen extraction (E). Pentobarbital-anesthetized 1- to 7-day-old sheep were first exchange transfused with plasma to lower Hct to 20%. Base-line E was set to either high or low levels by induction of hypocarbia, or hypercarbia. A second isovolemic exchange transfusionmore » with pure methemoglobin-containing adult sheep red cells then raised Hct with no significant increase in Ca{sub O{sub 2}}. Pa{sub CO{sub 2}} was maintained and other variables with potential effect on CBF did not change. CBF corrected for any individual alteration in CMRo{sub 2}. This study supports the hypothesis that the magnitude of the decline in CBF secondary to an increase in RBC concentration depends on the initial E. The effect of RBC concentration on CBF is greatest when E is low.« less

N-terminal pro-brain natriuretic peptide in prevalent peritoneal dialysis patients.

PubMed

Adachi, Yoko; Nishio, Akira

2008-01-01

Previous reports have shown that N-terminal pro-brain natriuretic peptide (NT-Pro-BNP) is a predictive marker for mortality in both peritoneal dialysis (PD) and hemodialysis (HD) patients. The aim of the present study was to clarify whether NT-Pro-BNP reflects a specific status in PD patients. We analyzed 40 stable PD patients, allocating them to one of two groups (20 each) according to the median value of NT-Pro-BNP: group A below and group B above 5423 pg/mL. In group B as compared with group A, red blood cell (RBC) counts, hemoglobin, hematocrit, sodium, chlorine, albumin, and daily urinary volume were significantly lower, and cardiothoracic ratio (CTR) and daily ultrafiltration volume were significantly higher. Patients using icodextrin and diabetic patients showed significantly higher NT-Pro-BNP values. We observed significant correlations between NT-Pro-BNP and RBC count, hematocrit, hemoglobin, sodium, chlorine, albumin, lactate dehydrogenase, CTR, daily urinary volume, and ultrafiltration volume. Multiple regression analysis revealed that increasing CTR and hyponatremia were significant predictors of an increase in NT-Pro-BNP. Our results indicate that increased serum NT-Pro-BNP well reflects anemia status, water balance, hyponatremia, and hypoalbuminemia in prevalent PD patients.

Communications: Blood chemistry of laboratory-reared Golden trout

USGS Publications Warehouse

Hunn, Joseph B.; Wiedmeyer, Ray H.; Greer, Ivan E.; Grady, Andrew W.

1992-01-01

Golden trout Oncorhynchus aguabonita obtained from a wild stock as fertilized eggs were reared in the laboratory for 21 months. The laboratory-reared golden trout in our study reached sexual maturity earlier and grew more rapidly than wild golden trout do (according to the scientific literature). Male fish averaged 35.6 cm in total length and 426 g in weight, and females averaged 36.2 cm and 487 g. All golden trout were sexually mature when used for hematological analysis. The hematological profile (hematocrit, red blood cells, white blood cells, and thrombocytes) of golden trout was similar to that reported elsewhere for other trout species. Male and female golden trout did not have significantly different thrombocyte counts; however, the immobilization treatment used on the fish (anesthesia versus a blow to the head) resulted in significant treatment differences in thrombocyte numbers and interaction effect of sex in treatment for hematocrits. Gravid female golden trout had significantly higher plasma protein and calcium levels than did males. The ionic compositions of plasma (sodium, potassium, calcium, magnesium, copper, zinc, iron, and chloride) and gallbladder bile (calcium and chloride) were similar to those reported for other salmonids.

Direct numerical simulation of cellular-scale blood flow in microvascular networks

NASA Astrophysics Data System (ADS)

Balogh, Peter; Bagchi, Prosenjit

2017-11-01

A direct numerical simulation method is developed to study cellular-scale blood flow in physiologically realistic microvascular networks that are constructed in silico following published in vivo images and data, and are comprised of bifurcating, merging, and winding vessels. The model resolves large deformation of individual red blood cells (RBC) flowing in such complex networks. The vascular walls and deformable interfaces of the RBCs are modeled using the immersed-boundary methods. Time-averaged hemodynamic quantities obtained from the simulations agree quite well with published in vivo data. Our simulations reveal that in several vessels the flow rates and pressure drops could be negatively correlated. The flow resistance and hematocrit are also found to be negatively correlated in some vessels. These observations suggest a deviation from the classical Poiseuille's law in such vessels. The cells are observed to frequently jam at vascular bifurcations resulting in reductions in hematocrit and flow rate in the daughter and mother vessels. We find that RBC jamming results in several orders of magnitude increase in hemodynamic resistance, and thus provides an additional mechanism of increased in vivo blood viscosity as compared to that determined in vitro. Funded by NSF CBET 1604308.

Correlation between hematologic profile and transaminase enzymes with hospitalization duration dengue

NASA Astrophysics Data System (ADS)

Tinambunan, E.; Suryani; Katu, S.; Halim, R.; Mubin, A. H.; Sahyuddin

2018-03-01

Dengue is an infectious disease that can be found from mild to severe andaffected the clinical spectrum of the disease. Various hematologic profiles and transaminase enzymes are thought to reflect the severity of the disease thus affecting the hospitalization duration. For determining the correlation between hematological profile and transaminase enzyme to the hospitalization duration in dengue patients, an observational design study with the cross-sectional approach on dengue subjects was from 2 hospitals in Makassar. Hemoglobin, leukocyte, thrombocyte, AST, ALT, PT, and APTT were examined for hospitalization duration. There were 65 samples (34 men, 31 women) with the length of stay <5 days 34 people and ≥ 5 days 31 people. The result of the analysis showed that there was a low correlation of leukocyte value (p = 0.036) and APTT prolongation (p = 0.023) with hospitalization duration of dengue patients. There was no correlation between the elevated of hematocrit value (p = 0.429), thrombocytopenia (p = 1.000), elevated of AST (p = 0.456) and ALT (p = 0.285) on hospitalization duration. In conclusion, low leukocyte values and APTT prolongation correlate with hospitalization duration but did not correlate significantly with hospitalization duration for elevated hematocrit, thrombocytopenia, elevated AST, and ALT.

[Influence of postural changes on the variations of blood volume in hemodialysis and reincidence post-dialysis blood volume].

PubMed

López Ramón, I; Muro, B; Azcona, M; Moleres, M; Sagüés, C; Maeztu, B; Zubía, A; Martínez de Irujo, S

1997-01-01

The aim of the present work is to study the possible increment of blood volume, in the seated as well as the lying position, and to analyse the influence of changes of posture on the changes of blood volume during the hemodialysis. 17 patients were studied, evaluating the variations of the hematocrit in the extracorporeal circuit on entry into the dialyzer, by means of a photometric system (Crit-Line Instrument, Izasa). Every 15 minutes the values of the hematocrit were taken and heir repercussion in the blood volume in different changes of posture. Initially all of the patients improved their blood volume, both seated and lying down. During the session of hemodialysis and ultrafiltration, with the patient in a seated position, an important drop in the blood volume was noticed; this was the case in the 1st, 2nd and 3rd hours. This drop improved when the patient adopted a lying position and there was a "reincidence of post-dialysis blood volume" at the end. According to these results, the supine posture improves the refill, confirming that the patients position influences the vascular refill.

Short-term dynamic changes in hematologic and biochemical tests during follow-up of definite heart failure patients.

PubMed

Kataoka, Hajime

2010-10-29

There are few studies on the short-term changes in routine peripheral blood data in definite heart failure (HF) patients. This study examined whether or not such changes existed and evaluated the feasibility of monitoring changes in common blood tests to estimate body fluid status in HF patients. The blood test data both at worsening and recovery of HF status were obtained from 27 definite HF patients. Hemoglobin, hematocrit, total protein, albumin, and creatinine values were significantly lower during the period of worsening HF status than those obtained during a period of recent clinical stability. At recovery, the values of all measured blood markers had significantly increased compared to those obtained during the period of worsening HF status. At recovery, changes in body weight were negatively correlated with hemoglobin (r=-0.475, p=0.012), hematocrit (r=-0.429, p=0.026), and total protein (r=-0.442, p=0.021). Careful attention should be paid to short-term changes in routine blood tests to correctly interpret test results and to aid in monitoring body fluid status in HF patients. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Beta-fibrinogen allele frequencies in Peruvian Quechua, a high-altitude native population.

PubMed

Rupert, J L; Devine, D V; Monsalve, M V; Hochachka, P W

1999-06-01

Elevated hematocrits, which are found in many high-altitude populations, increase the oxygen-carrying capacity of blood and may represent an adaptation to hypoxic environments. However, as high hematocrit increases blood viscosity, which in turn is associated with hypertension and heart disease, it may be advantageous for high-altitude populations to limit other factors that contribute to increased blood viscosity. One such factor is the plasma concentration of the coagulation protein fibrinogen. Several common polymorphisms in the beta-fibrinogen gene have been identified that affect fibrinogen concentrations. We determined the allele frequencies of three of these polymorphisms (G/A-455(HaeIII), C/T-148(HindIII), and G/A+448(MnlI)) in sample groups drawn from three populations: Quechua-speaking natives living at over 3,200 m in the Peruvian Andes, North American natives (Na-Dene) from coastal British Columbia, and Caucasian North Americans. The frequencies of the alleles previously shown to be associated with increased fibrinogen levels were so low in the Quechuas that their presence could be accounted for solely by genetic admixture with Caucasians. Frequencies in the Na-Dene, a Native American group unrelated to the Quechua, were not significantly different from those in Caucasians.

Elliptocytes and tailed poikilocytes correlate with severity of iron-deficiency anemia.

PubMed

Rodgers, M S; Chang, C C; Kass, L

1999-05-01

This study examines the relationships between abnormal RBC morphology, RBC indices measured with an automated hematology analyzer, serum iron studies, and severity of anemia in patients with findings indicative of iron-deficiency anemia. Counts and morphologic classification of 1,000 RBCs from each of 22 patients were performed, and correlations were determined between parameters. The Student t test was used to determine the level of significance for correlations between parameters. Several significant relationships were found. As the percentage of elliptocytes increased, hemoglobin concentration, hematocrit, RBC concentration, and mean corpuscular hemoglobin level decreased (r = .48, .44, .40, and .49, respectively; P < .05). As the percentage of tailed poikilocytes increased, hemoglobin concentration, hematocrit, and RBC concentration decreased (r = .70, .77, and .71, respectively; P < .01) and RBC distribution width increased (r = .73; P < .01). Of significance, serum ferritin levels, long considered the best single indicator of iron deficiency, showed no correlation with the morphologic abnormalities assessed, severity of anemia, or any of the analyzer-generated indices. Our results indicate that microscopic evaluation of RBC morphology remains an important tool for the pathologist to evaluate the severity of anemia in patients with iron deficiency.

Blood-plasma separation in Y-shaped bifurcating microfluidic channels: A dissipative particle dynamics simulation study

PubMed Central

Li, Xuejin; Popel, Aleksander S.; Karniadakis, George Em

2012-01-01

The motion of a suspension of red blood cells (RBCs) flowing in a Y-shaped bifurcating microfluidic channel is investigated using a validated low-dimensional RBC (LD-RBC) model based on dissipative particle dynamics (DPD). Specifically, the RBC is represented as a closed torus-like ring of ten colloidal particles, which leads to efficient simulations of blood flow in microcirculation over a wide range of hematocrits. Adaptive no-slip wall boundary conditions were implemented to model hydrodynamic flow within a specific wall structure of diverging 3D microfluidic channels, paying attention to controlling density fluctuations. Plasma skimming and the all-or-nothing phenomenon of RBCs in a bifurcating microfluidic channel have been investigated in our simulations for healthy and diseased blood, including the size of cell-free layer on the daughter branches. The feed hematocrit level in the parent channel has considerable influence on blood-plasma separation. Compared to the blood-plasma separation efficiencies of healthy RBCs, malaria-infected stiff RBCs (iRBCs) have a tendency to travel into the low flowrate daughter branch because of their different initial distribution in the parent channel. Our simulation results are consistent with previously published experimental results and theoretical predictions. PMID:22476709

Alterations in hematologic indices during long-duration spaceflight.

PubMed

Kunz, Hawley; Quiriarte, Heather; Simpson, Richard J; Ploutz-Snyder, Robert; McMonigal, Kathleen; Sams, Clarence; Crucian, Brian

2017-01-01

Although a state of anemia is perceived to be associated with spaceflight, to date a peripheral blood hematologic assessment of red blood cell (RBC) indices has not been performed during long-duration space missions. This investigation collected whole blood samples from astronauts participating in up to 6-months orbital spaceflight, and returned those samples (ambient storage) to Earth for analysis. As samples were always collected near undock of a returning vehicle, the delay from collection to analysis never exceeded 48 h. As a subset of a larger immunologic investigation, a complete blood count was performed. A parallel stability study of the effect of a 48 h delay on these parameters assisted interpretation of the in-flight data. We report that the RBC and hemoglobin were significantly elevated during flight, both parameters deemed stable through the delay of sample return. Although the stability data showed hematocrit to be mildly elevated at +48 h, there was an in-flight increase in hematocrit that was ~3-fold higher in magnitude than the anticipated increase due to the delay in processing. While susceptible to the possible influence of dehydration or plasma volume alterations, these results suggest astronauts do not develop persistent anemia during spaceflight.

Effects of dance therapy on the selected hematological and rheological indicators in older women.

PubMed

Filar-Mierzwa, Katarzyna; Marchewka, Anna; Bac, Aneta; Kulis, Aleksandra; Dąbrowski, Zbigniew; Teległów, Aneta

2017-01-01

The aim of this study was to analyze the effects of dance therapy on selected hematological and rheological indicators in older women. The study included 30 women (aged 71.8±7.4), and the control group comprised of 10 women of corresponding age. Women from the experimental group were subjected to a five-month dance therapy program (three 45-minute sessions per week); women from the control group were not involved in any regular physical activity. Blood samples from all the women were examined for hematological, rheological, and biochemical parameters prior to the study and five months thereafter. The dance therapy program was reflected by a significant improvement of erythrocyte count and hematocrit. Furthermore, the dance therapy resulted in a significant increase in the plasma viscosity, while no significant changes in glucose and fibrinogen levels were noted. Dance therapy modulates selected hematological parameters of older women; it leads to increase in erythrocyte count and hematocrit level. Dance therapy is reflected by higher plasma viscosity. Concentrations of fibrinogen and glucose are not affected by the dance therapy in older women, suggesting maintenance of homeostasis. Those findings advocate implementation of dance therapy programs in older women.

The influence of moderate-intensity physical effort on peripheral blood in adults with Down syndrome - a pilot study.

PubMed

Aleksander-Szymanowicz, P; Marchewka, A; Dabrowski, Z; Teleglow, A; Bac, A; Glodzik, J

2014-10-01

The aim of this study was to evaluate the influence of a six-week aerobic training on peripheral blood in adults with Down syndrome. Fifteen men with Down syndrome (average age 22.4 years ± 0.91) with moderate or severe intellectual disability took part in the study. Patients underwent a training program three times a week for six weeks. Venous blood samples of 10 ml were collected from every examined patient, 24 hours before and after the exercise. The blood samples were submitted to hematological examination (hematocrit, fibrinogen, plasma viscosity, red blood cell (RBC) number, RBC indicators: mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular hemoglobin (MCH)), reduced glutathione (GSH) level and number of macrocytes, polikilocytrometric examination of RBC and rheological blood examination (elongation index (EI), aggregation index (AI), syllectogram amplitude (AMP), aggregation half time (t1/2)) was made by LORCA. Amoderate six-week physical training performed on a cycloergometer resulted in a statistically significant decrease in the MCV value, hematocrit and plasma viscosity. The six-week cycloergometer training caused a statistically significant increase in the GSH level and erythrocyte pliability at a shear stress of 0.58 Pa.

Use of isovolemic hemodilution in the management of arterial ischemia in patients with polycythemia.

PubMed

Shah, D M; Buchbinder, D; Balko, A; Karmody, A M; Leather, R P

1981-08-01

The management of patients with both polycythemia and limb-threatening ischemia presents many difficulties because in this population, vascular surgical procedures carry a particularly high incidence of hemorrhagic and thromboembolic complications. We evaluated the use of acute isovolemic hemodilution in 12 polycythemic patients who required urgent surgery due to severe ischemia and threatened limb loss. Within 48 hours, blood was withdrawn in units of 500 ml and simultaneously replaced with 1,500 ml of lactated Ringer's solution until a hematocrit of 35 to 40 percent was achieved. After hemodilution, two patients had such a marked improvement that no further therapeutic measures were required immediately. Four patients showed definite improvement in pulmonary vascular resistance tracings and segmental Doppler pressures, but ischemia was not fully ameliorated. These patients together with the remaining six patients underwent vascular surgery within 1 to 14 days after hemodilution. A hematocrit of 32 to 40 percent was maintained during the perioperative period. All arterial reconstructions were successfully completed and there were no perioperative failures. No pulmonary emboli, myocardial infarctions, or deaths occurred in this period. These results indicate that in polycythemic patients, urgent vascular surgery can be performed more safely with the concomitant use of acute isovolemic hemodilution.

Veterinary Research Manpower Development for Defense

DTIC Science & Technology

2013-09-01

combination of Newcastle Disease (ND) control and improved husbandry practices shows promise as a means to improve the nutrition and overall quality of...of antibiotic resistance.  T. gondii seropositive cats had significantly lower levels of hemoglobin , red blood cell counts, and hematocrit (Pɘ.05...dogs.  The body condition scores of captive elephants declined after the age of 40 years suggesting that the nutritional needs of older

The Effect of Heparin on Fibrinolytic Activity and Platelet Function

DTIC Science & Technology

1995-09-16

or e- aminocaproic acid (38). For example, aprotinin administration prior to bypass has been shown to prevent the formation of FDP and the...Stephenson, and K. Rooney. The role of e- aminocaproic acid in reducing bleeding after cardiac operation: a double-blind randomized study. ;. Thorac...Specimens: Acquisition and Assays Blood was collected into tripotassium ethylenediaminetetraacetic acid (EDTA) for the measurement of hematocrit

Carbon Dioxide Tolerance: A Review

DTIC Science & Technology

1967-09-01

limited buffering capabilities. 3. !rrncefihdtar btif, frig. Part of the excess H4 diffuses into cells and is buffered by intracellular HCO...correspond with changes in venous pH and pulmonary 00- excretion, possibly indicating a significant role of bone CO.. stores in acclimatization to carbon...blood parameters included no change in hematocrit, re- ticulocyte counts, and white blood cell counts while scme decrease was seen in circulating

Toxic Hazards Research Unit. Annual Technical Report. 1978

DTIC Science & Technology

1978-08-01

determinations made for the following battery of clinical tests: HCT Bilirubin RBC Glucose WBC Triglycerides HGB Iron Alkaline Sedimentation Phosphatase Rate ...Count WBC Hematocrit HCT Hemoglobin HGB Sedimentation Rate SEDI Reticulocytes RETIC MCORP Mean Corpuscular Volume MCV Mean Corpuscular Hemoglobin MCH...Contract F33615-76-C-5005 9. PERFORMING ORGANIZATION NAME AND ADDRESS 10. PPOGPAM ELEMENT, PROJECT , TASK University of California, Irvine APEA A WORK UNIT

Ruxolitinib versus standard therapy for the treatment of polycythemia vera.

PubMed

Vannucchi, Alessandro M; Kiladjian, Jean Jacques; Griesshammer, Martin; Masszi, Tamas; Durrant, Simon; Passamonti, Francesco; Harrison, Claire N; Pane, Fabrizio; Zachee, Pierre; Mesa, Ruben; He, Shui; Jones, Mark M; Garrett, William; Li, Jingjin; Pirron, Ulrich; Habr, Dany; Verstovsek, Srdan

2015-01-29

Ruxolitinib, a Janus kinase (JAK) 1 and 2 inhibitor, was shown to have a clinical benefit in patients with polycythemia vera in a phase 2 study. We conducted a phase 3 open-label study to evaluate the efficacy and safety of ruxolitinib versus standard therapy in patients with polycythemia vera who had an inadequate response to or had unacceptable side effects from hydroxyurea. We randomly assigned phlebotomy-dependent patients with splenomegaly, in a 1:1 ratio, to receive ruxolitinib (110 patients) or standard therapy (112 patients). The primary end point was both hematocrit control through week 32 and at least a 35% reduction in spleen volume at week 32, as assessed by means of imaging. The primary end point was achieved in 21% of the patients in the ruxolitinib group versus 1% of those in the standard-therapy group (P<0.001). Hematocrit control was achieved in 60% of patients receiving ruxolitinib and 20% of those receiving standard therapy; 38% and 1% of patients in the two groups, respectively, had at least a 35% reduction in spleen volume. A complete hematologic remission was achieved in 24% of patients in the ruxolitinib group and 9% of those in the standard-therapy group (P=0.003); 49% versus 5% had at least a 50% reduction in the total symptom score at week 32. In the ruxolitinib group, grade 3 or 4 anemia occurred in 2% of patients, and grade 3 or 4 thrombocytopenia occurred in 5%; the corresponding percentages in the standard-therapy group were 0% and 4%. Herpes zoster infection was reported in 6% of patients in the ruxolitinib group and 0% of those in the standard-therapy group (grade 1 or 2 in all cases). Thromboembolic events occurred in one patient receiving ruxolitinib and in six patients receiving standard therapy. In patients who had an inadequate response to or had unacceptable side effects from hydroxyurea, ruxolitinib was superior to standard therapy in controlling the hematocrit, reducing the spleen volume, and improving symptoms associated with polycythemia vera. (Funded by Incyte and others; RESPONSE ClinicalTrials.gov number, NCT01243944.).

Effects of Scrambling trumpet Creeper flavone on transient cerebral ischemia model (TIA) in rats.

PubMed

Miao, Mingsan; Zhang, Xu; Zhang, Fan; Wang, Can; Fang, Xiaoyan; Bai, Ming; Xu, Cuishan; Teng, Leshang

2018-03-01

To investigate the effects of Scrambling Trumpet Creeper flavone on neurological function score, brain tissue lesion and related biochemical indexes in rat TIA model. Methods: TIA model was induced by tail vein injection of t-butanol (t-BHP). The rats in each administration group were given large, medium and low dose of Scrambling Trumpet Creeper flavone 0.1% CMC suspension, nimodipine and Yangxueqingnao particles group 0.1% CMC suspension, model group and blank group fed the same volume 0.1% CMC. Once a day, continuous administration of 7d. On the 3rd and 6th day after administration, t-BHP was injected into the tail vein, and then placed in a sealed 1 L jar. After 10 min of hypoxia, the neurological function score (NDS) was performed. After the first 2 days of TIA administration, the hem rheology was measured immediately after 1 h of administration, and blood rheology was measured immediately after the administration of blood, blood clotting, hematocrit, hematocrit and whole blood viscosity. After HE is staining to observe the pathological changes of hippocampus and cortex in the left-brain tissue. (LDH) and adenosine triphosphate (ATP) were measured. The right brain tissue of the cerebral cortex was observed. The expression of lactate (LD), lactate dehydrogenase (LDH) Fibroblast growth factor (FGF) and insulin growth factor (IGF) were detected by immunohistochemistry. Compared with the blank group, the coagulation time of the model rats was significantly shortened. The red blood cell deformation index was significantly decreased. Erythrocyte sedimentation rate, hematocrit, plasma viscosity, whole blood viscosity, erythrocyte rigidity index and blood sedimentation equation K value were significantly increased; LD content increased significantly, and LDH, ATP enzyme activity decreased significantly. The positive expression of FGF and IGF in the cortical area had a trend of increasing. The Scrambling Trumpet Creeper flavone significantly improved the indexes of whole blood rheology; the energy metabolism of cerebral ischemia was increased, and the positive expression of neurotrophic factor in cortex was significantly increased.

Screening for hypoglycemia at the bedside in the neonatal intensive care unit (NICU) with the Abbott PCx glucose meter.

PubMed

Balion, Cynthia; Grey, Vijaylaxmi; Ismaila, Afisi; Blatz, Susan; Seidlitz, Wendy

2006-11-03

Point of care (POC) glucose meters are routinely used as a screening tool for hypoglycemia in a neonatal setting. Glucose meters however, lack the same accuracy as laboratory instruments for glucose measurement. In this study we investigated potential reasons for this inaccuracy and established a cut off value for confirmatory testing. In this prospective study, all patients in the neonatal intensive care unit who had a plasma glucose test ordered were eligible to participate. Demographic information, sample collection information (nine variables) and a recent hematocrit value were recorded for each sample. Glucose measurements were taken at the bedside on the glucose meter (RN PCx) as well as in the laboratory on both the glucose meter (LAB PCx) and the laboratory analyzer (PG). Data were analyzed by simple and mixed-effects regression analysis and by analysis of a receiver operator characteristics (ROC) curve. There were 475 samples analyzed from 132 patients. RN PCx values were higher than PG values (mean = 4.9%), while LAB PCx results were lower (mean = -5.2%) than PG values. Only 31% of the difference between RN PCx--PG and 46% of the difference for LAB PCx--PG could be accounted for by the variables tested. The largest proportion of variance between PCx and PG measurements was explained by hematocrit (about 30%) with a greater effect seen at glucose concentrations < or =4.0 mmol/L (< or =72 mg/dL)(48% and 40% for RN PCx and LAB PCx, respectively). The ROC analysis showed that for detection of all cases of hypoglycemia (PG < 2.6 mmol/L)(PG < 47 mg/dL) the PCx screening cut off value would need to be set at 3.8 mmol/L (68 mg/dL) requiring 20% of all samples to have confirmatory analysis by the laboratory method. The large difference between glucose results obtained by PCx glucose meter compared to the laboratory analyzer can be explained in part by hematocrit and low glucose concentration. These results emphasize that the glucose meter is useful only as a screening device for neonatal hypoglycemia and that a screening cut off value must be established.

COMPARATIVE DETERMINATION OF BLOOD VOLUME WITH EVANS BLUE AND Cr$sup 51$ IN HEALTHY SUBJECTS AND POLYCYTHEMIA PATIENTS TREATED WITH P$sup 3$$sup 2$ (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schneider, K.W.; Becker, G.

1962-09-12

Blood volume was determined by the Evans blue and the Cr/sup 51/ methods in 40 normals and 17 cases of polycythemia. In normals there was good agreement of the results of both methods, however, in polycythemia differences were observed. With the Crsl-method the erythrocyte volume was found to be lower than with the Evans blue technique although the difference was not significant. When the active circulating blood volume is determined, the introduction of a correction factor for the so-called body hematocrit is not necessary. lt is possible that the difference between venous hematocrit and the quotient Evans blueplasma volume/Cr/sup 51/more » erythrocyte volume is caused by an increase of the error due to the trapped plasma. In case with increased hematocrit values the plasma volume should be determined by Evans blue and the erythrocyte volume by Cr/ sup 51/. In polycythemia the mean values were lower the those previously estimated by Seyderheim and Lampe. In the untreated state of polycythemia the mean plasma volume is reduced; in 80% of the cases a reduction was found initially. With successful treatment the plasma volume increased. Treatment consisted of injection of 0.08-0.09 mC P/sup 32/ per kg body wt, which was repeated three months later if necessary. Half the patients required only one such dose for remission; only one required three doses. Improvement in plasma volume showed no correlation with the size of the spleen or the presence of hypertension. The venous pressure was normal in all cases. Circulation time was variable but showed a tendency to become shorter following treatment with P/sup 32/. Renal function studies are discussed. Creatinine-clearance and phenolsulfonphthalein (PSP) excretion were often reduced, and albuminuria, hematuria, and azotemia were present. With clinical improvement after P/sup 32/ treatment these symptoms are reversible except for the reduced PSP excretion. (BBB)« less

Glucose-6-Phosphate Dehydrogenase Deficiency in Nigerian Children

PubMed Central

Williams, Olatundun; Gbadero, Daniel; Edowhorhu, Grace; Brearley, Ann; Slusher, Tina; Lund, Troy C.

2013-01-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzymopathy and in Sub-Saharan Africa, is a significant cause of infection- and drug-induced hemolysis and neonatal jaundice. Our goals were to determine the prevalence of G6PD deficiency among Nigerian children of different ethnic backgrounds and to identify predictors of G6PD deficiency by analyzing vital signs and hematocrit and by asking screening questions about symptoms of hemolysis. We studied 1,122 children (561 males and 561 females) aged 1 month to 15 years. The mean age was 7.4±3.2 years. Children of Yoruba ethnicity made up the largest group (77.5%) followed by those Igbo descent (10.6%) and those of Igede (10.2%) and Tiv (1.8%) ethnicity. G6PD status was determined using the fluorescent spot method. We found that the overall prevalence of G6PD deficiency was 15.3% (24.1% in males, 6.6% in females). Yoruba children had a higher prevalence (16.9%) than Igede (10.5%), Igbo (10.1%) and Tiv (5.0%) children. The odds of G6PD deficiency were 0.38 times as high in Igbo children compared to Yoruba children (p = 0.0500). The odds for Igede and Tiv children were not significantly different from Yoruba children (p = 0.7528 and 0.9789 respectively). Mean oxygen saturation, heart rate and hematocrit were not significantly different in G6PD deficient and G6PD sufficient children. The odds of being G6PD deficient were 2.1 times higher in children with scleral icterus than those without (p = 0.0351). In conclusion, we determined the prevalence of G6PD deficiency in Nigerian sub-populations. The odds of G6PD deficiency were decreased in Igbo children compared to Yoruba children. There was no association between vital parameters or hematocrit and G6PD deficiency. We found that a history of scleral icterus may increase the odds of G6PD deficiency, but we did not exclude other common causes of icterus such as sickle cell disease or malarial infection. PMID:23874768

Growth and physiological responses to surgical and gastric radio transmitter implantation techniques in subyearling chinook salmon (Oncorhynchus tshawytscha)

USGS Publications Warehouse

Martinelli, Theresa L.; Hansel, H.C.; Shively, R.S.

1998-01-01

We examined the effects of surgical and gastric transmitter implantation techniques on the growth, general physiology and behavior of 230 subyearling chinook salmon (Oncorhynchus tshawytscha, Walbaum) (100 mm-154 mm fork length). The transmitter weighed 1.3 g in air (0.9 g in water) and comprised, on average, 6% of the body weight of the fish (in air). Individuals were randomly assigned to an experimental group (control, surgical or gastric) and a sampling period (day 5 or day 21). Relative growth rate was expressed as% body weight gained/day. General condition was assessed by necropsy. Physiological response variables included hematocrit, leucocrit and plasma protein concentration. The mean relative growth rates of control, surgical and gastric fish were not significantly different at day 5. By day 21, the gastric group had a significantly lower relative growth rate (1.3%) as compared to the surgical group (1.8%) and the control group (1.9%) (P = 0.0001). Mean hematocrit values were significantly lower in the surgical (41.8%) and gastric (42.2%) groups as compared to controls (47.3%) at day 5 (P = 0.01), but all were within normal range for salmonids. No significant differences in hematocrit values were detected at day 21. Leucocrit values for all groups were ??? 1% in 99% of the fish. Both tagged groups had significantly lower mean plasma protein levels as compared to controls at day 5 (P = 0.001) and day 21 (P = 0.0001). At day 21 the gastric group (64.4 g 100 m1-1) had significantly lower mean plasma protein levels than the surgical group (68.8 g 100 ml-1) (P = 0.0001). Necropsies showed decreasing condition of gastrically tagged fish over time, and increasing condition of surgical fish. Paired releases of surgically and gastrically implanted yearling chinook salmon in the lower Columbia River in spring, 1996 revealed few significant differences in migration behavior through two reservoirs. We conclude that gastrically implanted fish show decreased growth and condition over a 21 d period. We recommend a surgical implantation method for long-term studies of juvenile salmonids, however, gastric implantation may be suitable for short-term studies.

Elevated global cerebral blood flow, oxygen extraction fraction and unchanged metabolic rate of oxygen in young adults with end-stage renal disease: an MRI study.

PubMed

Zheng, Gang; Wen, Jiqiu; Lu, Hanzhang; Lou, Yaxian; Pan, Zhiying; Liu, Wei; Liu, Hui; Li, Xue; Zhang, Zhe; Chen, Huijuan; Kong, Xiang; Luo, Song; Jiang, Xiaolu; Liu, Ya; Zhang, Zongjun; Zhang, Long Jiang; Lu, Guang Ming

2016-06-01

To noninvasively assess global cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO2) in young adults with end-stage renal disease (ESRD). Thirty-six patients and 38 healthy volunteers were included and took part in MR examinations, blood and neuropsychological tests. CBF and OEF were measured by phase-contrast and T2-relaxation-under-spin-tagging MRI techniques, respectively. CMRO2 was computed from CBF, OEF and hematocrit according to Fick's principle. Correlations were performed between MR measurements, blood biochemistry measurements and neuropsychological test scores. Compared with controls, ESRD patients had elevated CBF (72.9 ± 12.5 vs. 63.8 ± 8.5 ml min(-1) 100 g(-1), P < 0.001), elevated OEF (47.2 ± 10.2 vs. 35.8 ± 5.4 %, P < 0.001), but unaffected CMRO2 (199.5 ± 36.4 vs. 193.8 ± 28.6 μmol O2 min(-1) 100 g(-1), P = 0.879). Hematocrit negatively correlated with CBF (r = -0.640, P < 0.001) and OEF (r = -0.701, P < 0.001), but not with CMRO2. Altered neuropsychological test scores of ESRD patients were associated with OEF and CBF, but not with CMRO2. There were weak relationships between eGFR and hematocrit (r = 0.308, P = 0.068) or CBF (r = 0.318, P = 0.059). Our findings suggested that anaemic young adults with ESRD may afford higher CBF and OEF to maintain a normal CMRO2. Despite this compensatory process, however, cognitive function was still impaired and its severity was correlated with their CBF and OEF abnormality. • Anaemic young adults with ESRD may afford higher CBF and OEF. • Anaemic young adults with ESRD maintain a normal CMRO 2 . • Cognitive function was still impaired in young ESRD adults. • The severity of cognitive dysfunction correlated with CBF and OEF changes.

Cell Salvage Used in Scoliosis Surgery: Is It Really Effective?

PubMed

Liu, Jia-Ming; Fu, Bi-Qi; Chen, Wen-Zhao; Chen, Jiang-Wei; Huang, Shan-Hu; Liu, Zhi-Li

2017-05-01

Scoliosis surgery usually is associated with large volume of intraoperative blood loss, and cell salvage is used commonly to filter and retranfusion autologous blood to patients. The efficacy of using cell salvage in scoliosis surgery, however, is still controversial. The purpose of this study is to make clear that intraoperative use of cell salvage is effective to decrease the volume of perioperative allogenic blood transfusion in scoliosis surgery. A meta-analysis was conducted to identify the relevant studies from PubMed, Embase, Medline, Cochrane library, and Google scholar until July 2016. All randomized trials and controlled clinical studies comparing the clinical outcomes of using cell salvage versus noncell salvage in scoliosis surgery were retrieved for the meta-analysis. The data were analyzed by RevMan 5.3. A total of 7 studies with 562 patients were included in this meta-analysis. Based on the analysis, the volumes of perioperative and postoperative allogenic red blood cell (RBC) transfusion in cell salvage group were significantly less than those in control group (P = 0.04 and P = 0.01); however, no significant difference was detected in the amount of intraoperative allogenic RBC transfusion and the risk of patients needing allogenic blood transfusion between the 2 groups (P = 0.14 and P = 0.61). Both the hemoglobin and hematocrit levels on the first day after surgery were significantly greater in cell salvage group than those in control group (P = 0.002 and P < 0.001). No significant differences, however, were noted in neither hemoglobin nor hematocrit level at the time of discharge between the 2 groups (P = 0.76 and P = 0.32). One of the included study reported the number of patients with complications related to transfusion in the two groups, which was not significant different (P = 0.507). Cell salvage significantly reduced the volumes of perioperative and postoperative allogenic RBC transfusion in scoliosis surgery and increased the hemoglobin and hematocrit levels on the first day postoperatively. In addition, it seemed not to increase the rate of transfusion complications during the surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Glucose-6-phosphate dehydrogenase deficiency in Nigerian children.

PubMed

Williams, Olatundun; Gbadero, Daniel; Edowhorhu, Grace; Brearley, Ann; Slusher, Tina; Lund, Troy C

2013-01-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzymopathy and in Sub-Saharan Africa, is a significant cause of infection- and drug-induced hemolysis and neonatal jaundice. Our goals were to determine the prevalence of G6PD deficiency among Nigerian children of different ethnic backgrounds and to identify predictors of G6PD deficiency by analyzing vital signs and hematocrit and by asking screening questions about symptoms of hemolysis. We studied 1,122 children (561 males and 561 females) aged 1 month to 15 years. The mean age was 7.4 ± 3.2 years. Children of Yoruba ethnicity made up the largest group (77.5%) followed by those Igbo descent (10.6%) and those of Igede (10.2%) and Tiv (1.8%) ethnicity. G6PD status was determined using the fluorescent spot method. We found that the overall prevalence of G6PD deficiency was 15.3% (24.1% in males, 6.6% in females). Yoruba children had a higher prevalence (16.9%) than Igede (10.5%), Igbo (10.1%) and Tiv (5.0%) children. The odds of G6PD deficiency were 0.38 times as high in Igbo children compared to Yoruba children (p=0.0500). The odds for Igede and Tiv children were not significantly different from Yoruba children (p=0.7528 and 0.9789 respectively). Mean oxygen saturation, heart rate and hematocrit were not significantly different in G6PD deficient and G6PD sufficient children. The odds of being G6PD deficient were 2.1 times higher in children with scleral icterus than those without (p=0.0351). In conclusion, we determined the prevalence of G6PD deficiency in Nigerian sub-populations. The odds of G6PD deficiency were decreased in Igbo children compared to Yoruba children. There was no association between vital parameters or hematocrit and G6PD deficiency. We found that a history of scleral icterus may increase the odds of G6PD deficiency, but we did not exclude other common causes of icterus such as sickle cell disease or malarial infection.

Fatty emaciation: a case report of suspected fat overload syndrome in oral refeeding.

PubMed

Macher, Arielle D; Palazuelos, Daniel; Maviglia, Saverio M

2012-07-01

Refeeding syndrome has been observed in patients receiving nutrition after a prolonged period of malnourishment and is characterized by multiple metabolic derangements. Besides hypophosphatemia and hypoglycemia, lipemia has been described in association with parenteral nutrition administration to the malnourished. The authors describe one anorexic patient who developed lipemia during oral refeeding, followed by a precipitous drop in hematocrit suggestive of fat overload syndrome.

Protease Profiling in Prostate Cancer

DTIC Science & Technology

2004-05-01

the study reaffirms the significance of FAS in tumor ability to inhibit fatty-acid synthase, Orlistat halts tumor cell proliferation, Induces tumor...The study also indicates that compounds with reac- tive 13-lactones, such as Orlistat , should be evaluated as potential INTRODUCTION antitumor agents...any effects of Orlistat (240 mg/kg/day) on hematocrit point , however, only a modest effect was observed on death of the or WBC levels (data not shown

Dissecting aneurysm of arch and descending thoracic aorta presenting as a left sided hemorrhagic pleural effusion

PubMed Central

Shamim, Shelley; Thakur, Sumitra Basu; Sengupta, Amitava; Bhattacharyya, Sujit Kumar; Sit, Niranjan

2010-01-01

The most common cause of massive hemorrhagic effusion is malignancy. Herein we present a case of dissecting aneurysm of descending thoracic aorta presenting initially with shortness of breath due to left sided massive pleural effusion. Effusion was hemorrhagic in nature with high hematocrit value. CT scan of thorax with CT angiogram was done and that revealed the diagnosis. PMID:21139725

Evaluation of the Effect of Hemoglobin or Hematocrit Level on Dural Sinus Density Using Unenhanced Computed Tomography

PubMed Central

Cha, Sang-Hoon; Lee, Sung-Hyun; Shin, Dong-Ick

2013-01-01

Purpose To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). Materials and Methods Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. Results The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). Conclusion Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis. PMID:23225795

A randomized clinical trial of the efficacy of single versus double-daily dose of oral iron for prevention of iron deficiency anemia in women with twin gestations.

PubMed

Ali, Mohammed K; Abbas, Ahmed M; Abdelmagied, Ahmed M; Mohammed, Ghada E; Abdalmageed, Osama S

2017-12-01

The study aims to assess the efficacy of single versus double-daily oral iron dose on prevention of iron deficiency anemia in women with twin gestations. A randomized controlled trial (NCT02858505) conducted at Woman's Health Hospital, Assiut, Egypt, between August 2015 and June 2016 included 120 non-anemic pregnant women with twin gestations in the first trimester. Women were randomly assigned to either group I (27 mg elemental iron) or group II (54 mg elemental iron) daily starting from 12 weeks of pregnancy till 36 weeks. The primary outcomes included the mean level of hemoglobin, hematocrit and serum ferritin at 36 weeks' gestation. Both iron doses maintained the mean hemoglobin and hematocrit within the normal level from 12 weeks to 36 weeks (p = 0.378 and p = 0.244, respectively). However, the mean serum ferritin level was higher in group II than group I (p = 0.000) at 36 weeks' gestation. Moreover, women in group II reported more side effects than group I at 36 weeks' gestation. Doubling the prophylactic iron dose is comparable to single dose in the prevention of iron deficiency anemia among women with twin gestations with more side effects.

Development of an assay of seven biochemical items, HbA1c, and hematocrit using a small amount of blood collected from the fingertip.

PubMed

Shinya, Sugimoto; Masaru, Akimoto; Akira, Hayakawa; Eisaku, Hokazono; Susumu, Osawa

2012-01-18

Lifestyle-related diseases in Japan account for 30% of the entire medical expenditure of the country and cause 60% of all deaths. For the prevention of lifestyle-related diseases, medical examination by laboratory tests on metabolic syndrome is important. To undertake examination by collection of blood from a fingertip, we developed the "Well Kit". About 65 μl of blood collected from a fingertip was diluted with buffer solution, which contained two internal standard materials. The kit also separated corpuscles and diluted plasma with a special filter. It measured the obtained diluted plasma using the JCA-BM2250. This measurement system was evaluated for the quantitative analysis of 8 items. The uncertainties of tested items of this measurement system were 1.7% to 6.4%. The coefficients of correlation of all tested items between this measurement value and the venous plasma sample value were 0.876-0.991, and hematocrit was 0.958. This system for testing blood collected from a fingertip is simple to use and can be applied in testing for metabolic syndrome. In addition, this testing system is useful in the medical examination of the personal healthcare and inhabitants. Copyright © 2011 Elsevier B.V. All rights reserved.

Hematocrit levels as cardiovascular risk among taxi drivers in Bangkok, Thailand

PubMed Central

ISHIMARU, Tomohiro; ARPHORN, Sara; JIRAPONGSUWAN, Ann

2016-01-01

In Thailand, taxi drivers employed in the informal sector often experience hazardous working conditions. Previous studies revealed that elevated Hematocrit (HCT) is a predictor of cardiovascular disease (CVD) risk. This study assessed factors associated with HCT in taxi drivers to predict their occupational CVD risk factors. A cross-sectional study was conducted on 298 male taxi drivers who joined a health check-up campaign in Bangkok, Thailand. HCT and body mass index were retrieved from participant health check-up files. Self-administered questionnaires assessed demographics, driving mileage, working hours, and lifestyle. Statistical associations were analyzed using stepwise linear regression. Our results showed that obesity (p=0.007), daily alcohol drinking (p=0.003), and current or past smoking (p=0.016) were associated with higher HCT levels. While working hours were not directly associated with HCT levels in the current study, the effect on overworking is statistically arguable because most participants worked substantially longer hours. Our findings suggest that taxi drivers’ CVD risk may be increased by their unhealthy work styles. Initiatives to improve general working conditions for taxi drivers should take into account health promotion and CVD prevention. The policy of providing periodic health check-ups is important to make workers in the informal sector aware of their health status. PMID:27151439

Effects of episodic acidification on Atlantic salmon (Salmo salar) smolts

USGS Publications Warehouse

Magee, J.A.; Obedzinski, M.; McCormick, S.D.; Kocik, J.F.

2003-01-01

The effect of episodic acidification on Atlantic salmon (Salmo salar) smolt physiology and survival in fresh water (FW) and seawater (SW) was investigated. Smolts were held in either ambient (control, pH 6.0-6.6), acidified (chronic, pH 4.4-6.1), or episodically acidified (episodic, pH reduction from control levels to pH ???5.2 for 48 h once weekly) river water for 31 days and then transferred to 34??? SW. Smolts fed little while in acidified conditions and chronic smolts did not grow in length or weight. In FW, chronic smolts experienced increases in hematocrit and plasma potassium and reductions in plasma sodium and chloride. Upon transfer to SW, chronic and episodic smolts experienced reductions in hematocrit, increases in plasma sodium, chloride, and potassium levels, and suffered mortalities. Gill Na+,K+-ATPase and citrate synthase activities were reduced by exposure to acid. For most parameters, the effect of episodic acid exposure was less than that of chronic acidification. Exposure to acidic conditions, even when short in duration and followed by a 30-h recovery period in suitable water (pH 6.5), led to a 35% mortality of smolts upon transfer to SW. This study highlights the importance of measuring and assessing sublethal stresses in FW and their ultimate effects in marine ecosystems.

Atrial natriuretic factor increases vascular permeability

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lockette, W.; Brennaman, B.

An increase in central blood volume in microgravity may result in increased plasma levels of atrial natriuretic factor (ANF). Since elevations in plasma ANF are found in clinical syndromes associated with edema, and since space motion sickness induced by microgravity is associated with an increase in central blood volume and facial edema, we determined whether ANF increases capillary permeability to plasma protein. Conscious, bilaterally nephrectomized male rats were infused with either saline, ANF + saline, or hexamethonium + saline over 2 h following bolus injections of 125I-albumin and 14C-dextran of similar molecular size. Blood pressure was monitored and serial determinationsmore » of hematocrits were made. Animals infused with 1.0 micrograms.kg-1.min-1 ANF had significantly higher hematocrits than animals infused with saline vehicle. Infusion of ANF increased the extravasation of 125I-albumin, but not 14C-dextran from the intravascular compartment. ANF also induced a depressor response in rats, but the change in blood pressure did not account for changes in capillary permeability to albumin; similar depressor responses induced by hexamethonium were not accompanied by increased extravasation of albumin from the intravascular compartment. ANF may decrease plasma volume by increasing permeability to albumin, and this effect of ANF may account for some of the signs and symptoms of space motion sickness.« less

A new dose of maximal-intensity interval training in hypoxia to improve body composition and hemoglobin and hematocrit levels: a pilot study.

PubMed

Camacho-Cardenosa, Marta; Camacho-Cardenosa, Alba; Martínez Guardado, Ismael; Marcos-Serrano, Marta; Timon, Rafael; Olcina, Guillermo

2017-01-01

This pilot study had the aim to determine the effects of a new dose of maximal-intensity interval training in hypoxia in active adults. Twenty-four university student volunteers were randomly assigned to three groups: hypoxia group, normoxia group or control group. The eight training sessions consisted of 2 sets of 5 repeated sprints of 10 seconds with a recovery of 20 seconds between sprints and a recovery period of 10 minutes between sets. Body composition was measured following standard procedures. A blood sample was taken for an immediate hematocrit (HCT) and hemoglobin (Hb) concentration assessment. An all-out 3-ute test was performed to evaluate ventilation parameters and power. HCT and Hb were significantly higher for the hypoxia group in Post- and Det- (P=0.01; P=0.03). Fat mass percentage was significantly lower for the hypoxia group in both assessments (P=0.05; P=0.05). The hypoxia group underwent a significant increase in mean power after the recovery period. A new dose of 8 sessions of maximal-intensity interval training in hypoxia is enough to decrease the percentage of fat mass and to improve HCT and Hb parameters and mean muscle power in healthy and active adults.

Testosterone Replacement Therapy and Cardiovascular Risk: A Review

PubMed Central

Corona G, Giovanni; Rastrelli, Giulia; Maseroli, Elisa; Sforza, Alessandra

2015-01-01

Recent reports in the scientific and lay press have suggested that testosterone (T) replacement therapy (TRT) is likely to increase cardiovascular (CV) risk. In a final report released in 2015, the Food and Drug Administration (FDA) cautioned that prescribing T products is approved only for men who have low T levels due to primary or secondary hypogonadism resulting from problems within the testis, pituitary, or hypothalamus (e.g., genetic problems or damage from surgery, chemotherapy, or infection). In this report, the FDA emphasized that the benefits and safety of T medications have not been established for the treatment of low T levels due to aging, even if a man's symptoms seem to be related to low T. In this paper, we reviewed the available evidence on the association between TRT and CV risk. In particular, data from randomized controlled studies and information derived from observational and pharmacoepidemiological investigations were scrutinized. The data meta-analyzed here do not support any causal role between TRT and adverse CV events. This is especially true when hypogonadism is properly diagnosed and replacement therapy is correctly performed. Elevated hematocrit represents the most common adverse event related to TRT. Hence, it is important to monitor hematocrit at regular intervals in T-treated subjects in order to avoid potentially serious adverse events. PMID:26770933

Ferrokinetic and hematologic studies in cystic fibrosis patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wagener, J.S.; McNeill, G.C.; Taussig, L.M.

We investigated 28 cystic fibrosis (CF) patients to determine why hypoxia from their obstructive pulmonary disease does not produce polycythemia. Oxygen saturation was lower and erythropoietin levels were higher in CF patients than in 25 age-comparable reference subjects (90.8% and 47 mimu vs. 94.7% and 29 mimu, p less than 0.01). Hematocrit and red blood cell (RBC) indices were not different between groups. Serum vitamin and iron levels, ferrokinetics, RBC volume, and RBC survival were studied in 10 of the 28 CF patients. Total iron-binding capacity and vitamin E levels were low, and serum iron, ferritin, vitamin B12, and folatemore » levels were normal in these patients. Red blood cell survival was minimally decreased in six patients although there was no other evidence for hemolysis. Ferrokinetics (/sup 59/Fe) indicated a reduction in total erythropoiesis in only two patients. Plasma volume was high-normal in five and above normal in four CF patients; RBC mass was increased appropriately for each patient's degree of hypoxia, when compared to healthy individuals living at different altitudes. These results suggest that CF patients are able to compensate for hypoxia by increasing RBC mass; however, an expanded plasma volume prevents a detectable rise in hematocrit.« less

Erythropoiesis in the aged mouse. I. Response to stimulation in vivo

DOE Office of Scientific and Technical Information (OSTI.GOV)

Udupa, K.B.; Lipschitz, D.A.

1984-04-01

Changes in erythropoiesis with age were studied by examining the hematocrit increase in response to hypoxia in aged mice and by assessing the change in erythropoiesis following the injection of erythropoietin in young and old polycythemic mice. The increase in hematocrit after exposure to hypoxia was more variable and generally lower in old mice than in young mice. When erythropoietin was injected into polycythemic animals, the increase in differentiated erythroid cells and /sup 59/Fe incorporation into erythroid marrow and peripheral blood cells was significantly lower in old mice than in young mice. In contrast to differentiated erythroid cells, there wasmore » less evidence of a reduced response to simulation of the more primitive erythroid progenitor cells of aged animals. The early undifferentiated erythroid progenitor, burst-forming units, did not decrease when either young or aged mice were made polycythemic, and no change following erythropoietin injection was noted. Polycythemia suppressed the late-differentiated erythroid progenitor, erythroid colony-forming units, to a greater extent in aged animals, but when erythropoietin was injected, the percent increase over the subsequent 24 hours was identical to that in young mice. These observations indicate a reduced erythropoietic capacity with age, the abnormality being most obvious in the more mature erythroid precursors.« less

Subgaleal hemorrhage in the newborn infant associated with silicone elastomer vacuum extractor.

PubMed

Florentino-Pineda, I; Ezhuthachan, S G; Sineni, L G; Kumar, S P

1994-01-01

Subgaleal hemorrhage in the newborn infant has been reported worldwide, but despite the efforts of previous authors, this entity has not received the necessary attention in pediatric literature, and continues to represent a potentially fatal problem. Although the association of subgaleal hemorrhage with the use of the metal cup vacuum extractor has clearly been documented, its association with the silicone elastomer version has not been previously reported. We describe two cases in newborn infants where silicone elastomer cup vacuum extractor was used. The diagnosis of subgaleal hemorrhage must be considered in any infant with a scalp swelling and a falling hematocrit, and coagulation studies should be performed in all infants with a diagnosis of subgaleal hemorrhage. Complications include shock and death if subgaleal hemorrhage is massive and acute, and anemia and hyperbilirubinemia if it is slowly progressive. The familiarity with and ability of care givers to recognize the signs and symptoms of subgaleal hemorrhage are essential in preventing fatalities. A systematic approach to diagnosis with close monitoring of vital signs, hematocrit, blood gases, head circumference, and signs of tissue hypoperfusion is recommended for infants after instrument deliveries. Pathogenesis of this lesion needs to be emphasized in pediatric literature so that early recognition and prompt treatment may avoid a fatal outcome.

The Effects of Acute Waterborne Exposure to Sublethal Concentrations of Molybdenum on the Stress Response in Rainbow Trout, Oncorhynchus mykiss

PubMed Central

Ricketts, Chelsea D.; Bates, William R.; Reid, Scott D.

2015-01-01

To determine if molybdenum (Mo) is a chemical stressor, fingerling and juvenile rainbow trout (Oncorhynchus mykiss) were exposed to waterborne sodium molybdate (0, 2, 20, or 1,000 mg l-1 of Mo) and components of the physiological (plasma cortisol, blood glucose, and hematocrit) and cellular (heat shock protein [hsp] 72, hsp73, and hsp90 in the liver, gills, heart, and erythrocytes and metallothionein [MT] in the liver and gills) stress responses were measured prior to initiation of exposure and at 8, 24, and 96 h. During the acute exposure, plasma cortisol, blood glucose, and hematocrit levels remained unchanged in all treatments. Heat shock protein 72 was not induced as a result of exposure and there were no detectable changes in total hsp70 (72 and 73), hsp90, and MT levels in any of the tissues relative to controls. Both fingerling and juvenile fish responded with similar lack of apparent sensitivity to Mo exposure. These experiments demonstrate that exposure to waterborne Mo of up to 1,000 mg l-1 did not activate a physiological or cellular stress response in fish. Information from this study suggests that Mo water quality guidelines for the protection of aquatic life are highly protective of freshwater fish, namely rainbow trout. PMID:25629693

Effects of competitive red blood cell binding and reduced hematocrit on the blood and plasma levels of (/sup 14/C)Indapamide in the rat

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lettieri, J.T.; Portelli, S.T.

1983-02-01

The effects of chlorthalidone and acetazolamide on the red blood cell binding of indapamide were investigated. Both drugs caused a substantial decrease in the amount of indapamide bound to the erythrocytes in vitro. This effect was demonstrated by a change in the indapamide blood/plasma ratio from approximately 6 in control samples, to a value of 1 when either of the displacing agents was added. Coadministration of acetazolamide with /sup 14/C-labeled indapamide to rats, resulted in a 5-fold drop in the blood levels of total radioactivity, relative to rats dosed with (/sup 14/C)indapamide alone. Concomitantly, there was a 2-fold increase inmore » the plasma levels of total radioactivity after acetazolamide coadministration. In rats whose hematocrits had been reduced by extensive bleeding, there were only minor alterations in the blood/plasma partitioning of (/sup 14/C)indapamide. Thus, chlorthalidone and acetazolamide were able to displace indapamide from erythrocytes in vitro and in vivo, possibly by competition at a carbonic anhydrase binding site. The pharmacokinetics of drugs which are extensively bound to erythrocytes may be significantly altered by the presence of other agents capable of competitive binding.« less

Lead exposure in passerines inhabiting lead-contaminated floodplains in the Coeur d'Alene River Basin, Idaho, USA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, G.D.; Kern, J.W.; Strickland, M.D.

1999-06-01

Blood collected from song sparrows (Melospiza melodia) and American robins (Turdus migratorius) captured with mist nets in a lead-contaminated (assessment) area and nearby uncontaminated (reference) areas within the Coeur d'Alene Basin in northern Idaho was analyzed for [delta]-aminolevulinic acid dehydratase activity (ALAD) and hematocrit levels, and livers were analyzed for lead. Mean ALAD inhibition in the assessment area was 51% in song sparrows and 75% in American robins. The proportion of the sampled population with ALAD inhibition > 50% was calculated to be 43% for song sparrows and 83% for American robins. Assessment area hematocrit values for song sparrows andmore » American robins were lower than in reference areas; however, differences were not statistically significant. Significantly higher levels of lead (wet weight) were found in livers from song sparrows captured on the assessment area ([bar x] = 1.93 ppm) than on reference areas. Study results indicate that 43% of the song sparrows and 83% of the American robins inhabiting the floodplain along the Coeur d'Alene River in the assessment area are being exposed to lead at levels sufficient to inhibit ALAD by > 50%. Variability in lead exposure indicators was attributed to high variability in environmental lead concentrations in the Coeur d'Alene River Basin.« less

What do cardiovascular nurses know about the hematological management of patients with Eisenmenger syndrome?

PubMed

Moons, Philip; Fleck, Desiree; Jaarsma, Tiny; Norekval, Tone M; Smith, Karen; Stromberg, Anna; Thompson, David R; Budts, Werner

2009-10-01

We investigated the level of knowledge of hematological management of patients with Eisenmenger syndrome among general cardiovascular nurses and nurses who specialize in congenital heart disease (CHD). We conducted a survey at two international conferences attended by cardiovascular nurses. Nurses were asked to complete a questionnaire comprising two questions and three clinical case scenarios. Overall, 89 nurses participated (response rate 90.8%), 43 of whom specialized in CHD. The level of knowledge displayed among cardiovascular nurses is poor. About one-third of nurses not specialized in CHD recognized the definition of Eisenmenger syndrome and knew what normal hematocrit levels are. With respect to the cases presented, less than 10% of the nurses could give a correct answer. The level of knowledge of specialized nurses was significantly higher, but also here, important gaps in the level of knowledge could be observed. Less than two-thirds knew the reference values of hematocrit and knew the appropriate management in two cases. Less than half of the specialized nurses knew about the procedure of isovolumic phlebotomy. The level of knowledge displayed by cardiovascular nurses regarding the hematological management of patients with Eisenmenger syndrome is poor. Also the knowledge of nurses specialized in CHD could be improved.

Levonorgestrel-releasing intrauterine system use in premenopausal women with symptomatic uterine leiomyoma: a systematic review.

PubMed

Jiang, Wenxiao; Shen, Qi; Chen, Miaomiao; Wang, Ying; Zhou, Qingfeng; Zhu, Xuejie; Zhu, Xueqiong

2014-08-01

A systematic review is done to determine the efficacy and safety of levonorgestrel-releasing intrauterine systems as a treatment using in premenopausal women with symptomatic uterine leiomyoma. We searched the Medline, Central and ICTRP databases for all articles published from inception through July 2013 that examined the following outcomes: uterine volume, uterine leiomyoma volume, endometrial thickness, then menstrual blood loss, blood haemoglobin, ferritin and hematocrit levels, treatment failure rate, device expulsion rate, hysterectomy rate and side effects. From 645 studies, a total of 11 studies met our inclusion criteria with sample sizes ranging from 10 to 104. Evidence suggested that levonorgestrel-releasing intrauterine systems could decrease uterine volume and endometrial thickness, significantly reduce menstrual blood loss, and increase blood haemoglobin, ferritin and hematocrit levels. There was no evidence for decreasing uterine leiomyoma volume. There were no adverse effects on the ovarian function except for ovarian cysts. Device expulsion rates were low, which associated with leiomyoma size (larger than 3cm) but not with leiomyoma location. Irregular bleeding/spotting was observed at the beginning of the follow-up period and then decreased progressively. Results of this systematic review indicate that levonorgestrel-releasing intrauterine systems may be effective and safe treatment for symptomatic uterine leiomyoma in premenopausal women. Copyright © 2014 Elsevier Inc. All rights reserved.

Detection of Babesia caballi and Theileria equi in Blood from Equines from Four Indigenous Communities in Costa Rica.

PubMed

Posada-Guzmán, María Fernanda; Dolz, Gaby; Romero-Zúñiga, Juan José; Jiménez-Rocha, Ana Eugenia

2015-01-01

A cross-sectional study was carried out in four indigenous communities of Costa Rica to detect presence and prevalence of Babesia caballi and Theileria equi and to investigate factors associated with presence of these hemoparasites. General condition of horses (n = 285) was evaluated, and hematocrits and hemoglobin were determined from blood samples of 130 horses, which were also analyzed using blood smears, nested polymerase chain reaction (PCR), and immunosorbent assay (c-ELISA). The general condition of the horses (n = 285) in terms of their body and coat was between regular and poor, and hematocrit and hemoglobin average values were low (19% and 10.65 g/dL, resp.). Erythrocyte inclusions were observed in 32 (24.6%) of the samples. Twenty-six samples (20.0%) gave positive results for B. caballi and 60 (46.2%) for T. equi; 10 horses (7.7%) showed mixed infection, when analyzed by PCR. Using c-ELISA, it was found that 90 (69.2%) horses had antibodies against B. caballi and 115 (88.5%) against T. equi, while 81 (62.3%) showed mixed reactions. There were no factors associated with the presence of B. caballi and T. equi. These results contrast with results previously obtained in equines in the Central Valley of Costa Rica.

Detection of Babesia caballi and Theileria equi in Blood from Equines from Four Indigenous Communities in Costa Rica

PubMed Central

Posada-Guzmán, María Fernanda; Romero-Zúñiga, Juan José; Jiménez-Rocha, Ana Eugenia

2015-01-01

A cross-sectional study was carried out in four indigenous communities of Costa Rica to detect presence and prevalence of Babesia caballi and Theileria equi and to investigate factors associated with presence of these hemoparasites. General condition of horses (n = 285) was evaluated, and hematocrits and hemoglobin were determined from blood samples of 130 horses, which were also analyzed using blood smears, nested polymerase chain reaction (PCR), and immunosorbent assay (c-ELISA). The general condition of the horses (n = 285) in terms of their body and coat was between regular and poor, and hematocrit and hemoglobin average values were low (19% and 10.65 g/dL, resp.). Erythrocyte inclusions were observed in 32 (24.6%) of the samples. Twenty-six samples (20.0%) gave positive results for B. caballi and 60 (46.2%) for T. equi; 10 horses (7.7%) showed mixed infection, when analyzed by PCR. Using c-ELISA, it was found that 90 (69.2%) horses had antibodies against B. caballi and 115 (88.5%) against T. equi, while 81 (62.3%) showed mixed reactions. There were no factors associated with the presence of B. caballi and T. equi. These results contrast with results previously obtained in equines in the Central Valley of Costa Rica. PMID:26649225

Prevalence of anemia and its risk factors among pregnant women in Khorramabad (Iran) 2010-2014.

PubMed

Mardani, Mahnaz; Rezapour, Sadegh; Ahmadipour, Shokoufeh; Mohsenzadeh, Azam; Khalkhali Rad, A H; Roosta, Sajjad; Ebrahimzadeh, Farzad

2017-04-01

Anemia's adverse effects on physical and behavioral development and on the reduction of efficiency have been proven. The aim of this study was to determine the prevalence of anemia in pregnant women referred to the health care centers of Khorramabad from 2010 to 2014. In this cross-sectional study, 2821 prenatal care cases of pregnant women referred to health care centers of Khorramabad were studied. Studied variables included the following: hemoglobin, hematocrit, age, parity, trimester of pregnancy status, number of deliveries, number of abortions, number of children, weight, height, time gap from previous delivery, negative RH, history of eclampsia/preeclampsia, coagulation disorder and blood pressure. The mean age of the studied women was 26.7 ± 5.5. The mean levels of hemoglobin and hematocrit from the population was 12 ± 1.1 and 36.1 ± 9.2, respectively. The prevalence of anemia was 16.8%. Prevalence of anemia among pregnant women referred to health care centers of Khorramabad was found to be high. Staff working at different parts of health care centers were advised to pay more attention to this problem. They should also try to control and treat anemia by regular distribution of iron supplements among women referred to health care centers.

Hematocrit levels as cardiovascular risk among taxi drivers in Bangkok, Thailand.

PubMed

Ishimaru, Tomohiro; Arphorn, Sara; Jirapongsuwan, Ann

2016-10-08

In Thailand, taxi drivers employed in the informal sector often experience hazardous working conditions. Previous studies revealed that elevated Hematocrit (HCT) is a predictor of cardiovascular disease (CVD) risk. This study assessed factors associated with HCT in taxi drivers to predict their occupational CVD risk factors. A cross-sectional study was conducted on 298 male taxi drivers who joined a health check-up campaign in Bangkok, Thailand. HCT and body mass index were retrieved from participant health check-up files. Self-administered questionnaires assessed demographics, driving mileage, working hours, and lifestyle. Statistical associations were analyzed using stepwise linear regression. Our results showed that obesity (p=0.007), daily alcohol drinking (p=0.003), and current or past smoking (p=0.016) were associated with higher HCT levels. While working hours were not directly associated with HCT levels in the current study, the effect on overworking is statistically arguable because most participants worked substantially longer hours. Our findings suggest that taxi drivers' CVD risk may be increased by their unhealthy work styles. Initiatives to improve general working conditions for taxi drivers should take into account health promotion and CVD prevention. The policy of providing periodic health check-ups is important to make workers in the informal sector aware of their health status.

Hematological parameters and anaerobic threshold in Brazilian soccer players throughout a training program.

PubMed

Silva, A S R; Santhiago, V; Papoti, M; Gobatto, C A

2008-04-01

We assessed the responses of hematological parameters and their relationship to the anaerobic threshold of Brazilian soccer players during a training program. Twelve athletes were evaluated at the beginning (week 0, T1), in the middle (week 6, T2), and at the end (week 12, T3) of the soccer training program. On the first day at 7:30 am, before collecting the blood sample at rest for the determination of the hematological parameters, the athletes were conducted to the anthropometric evaluation. On the second day at 8:30 am, the athletes had their anaerobic threshold measured. Analysis of variance with Newman-Keuls'post hoc was used for statistical comparisons between the parameters measured during the soccer training program. Correlations between the parameters analyzed were determined using the Pearson's correlation coefficient. Erythrocytes concentration, hemoglobin, and hematocrit were significantly increased from T1 to T2. The specific soccer training program led to a rise in erythrocytes, hemoglobin, and hematocrit from T1 to T2. We assumed that these results occurred due to the plasma volume reduction and may be explained by the soccer training program characteristics. Furthermore, we did not observe any correlation between the anaerobic threshold and the hematological parameters.

Comparison of New Technology Integrated and Nonintegrated Arterial Filters Used in Cardiopulmonary Bypass Surgery: A Randomized, Prospective, and Single Blind Study

PubMed Central

Gürsu, Özgür; Isbir, Selim; Ak, Koray; Gerin, Fethullah; Arsan, Sinan

2013-01-01

Background. Innovative cardiopulmonary bypass (CPB) settings have been developed in order to integrate the concepts of “surface-coating,” “blood-filtration,” and “miniaturization.” Objectives. To compare integrated and nonintegrated arterial line filters in terms of peri- and postoperative clinical variables, inflammatory response, and transfusion needs. Material and Methods. Thirty-six patients who underwent coronary bypass surgery were randomized into integrated (Group In) and nonintegrated arterial line filter (Group NIn) groups. Arterial blood samples for the assessments of complete hemogram, biochemical screening, interleukin-6, interleukin-2R, and C-reactive protein were analyzed before and after surgery. Need for postoperative dialysis, inotropic therapy and transfusion, in addition to extubation time, total amount of drainage (mL), length of intensive care unit, and hospital stay, and mortality rates was also recorded for each patient. Results. Prime volume was significantly higher and mean intraoperative hematocrit value was lower in Group NIn, but need for erythrocyte transfusion was significantly higher in Group NIn. C-reactive protein values did not differ significantly except for postoperative second day's results, which were found significantly lower in Group In than in Group NIn. Conclusion. Intraoperative hematocrit levels were higher and need for postoperative erythrocyte transfusion was decreased in Group In. PMID:24319685

Comparing the clinical profile of non obese children with sleep apnea and snoring.

PubMed

Stefanini, Daniele de Oliveira Soares; Barros, Emília Leite de; Stefanini, Renato; Pradella-Hallinan, Márcia Lurdes de Cássia; Pignatari, Shirley Shizue Nagata; Fujita, Reginaldo Raimundo

2012-10-01

Few studies in the literature have looked into the cardiovascular and metabolic effects of Obstructive Sleep Apnea Syndrome (OSAS) in children. This study aims to evaluate the metabolic profile of non-obese children with OSAS. Fifty-two children were enrolled in this study, 21 girls and 31 boys. Patients were divided into two groups: OSAS (28 children) and Snore (22 children) according to polysomnographic evaluation. All children were submitted to ENT examination, measurements of weight, height and blood pressure. Blood samples were tested for hemoglobin, hematocrit, fasting glucose, fasting insulin, triglycerides, total cholesterol, HDL, LDL, VLDL, TSH and T4. The gathered data sets were compared between groups and also within the OSAS group according to the severity of the syndrome. The children from both groups had no alterations in blood pressure levels. The results of the blood tests were normal for both groups. Results of hemoglobin, hematocrit, and HDL were all significantly higher in the Snore group when compared to the OSAS group; by their turn, VLDL levels were higher in the OSAS group. There was no statistical difference between the groups based on OSAS severity. Non-obese children with OSAS present no significant alterations in metabolic tests or blood pressure levels.

Effect of diet composition and mixture of selected food additives on the erythrocytic system and iron metabolism in peripheral blood of male rats.

PubMed

Sadowska, Joanna; Kuchlewska, Magdalena

2011-01-01

Metabolic processes of food additives which are "exogenous xenobiotics" are catalysed, primarily, by enzymes located in microsomes of hepatocytes affiliated to P-450 cytochrome superfamily, containing iron. The aim of the study was to investigate the effect of diet composition and selected food additives on the erythrocyte system and iron metabolism in peripheral blood of male rats. The experiment was carried out on 30 male rats sorted into three equinumerous groups. For drinking animals received pure, settled tap water, animals from group III were receiving additionally an aqueous solution of sodium (nitrate), potassium nitrite, benzoic acid, sorbic acid and monosodium glutamate. Ascertained a significant effect of changes in diet composition on the increase in hematocrit marker value and the count of red blood cells in blood of animals examined. Used food additives diminished hemoglobin concentration, hematocrit value and red blood cell count, diminishing also iron concentration in serum, the total iron binding capacity and transferrin saturation with iron. Analysis of the results allowed ascertain adverse changes in values of the erythrocytic system markers, occurring under the influence of the applied mixture of food additives. Used food additives change the iron metabolism, most likely from the necessity of applied xenobiotics biotransformation by heme-containing monoxygenases of P-450 cytochrome.

Swimming endurance of bull trout, lake trout, arctic char, and rainbow trout following challenge with Renibacterium salmoninarum

USGS Publications Warehouse

Jones, D.T.; Moffitt, C.M.

2004-01-01

We tested the swimming endurance of juvenile bull trout Salvelinus confluentus, lake trout S. namaycush, Arctic char S. alpinus, and rainbow trout Oncorhynchus mykiss at 9??C and 15??C to determine whether sublethal infection from a moderate challenge of Renibacterium salmoninarum administered months before testing affected the length of time fish could maintain a swimming speed of 5-6 body lengths per second in an experimental flume. Rainbow trout and Arctic char swam longer in trials than did bull trout or lake trout, regardless of challenge treatment. When we tested fish 14-23 weeks postchallenge, we found no measurable effect of R. salmoninarum on the swimming endurance of the study species except for bull trout, which showed a mixed response. We conducted additional trials with bull trout 5-8 weeks postchallenge to determine whether increasing the challenge dose would affect swimming endurance and hematocrit. In those tests, bull trout with clinical signs of disease and those exposed to the highest challenge doses had significantly reduced swimming endurance compared with unchallenged control fish. Fish hematocrit levels measured at the end of all swimming endurance tests varied among species and between test temperatures, and patterns were not always consistent between challenged and control fish.

Development of a Nanotechnology Platform for Prostate Cancer Gene Therapy

DTIC Science & Technology

2013-07-01

advan- tages of using recombinant techniques to synthesize fusion biopolymers allowing the production of biomacromolecules in a cost-effective manner...from both legs using a 3mm lancet (GoldenRod). Approximately 200ul of blood was collected in heparinized micro -Hematocrit tubes (Kontes). Blood from...NanoDDS, now entering its eighth year, began in 2003 as a US -Japan mini-symposium organized by Dr. A. Kabanov and Dr. K. Kataoka. According to Dr

Intraosseous Erythropoietin for Acute Tissue Protection in Battlefield Casualties Suffering Hypovolemic Shock

DTIC Science & Technology

2015-07-01

excess deficit, likely related to a flow dependent reduction in systemic oxygen consumption (VO2), but this effect was transient attain- ing values... oxygen delivery index; VO2, systemic oxygen consumption index; Hct, hematocrit, PaCO2, arterial PCO2; PETCO2, end-tidal PCO2. Table S1: Effect of...response that enabled maintaining oxygen consumption close to baseline resulting in minimal lactate increases and high resuscitability and survival without

Effect of Packed Red Blood Cell Cryopreservation on Development of the Storage Lesion and Inflammation

DTIC Science & Technology

2015-09-01

Scientific International Inc., Hampton, NH) at 22°C. Lactic acid (LA) and cell free potassium (K+) were measured using point of care clinical blood...equilibrium maintained by adenosine triphosphate (ATP) dependent potassium pumps [17]. Lactic acid accumulation was more pronounced in the first 21 days...Hct hematocrit Hgb hemoglobin K+ cell free potassium LA lactic acid pRBC packed red blood cell PS phosphatidylserine

Blood Transfusion Therapy in Patients with Heart Disease.

DTIC Science & Technology

1982-04-07

Delivoria-Papadopoulos M, Miller WW. Red cell 2,3 diphosphoglycerate levels in subjects with chronic hypoxemia. N Engl J Med 1969;280:1165-66. I 60...solution will do this. Red cells with elevated 2,3 DPG levels do ensure optimum delivery of oxygen to tissue, especially during hypothermia, although...increased in congestive heart failure. More- over, certain drugs may reduce plasma volume and raise the hematocrit level , and splenomegaly will further reduce

Anemia Causes Hypoglycemia in Intensive Care Unit Patients Due to Error in Single-Channel Glucometers: Methods of Reducing Patient Risk

DTIC Science & Technology

2010-01-01

hematocrit, low oxygen tension, acetaminophen, uric acid , ascorbic acid , maltose, galactose, xy- lose, lactose, operator inexperience, age of strips, heat...Biomedical, Waltham, MA) that corrects for the effects of anemia, low oxygen tension, acetaminophen, uric acid , ascorbic acid , maltose, galactose, xylose, and...resulted in inappropriately high glucometer values (data not shown). The effects of interfering substances (acetaminophen, uric acid , ascorbic acid

Hematocrit Causes the Most Significant Error in Point of Care Glucometers

DTIC Science & Technology

2009-04-01

pneumonia, as it permits leakage of pharyngeal secretions around the cuff. In our randomized controlled trial (5) of 165 patients included in the...interven- tion group, only 9 (5%) required reintu- bation. A few of these patients could per- haps benefit of the evaluation proposed by Stocchetti et al...and avoid an undue extubation; the duration of mechanical ventilation for the overall patients , how- ever, would have been certainly much higher. The

Correction for the Hematocrit Bias in Dried Blood Spot Analysis Using a Nondestructive, Single-Wavelength Reflectance-Based Hematocrit Prediction Method.

PubMed

Capiau, Sara; Wilk, Leah S; De Kesel, Pieter M M; Aalders, Maurice C G; Stove, Christophe P

2018-02-06

The hematocrit (Hct) effect is one of the most important hurdles currently preventing more widespread implementation of quantitative dried blood spot (DBS) analysis in a routine context. Indeed, the Hct may affect both the accuracy of DBS methods as well as the interpretation of DBS-based results. We previously developed a method to determine the Hct of a DBS based on its hemoglobin content using noncontact diffuse reflectance spectroscopy. Despite the ease with which the analysis can be performed (i.e., mere scanning of the DBS) and the good results that were obtained, the method did require a complicated algorithm to derive the total hemoglobin content from the DBS's reflectance spectrum. As the total hemoglobin was calculated as the sum of oxyhemoglobin, methemoglobin, and hemichrome, the three main hemoglobin derivatives formed in DBS upon aging, the reflectance spectrum needed to be unmixed to determine the quantity of each of these derivatives. We now simplified the method by only using the reflectance at a single wavelength, located at a quasi-isosbestic point in the reflectance curve. At this wavelength, assuming 1-to-1 stoichiometry of the aging reaction, the reflectance is insensitive to the hemoglobin degradation and only scales with the total amount of hemoglobin and, hence, the Hct. This simplified method was successfully validated. At each quality control level as well as at the limits of quantitation (i.e., 0.20 and 0.67) bias, intra- and interday imprecision were within 10%. Method reproducibility was excellent based on incurred sample reanalysis and surpassed the reproducibility of the original method. Furthermore, the influence of the volume spotted, the measurement location within the spot, as well as storage time and temperature were evaluated, showing no relevant impact of these parameters. Application to 233 patient samples revealed a good correlation between the Hct determined on whole blood and the predicted Hct determined on venous DBS. The bias obtained with Bland and Altman analysis was -0.015 and the limits of agreement were -0.061 and 0.031, indicating that the simplified, noncontact Hct prediction method even outperforms the original method. In addition, using caffeine as a model compound, it was demonstrated that this simplified Hct prediction method can effectively be used to implement a Hct-dependent correction factor to DBS-based results to alleviate the Hct bias.

A novel splicing site IRP1 somatic mutation in a patient with pheochromocytoma and JAK2V617F positive polycythemia vera: a case report.

PubMed

Pang, Ying; Gupta, Garima; Yang, Chunzhang; Wang, Herui; Huynh, Thanh-Truc; Abdullaev, Ziedulla; Pack, Svetlana D; Percy, Melanie J; Lappin, Terence R J; Zhuang, Zhengping; Pacak, Karel

2018-03-13

The role of the hypoxia signaling pathway in the pathogenesis of pheochromocytoma/paraganglioma (PPGL)-polycythemia syndrome has been elucidated. Novel somatic mutations in hypoxia-inducible factor type 2A (HIF2A) and germline mutations in prolyl hydroxylase type 1 and type 2 (PHD1 and PHD2) have been identified to cause upregulation of the hypoxia signaling pathway and its target genes including erythropoietin (EPO) and its receptor (EPOR). However, in a minority of patients presenting with this syndrome, the genetics and molecular pathogenesis remain unexplained. The aim of the present study was to uncover novel genetic causes of PPGL-polycythemia syndrome. A female presented with a history of JAK2 V617F positive PV, diagnosed in 2007, and right adrenal pheochromocytoma diagnosed and resected in 2011. Her polycythemia symptoms and hematocrit levels continued to worsen from 2007 to 2011, with an increased frequency of phlebotomies. Postoperatively, until early 2013, her hematocrit levels remained normalized. Following this, the hematocrit levels ranged between 46.4 and 48.9% [35-45%]. Tumor tissue from the patient was further tested for mutations in genes related to upregulation of the hypoxia signaling pathway including iron regulatory protein 1 (IRP1), which is a known regulator of HIF-2α mRNA translation. Functional studies were performed to investigate the consequences of these mutations, especially their effect on the HIF signaling pathway and EPO. Indel mutations (c.267-1_267delGGinsTA) were discovered at the exon 3 splicing site of IRP1. Minigene construct and splicing site analysis showed that the mutation led to a new splicing site and a frameshift mutation of IRP1, which caused a truncated protein. Fluorescence in situ hybridization analysis demonstrated heterozygous IRP1 deletions in tumor cells. Immunohistochemistry results confirmed the truncated IRP1 and overexpressed HIF-2α, EPO and EPOR in tumor cells. This is the first report which provides direct molecular genetic evidence of association between a somatic IRP1 loss-of-function mutation and PHEO and secondary polycythemia. In patients diagnosed with PHEO/PGL and polycythemia with negative genetic testing for mutations in HIF2A, PHD1/2, and VHL, IRP1 should be considered as a candidate gene.

The effect of Chaetoceros calcitrans extract on hematology common carp (Cyprinus carpio) infected by Aeromonas salmonicida

NASA Astrophysics Data System (ADS)

Maftuch; Wulan, N. D. A.; Suprastyani, H.; Wijayanto, E.; Noercholis, M.; Prihanto, A. A.; Kurniawan, A.

2018-04-01

The application of C. calcitrans extract in carp (C. carpio) is expected to inhibit the growth of A. salmonicida. A. salmonicida-infected common carp (C. carpio) were treated with the extract of C. calcitrans. Hematology, erythrocyte, leukocyte, hematocrit and hemoglobin test analysis was observed. The result indicated that the extract can be used to treat the infected fish. The best dose was treatment of D with 45.3 ppm.

Hematocrit and plasma albumin levels difference may be a potential biomarker to discriminate preeclampsia and eclampsia in patients with hypertensive disorders of pregnancy.

PubMed

Dai, Dong-Mei; Cao, Jing; Yang, Hong-Mei; Sun, Hai-Mei; Su, Yu; Chen, Yuan-Yuan; Fang, Xiao; Xu, Wang-Bin

2017-01-01

We evaluated whether alterations of hemoglobin (HB), hematocrit (HCT), serum albumin level (ALB), and the difference of HCT and ALB can be used in the diagnosis of preeclampsia and eclampsia in patients with hypertensive disorders of pregnancy (HDP). A total of 509 individuals were recruited and divided into 4 groups: Group 1, 170 healthy non-pregnant women; Group 2, 125 normal pregnant women; Group 3, 105 pregnant women diagnosed with gestational and chronic hypertension; Group 4, 109 pregnant women diagnosed as having preeclampsia and eclampsia. Data of HB, HCT, ALB, globulin (GLB) were collected at the time of a prenatal examination during the third trimester. Alterations in the HCT and the ALB levels in these groups were significantly different. Group 4 had a higher mean HCT-ALB value (P<0.01), but lower ALB and GLB values compared with the other three groups. We used Groups 2 and 3 as the respective reference to draw the receiver operating characteristic (ROC) curves of HCT-ALB in Group 4, and found that the threshold values of maximum index corresponding were 12.95 and 12.65 (sensitivity>57.0%, specificity>98.9%), respectively. The value of HCT-ALB>12.65 might be used as a potential biomarker for the auxiliary diagnosis of preeclampsia and eclampsia in HDP. Copyright © 2016 Elsevier B.V. All rights reserved.

Thrombopoietin Receptor Agonist Mitigates Hematopoietic Radiation Syndrome and Improves Survival after Whole-Body Ionizing Irradiation Followed by Wound Trauma

PubMed Central

Zhai, Min; Liao, Pei-Jun; Elliott, Thomas B.

2017-01-01

Ionizing radiation combined with trauma tissue injury (combined injury, CI) results in greater mortality and H-ARS than radiation alone (radiation injury, RI), which includes thrombocytopenia. The aim of this study was to determine whether increases in numbers of thrombocytes would improve survival and mitigate H-ARS after CI. We observed in mice that WBC and platelets remained very low in surviving RI animals that were given 9.5 Gy 60Co-γ-photon radiation, whereas only lymphocytes and basophils remained low in surviving CI mice that were irradiated and then given skin wounds. Numbers of RBC and platelets, hemoglobin concentrations, and hematocrit values remained low in surviving RI and CI mice. CI induced 30-day mortality higher than RI. Radiation delayed wound healing by approximately 14 days. Treatment with a thrombopoietin receptor agonist, Alxn4100TPO, after CI improved survival, mitigated body-weight loss, and reduced water consumption. Though this therapy delayed wound-healing rate more than in vehicle groups, it greatly increased numbers of platelets in sham, wounded, RI, and CI mice; it significantly mitigated decreases in WBC, spleen weights, and splenocytes in CI mice and decreases in RBC, hemoglobin, hematocrit values, and splenocytes and splenomegaly in RI mice. The results suggest that Alxn4100TPO is effective in mitigating CI. PMID:28408792

Short communication: Effect of maternal heat stress in late gestation on blood hormones and metabolites of newborn calves.

PubMed

Guo, J-R; Monteiro, A P A; Weng, X-S; Ahmed, B M; Laporta, J; Hayen, M J; Dahl, G E; Bernard, J K; Tao, S

2016-08-01

Maternal heat stress alters immune function of the offspring, as well as metabolism and future lactational performance, but its effect on the hormonal and metabolic responses of the neonate immediately after birth is still not clear. The objective of this study was to investigate the blood profiles of hormones and metabolites of calves born to cows that were cooled (CL) or heat-stressed (HS) during the dry period. Within 2 h after birth, but before colostrum feeding, blood samples were collected from calves [18 bulls (HS: n=10; CL: n=8) and 20 heifers (HS: n=10; CL: n=10)] born to CL or HS dry cows, and hematocrit and plasma concentrations of total protein, prolactin, insulin-like growth factor-I, insulin, glucose, nonesterified fatty acid, and β-hydroxybutyrate were measured. Compared with CL, HS calves had lower hematocrit and tended to have lower plasma concentrations of insulin, prolactin, and insulin-like growth factor-I. However, maternal heat stress had no effect on plasma levels of total protein, glucose, fatty acid, and β-hydroxybutyrate immediately after birth. These results suggest that maternal heat stress desensitizes a calf's stress response and alters the fetal development by reducing the secretion of insulin-like growth factor-I, prolactin, and insulin. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Effectiveness and tolerability of parenteral testosterone undecanoate: a post-marketing surveillance study.

PubMed

Wolf, Jan; Keipert, Dieter; Motazedi, Heiko; Ernst, Michael; Nettleship, Joanne; Gooren, Louis

2017-12-01

This observational post-marketing study of parenteral testosterone undecanoate (TU) in a non-selected population aimed to: examine the effectiveness of TU as treatment of hypogonadism; record adverse drug reactions (ADR) quantitatively particularly regarding polycythemia, prostate safety and cardiovascular-related metabolic risk factors; and verify whether recommended injection intervals apply to routine clinical practice. Eight hundred and seventy subjects from 259 outpatient units scheduled to visit the clinic six times were included. Effectiveness and tolerability of TU administration were assessed on a 4-point scale. Body weight, waist girth, blood pressure, hemoglobin levels, hematocrit, prostate-specific antigen (PSA), and digital rectal prostate examination were assessed. Over 90% of subjects completed the observational duration of 52.8 ± 9.7 weeks (mean ± SD) and 56% judged effectiveness as very good, 30.8% as good. 63.1% judged tolerability as very good, and 24.4% as good. No adverse effects on indicators of cardiovascular risk were observed. Polycythemia occurred in one subject and a supranormal hematocrit in one subject. Four subjects developed supranormal PSA levels. Prostate carcinoma was found in one subject, one subject had recurrence of a previously surgically treated prostate carcinoma, and the other two showed no indication of malignancy. Parenteral TU is safe, effective, and well-tolerated in clinical practice proving a good therapeutic option for hypogonadism.

Plasma-equivalent glucose at the point-of-care: evaluation of Roche Accu-Chek Inform and Abbott Precision PCx glucose meters.

PubMed

Ghys, Timothy; Goedhuys, Wim; Spincemaille, Katrien; Gorus, Frans; Gerlo, Erik

2007-01-01

Glucose testing at the bedside has become an integral part of the management strategy in diabetes and of the careful maintenance of normoglycemia in all patients in intensive care units. We evaluated two point-of-care glucometers for the determination of plasma-equivalent blood glucose. The Precision PCx and the Accu-Chek Inform glucometers were evaluated. Imprecision and bias relative to the Vitros 950 system were determined using protocols of the Clinical Laboratory Standards Institute (CLSI). The effects of low, normal, and high hematocrit levels were investigated. Interference by maltose was also studied. Within-run precision for both instruments ranged from 2-5%. Total imprecision was less than 5% except for the Accu-Chek Inform at the low level (2.9 mmol/L). Both instruments correlated well with the comparison instrument and showed excellent recovery and linearity. Both systems reported at least 95% of their values within zone A of the Clarke Error Grid, and both fulfilled the CLSI quality criteria. The more stringent goals of the American Diabetes Association, however, were not reached. Both systems showed negative bias at high hematocrit levels. Maltose interfered with the glucose measurements on the Accu-Chek Inform but not on the Precision PCx. Both systems showed satisfactory imprecision and were reliable in reporting plasma-equivalent glucose concentrations. The most stringent performance goals were however not met.

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding.

PubMed

Haber, Zachary M; Charles, Hearns W; Erinjeri, Joseph P; Deipolyi, Amy R

2017-04-18

Conventional angiography is used to evaluate and treat possible sources of intraabdominal bleeding, though it may cause complications such as contrast-induced nephropathy (CIN). The study's purpose was to identify factors predicting active extravasation and complications during angiography for acute intraabdominal bleeding. All conventional angiograms for acute bleeding (January 2013-June 2015) were reviewed retrospectively, including 75 angiograms for intraabdominal bleeding in 70 patients. Demographics, comorbidities, vital signs, complications within one month, and change in hematocrit (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation ( p = 0.017), with larger ΔHct (-17%) in patients with versus those without extravasation (-1%) ( p = 0.01). CIN was the most common complication, occurring in 10 of 66 angiograms (15%). Glomerular filtration rate (GFR) was the only independent predictor ( p = 0.03); 67% of patients with GFR < 30, 29% of patients with GFR 30-60, and 8% of patients with GFR > 60 developed CIN. For patients with intraabdominal bleeding, greater ΔHct decrease over 24 h before angiography predicts active extravasation. Pre-existing renal impairment predicts CIN. Patients with large hematocrit declines should be triaged for rapid angiography, though benefits can be weighed with the risk of renal impairment.

Anemia and malaria in a Yanomami Amerindian population from the southern Venezuelan Amazon.

PubMed

Pérez Mato, S

1998-12-01

The prevalence and age distribution of anemia and malaria among Yanomami Amerindians undergoing sociocultural assimilation are described. Anemia and malaria proportions were determined in 103 individuals randomly selected from 515 villagers in Mavaca in the southern Venezuelan Amazon. The age and sex distribution reflected that of the entire village cluster. Anemia (hematocrit less than World Health Organization/Centers for Disease Control and Prevention reference values) was found in 91% of the study population. As a group, adults (> or = 15 years old) had the highest proportion of anemia (P=0.037). Adult females had lower mean hematocrit values than adult males (P=0.013). The anemia was predominantly hypochromic and microcytic (62%), a finding that could suggest a diagnosis of iron deficiency in the absence of known hereditary hemoglobinopathies in these Amerindians. Malaria was diagnosed in 14% overall. Children (< 10 years old) displayed the highest proportion of Plasmodium falciparum (17%) and P. vivax (14%) parasitemia, splenomegaly (94%), and fever (34%) (P=0.059, 0.039, 0.005, and 0.008, respectively). The high proportions of anemia and splenomegaly observed in the survey may be used as indicators of inadequately controlled malaria in this community. Further studies to assess the epidemiology of risk factors for the high prevalence of anemia, and predominance of P. falciparum infections in the area are urgently needed.

Recombinant human erythropoietin in the prevention of late anemia in intrauterine transfused neonates with Rh-isoimmunization.

PubMed

Zuppa, Antonio Alberto; Alighieri, Giovanni; Calabrese, Valentina; Visintini, Federica; Cota, Francesco; Carducci, Chiara; Antichi, Eleonora; Noia, Giuseppe Antonio; Fortunato, Giuseppe; Romagnoli, Costantino

2010-04-01

The majority of neonates with Rh-isoimmunization develops late anemia between the second and the sixth week of life. We report the effectiveness of recombinant human erythropoietin (rHuEPO) in preventing late anemia in 25 intrauterine and nonintrauterine-transfused neonates. The neonates were treated from 11+/-4 days after birth to 26+/-14 days (400 U/kg/d of rHuEpo, administered subcutaneously). During rHuEpo therapy, vitamin E, calcium folinate, and iron maltose were administered intramuscularly on a daily basis. Hematocrit, platelet, and neutrophil counts did not differ significantly before and after 21-days therapy. However, average values for reticulocyte showed a significant increase. The hematocrit values in the non-intrauterine transfusion (IUT) group increased progressively from the beginning to the end of the treatment, whereas that in the IUT group remained stable. Reticulocyte count increased during treatment in both groups, but it was significantly elevated in the non-IUT group only. Moreover, we observed that only neonates transfused with IUTs needed transfusions before and after treatment. This study suggests the effectiveness of rHuEpo therapy in the treatment of neonates with Rh-isoimmunization and it highlights how IUTs decrease the neonatal response efficacy. Larger, better if multicentric, randomized controlled trial are needed to definitely state whether rHuEPO safely decreases the incidence of late onset anemia.

Comparison between two treatment protocols with recombinant human erythropoietin (rHuEpo) in the treatment of late anemia in neonates with Rh-isoimmunization.

PubMed

Zuppa, A A; Alighieri, G; Fracchiolla, A; Catenazzi, P; D'Antuono, A; Riccardi, R; Cavani, M; Romagnoli, C

2012-01-01

[corrected] The Rh-hemolytic disease can lead to a late anemia by hemolytic and hyporigenerative mechanism. We compared the effectiveness of rHuEPO in two care protocols that differ for doses of rHuEPO administrated and for timing of administration. A cohort of 14 neonates was investigated. The neonates were treated with two different protocols. Protocol A: a dose of 200 U/kg/day of rHuEpo administered subcutaneously starting from the end of the second week of life; Protocol B: a dose of 400 U/kg/day of rHuEpo administered subcutaneously starting from the end of the first week of life. The hematocrit values in the protocol A group decreased during treatment (32,5% vs 25,2%), whereas the hematocrit value in protocol B group remained almost stable (38,7% vs 42,8%). The mean numbers of platelets remained stable in both groups while neutrophils increased in protocol A group and decreased in protocol B (p<0,05). Reticulocyte count increased during treatment in both groups, although only in protocol B group it was statistically significative (p<0,05). Our results suggest a similar efficacy between the two treatment protocols. Increasing doses of rHuEPO do not seem enhancing their effectiveness and the incidence of side effects.

The effect of Iron Supplying on VO2 MAX and Haematology Parameter on Menstrual Woman

NASA Astrophysics Data System (ADS)

Nailuvar Sinaga, Rika; Sari Harahap, Novita; Mediyana Sari, Rima

2018-03-01

One of the supporting factors to have good aerobic endurance requires high VO2 max levels supported by good quality and quantity level of Haematology parameter especially such as erythrocytes, hematocrit and hemoglobin. One of the components in hemoglobin is iron which functions as theoxygen transport to parts of all body required in the process of metabolism. The objective of this research was to find out the difference between VO2 Max and Haematology parameter between iron supplying and no iron supplyingonmenstrual woman. The type of this research is quasi experimental research with non-randomized control group Pretest-Postest Design. The subjectsarethe studentsat faculty of Sports Sciences, Medan State University with the criteria of female gender, monthly regular menstrual cycle, having the level of health and the level of training, willing to be a sample by filling out informed consent. The total number of research subjectsis twenty students, divided into two groups namely the treatment group and the control group. The hematology parameter was measuredby Haemotology analyzer and VO2 Max was measured by multi-stage run. The result showed that there was a significant effect of iron supplyingon the increase of erythrocyte level on menstrual women, hemotocrit, haemoglobin and an increase in VO2 Max. Iron supplying on menstrual woman has the effect on the increase of erythrocyte, hematocrit, hemoglobin level and VO2 Max

Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

PubMed Central

Haber, Zachary M.; Charles, Hearns W.; Erinjeri, Joseph P.; Deipolyi, Amy R.

2017-01-01

Conventional angiography is used to evaluate and treat possible sources of intraabdominal bleeding, though it may cause complications such as contrast-induced nephropathy (CIN). The study’s purpose was to identify factors predicting active extravasation and complications during angiography for acute intraabdominal bleeding. All conventional angiograms for acute bleeding (January 2013–June 2015) were reviewed retrospectively, including 75 angiograms for intraabdominal bleeding in 70 patients. Demographics, comorbidities, vital signs, complications within one month, and change in hematocrit (ΔHct) and fluids and blood products administered over the 24 h prior to angiography were recorded. Of 75 exams, 20 (27%) demonstrated extravasation. ΔHct was the only independent predictor of extravasation (p = 0.017), with larger ΔHct (−17%) in patients with versus those without extravasation (–1%) (p = 0.01). CIN was the most common complication, occurring in 10 of 66 angiograms (15%). Glomerular filtration rate (GFR) was the only independent predictor (p = 0.03); 67% of patients with GFR < 30, 29% of patients with GFR 30–60, and 8% of patients with GFR > 60 developed CIN. For patients with intraabdominal bleeding, greater ΔHct decrease over 24 h before angiography predicts active extravasation. Pre-existing renal impairment predicts CIN. Patients with large hematocrit declines should be triaged for rapid angiography, though benefits can be weighed with the risk of renal impairment. PMID:28420210

Small vessel hematocrit in ischemic myocardium

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gumm, D.C.; Cooper, S.M.; Marcus, M.L.

1986-03-01

As blood enters the microvasculature of normally perfused myocardium, there is a progressive decrease in small vessel hematocrit (SV Hct) due to RBC streaming in smaller branching vessels and the Fahraeus-Lindqvist effect. We hypothesized that if the coronary collateral circulation was composed of very small vessels branching from large parent vessels, plasma streaming would result in a further decrease of SV Hct in ischemic myocardium. Six open chest anesthetized dogs were studied. Plasma was labelled with /sup 59/FeCl siderophilin and RBC's with /sup 99/mTc to estimate SV Hct from myocardial biopsies. The LAD was occluded and cannulated for measurement ofmore » retrograde flow (arising presumably from proximal collaterals). The ischemic region was identified using the microsphere shadow technique. Collateral flow after LAD occlusion was 30 +- 12 ml/min 100g (x +- SE). Systemic Hct was 40 +- 1%. The Hct of blood from retrograde flow was 39 +- 1% (p = NS). Activity of /sup 59/FeCl and /sup 99/mTc in known quantities of blood were compared to myocardial biopsies to estimate SV Hct. Ischemic SV Hct was 23 +- 2% and non-ischemic SV Hct was 21 +- 1% (p = NS). We conclude that the size and branching pattern of coronary collaterals is such that plasma streaming in collaterals does not result in an additional decrease in SV Hct in ischemic myocardium.« less

Routine health monitoring in an aquatic species (Oryzias latipes) used in toxicological testing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Twerdok, L.E.; Beaman, J.R.; Curry, M.W.

1995-12-31

It is critical to establish baseline health endpoints in animal models used in toxicological studies. In mammalian models, procedures for monitoring the health status of test animals have been established and in use for many years; in many aquatic models, including medaka, much of this routine health screening has not been documented. Thus, the purpose of this study was to characterize routine health parameters in medaka and to identify parameters sensitive to changes in health status which could affect the suitability of animals for use in general toxicity and immunotoxicological studies. The endpoints assessed included histopathology (31 organs), identification ofmore » endogenous bacterial flora and, gross necropsy including body weight, length, hematocrit, leukocrit, and plasma immunoglobulin levels. Additional parameters included anterior kidney (the teleost bone marrow equivalent) weight and cell yields plus superoxide anion production. Histological findings included observation of age-related incidence of granulomatous lesions in a variety of organs. Multiple strains of Aeromonas and Pseudomonas were the predominant internal flora in healthy medaka. Hematocrit, leukocrit and plasma IgM levels were within the normal range for this species. Comparisons were made between healthy and handling-stressed fish. Evaluation of data collected to date suggest that leukocrit and superoxide anion production were the most sensitive indicators of the fish health status and suitability for use in general and/or immunotoxicological studies.« less

Effects of road type during transport on lamb welfare and meat quality in dry hot climates.

PubMed

Miranda-de la Lama, Genaro C; Monge, Paula; Villarroel, Morris; Olleta, Jose Luis; García-Belenguer, Sylvia; María, Gustavo A

2011-06-01

This study determined whether transporting lambs on paved (PR) or unpaved roads (UR) for 3 h had an effect on plasma stress indicators (cortisol, lactate, glucose, creatine kinase [CK], red blood cells, white blood cells, hematocrit, and neutrophil/lymphocyte [N/L] ratio) and instrumental meat quality (pH24, bruising score, water holding capacity [WHC], color, and texture). A total of 48 Rasa Aragonesa male lambs were used that were approximately 100 days old (12.5 kg ± 1.64, carcass weight). The results suggest that transport on unpaved roads had a significant influence on physiological and hematological stress parameters. Road type had a significant effect on all variables, except for white and red blood cells, and hematocrit levels. The UR lambs had significantly higher (at least p ≤ 0.01) cortisol, lactate, glucose, and CK levels and a higher N/L ratio than PR lambs. Meat from UR lambs had some dark-cutting characteristics, with a darker color, higher ultimate pH, and higher tenderness values than PR. In conclusion, lambs transported on unpaved roads had a more intense stress response and poorer meat quality than lambs transported on paved roads. An effort to improve the logistics associated with route planning is necessary to prevent welfare problems during transport to slaughter.

Immunological and Psychological Benefits of Aromatherapy Massage

PubMed Central

2005-01-01

This preliminary investigation compares peripheral blood cell counts including red blood cells (RBCs), white blood cells (WBCs), neutrophils, peripheral blood lymphocytes (PBLs), CD4+, CD8+ and CD16+ lymphocytes, CD4+/CD8+ ratio, hematocrit, humoral parameters including serum interferon-γ and interleukin-6, salivary secretory immunoglobulin A (IgA). Psychological measures including the State–Trait Anxiety Inventory (STAI) questionnaire and the Self-rating Depression Scale (SDS) between recipients (n = 11) of carrier oil massage and aromatherapy massage, which includes sweet almond oil, lavender oil, cypress oil and sweet marjoram oil. Though both STAI and SDS showed a significant reduction (P < 0.01) after treatment with aromatherapy and carrier massage, no difference between the aromatherapy and control massage was observed for STAI and SDS. Aromatherapy, in contrast to control massage, did not significantly reduce RBC count or hematocrit. However, aromatherapy massage showed a significant (P > 0.05) increase in PBLs, possibly due to an increase in CD8+ and CD16+ lymphocytes, which had significantly increased post-treatment (P < 0.01). Consequently, the CD4+/CD8+ ratio decreased significantly (P < 0.01). The paucity of such differences after carrier oil massage suggests that aromatherapy massage could be beneficial in disease states that require augmentation of CD8+ lymphocytes. While this study identifies the immunological benefits of aromatherapy massage, there is a need to validate the findings prospectively in a larger cohort of patients. PMID:15937558

Molt-associated changes in hematologic and plasma biochemical values and stress hormone levels in African penguins (Spheniscus demersus).

PubMed

Mazzaro, Lisa M; Meegan, Jenny; Sarran, Delphine; Romano, Tracy A; Bonato, Vinicius; Deng, Shibing; Dunn, J Lawrence

2013-12-01

Handling, including blood collection, has often been discouraged in molting penguins because it is considered an additional stress imposed on birds already experiencing major physiologic stress associated with molting. To evaluate the degree of physiologic stress posed by molting, we compared the hematologic and plasma biochemical values and hormone levels of molting and nonmolting African penguins, Spheniscus demersus. Five male and 5 female penguins randomly chosen were given complete physical examinations, were weighed, and blood samples were taken at 7 time points before, during, and after the molt. Data were analyzed by linear mixed-model analysis of variance. Throughout the study, behavior and appetite remained normal. Catecholamine levels were highly variable within and among subjects, whereas mean corticosterone levels were significantly different between baseline, molt, and postmolt values. Significant differences from baseline values were observed in many of the hematologic analytes; however, only decreases in hematocrit and red blood cell count values were considered clinically significant. Anemia due to experimentally induced blood loss as a possible cause of the significant hematologic changes was ruled out based on results of a follow-up control study during the nonmolt season, which showed no significant changes in hematocrit level or total red blood cell counts when using similar sampling protocols, which indicates that these changes were associated with molt.

Low-shear red blood cell oxygen transport effectiveness is adversely affected by transfusion and further worsened by deoxygenation in sickle cell disease patients on chronic transfusion therapy.

PubMed

Detterich, Jon; Alexy, Tamas; Rabai, Miklos; Wenby, Rosalinda; Dongelyan, Ani; Coates, Thomas; Wood, John; Meiselman, Herbert

2013-02-01

Simple chronic transfusion therapy (CTT) is a mainstay for stroke prophylaxis in sickle cell anemia, but its effects on hemodynamics are poorly characterized. Transfusion improves oxygen-carrying capacity, reducing demands for high cardiac output. While transfusion decreases factors associated with vasoocclusion, including percent hemoglobin (Hb)S, reticulocyte count, and circulating cell-free Hb, it increases blood viscosity, which reduces microvascular flow. The hematocrit-to-viscosity ratio (HVR) is an index of red blood cell oxygen transport effectiveness that varies with shear stress and balances the benefits of improved oxygen capacity to viscosity-mediated impairment of microvascular flow. We hypothesized that transfusion would improve HVR at high shear despite increased blood viscosity, but would decrease HVR at low shear. To test this hypothesis, we examined oxygenated and deoxygenated blood samples from 15 sickle cell patients on CTT immediately before transfusion and again 12 to 120 hours after transfusion. Comparable changes in Hb, hematocrit (Hct), reticulocyte count, and HbS with transfusion were observed in all subjects. Viscosity, Hct, and high-shear HVR increased with transfusion while low-shear HVR decreased significantly. Decreased low-shear HVR suggests impaired oxygen transport to low-flow regions and may explain why some complications of sickle cell anemia are ameliorated by CTT and others may be made worse. © 2012 American Association of Blood Banks.

A Rare Non-Hemolytic Case of Idiopathic Cold Agglutinin Disease.

PubMed

Erkus, Edip; Kocak, Mehmet Z; Aktas, Gulali; Ozen, Mehmet; Atak, Burcin M; Duman, Tuba T; Tekce, Buket K; Savli, Haluk

2018-06-01

Cold agglutinin disease is a very rare condition associated with agglutination of erythrocytes in cold environment usually due to IgM type antibodies. Other than hemolytic anemias, it may interfere with routine hemogram tests due to miscalculation of red blood cell count (RBC) and other hemogram parameters calculated with involvement of RBC. Awareness of the condition is important to overcome laboratory errors. We studied a peripheral blood smear and repeated the hemogram test at 37°C to establish the diagnosis of cold agglutinin disease. Initial hemogram test results of the fifty-eight year-old man was as follows: RBC: 1.34 M/µL, hemoglobin (Hb): 12.4 g/dL, hematocrit (Htc): 11.8%, mean corpuscular hemoglobin (MCH): 92.4 pg, and mean corpuscular hemoglobin concentration (MCHC): 105 gr/dL. Despite the standard indirect Coombs test being negative, repeated tests at room temperature was 4+. We suspected cold agglutinin disease and repeated the hemogram test using the Bain-Marie method at 37°C and the test results showed RBC: 3.4 M/µL, hemoglobin: 12.6 g/dL, hematocrit: 30.2%, MCH: 31.7 pg, and MCHC: 41.8 g/dL. Inappropriate hemogram results may be a sign of underlying cold agglutinin disease. Hemolytic anemia not always accompanies the disease; however, cold exposure may trigger erythrocyte agglutination in vitro and may cause erratic laboratory results.

Fetal hydrops and other variables associated with the fetal hematocrit decrease after the first intrauterine transfusion for red cell alloimmunization.

PubMed

Lobato, Gustavo; Soncini, Cristina Silveira

2008-01-01

To evaluate the influence of fetal hydrops and other variables on fetal hematocrit (Hct) decrease after the first intrauterine transfusion (IUT) in alloimmunized pregnancies. From 1996 to 2006, the data of all alloimmunized pregnancies submitted to IUT were assessed. Exclusion criteria included: fetuses submitted to intraperitoneal transfusion; pregnancies complicated by other fetal abnormalities; pregnancies submitted to only one IUT, and cases in which posttransfusion or pretransfusion blood samples were not obtained. Linear regression models were implemented to assess the relationship between the rate of Hct fall after the first IUT and the following variables: fetal hydrops; antibody titer; gestational age at the first IUT; number of days between the first and second IUT; pretransfusion and posttransfusion fetal Hct values. Fifty fetuses fulfilled the study criteria. The fetal Hct decrease after the first IUT was 1.21 (range 0.18-2.3) %/day. The variables independently associated with the fetal Hct drop after the first IUT were the fetal hydrops (p = 0.000), the pretransfusion fetal Hct (p = 0.001) and the posttransfusion fetal Hct (p = 0.016). Fetal hydrops, pretransfusion fetal Hct and posttransfusion fetal Hct seem to influence the fetal Hct decrease between the first and second IUT. These findings may be helpful for estimating the rate of fetal Hct drop and programming the following IUT. Copyright 2008 S. Karger AG, Basel.

Cl- channel blockers NPPB and niflumic acid blunt Ca(2+)-induced erythrocyte 'apoptosis'.

PubMed

Myssina, Svetlana; Lang, Philipp A; Kempe, Daniela S; Kaiser, Stefanie; Huber, Stephan M; Wieder, Thomas; Lang, Florian

2004-01-01

Exposure to Ca2+ ionophore ionomycin, osmotic shock, oxidative stress and glucose depletion trigger cell shrinkage and scramblase-mediated phosphatidylserine exposure at the outer leaflet of the erythrocyte cell membrane. The effects are partially due to activation of GARDOS channels and subsequent cellular K+ loss leading not only to cell shrinkage but also participating in the triggering of erythrocyte scramblase. As conductive loss of K+ would depend on the parallel loss of anions we hypothesised that activation of scramblase is similarly dependent on the activity of Cl- channels. To test this hypothesis, we used Cl- channel blockers NPPB and niflumic acid. It is shown here that treatment of erythrocytes with 1 microM ionomycin leads to cellular K+ loss, decrease of hematocrit and decrease of forward scatter in FACS analysis reflecting cell shrinkage as well as increase of annexin positive cells reflecting phosphatidylserine exposure. Those events were significantly blunted in the presence of 100 microM NPPB by 34% (K+ loss), 45% (hematocrit), 32% (forward scatter) and 69% (annexin binding), or in the presence of 100 microM niflumic acid by 15% (forward scatter) and 45% (annexin binding), respectively. Moreover, oxidative stress triggered annexin binding which was again significantly inhibited (by 51%) in the presence of 100 microM NPPB. In conclusion, Cl- channels presumably participate in the regulation of erythrocyte 'apoptosis'. Copyright 2004 S. Karger AG, Basel

Complex Cardiac Surgery on Patients with a Body Weight of Less Than 5 kg without Donor Blood Transfusion

PubMed Central

Boettcher, Wolfgang; Dehmel, Frank; Redlin, Mathias; Miera, Oliver; Musci, Michele; Cho, Mi-Young; Photiadis, Joachim

2017-01-01

Abstract: Performing safe cardiac surgery in neonates or infants whose parents are Jehovah's Witnesses is only possible in a coordinated team approach. An unconditional prerequisite is a cardiopulmonary bypass (CPB) circuit with a very low priming volume to minimize hemodilution. In the past decade, we have developed a functional blood-sparing approach at our institution. The extracorporeal circuit was miniaturized. This had to be recently adapted, faced with a challenge associated with the switch to high-volume crystalloid cardioplegia. A filtration circuit was added. Here, we report an open heart surgery on three consecutive children of Jehovah's Witness parents with a body weight of 2.7, 4.5, and 4.8 kg, respectively. Procedures consisted of one arterial switch operation and two repairs of complete atrioventricular septal defects. Our static priming volume of less than 90 mL resulted in a nadir hematocrit during CPB of 27.7% (Hb 8.9 g/dL) in a patient which happened to have the lowest body weight of 2.7 kg. The two other patients had their lowest hematocrit at 31.4% (Hb 10.2 g/dL). The three children could be treated without any kind of transfusion of blood which had left the circulation or its extensions, in accordance with the parents' wishes, and enjoy favorable outcomes without transfusion of blood products during their entire hospital stay. PMID:28638157

Trains of Red Blood Cells in a bi-dimensional microflows

NASA Astrophysics Data System (ADS)

Viallat, Annie; Iss, Cecile; Held, Delphine; Badens, Catherine; Charrier, Anne; Helfer, Emmanuèle; CINaM Team; Dpt de Génétique Médicale Team

2017-11-01

In the vascular microcirculation RBC distribution is uneven in the direction normal to the blood flow, as first evidenced by the existence of a cell-free layer near the vessel wall. In addition, the most rigid cells such as white blood cells and platelets are known to segregate to the walls while flowing in wide channels. We use microfluidic bi-dimensional channels (60 µm wide, 8 µm high, 5 mm long) to explore the flow structure in RBC suspensions at several hematocrits, flow rates and RBC rigidities. We observe the dynamical formation of RBC clusters and their motion along the flow direction. We study healthy RBCs, RBCs stiffened with glutaraldehyde, mixture of healthy and stiffened RBCs and RBC from sickle cell patients. Initially dispersed healthy RBCs organize, while flowing along the channel, into series of parallel trains. The train length depends on RBC hematocrit and flow rate. Stiffened RBCs do not cluster and mainly display tumbling motion like rigid disks. They destabilize existing trains and are preferentially observed close to the walls. We compared our results to that observed in microcapillaries, where trains of RBCs entirely fill in width the microchannel. This work has been carried out thanks to the support of the A*MIDEX project (n° ANR-11-IDEX-0001-02) funding by the ''Investissements d'Avenir'' French Government program, ma,ged by ANR.

Markers of iron deficiency in patients with polycythemia vera receiving ruxolitinib or best available therapy.

PubMed

Verstovsek, Srdan; Harrison, Claire N; Kiladjian, Jean-Jacques; Miller, Carole; Naim, Ahmad B; Paranagama, Dilan C; Habr, Dany; Vannucchi, Alessandro M

2017-05-01

Polycythemia vera (PV) is characterized by erythropoiesis and JAK2-activating mutations, with increased risks of morbidity and mortality. Most patients with PV are iron deficient, and treatment often includes hematocrit control with phlebotomy, which may exacerbate iron deficiency-associated complications. The phase 3 RESPONSE trial evaluated the JAK1/JAK2 inhibitor ruxolitinib (n=110) versus best available therapy (BAT; n=112) in patients with PV who were hydroxyurea-resistant/intolerant. Ruxolitinib was superior to BAT for hematocrit control, reduction in splenomegaly, and blood count normalization. This exploratory analysis, the first to evaluate iron status in a prospective study of patients with PV, investigated ruxolitinib effects on 7 serum iron markers and iron deficiency-related patient-reported outcomes (PRO). Among patients with evidence of baseline iron deficiency, ruxolitinib was associated with normalization of iron marker levels, compared with lesser improvement with BAT. Iron levels remained stable in ruxolitinib patients with normal iron levels at baseline. Regardless of baseline iron status, treatment with ruxolitinib was associated with improvements in concentration problems, cognitive function, dizziness, fatigue, headaches, and inactivity, although improvements were generally greater among patients with baseline iron deficiency. The improvements in iron deficiency markers and PROs observed with ruxolitinib are suggestive of clinical benefits that warrant further exploration. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Lead Exposures and Biological Responses in Military Weapons Systems: Aerosol Characteristics and Acute Lead Effects among U.S. Army Artilleryman - Final Report

DTIC Science & Technology

1993-03-01

change in hematocra from BL to IPE and the change in blood lead concentration from BL to DPE ........................ 87 32 Relationship between the...change in hematocrit from IPE to DPE and the change in blood lead concentration from BL to DPE ....................... 87 33 Relationship between the...change in FEP concentration from BL to IPE and the change in blood lead concentration from BL to DPE ................. 89 34 Relationship between the

Clinical pathology results from cranes with experimental West Nile Virus infection

USGS Publications Warehouse

Olsen, Glenn H.

2011-01-01

Sandhill cranes (Grus canadensis) were vaccinated for and then challenged with West Nile virus. Resulting titers demonstrated protection in the vaccinated-challenged cranes as compared to the unvaccinated-challenged cranes. Clinical pathology results showed challenged cranes, whether vaccinated or not, had a decrease in their hematocrits and an elevation of 2.5-fold in their white blood cell counts as compared to unchallenged control sandhill cranes. No differences were apparent in the differential counts of heterophils and lymphocytes.

Red blood cells in thrombosis.

PubMed

Byrnes, James R; Wolberg, Alisa S

2017-10-19

Red blood cells (RBCs) have historically been considered passive bystanders in thrombosis. However, clinical and epidemiological studies have associated quantitative and qualitative abnormalities in RBCs, including altered hematocrit, sickle cell disease, thalassemia, hemolytic anemias, and malaria, with both arterial and venous thrombosis. A growing body of mechanistic studies suggests that RBCs can promote thrombus formation and enhance thrombus stability. These findings suggest that RBCs may contribute to thrombosis pathophysiology and reveal potential strategies for therapeutically targeting RBCs to reduce thrombosis. © 2017 by The American Society of Hematology.

Feasibility of Standardizing Automated Laboratory Analyzers On-Board U.S. Naval Ships

DTIC Science & Technology

1999-12-01

K), Chloride (Cl), Carbon Dioxide (C02) Fecal Leukocytes Feces for Ova, Cysts and Parasites Glucose Hematocrit Occult Blood Partial...Culture, Wound Culture, Throat Electrolytes (NA, K, Cl, C02) Fecal Leukocytes Feces for Ova, Cysts and Parasites Fibrinogen and FSP Gonorrhea...0.00 Drug screen, urine 0 0.00 0 0.00 Electrolytes 18 4.83 202 11.66 Fecal leukocytes 6 1.61 5 0.29 Fibrinogen/FSP 0 0.00 4 .023 GC

Weights, hematology, and serum chemistry of free-ranging brown boobies (Sula leucogaster) in Johnston Atoll, Central Pacific.

PubMed

Work, T M

1999-03-01

Hematologic and serum chemistry values are reported for 105 brown boobies (Sula leucogaster) from Johnston Atoll, Central Pacific. Hematocrit, estimated total plasma solids, total and differential white cell counts, serum glucose, calcium, phosphorus, uric acid, total protein, albumin, globulin, aspartate aminotransferase, and creatinine phosphokinase were analyzed. Hematologic and serum chemistry values varied with age and sex. Values were compared with those of red-footed boobies and other tropical and temperate marine pelecaniforms.

Endocrinological Responses to the Administration of Nicotine: Interactions with Drug Initiation, Conditioned Effects, and Conditions of Stress, Volume II

DTIC Science & Technology

1984-01-07

Benowitz, Kuyt and Jacob, 1982; Feyerabend S Russe l l , 1978). 273 10 Measurement of hematocrit was performed as follows: 1) after centrifugation of...Incentives, Washington, D.C.: Winston. Feyerabend , C. , & Russell, M. A. H. (1978). Effect of urinary pH and nicotine excretion rate can plasma...s Feyerabend , c. (1978). Cigarette smoking: A dependence on high-nicotine boll. Drug Metabolism Review, 8_, 29-57. Russell, M. A. H. , Wilson, C

Effects of Crystalloid and Colloid Resuscitation on Hemorrhage-Induced Vascular Hyporesponsiveness to Norepinephrine in the Rat

DTIC Science & Technology

2003-05-01

SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT SAR 18. NUMBER OF PAGES 10 19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b ...the basis of the following equation: The relative change in blood flow after NE (A B )/A, where A blood flow before NE administration and B the...baseline and at the end of the experiment were used for determination of hematocrit (Hct) and blood Na, K , and Cl according to standard clinical

Blood Ferrokinetics in Normal Man*

PubMed Central

Hosain, Fazle; Marsaglia, George; Finch, Clement A.

1967-01-01

The clearance of radioiron from plasma and its appearance in circulating erythrocytes in normal subjects are studied. The importance of correcting for plasma iron fluctuations and for mean body hematocrit is illustrated. The data are analyzed by probability theory to determine relationships between intravascular and extravascular iron. Two refluxes are described, one of about 7 particles of every 100 leaving the plasma, and the second of about 23. The return times of these are about 5 hours and 8 days, respectively. Images PMID:6018746

Weights, hematology and serum chemistry of free-ranging brown boobies (Sula leucogaster) in Johnston Atoll, Central Pacific

USGS Publications Warehouse

Work, Thierry M.

1999-01-01

Hematologic and serum chemistry values are reported for 105 brown boobies (Sula leucogaster) from Johnston Atoll, Central Pacific. Hematocrit, estimated total plasma solids, total and differential white cell counts, serum glucose, calcium, phosphorus, uric acid, total protein, albumin, globulin, aspartate aminotransferase, and creatinine phosphokinase were analyzed. Hematologic and serum chemistry values varied with age and sex. Values were compared with those of red-footed boobies and other tropical and temperate marine pelecaniforms.

Expression of vascular endothelial growth factor in third-trimester placentas is not increased in growth-restricted fetuses.

PubMed

Tse, J Y; Lao, T T; Chan, C C; Chiu, P M; Cheung, A N

2001-01-01

Vascular endothelial growth factor (VEGF) is considered the growth factor that stimulates vasculogenesis and angiogenesis. Recent studies have demonstrated its role in regulating placental growth and invasion. Its expression can be upregulated by hypoxia. Intrauterine growth restriction (IUGR) is thought to be associated with inadequate placental perfusion, which might result from a failure in the development of the villous vascular network. Our present study was undertaken to examine the relationship between VEGF expression and IUGR in pregnancies with preserved umbilical artery end-diastolic flow. VEGF Expression was determined by immunohistochemical analysis of placentas from 17 pregnancies with normal infant birth weight and 17 pregnancies complicated by IUGR. We found no significant differences in the expression of VEGF in villous syncytiotrophoblasts and intermediate trophoblasts in maternal decidua between IUGR and normal pregnancies. However, in both groups there was a strong correlation in the expression of VEGF with villous syncytiotrophoblasts and intermediate trophoblasts. In normal and IUGR pregnancies the infants' Apgar scores at birth were significantly correlated with VEGF staining in both syncytiotrophoblasts and intermediate trophoblasts (P < .05). A strong correlation also was found between cord hematocrit and VEGF staining in villous syncytiotrophoblasts (P < .05), but VEGF staining in intermediate trophoblasts was not correlated with cord hemoglobin or hematocrit. Our results suggest that VEGF acts in an autocrine and paracrine fashion in both normal and IUGR placentas, and its expression can have an effect on the well being of the infant at birth.

Myocardial perfusion quantification using simultaneously acquired 13 NH3 -ammonia PET and dynamic contrast-enhanced MRI in patients at rest and stress.

PubMed

Kunze, Karl P; Nekolla, Stephan G; Rischpler, Christoph; Zhang, Shelley HuaLei; Hayes, Carmel; Langwieser, Nicolas; Ibrahim, Tareq; Laugwitz, Karl-Ludwig; Schwaiger, Markus

2018-04-19

Systematic differences with respect to myocardial perfusion quantification exist between DCE-MRI and PET. Using the potential of integrated PET/MRI, this study was conceived to compare perfusion quantification on the basis of simultaneously acquired 13 NH 3 -ammonia PET and DCE-MRI data in patients at rest and stress. Twenty-nine patients were examined on a 3T PET/MRI scanner. DCE-MRI was implemented in dual-sequence design and additional T 1 mapping for signal normalization. Four different deconvolution methods including a modified version of the Fermi technique were compared against 13 NH 3 -ammonia results. Cohort-average flow comparison yielded higher resting flows for DCE-MRI than for PET and, therefore, significantly lower DCE-MRI perfusion ratios under the common assumption of equal arterial and tissue hematocrit. Absolute flow values were strongly correlated in both slice-average (R 2  = 0.82) and regional (R 2  = 0.7) evaluations. Different DCE-MRI deconvolution methods yielded similar flow result with exception of an unconstrained Fermi method exhibiting outliers at high flows when compared with PET. Thresholds for Ischemia classification may not be directly tradable between PET and MRI flow values. Differences in perfusion ratios between PET and DCE-MRI may be lifted by using stress/rest-specific hematocrit conversion. Proper physiological constraints are advised in model-constrained deconvolution. © 2018 International Society for Magnetic Resonance in Medicine.

Inflow/outflow boundary conditions for particle-based blood flow simulations: Application to arterial bifurcations and trees

DOE PAGES

Lykov, Kirill; Li, Xuejin; Lei, Huan; ...

2015-08-28

When blood flows through a bifurcation, red blood cells (RBCs) travel into side branches at different hematocrit levels, and it is even possible that all RBCs enter into one branch only, leading to a complete separation of plasma and R- BCs. To quantify this phenomenon via particle-based mesoscopic simulations, we developed a general framework for open boundary conditions in multiphase flows that is effective even for high hematocrit levels. The inflow at the inlet is duplicated from a fully developed flow generated in a pilot simulation with periodic boundary conditions. The outflow is controlled by adaptive forces to maintain themore » flow rate and velocity gradient at fixed values, while the particles leaving the arteriole at the outlet are removed from the system. Upon valida- tion of this approach, we performed systematic 3D simulations to study plasma skimming in arterioles of diameters 20 to 32 microns. For a flow rate ratio 6:1 at the branches, we observed the \\all-or-nothing" phenomenon with plasma only entering the low flow rate branch. We then simulated blood-plasma separation in arteriolar bifurcations with different bifurcation angles and same diameter of the daughter branches. Our simulations predict a significant increase in RBC flux through the main daughter branch as the bifurcation angle is increased. Lastly, we demonstrated the new methodology for simulating blood flow in ves- sels with multiple inlets and outlets, constructed using an angiogenesis model.« less

Case study: Idiopathic hemothorax in a patient with status asthmaticus.

PubMed

Ricketti, Peter A; Unkle, David W; Lockey, Richard; Cleri, Dennis J; Ricketti, Anthony J

2016-09-01

Idiopathic spontaneous hemothorax has been rarely described in the literature. A case of status asthmaticus and spontaneous hemothorax is described in a 29-year-old female of African descent who presented to the emergency room after 2 days of severe cough productive of yellow sputum, otalgia, sore throat, subjective fevers, chills, headache, progressive wheezing, chest tightness and dyspnea. She had a history of 7 years of asthma and was non-adherent with her controller asthma medications. Prophylactic subcutaneous administration of enoxaparin 40 milligrams was initiated upon hospitalization. The patient initially had a normal chest radiograph but subsequently developed a large, left hemothorax that required tube thoracostomy placement followed by video-assisted thoracoscopic surgery (VATS). The patient was transferred to the Intensive Care Unit (ICU) and tube thoracostomy resulted in evacuation of 1,400 milliliters of blood-like fluid, which had a pleural fluid hematocrit greater than 50% of the serum hematocrit. A contrast-enhanced computed tomography (CT) scan of the chest did not reveal any source for the bleeding and a technetium bone scan of the chest was normal. The patient required transfusion of 5 units of packed red blood cells. She was then taken to the operating room for VATS because of continued chest tube drainage (3,200 milliliters of fluid over a 48-hour period). The etiology of the hemothorax was unknown despite surgical exploration but was felt to be secondary to cough and bronchospasm associated with status asthmaticus.

Hemodynamics in a Pediatric Ascending Aorta Using a Viscoelastic Pediatric Blood Model

PubMed Central

Good, Bryan C.; Deutsch, Steven; Manning, Keefe B.

2015-01-01

Congenital heart disease is the leading cause of infant death in the United States with over 36,000 newborns affected each year. Despite this growing problem there are few mechanical circulatory support devices designed specifically for pediatric and neonate patients. Previous research has been done investigating pediatric ventricular assist devices (PVADs) assuming blood to be a Newtonian fluid in computational fluid dynamics (CFD) simulations, ignoring its viscoelastic and shear-thinning properties. In contrast to adult VADs, PVADs may be more susceptible to hemolysis and thrombosis due to altered flow into the aorta, and therefore, a more accurate blood model should be used. A CFD solver that incorporates a modified Oldroyd-B model designed specifically for pediatric blood is used to investigate important hemodynamic parameters in a pediatric aortic model under pulsatile flow conditions. These results are compared to Newtonian blood simulations at three physiological pediatric hematocrits. Minor differences are seen in both velocity and WSS during early stages of the cardiac systole between the Newtonian and viscoelastic models. During diastole, significant differences are seen in the velocities in the descending aorta (up to 12%) and in the aortic branches (up to 30%) between the two models. Additionally, peak wall shear stress (WSS) differences are seen between the models throughout the cardiac cycle. At the onset of diastole, peak WSS differences of 43% are seen between the Newtonian and viscoelastic model and between the 20 and 60% hematocrit viscoelastic models at peak systole of 41%. PMID:26159560

Inflow/outflow boundary conditions for particle-based blood flow simulations: Application to arterial bifurcations and trees

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lykov, Kirill; Li, Xuejin; Lei, Huan

When blood flows through a bifurcation, red blood cells (RBCs) travel into side branches at different hematocrit levels, and it is even possible that all RBCs enter into one branch only, leading to a complete separation of plasma and R- BCs. To quantify this phenomenon via particle-based mesoscopic simulations, we developed a general framework for open boundary conditions in multiphase flows that is effective even for high hematocrit levels. The inflow at the inlet is duplicated from a fully developed flow generated in a pilot simulation with periodic boundary conditions. The outflow is controlled by adaptive forces to maintain themore » flow rate and velocity gradient at fixed values, while the particles leaving the arteriole at the outlet are removed from the system. Upon valida- tion of this approach, we performed systematic 3D simulations to study plasma skimming in arterioles of diameters 20 to 32 microns. For a flow rate ratio 6:1 at the branches, we observed the \\all-or-nothing" phenomenon with plasma only entering the low flow rate branch. We then simulated blood-plasma separation in arteriolar bifurcations with different bifurcation angles and same diameter of the daughter branches. Our simulations predict a significant increase in RBC flux through the main daughter branch as the bifurcation angle is increased. Lastly, we demonstrated the new methodology for simulating blood flow in ves- sels with multiple inlets and outlets, constructed using an angiogenesis model.« less

Determinants of systemic zero-flow arterial pressure.

PubMed

Brunner, M J; Greene, A S; Sagawa, K; Shoukas, A A

1983-09-01

Thirteen pentobarbital-anesthetized dogs whose carotid sinuses were isolated and perfused at a constant pressure were placed on total cardiac bypass. With systemic venous pressure held at 0 mmHg (condition 1), arterial inflow was stopped for 20 s at intrasinus pressures of 50, 125, and 200 mmHg. Zero-flow arterial pressures under condition 1 were 16.2 +/- 1.3 (SE), 13.8 +/- 1.1, and 12.5 +/- 0.8 mmHg, respectively. In condition 2, the venous outflow tube was clamped at the instant of stopping the inflow, causing venous pressure to rise. The zero-flow arterial pressures were 19.7 +/- 1.3, 18.5 +/- 1.4, and 16.4 +/- 1.2 mmHg for intrasinus pressures of 50, 125, and 200 mmHg, respectively. At all levels of intrasinus pressure, the zero-flow arterial pressure in condition 2 was higher (P less than 0.005) than in condition 1. In seven dogs, at an intrasinus pressure of 125 mmHg, epinephrine increased the zero-flow arterial pressure by 3.0 mmHg, whereas hexamethonium and papaverine decreased the zero-flow arterial pressure by 2 mmHg. Reductions in the hematocrit from 52 to 11% resulted in statistically significant changes (P less than 0.01) in zero-flow arterial pressures. Thus zero-flow arterial pressure was found to be affected by changes in venous pressure, hematocrit, and vasomotor tone. The evidence does not support the literally interpreted concept of the vascular waterfall as the model for the finite arteriovenous pressure difference at zero flow.

Inflow/Outflow Boundary Conditions for Particle-Based Blood Flow Simulations: Application to Arterial Bifurcations and Trees.

PubMed

Lykov, Kirill; Li, Xuejin; Lei, Huan; Pivkin, Igor V; Karniadakis, George Em

2015-08-01

When blood flows through a bifurcation, red blood cells (RBCs) travel into side branches at different hematocrit levels, and it is even possible that all RBCs enter into one branch only, leading to a complete separation of plasma and RBCs. To quantify this phenomenon via particle-based mesoscopic simulations, we developed a general framework for open boundary conditions in multiphase flows that is effective even for high hematocrit levels. The inflow at the inlet is duplicated from a fully developed flow generated in a pilot simulation with periodic boundary conditions. The outflow is controlled by adaptive forces to maintain the flow rate and velocity gradient at fixed values, while the particles leaving the arteriole at the outlet are removed from the system. Upon validation of this approach, we performed systematic 3D simulations to study plasma skimming in arterioles of diameters 20 to 32 microns. For a flow rate ratio 6:1 at the branches, we observed the "all-or-nothing" phenomenon with plasma only entering the low flow rate branch. We then simulated blood-plasma separation in arteriolar bifurcations with different bifurcation angles and same diameter of the daughter branches. Our simulations predict a significant increase in RBC flux through the main daughter branch as the bifurcation angle is increased. Finally, we demonstrated the effectiveness of the new methodology in simulations of blood flow in vessels with multiple inlets and outlets, constructed using an angiogenesis model.

Alterations in malondialdehyde levels and laboratory parameters among methamphetamine abusers.

PubMed

Suriyaprom, Kanjana; Tanateerabunjong, Rossukon; Tungtrongchitr, Anchalee; Tungtrongchitr, Rungsunn

2011-12-01

To determine the concentrations of malondialdehyde, biochemical, and hematological parameters among methamphetamine abusers compared with a healthy control group and to evaluate the association between malondialdehyde and biochemical-hematological parameters. The concentrations of malondialdehyde, lipids, liver enzymes, albumin, blood urea nitrogen, creatinine, and hematological measurements were determined in 60 methamphetamine abusers and 60 controls. Significantly higher levels of malondialdehyde were found in the methamphetamine abusers than the controls [2.45 (2.12-2.81) vs. 1.41 (1.15-2.08)]. The levels ofalanine aminotransferase and alkaline phosphatase and white blood cell and platelet counts of the methamphetamine abusers were significantly elevated (p-value < 0.05) compared with the controls. Meanwhile, the levels of hemoglobin, hematocrit, albumin and body mass index were significantly lower among the methamphetamine-abusing group than the control group (p-value < 0.05). It was found that higher numbers of methamphetamine tablets per day were associated with higher malondialdehyde concentrations in methamphetamine abusers, and that malondialdehyde concentration inversely correlated with albumin level (r = -0.458, p-value < 0.05). Stepwise multiple regression analysis revealed that number of methamphetamine tablets per day, white blood cell count and albumin level were independent predictors of malondialdehyde level (p-value < 0.05). Methamphetamine abuse is related to increased lipid peroxidation, changes in inflammatory marker level, increase in liver enzymes, and decrease in hemoglobin and hematocrit concentrations. These effects may be early signs of the development of diseases associated with methamphetamine abuse.

The Effect of Growing Rod Treatment on Hemoglobin and Hematocrit Levels in Early-onset Scoliosis.

PubMed

Barrett, Kody K; Lee, Christopher; Myung, Karen; Johnston, Charles; Shah, Suken A; Akbarnia, Behrooz A; Skaggs, David L

2016-09-01

This study examines preoperative hemoglobin (Hgb) and hematocrit (Hct) levels in a group of early-onset scoliosis (EOS) patients and the effect of distraction-based growing rods (GRs) on these levels. Children with EOS are at risk for respiratory insufficiency and chronic hypoxemia. Increased Hgb and Hct levels have been identified as surrogate markers for chronic hypoxemia. A study of patients who underwent VEPTR surgery showed a significant decrease in Hgb levels following surgery. Data were retrospectively collected on 66 EOS patients without confounding respiratory issues or oxygen dependence who were treated with GRs at 5 institutions. Average age at initial surgery was 5.5 years. Patients were followed for a minimum of 2 years (average 3.7 y). Preoperative and postoperative Hgb and Hct levels were converted to Z-scores based on age-adjusted mean blood indices and were compared using a paired t test. The prevalence of elevated Hgb and Hct levels (Z-score >2) preoperatively was 15% (10/66) and 19% (12/64), respectively. The average Hgb Z-score decreased from 0.20 to -0.31 (P=0.005) 6 to 24 months following surgery and the Hct Z-score decreased from 0.31 to -0.28 (P=0.002) 6 to 24 months following surgery. Following distraction-based GR treatment of children with EOS there was a significant decrease in both their Hgb and Hct. This is a physiological marker of decreased hypoxemia and improved pulmonary function. Level III-therapeutic study.

Acute kidney injury after non-cardiovascular surgery: risk factors and impact on development of chronic kidney disease and long-term mortality.

PubMed

Pourafkari, Leili; Arora, Pradeep; Porhomayon, Jahan; Dosluoglu, Hasan H; Arora, Preksha; Nader, Nader D

2018-05-03

To identify factors associated with acute kidney injury (AKI) and its progression to chronic kidney disease (CKD) in a non-cardiac/non-vascular surgery setting. This study examined the Veterans Affairs Surgical Quality database for surgical entries between 2000-2014. Demographics, comorbidities, laboratory findings and hospital outcomes were assessed. The primary end-point was the occurrence of AKI, defined as an increase of ≥0.3 mg/dL, 48 h post-operatively. Major adverse cardiac event (MACE) was defined as the composite first occurrence of myocardial infarction, cardiac arrest, and death in 30 days (secondary end-point) and was compared between two groups. Rates of progression to CKD in 1 year and long-term survival were examined. Occurrence of AKI 48 h post-operatively. AKI was documented in 8.5% of patients. Age, diabetes, and chronic obstructive pulmonary disease, chronic kidney disease, platelet count, serum albumin level, and duration of surgery were identified as independent predictors of AKI. In total, 6.4% patients developed MACE, which was more frequent in patients with AKI (p < .001). Age and pre-operative hematocrit <30% were independent predictors of progression to CKD. Pre-operative hematocrit with a cut-off value of 30% was the only modifiable factor to predict the long-term survival. Development of AKI is associated with increased odds of various post-operative complications and long-term renal insufficiency and mortality.

The CentriMag: a new optimized centrifugal blood pump with levitating impeller.

PubMed

Mueller, Juerg Peter; Kuenzli, Andreas; Reuthebuch, Oliver; Dasse, Kurt; Kent, Stella; Zuend, Gregor; Turina, Marko Ivan; Lachat, Mario Louis

2004-01-01

Blood pumps are routinely used for circulatory and pulmonary support. However, blood trauma and pump failure remain severe drawbacks of currently available pump models. This study evaluated the first clinical application of a new, totally bearingless centrifugal blood pump (CentriMag). A centrifugal pump consisting of an electromagnetic suspended impeller was used as a blood pump during beating-heart coronary artery bypass grafting in 11 patients (mean weight, 77.4 kg). Heparin in a bolus of 150 IU/kg body weight was administered, and activated clotting time was maintained at approximately 180 to 250 seconds during extracorporeal circulation. Pump-induced blood trauma was evaluated by measurement of plasma free hemoglobin (PFH), lactate dehydrogenase (LDH), hematocrit, total bilirubin, and platelet levels. Mean pump flow was 3.3 +/- 0.62 L/min, and mean pressure gradient through the oxygenator was 69 +/- 4 mm Hg. No pump dysfunction occurred during a mean application time of 105 +/- 26 minutes. Inspection of the pump housings showed no internal thrombus formation despite low-dose heparinization. Only slight hemolysis was observed with a mean PFH level of 1.96 micromol/L; LDH, 460 U/L; hematocrit, 33%; total bilirubin, 25 micromol/L; and platelets, 191 x 10(3)/microL. The bearingless CentriMag blood pump is a safe and reliable new device that produces only minimal hemolysis. It seems to be suited for long-term evaluation as a blood pump for extracorporeal membrane oxygenation or as ventricular assist device.

Impaired left ventricular systolic function and increased brachial-ankle pulse-wave velocity are independently associated with rapid renal function progression.

PubMed

Chen, Szu-Chia; Lin, Tsung-Hsien; Hsu, Po-Chao; Chang, Jer-Ming; Lee, Chee-Siong; Tsai, Wei-Chung; Su, Ho-Ming; Voon, Wen-Chol; Chen, Hung-Chun

2011-09-01

Heart failure and increased arterial stiffness are associated with declining renal function. Few studies have evaluated the association between left ventricular ejection fraction (LVEF) and brachial-ankle pulse-wave velocity (baPWV) and renal function progression. The aim of this study was to assess whether LVEF<40% and baPWV are associated with a decline in the estimated glomerular filtration rate (eGFR) and the progression to a renal end point of ≥25% decline in eGFR. This longitudinal study included 167 patients. The baPWV was measured with an ankle-brachial index-form device. The change in renal function was estimated by eGFR slope. The renal end point was defined as ≥25% decline in eGFR. Clinical and echocardiographic parameters were compared and analyzed. After a multivariate analysis, serum hematocrit was positively associated with eGFR slope, and diabetes mellitus, baPWV (P=0.031) and LVEF<40% (P=0.001) were negatively associated with eGFR slope. Forty patients reached the renal end point. Multivariate, forward Cox regression analysis found that lower serum albumin and hematocrit levels, higher triglyceride levels, higher baPWV (P=0.039) and LVEF<40% (P<0.001) were independently associated with progression to the renal end point. Our results show that LVEF<40% and increased baPWV are independently associated with renal function decline and progression to the renal end point.

Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss.

PubMed

Volquind, Daniel; Zardo, Remi Antônio; Winkler, Bruno Costamilan; Londero, Bruno Bertagnolli; Zanelatto, Natália; Leichtweis, Gisele Perondi

2016-01-01

The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis in primary total knee replacement. 62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2.5g of intravenous tranexamic acid (Group TA) or saline (Group GP), 5min before opening the pneumatic tourniquet, respectively. Hemoglobin, hematocrit, and blood loss were recorded 24h after surgery. Deep vein thrombosis was investigated during patient's hospitalization and 15 and 30 days after surgery in review visits. There was no demographic difference between groups. Group TA had 13.89% decreased hematocrit (p=0.925) compared to placebo. Group TA had a decrease of 12.28% (p=0.898) in hemoglobin compared to Group GP. Group TA had a mean decrease of 187.35mL in blood loss (25.32%) compared to group GP (p=0.027). The number of blood transfusions was higher in Group GP (p=0.078). Thromboembolic events were not seen in this study. Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

The efficiency of therapeutic erythrocytapheresis compared to phlebotomy: a mathematical tool for predicting response in hereditary hemochromatosis, polycythemia vera, and secondary erythrocytosis.

PubMed

Evers, Dorothea; Kerkhoffs, Jean-Louis; Van Egmond, Liane; Schipperus, Martin R; Wijermans, Pierre W

2014-06-01

Recently, therapeutic erythrocytapheresis (TE) was suggested to be more efficient in depletion of red blood cells (RBC) compared to manual phlebotomy in the treatment of hereditary hemochromatosis (HH), polycythemia vera (PV), and secondary erythrocytosis (SE). The efficiency rate (ER) of TE, that is, the increase in RBC depletion achieved with one TE cycle compared to one phlebotomy procedure, can be calculated based on estimated blood volume (BV), preprocedural hematocrit (Hct(B)), and delta-hematocrit (ΔHct). In a retrospective evaluation of 843 TE procedures (in 45 HH, 33 PV, and 40 SE patients) the mean ER was 1.86 ± 0.62 with the highest rates achieved in HH patients. An ER of 1.5 was not reached in 37.9% of all procedures mainly concerning patients with a BV below 4,500 ml. In 12 newly diagnosed homozygous HH patients, the induction phase duration was medially 38.4 weeks (medially 10.5 procedures). During the maintenance treatment of HH, PV, and SE, the interval between TE procedures was medially 13.4 weeks. This mathematical model can help select the proper treatment modality for the individual patient. Especially for patients with a large BV and high achievable ΔHct, TE appears to be more efficient than manual phlebotomy in RBC depletion thereby potentially reducing the numbers of procedures and expanding the interprocedural time period for HH, PV, and SE. © 2013 Wiley Periodicals, Inc.

Biochemical and hematological effects of lead ingestion in nestling American kestrels (Falco sparverius)

USGS Publications Warehouse

Hoffman, D.J.; Franson, J.C.; Pattee, O.H.; Bunck, C.M.; Murray, H.C.

1985-01-01

1. One-day old American kestrel (Faico sparverius) nestlings were orally dosed daily with 5 μl/g of corn oil (controls), 25, 125 or 625 mg/kg of metallic lead in corn oil for 10 days.2. Forty per cent of the nestlings receiving 625 mg/kg of lead died after 6 days and growth rates were significantly depressed in the two highest lead dosed groups. At 10 days hematocrit values were significantly lower in the two highest lead treated groups, and hemoglobin content and red blood cell (δ-aminolevulinic acid dehydratase (ALAD) activity was depressed in all lead treated groups. Plasma creatine phosphokinase decreased in the two highest treatment groups.3. Brain, liver and kidney ALAD activities, brain RNA to protein ratio and liver protein concentration decreased after lead exposure whereas liver DNA, DNA to RNA ratio and DNA to protein ratio increased. Brain monoamine oxidase and ATPase were not significantly altered.4. Measurements of the ontogeny of hematological variants and enzymes in normal development, using additional untreated nestlings, revealed decreases in red blood cell ALAD, plasma aspartate amino transferase, lactate dehydrogenase, brain DNA and RNA and liver DNA, whereas hematocrit, hemoglobin, plasma alkaline phosphatase, brain monoamine oxidase, brain ALAD and liver ALAD increased during the first 10 days of posthatching development.5. Biochemical and hematological alterations were more severe than those reported in adult kestrels or precocial young birds exposed to lead. Alterations may be due in part to delayed development.

The changes of red blood cell viscoelasticity and sports anemia in male 24-hr ultra-marathoners.

PubMed

Liu, Che-Hung; Tseng, Yen-Fang; Lai, Jiun-I; Chen, Yin-Quan; Wang, Shih-Hao; Kao, Wei-Fong; Li, Li-Hua; Chiu, Yu-Hui; How, Chorng-Kuang; Chang, Wen-Han

2018-05-01

In endurance sports, stress, dehydration and release of chemical factors have been associated with red blood cell (RBC) alterations of structure and function, which may contribute to sports anemia, a well-observed phenomenon during long-distance running. Until now, the investigation of the changes of viscoelastic properties of RBC membrane, a decisive factor of RBC deformability to avoid hemolysis, is lacking, especially in an Oriental population. nineteen runners were prospectively recruited into our study. Hematological parameters were analyzed before and immediately after the 2015 Taipei 24H Ultra-Marathon Festival, Taiwan. Video particle tracking microrheology was used to determine viscoelastic properties of each RBC sample by calculating the dynamic elastic modulus G'(f) and the viscous modulus G″(f) at frequency f = 20 Hz. Haptoglobin, RBC count, hemoglobin, hematocrit, mean cell hemoglobin, plasma free hemoglobin and unsaturated iron-binding capacity values of the recruited runners showed a statistically significant drop in the post-race values. Blood concentration of reticulocyte and ferritin were significantly higher at post-race compared with pre-race. 15 out of the 19 runners had a concurrent change in the elastic and the viscous moduli of their RBCs. Changes in the elastic and the viscous moduli were correlated with changes in the RBC count, hemoglobin and hematocrit. Viscoelasticity properties, the elastic modulus G'(f) and the viscous modulus G″(f) of RBCs are associated with endurance exercise-induced anemia. Copyright © 2017. Published by Elsevier Taiwan LLC.

Impaired acclimatization to chronic hypoxia in adult male and female rats following neonatal hypoxia.

PubMed

Lumbroso, Delphine; Joseph, Vincent

2009-08-01

We tested the hypothesis that neonatal exposure to hypoxia alters acclimatization to chronic hypoxia later in life. Rat pups were exposed to normobaric hypoxia (12% O(2); nHx group) in a sealed chamber, or to normoxia (21% O(2); nNx group) from the day before birth to postnatal day 10. The animals were then raised in normal conditions until reaching 12 wk of age. At this age, we assessed ventilatory and hematological acclimatization to chronic hypoxia by exposing male and female nHx and nNx rats for 2 wk to 10% O(2). Minute ventilation, metabolic rate, hypoxic ventilatory response, hematocrit, and hemoglobin levels were measured both before and after acclimatization. We also quantified right ventricular hypertrophy as an index of pulmonary hypertension both before and after acclimatization. There was a significant effect of neonatal hypoxia that decreases ventilatory response (relative to metabolic rate, VE/VCO(2)) to acute hypoxia before acclimatization in males but not in females. nHx rats had an impaired acclimatization to chronic hypoxia characterized by altered respiratory pattern and elevated hematocrit and hemoglobin levels after acclimatization, in both males and females. Right ventricular hypertrophy was present before and after acclimatization in nHx rats, indicating that neonatal hypoxia results in pulmonary hypertension in adults. We conclude that neonatal hypoxia impairs acclimatization to chronic hypoxia in adults and may be a factor contributing to the establishment of chronic mountain sickness in humans living at high altitude.

Undetected Severe Fetal Myelosuppression following Administration of High-Dose Cytarabine for Acute Myeloid Leukemia: Is More Frequent Surveillance Necessary?

PubMed Central

Holland, Marium

2017-01-01

Background Cytarabine use during pregnancy carries a 5–7% risk of neonatal cytopenia. We report two cases of fetal myelosuppression following high-dose cytarabine administration for acute myeloid leukemia (AML). Case 1 A 36-year-old G9P6 diagnosed with AML at 21 weeks was monitored for fetal anemia weekly and growth monthly. At 33 weeks (after 2 cycles), BPP was 2/10 and MCA PSV was elevated at 1.51 MoM. Urgent cesarean section was performed. The infant had an initial pH of 6.78 and pancytopenia (hematocrit 13.3%, platelets 3 K/UL, and white blood cell count 2.0 K/UL). Initially transfusion dependent, the neonate had count recovery by 3 weeks. Case 2 A 30-year-old G4P3 with AML at 26 weeks was monitored for fetal anemia twice weekly and growth monthly. At 34 weeks (after cycle 1), she was admitted with neutropenic fever. The fetal MCA PSV was borderline at 1.48 MoM. It improved to 1.38 MoM at 35 weeks but the fetal tracing worsened. At delivery the fetus was found to have a hematocrit of 30%, but with normal platelet and WBC. The fetus did not require any transfusions. Conclusion Cytarabine use during pregnancy may cause neonatal myelosuppression. We recommend monitoring for fetal anemia with MCA Dopplers twice weekly. PMID:29075543

Accounting for the role of hematocrit in between-subject variations of MRI-derived baseline cerebral hemodynamic parameters and functional BOLD responses.

PubMed

Xu, Feng; Li, Wenbo; Liu, Peiying; Hua, Jun; Strouse, John J; Pekar, James J; Lu, Hanzhang; van Zijl, Peter C M; Qin, Qin

2018-01-01

Baseline hematocrit fraction (Hct) is a determinant for baseline cerebral blood flow (CBF) and between-subject variation of Hct thus causes variation in task-based BOLD fMRI signal changes. We first verified in healthy volunteers (n = 12) that Hct values can be derived reliably from venous blood T 1 values by comparison with the conventional lab test. Together with CBF measured using phase-contrast MRI, this noninvasive estimation of Hct, instead of using a population-averaged Hct value, enabled more individual determination of oxygen delivery (DO 2 ), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO 2 ). The inverse correlation of CBF and Hct explained about 80% of between-subject variation of CBF in this relatively uniform cohort of subjects, as expected based on the regulation of DO 2 to maintain constant CMRO 2 . Furthermore, we compared the relationships of visual task-evoked BOLD response with Hct and CBF. We showed that Hct and CBF contributed 22%-33% of variance in BOLD signal and removing the positive correlation with Hct and negative correlation with CBF allowed normalization of BOLD signal with 16%-22% lower variability. The results of this study suggest that adjustment for Hct effects is useful for studies of MRI perfusion and BOLD fMRI. Hum Brain Mapp 39:344-353, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Preliminary study of percutaneous nephrolithotomy on an ambulatory basis.

PubMed

El-Tabey, Magdy Ahmed; Abd-Allah, Osama Abdel-Wahab; Ahmed, Ahmed Sebaey; El-Barky, Ehab Mohammed; Noureldin, Yasser Abdel-Sattar

2013-02-01

Preliminary study to assess the feasibility and safety of percutaneous nephrolithotomy (PCNL) as an ambulatory procedure. Between February 2011 and September 2012, 84 patients with renal calculi fulfilling the inclusion criteria were admitted to the Urology Department of Benha University Hospitals for PCNL. All patients were subjected to a full medical history, clinical, laboratory and radiological examinations. Tubeless PCNLs were done in the supine position, and an antegrade double-J stent was inserted. Operative time and intraoperative complications were recorded. Postoperatively, the hematocrit value, postoperative pain and analgesics, need of blood transfusion, stone-free rate, and length of hospital stay were recorded. Stable patients that could be safely discharged within 24 hours after surgery were considered ambulatory. All cases of tubeless PCNL were successfully done and no cases converted to open surgery. The overall stone-free rate was 91.7%, the mean postoperative pain score measured by the visual analog scale was 4.4 ± 1.2, the mean overall hematocrit deficit was 4.8 ± 2.2% and the mean hospital stay was 33.4 ± 17.5 hours. Ambulatory PCNL was accomplished in 60 out of 84 patients (71.4%) and double-J stents were removed 7-10 days postoperatively. In the non-ambulatory cases, double-J stents were removed after auxillary procedures were done according to each case. PCNL can be safely done on an ambulatory basis under strict criteria, but further studies are needed to confirm and expand these findings.

Elderly men over 65 years of age with late-onset hypogonadism benefit as much from testosterone treatment as do younger men.

PubMed

Saad, Farid; Yassin, Aksam; Haider, Ahmad; Doros, Gheorghe; Gooren, Louis

2015-04-01

To investigate the potential benefits of testosterone administration to elderly men (>65 years) with late-onset hypogonadism (LOH) in comparison with younger men and to assess the safety of testosterone administration to elderly men. A total of 561 hypogonadal men from two registry studies were divided into age groups of ≤65 years (group Y, n=450; range, 32-65 years) and >65 years (group O, n=111; range, 66-84 years). Following an initial 6-week interval, all men were treated with 3-month injections of parenteral testosterone undecanoate for up to 6 years. Over the 6 years, there was a progressive decrease of body weight and waist circumference. Beneficial effects on lipids and other metabolic factors and on psychological and sexual functioning progressed over the first 24 to 42 months and were sustained. Rather than a deterioration, there was an improvement of urinary parameters. Prostate volume and prostate-specific antigen increased moderately. Hematocrit levels increased but remained within safe margins. The benefits of restoring serum testosterone in men with LOH were not significantly different between men older than 65 years of age and younger men. There were no indications that side effects were more severe in elderly men. The effects on prostate and urinary function and hematocrit were within safe margins. Age itself need not be a contraindication to testosterone treatment of elderly men with LOH.

Diagnostic Usefulness of Transcutaneous Bilirubinometry in Very Preterm Newborns

PubMed Central

Badiee, Zohreh; Mohammadizadeh, Majid; Shamee, Masih

2012-01-01

Background: This study was performed to find out whether transcutaneous bilirubinometry could be a valid screening method for hyperbilirubinemia in preterm infants, especially for those who needed mechanical ventilation. Methods: We evaluated 63 preterm Iranian newborns who were managed in the neonatal intensive care unit of Shahidbeheshti University Hospital, Isfahan, Iran from April 2009 to April 2010. Transcutaneous bilirubin (TCB) measurements were obtained using BiliCheck™ shortly before or 10 minutes after taking blood for determination of the plasma bilirubin level in premature newborns, who did not receive phototherapy. We assessed the correlation between the transcutaneous bilirubin and plasma bilirubin level by linear regression analysis. We also analyzed the gestational age, birth weight, postnatal age, sex, and hematocrit, for determination of their effect on transcutaneous bilirubin accuracy. Results: The overall bilirubin concentration ranged from 5.4 to 17 mg/dL and from 4.8 to 17.3 mg/dl for total serum bilirubin (TSB) and transcutaneous bilirubin, respectively. The mean values obtained by transcutaneous bilirubinometry were slightly higher than the total TSB values. The correlation coefficient between TSB and TCB was r=0.82, P<0.001, and this was not influenced by gestational age, postnatal age or hematocrit, which were previously considered to be important. The correlation coefficient between TSB and TCB in mechanically ventilated preterm infants was r=0.75, P<0.001. Conclusion: Plasma bilirubin level can be accurately measured by BiliCheck™ in premature newborns, even in newborns who need mechanical ventilation. PMID:22624082

Early-developmental stress, repeatability, and canalization in a suite of physiological and behavioral traits in female zebra finches.

PubMed

Careau, Vincent; Buttemer, William A; Buchanan, Katherine L

2014-10-01

Adaptive developmental plasticity allows individuals experiencing poor environmental conditions in early life to adjust their life-history strategy in order to prioritize short-term fitness benefits and maximize reproductive output in challenging environments. Much research has been conducted to test whether such adoption of a "faster" life-history strategy is accompanied by concordant changes in behavior and physiology, with mixed results. As research in this field has focused on comparison of mean-level responses of treatment groups, few studies include repeated measures of response variables and the effect that developmental stress may have on repeatability per se. We investigated how early-developmental stress affects the mean expression of (and repeatability in) a variety of behavioral and physiological traits in female zebra finches. We predicted that: (1) individuals subjected to nutritional restriction in the nestling phase would have higher feeding and activity rates, with associated increases in hematocrit and basal metabolic rates (BMRs), (2) nutritional restriction in early life would alter adults' stress-induced corticosterone level, and (3) developmental stress would, respectively, influence the amount of among-individual and within-individual variation in behavioral and physiological traits, hence affecting the repeatability of these traits. In comparison to control females, stressed females did not differ in activity rate or stress-induced corticosterone level, but they did have higher levels of feeding, hematocrit, and BMR. Among-individual variance and repeatability were generally higher in stressed females than in controls. Finally, we found that developmental dietary restriction significantly reduced the amount of within-individual variance both in activity rate in the novel environment and in stress-induced corticosterone level. Our results not only confirm previous findings on the effect of early-developmental stress on BMR, but also extend its effect to feeding rate and hematocrit, suggesting that developmental plasticity in these traits is ontogenetically linked. Early-developmental stress may disable particular genetic canalizing processes, which would release cryptic genetic variation and explain why repeatability and among-individual variance were generally higher in the stressed groups than in controls. For activity rate in the novel environment and with stress-induced corticosterone level, however, early-developmental stress significantly reduced within-individual variance, which may be a consequence of increased canalization of these traits at the micro-environmental level. © The Author 2014. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology. All rights reserved. For permissions please email: journals.permissions@oup.com.

Evaluation of the BISAP scoring system in prognostication of acute pancreatitis - A prospective observational study.

PubMed

Hagjer, Sumitra; Kumar, Nitesh

2018-04-21

Severe acute pancreatitis has a high mortality and its early identification is important for management and risk stratification. The bedside index for severity in acute pancreatitis (BISAP) is a simple scoring system done at admission which predicts the severity of pancreatitis. Procalcitonin is an inflammatory marker which is raised very early and helps in early prediction of the severity of disease. This study aims to evaluate the BISAP score and Procalcitonin in prognostication of acute pancreatitis. A prospective observational study of 60 patients presenting with acute pancreatitis was done at XXX Medical College and Hospital from July 2015 to June 2016. BISAP, APACHE-II, Ranson criteria, and CT severity index (CTSI) of all patients were calculated. Procalcitonin card test was done for all patients. The patients were stratified according by BISAP score and procalcitonin positivity into categories of severe pancreatitis, organ failure and pancreatic necrosis, as well as the number of deaths. The comparison of BISAP with other scoring systems, Procalcitonin (PCT), C-reactive protein (CRP), hematocrit, and body mass index (BMI) was done by the area under the receiver-operating curve (AUC) to prediction of severe acute pancreatitis, organ failure, necrosis, and death. Of the 60 patients, 14 (23.3%) developed severe acute pancreatitis, 11 (18.3%) Organ failure, 21 (35%) pancreatic necrosis and 7 (11.6%) died. A BISAP score of ≥3 was a statistically significant cutoff value. AUCs for predicting severe pancreatitis and death of BISAP were 0.875 and 0.740respectively, similar to those for Ranson criteria (0.802, 0.763) and APACHE-II (0.891, 0.769) and greater than AUCs for CTSI (0.641, 0.554). The AUC for prediction of organ failure were 0.906, 0.833, 0.874 and 0.623 for BISAP, Ranson criteria, APACHE-II, and CTSI respectively. AUCs for PCT predicting severity, organ failure, and death were 0.940, 0.923 and 0.769 respectively were similar to BISAP but greater than those for CRP (0.755, 0.719, 0.693), hematocrit (0.540, 0.570, 0.550), and BMI (0.493, 0.523, 0.497). The BISAP predicts severity, organ failure and death, in acute pancreatitis very well.It is as good as APACHE-II but better than Ranson criteria, CTSI, CRP, hematocrit, and BMI. PCT is a promising inflammatory marker with prediction rates similar to BISAP. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

[The effect of vegetarian diet on selected biochemical and blood morphology parameters].

PubMed

Nazarewicz, Rafał

2007-01-01

The objective was to examine whether vegetarian diet influence biochemical parameters of blood and plasma urea in selective vegetarian group. The investigation covered 41 subject, 22 of them had been applying vegetarian diet and 19 were omnivorous. The study shows statistically significant lower values of white blood cells, % and amounts of neutrocytes and insignificant lower level of red blood cells, hemoglobine, hematocrit and platelet in vegetarian group. Significant lower plasma urea level was observed in that group. These changes indicate that high quality deficiency protein was due to vegetarian diet.

Spontaneous rupture of the spleen detected on CT as the initial manifestation of infectious mononucleosis.

PubMed

Gayer, Gabriela; Zandman-Goddard, Gisele; Kosych, Elena; Apter, Sara

2003-04-01

Spontaneous splenic rupture after infectious mononucleosis (IM) is a rare, potentially fatal complication of IM, occurring in 0.1-0.5% of patients with proven IM. It usually occurs several weeks after the onset of symptoms, but may, rarely, be the initial manifestation of the disease. The patient is usually examined as an emergency due to severe abdominal pain and a falling hematocrit. The radiologist should be aware of the pathologic conditions involving the spleen which may lead to its spontaneous rupture.

Neurologic complications of polycythemia and their impact on therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Newton, L.K.

1990-03-01

Polycythemia vera, a clonal stem cell disorder, produces neurologic problems in 50-80% of patients. Some symptoms, such as headache and dizziness, are related to hyperviscosity, and respond immediately to reduction of cell counts. Others seem to result from an associated coagulopathy. Patients with polycythemia tend to develop both arterial and venous thrombosis and are prone to hemorrhages. Treatments for polycythemia include phlebotomy, chlorambucil supplemented with phlebotomy, and {sup 32}P plus phlebotomy. Whatever treatment is chosen, the aim of therapy should be to reduce the hematocrit to approximately 40-45%.37 references.

The Effect of a Hypobaric, Hypoxic Environment on Acute Skeletal Muscle Edema After Ischemia-Reperfusion Injury in Rats

DTIC Science & Technology

2010-05-15

groups ( P < 0.05). Normobaric normoxia caused greater edema in the gastrocnemius compared with hypobaric hypoxia; the tibialis anterior was not signif...icantly different between groups. The decrease in body weight for NB and HB was 3.4 ± 1.4 and 10.7 ± 1.2 g, respectively ( P < 0.05). Hematocrit was...44.7 ± 0.5 and 42.6 ± 0.6 ( P < 0.05). Conclusions. The hypobaric, hypoxic conditions of simulated medical air evacuation were not associated with

Hematology and immunology studies

NASA Technical Reports Server (NTRS)

Kimzey, S. L.

1977-01-01

A coordinated series of experiments were conducted to evaluate immunologic and hemotologic system responses of Skylab crewmen to prolonged space flights. A reduced PHA responsiveness was observed on recovery, together with a reduced number of T-cells, with both values returning to normal 3 to 5 days postflight. Subnormal red cell count, hemoglobin concentration, and hematocrit values also returned gradually to preflight limits. Most pronounced changes were found in the shape of red blood cells during extended space missions with a rapid reversal of these changes upon reentry into a normal gravitational environment.

Drug delivery optimization through Bayesian networks.

PubMed Central

Bellazzi, R.

1992-01-01

This paper describes how Bayesian Networks can be used in combination with compartmental models to plan Recombinant Human Erythropoietin (r-HuEPO) delivery in the treatment of anemia of chronic uremic patients. Past measurements of hematocrit or hemoglobin concentration in a patient during the therapy can be exploited to adjust the parameters of a compartmental model of the erythropoiesis. This adaptive process allows more accurate patient-specific predictions, and hence a more rational dosage planning. We describe a drug delivery optimization protocol, based on our approach. Some results obtained on real data are presented. PMID:1482938

Four Week Oral Toxicity Study of WR242511 in Dogs. Volume 2

DTIC Science & Technology

1994-06-03

10^6/cmm Erythrocytes 0.00 NO 6.00 6.00 8.00 8.00 2. HGB g/dL Hemoglobin 0.0 NO 12.0 12.0 19.0 19.0 3. HCT % Hematocrit 0.0 NO 35.0 35.0...IS/ UU CAJ U INDIVIDUAL ANIMAL HEMATOLOGY REPORT BY GROUP TEST : Erythrocytes STUDY ID: 134 SEX: MALE STUDY NO: 134 • ABBR...FOUR WEEK ORAL TOXICITY STUDY OF WR242511 IN DOGS DRAFT INDIVIDUAL ANIMAL HEMATOLOGY REPORT BY GROUP TEST: Erythrocytes STUDY ID: 134 STUDY NO

Hematocrit Level could Reflect Inflammatory Response and Disease Activity in Patients with Systemic Lupus Erythematosus.

PubMed

Yang, Min; Ma, Ning; Fu, Haitao; Wei, Tingting; Tang, Qingqin; Qin, Baodong; Yang, Zaixing; Zhong, Renqian

2015-01-01

The previous study has reported the association of hematocrit (HCT) with inflammation in several diseases. But the role of HCT in systemic lupus erythematosus (SLE) remained unclear. We tried to evaluate the clinical significance of HCT levels in patients with SLE. A retrospective study including 127 adult SLE patients and 146 normal healthy controls was performed. HCT levels between SLE patients and normal healthy controls were compared, and correlations between HCT and clinical characteristics were evaluated. HCT levels in SLE patients were significantly decreased as compared with the normal healthy controls and negatively correlated with C-reactive protein (CRP) (r = -0.336, p < 0.01), erythrocyte sedimentation rate (ESR) (r = -0.332, p < 0.01), and SLEDAI scores (r = -0.376, p < 0.01). HCT levels were also significantly lower in SLE patients with decreased C3 and C4 as compared with those in SLE patients with normal C3 and C4, indicating that HCT was positively correlated with C3 and C4 levels (r = 0.272, p < 0.01; r = 0.273, p < 0.01). HCT was decreased in SLE patients with the presence of anti-Sm and anti-RNP antibodies as compared with those without these auto-antibodies (p = 0.013, p < 0.01). After adjusting RBC count and hemoglobin level, multiple linear regression analysis showed that HCT was independently associated with disease activity in SLE patients. In addition, HCT levels were elevated after treatment. HCT is correlated with CRP, ESR, and SLEDAI, suggesting that HCT could reflect inflammatory response and disease activity in SLE patients.

The effects of umbilical cord milking in extremely preterm infants: a randomized controlled trial

PubMed Central

March, MI; Hacker, MR; Parson, AW; Modest, AM; de Veciana, M

2014-01-01

OBJECTIVE Delayed cord clamping has been shown to decrease the need for transfusion in preterm neonates, but may delay resuscitation. The aim of this study was to determine whether umbilical cord milking compared with immediate cord clamping in extremely preterm deliveries reduces the need for neonatal red blood cell transfusion. STUDY DESIGN Women admitted to a tertiary care center and expected to deliver between 24 to 28 completed weeks of gestation were randomized to cord milking before clamping or immediate cord clamping. The primary outcome was the risk of neonatal transfusion, reported as risk ratio (RR) and 95% confidence interval (CI). RESULT Of 113 women who were enrolled and randomized, 56 were assigned to cord milking with 36 remaining eligible and completing the study and 57 were assigned to the control group with 39 remaining eligible and completing the study. Albeit not statistically significant, neonates in the cord milking group were less likely to require transfusion compared with those in the control group (RR: 0.86; 95% CI: 0.73 to 1.0). Neonates whose cords were milked had higher hematocrits at birth (P = 0.004) and were less likely to develop an intraventricular hemorrhage (P = 0.0195). CONCLUSION Milking the umbilical cord of a preterm neonate is an easy intervention with the potential to improve perinatal outcomes. Our results suggest that milking of the cord increases the neonate’s initial hematocrit and may lessen the need for transfusion in the neonatal period. The observed reduction in the incidence of intraventricular hemorrhage may have important long-term implications that warrant further study. PMID:23867960

Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors

PubMed Central

Doluoğlu, Ömer Gökhan; Karagöz, Mehmet Ali; Kılınç, Muhammet Fatih; Karakan, Tolga; Yücetürk, Cem Nedim; Sarıcı, Haşmet; Özgür, Berat Cem; Eroğlu, Muzaffer

2016-01-01

Objective In this study we aimed to evaluate prognostic factors for the survival of patients with Fournier’s gangrene (FG), and overview different validated scoring systems for outcome prediction. Material and methods We retrospectively analyzed the data of 39 patients treated for FG in our clinic. Data were collected on medical history, symptoms, physical examination findings, vital signs, laboratory parameters at admission and at the end of treatment, timing and extent of surgical debridement, and the antibiotic treatment used. The Fournier’s Gangrene Severity Index (FGSI) and Charlson Comorbidity Index (CCI) were used to predict outcome. The data were analyzed in relation with the survival of the patients. Mann-Whitney U test, chi -square test, Wilcoxon signed rank test, and Cox regression analysis were used for the statistical analysis. Results Of 39 patients analyzed, 8 (20.5%) died and 31 (79.5%) survived. The median FGSI score on admission was 2 (0–9) for the survivors and 6 (2–14) for the non-survivors (p=0.004). The median CCI scores of the survivors and non-survivors were 2 (0–10) and 6.5 (5–11), respectively (p=0.001). Except for urea, albumin and hematocrit levels, no significant differences were found between survivors and non-survivors for other laboratory parameters on admission. Lower albumin levels and advanced age were found to be associated with mortality. Conclusion High blood urea, low albumin, and low hematocrit levels were associated with poor prognosis. High CCI and FGSI scores could be associated with a poor prognosis in patients with FG. PMID:27635295

Serum ferritin, hematocrit and mean corpuscular volume in hemodialysis.

PubMed

Goldwasser, P; Koutelos, T; Abraham, S; Avram, M M

1994-01-01

Prior to beginning to administration erythropoietin (EPO) in 1989, we examined the relationships of hematocrit (HCT), mean corpuscular volume (MCV), and serum ferritin (FER) in one group of hemodialysis patients (group A, n = 117) and replicated the findings in a second group (group B, n = 73). The groups had similar mean (+/- SD) HCT (A: 25.7 +/- 5.3%; B: 25.2 +/- 5.1%), MCV (A: 83.3 +/- 6.5 fl; B: 83.5 +/- 7.5 fl) and FER (A: 607 +/- 1446 micrograms/l; B: 374 +/- 601 micrograms/l). For group A, iron stores [log (FER)] correlated inversely with HCT (r = -0.44, p < 10(-4)) and directly with MCV (r = 0.32, p < 10(-3)). After dividing group A into octiles by the FER level, the lowest octile (mean FER 17.8 +/- 6.2 micrograms/l) had the highest mean HCT (29.5 +/- 6.4%) and lowest mean MCV (80.8 +/- 7.1 fl), while the highest octile (mean FER 3,312 +/- 3,005 micrograms/l) had the lowest mean HCT (21.9 +/- 2.8%) and the second-highest mean MCV (86.4 +/- 4.9 fl). The trends were similar in group B. We conclude that increased erythropoiesis appeared to cause or, at least, unmask iron deficiency in HD patients even prior to the advent of EPO therapy. Variations in the level of erythropoiesis among these patients (presumably due to variation in EPO levels, chronic inflammation) strongly influenced the determinants of iron stores (i.e., marrow utilization of iron, transfusion need); iron stores, in turn, influenced MCV.

Change in serum sodium concentration during a cold weather ultradistance race.

PubMed

Stuempfle, Kristin J; Lehmann, Donald R; Case, H Samuel; Hughes, Sherri Lind; Evans, Deborah

2003-05-01

To investigate change in serum sodium concentration and its potential causes during a cold weather ultradistance race. Descriptive research. A 100-mile (161-km) race over a snow-packed course in the Alaskan wilderness. Athletes competed in 1 of 3 divisions: foot, bike, or ski. Twenty athletes (11 runners, 6 cyclists, 3 skiers) volunteered for the study. None. Subjects were weighed and had blood drawn for hematocrit, serum sodium, serum aldosterone, and plasma arginine vasopressin concentrations pre- and postrace. Fluid and sodium intake were determined by race dietary analysis. Serum sodium concentration decreased significantly prerace (140.8 +/- 1.2 mmol/L) to postrace (138.4 +/- 2.2 mmol/L), although no athletes were classified as hyponatremic. Mean weight loss was significant during the race (-1.2 kg), although 1 athlete maintained his weight, and 3 athletes gained small amounts of weight (0.2 kg, 0.2 kg, and 0.5 kg, respectively). Hematocrit decreased significantly prerace (42.2 +/- 3.5) to postrace (40.3 +/- 4.1). Plasma arginine vasopressin and serum aldosterone increased significantly during the race (2.6 +/- 0.7 to 6.0 +/- 4.6 pg/mL and 5.1 +/- 2.6 to 40.8 +/- 25.1 ng/dL, respectively). Fluid consumption was 300 +/- 100 mL/h, and sodium intake was 310 +/- 187 mg/h. Decreased serum sodium concentration after a cold weather ultradistance race was due to fluid overload caused by excessive fluid consumption. Current recommendations that ultradistance athletes consume 500 to 1000 mL/h may be too high for athletes competing in the extreme cold.

A normalization method for combination of laboratory test results from different electronic healthcare databases in a distributed research network.

PubMed

Yoon, Dukyong; Schuemie, Martijn J; Kim, Ju Han; Kim, Dong Ki; Park, Man Young; Ahn, Eun Kyoung; Jung, Eun-Young; Park, Dong Kyun; Cho, Soo Yeon; Shin, Dahye; Hwang, Yeonsoo; Park, Rae Woong

2016-03-01

Distributed research networks (DRNs) afford statistical power by integrating observational data from multiple partners for retrospective studies. However, laboratory test results across care sites are derived using different assays from varying patient populations, making it difficult to simply combine data for analysis. Additionally, existing normalization methods are not suitable for retrospective studies. We normalized laboratory results from different data sources by adjusting for heterogeneous clinico-epidemiologic characteristics of the data and called this the subgroup-adjusted normalization (SAN) method. Subgroup-adjusted normalization renders the means and standard deviations of distributions identical under population structure-adjusted conditions. To evaluate its performance, we compared SAN with existing methods for simulated and real datasets consisting of blood urea nitrogen, serum creatinine, hematocrit, hemoglobin, serum potassium, and total bilirubin. Various clinico-epidemiologic characteristics can be applied together in SAN. For simplicity of comparison, age and gender were used to adjust population heterogeneity in this study. In simulations, SAN had the lowest standardized difference in means (SDM) and Kolmogorov-Smirnov values for all tests (p < 0.05). In a real dataset, SAN had the lowest SDM and Kolmogorov-Smirnov values for blood urea nitrogen, hematocrit, hemoglobin, and serum potassium, and the lowest SDM for serum creatinine (p < 0.05). Subgroup-adjusted normalization performed better than normalization using other methods. The SAN method is applicable in a DRN environment and should facilitate analysis of data integrated across DRN partners for retrospective observational studies. Copyright © 2015 John Wiley & Sons, Ltd.

Plasma surface reflectance spectroscopy for non-invasive and continuous monitoring of extracellular component of blood

NASA Astrophysics Data System (ADS)

Sakota, Daisuke; Takatani, Setsuo

2012-04-01

To achieve the quantitative optical non-invasive diagnosis of blood during extracorporeal circulation therapies, the instrumental technique to extract extracellular spectra from whole blood was developed. In the circuit, the continuous blood flow was generated by a centrifugal blood pump. The oxygen saturation was maintained 100% by an oxygenator. The developed glass optical flow cell was attached to the outlet tubing of the oxygenator. The halogen lamp including the light from 400 to 900 nm wavelength was used for the light source. The light was guided into an optical fiber. The light emitted by the fiber was collimated and emitted to the flow cell flat surface at the incident angle of 45 degrees. The light just reflected on the boundary between inner surface of the flow cell and plasma at 45 degrees was detected by the detection fiber. The detected light was analyzed by a spectral photometer. The obtained spectrum from 400 to 600nm wavelength was not changed with respect to the hematocrit. In contrast, the signal in the spectral range was changed when the plasma free hemoglobin increased. By using two spectral range, 505+/-5 nm and 542.5+/-2.5 nm, the differential spectrum was correlated with the free hemoglobin at R2=0.99. On the other hand, as for the hematocrit, the differential spectrum was not correlated at R2=0.01. Finally, the plasma free hemoglobin was quantified with the accuracy of 22+/-19mg/dL. The result shows that the developed plasma surface reflectance spectroscopy (PSRS) can extract the plasma spectrum from flowing whole blood.

Effects of Testosterone on Erythropoiesis in a Female Mouse Model of Anemia of Inflammation

PubMed Central

Schmidt, Paul J.; Fleming, Mark D.; Bhasin, Shalender

2016-01-01

The anemia of inflammation is a common problem in inflammatory and autoimmune diseases. We characterized a mouse model of anemia of chronic inflammation induced by repeated injections of low doses of heat-killed Brucella abortus (HKBA), and determined the effects of T administration on erythropoiesis in this model. Female C57BL/6NCrl mice were injected weekly with HKBA for 10 wk. Weekly injections of T or vehicle oil were started 4 wk later. Control mice were injected with saline and vehicle oil in parallel. HKBA-injected mice had significantly lower hemoglobin, hematocrit, mean corpuscular volume, reticulocyte hemoglobin, transferrin saturation (TSAT), and tissue nonheme iron in liver and spleen, enlarged spleen, and up-regulated hepatic expression of inflammatory markers, serum amyloid A1, and TNFα, but down-regulated IL-6, bone morphogenic protein 6, and hepcidin compared with saline controls. HKBA also reduced serum hepcidin and increased serum erythropoietin. Bone marrow erythroid precursors were substantially reduced in HKBA-injected mice. Cotreatment with T increased the percentage of late-stage erythroid precursors in the bone marrow relative to HKBA-injected and saline controls and reversed HKBA-induced suppression of hemoglobin and hematocrit. T also normalized serum erythropoietin, TSAT, and reticulocyte hemoglobin without correcting the expression of the hepatic inflammation markers. Conclusions are that low-dose HKBA induces moderate anemia characterized by chronic inflammation, decreased iron stores, and suppression of erythroid precursors in the bone marrow. T administration reverses HKBA-induced anemia by stimulating erythropoiesis, which is associated with a shift toward accelerated maturation of erythroid precursors in the bone marrow. PMID:27074351

Performance of a new test strip for freestyle blood glucose monitoring systems.

PubMed

Lock, John Paul; Brazg, Ronald; Bernstein, Robert M; Taylor, Elizabeth; Patel, Mona; Ward, Jeanne; Alva, Shridhara; Chen, Ting; Welsh, Zoë; Amor, Walter; Bhogal, Claire; Ng, Ronald

2011-01-01

a new strip, designed to enhance the ease of use and minimize interference of non-glucose sugars, has been developed to replace the current FreeStyle (Abbott Diabetes Care, Alameda, CA) blood glucose test strip. We evaluated the performance of this new strip. laboratory evaluation included precision, linearity, dynamic range, effects of operating temperature, humidity, altitude, hematocrit, interferents, and blood reapplication. System accuracy, lay user performance, and ease of use for finger capillary blood testing and accuracy for venous blood testing were evaluated at clinics. Lay users also compared the speed and ease of use between the new strip and the current FreeStyle strip. for glucose concentrations <75 mg/dL, 73%, 100%, and 100% of the individual capillary blood glucose results obtained by lay users fell within ± 5, 10, and 15 mg/dL, respectively, of the reference. For glucose concentrations ≥75 mg/dL, 68%, 95%, 99%, and 99% of the lay user results fell within  ±  5%, 10%, 15%, and 20%, respectively, of the reference. Comparable accuracy was obtained in the venous blood study. Lay users found the new test strip easy to use and faster and easier to use than the current FreeStyle strip. The new strip maintained accuracy under various challenging conditions, including high concentrations of various interferents, sample reapplication up to 60 s, and extremes in hematocrit, altitude, and operating temperature and humidity. our results demonstrated excellent accuracy of the new FreeStyle test strip and validated the improvements in minimizing interference and enhancing ease of use.

Coagulation is more affected by quick than slow bleeding in patients with massive blood loss.

PubMed

Zhao, Juan; Yang, Dejuan; Zheng, Dongyou

2017-03-01

Profuse blood loss affects blood coagulation to various degrees. However, whether bleeding speed affects coagulation remains uncertain. This study aimed to evaluate the effect of bleeding speed on coagulation function. A total of 141 patients in the Department of Thoracic Surgery of our hospital were evaluated between January 2007 and February 2014. There are two groups of patients, those who received decortication for chronic encapsulated empyema were called the slow-bleeding group, and those who received thoracoscopic upper lobectomy were called the fast bleeding group; each group was further subdivided into three: group A, 1000 ml ≤ bleeding amount < 1500 ml; group B, 1500 ml ≤ bleeding amount < 1700 ml; group C, 1700 ml ≤ bleeding amount < 2000 ml. Then, coagulation function was assessed in all patients before and during surgery and at 1, 2, and 24 h after surgery, measuring prothrombin time, activated partial thromboplastin time (APTT), fibrinogen, blood pressure, hematocrit, hemoglobin, and platelets. Bleeding duration was overtly longer in the slow-bleeding group than that in quick bleeding individuals (2.3 ± 0.25 h vs. 0.41 ± 0.13 h, P < 0.001). Fibrinogen, hematocrit, hemoglobin, and platelets strikingly decreased, whereas prothrombin time and APTT values significantly increased with bleeding amounts in both quick and slow-bleeding groups. Interestingly, compared with slow-bleeding patients, coagulation indices at each time point and bleeding amounts had significant differences in the quick bleeding group.Increased consumption of coagulation factors in quick bleeding may have greater impact on coagulation function.

Long-term erythropoietin gene expression from transduced cells in bioisolator devices.

PubMed

Yanay, Ofer; Barry, Simon C; Flint, Lisa Y; Brzezinski, Margaret; Barton, Randall W; Osborne, William R A

2003-11-20

Recombinant erythropoietin (EPO) is widely administered for long-term treatment of anemia associated with renal failure and other chronic diseases. The ability to deliver EPO by gene therapy would have clinical and economic benefit. We compared autologous and allogeneic transduced primary vascular smooth muscle cells for their ability to provide sustained EPO gene expression when encapsulated in TheraCyte devices implanted subcutaneously (SQ) or intraperitoneally (IP) in rats. Cells were transduced with retrovirus vector LrEpSN encoding rat EPO cDNA. Rats that received either autologous or allogeneic transduced cells showed elevated hematocrits (HCTs) ranging from 50 to 79% that were sustained for more than 12 months. The HCT of control rats remained at baseline (45.8%). Rats that received second SQ implants of either autologous or allogeneic cells showed elevations in hematocrit that were sustained for up to 12 months, suggesting the absence of immunological responses to transduced cells or implant material. All experimental groups had statistically significant elevated HCT (p < 0.001) when compared with controls. Both SQ and IP implantation were equally effective in delivering EPO long term. There were no significant differences in white blood cell (WBC) or platelet (PLT) values between treated and control animals. Implantation of TheraCyte devices was well tolerated and histological evaluation of the devices up to 12 months after surgery revealed a high degree of vascularization and no evidence of host immune response. TheraCyte devices offer a simple and safe gene delivery system that provides sustained therapeutic gene expression, permit removal and implantation of new devices, and do not require immunosuppression of the host.

Effect of transportation duration of 1-day-old chicks on postplacement production performances and pododermatitis of broilers up to slaughter age.

PubMed

Bergoug, H; Guinebretière, M; Tong, Q; Roulston, N; Romanini, C E B; Exadaktylos, V; Berckmans, D; Garain, P; Demmers, T G M; McGonnell, I M; Bahr, C; Burel, C; Eterradossi, N; Michel, V

2013-12-01

This experiment studied the effect of transportation duration of 1-d-old chicks on dehydration, mortality, production performance, and pododermatitis during the growout period. Eggs from the same breeder flock (Ross PM3) were collected at 35, 45, and 56 wk of age, for 3 successive identical experiments. In each experiment, newly hatched chicks received 1 of 3 transportation duration treatments from the hatchery before placement in the on-site rearing facility: no transportation corresponding to direct placement in less than 5 min (T00), or 4 (T04) or 10 h (T10) of transportation. The chicks were housed in 35-m(2) pens (650 birds each) and reared until 35 d old. Hematocrit and chick BW were measured on sample chicks before and after transportation. During the growout period, bird weight, feed uptake, and feed conversion ratio were measured weekly until slaughter. Transportation duration affected BW; T00 groups had a significantly higher BW than T04 and T10 transported birds but this effect lasted only until d 21. No clear effect on hematocrit, feed uptake, feed conversion ratio, or mortality was observed for birds transported up to 10 h. The decrease in weight in T10 birds was associated with less severe pododermatitis. Increasing age of the breeder flock was correlated with reduced egg fertility and hatchability, and also with higher quality and BW of hatched chicks. Chicks from older breeders also exhibited reduced mortality during the growout period.

EVALUATION OF THE CHELATING EFFECT OF METHANOLIC EXTRACT OF CORIANDRUM SATIVUM AND ITS FRACTIONS ON WISTAR RATS POISONED WITH LEAD ACETATE.

PubMed

Téllez-López, Miguel Ángel; Mora-Tovar, Gabriela; Ceniceros-Méndez, Iromi Marlen; García-Lujan, Concepción; Puente-Valenzuela, Cristo Omar; Vega-Menchaca, María Del Carmen; Serrano-Gallardo, Luis Benjamín; Garza, Rubén García; Morán-Martínez, Javier

2017-01-01

The rate of lead poisoning has decreased in recent years due to increased health control in industries that use this metal. However, it is still a public health problem worldwide. The use of various plants with chelating properties has been a topic of research today. In traditional medicine, it is said that Coriandrum sativum has chelating properties, but there is no scientific evidence to support this fact. The purpose of this research is to evaluate the chelating effect of methanol extract of coriander and its fractions on Wistar rats intoxicated with lead. In this research, male Wistar rats were poisoned with 50 mg/kg of lead acetate and treated with 50 mg/kg of methanol extract and its fractions. The extract and its fractions were administered to four treatment groups. Positive and negative controls were established. Hemoglobin, hematocrit and lead concentrations were analyzed; liver was evaluated histologically in control and treatment groups. The methanol extract of coriander presented a LD 50 >1000 mg/dL. The group administered with the methanol extract showed significant difference in the levels of hemoglobin and hematocrit compared to the negative control group. Lead concentration in treatment groups showed a decrease compared to the positive control. Histological evaluation of tissue showed less damage in groups administered with methanolic extract and its fractions compared to the positive control which presented structural alterations. Coriander extracts protect liver and lower lead concentration in rats intoxicated with lead in contrast to the positive control group.

Improvement of anemia in W/WV mice by recombinant human erythropoietin (rHuEPO) mediated through EPO receptors with lowered affinity.

PubMed

Kabaya, K; Akiyama, H; Nishi, N; Misaizu, T; Okada, Y; Kawagishi, M; Amano, K; Kusaka, M; Seki, M; Uzumaki, H

1995-01-01

We studied the effects of recombinant human erythropoietin (rHuEPO) on anemic W/WV mice which manifested severe anemia accompanied by mutation of the W gene encoding tyrosine kinase type receptor (c-kit gene) of bone marrow hematopoietic cells. Nine-week-old male W/WV mice or normal littermates (+/+) were used. Since serum EPO concentration in W/WV mice increased in proportion to severity of anemia, EPO production in the kidneys of these animals was found to be regulated normally. Hematocrit in +/+ mice increased and a maximal response was also obtained with 2,000 IU/kg of rHuEPO. On the other hand, hematocrit in W/WV mice increased in a dose-responsive manner by administration with 2,000 and 10,000 IU/kg, showing different responses to rHuEPO in these two types of mice. The responsiveness of W/WV mice to rHuEPO was low in terms of increases in erythroblastic precursor cells (CFU-E), and immature cells in the bone marrow. Scatchard analysis of the specific binding of 125I-rHuEPO against bone marrow cells revealed that the different responsiveness to rHuEPO between W/WV and +/+ mice may be correlated with differences in affinity of EPO receptor of bone marrow cells in these mice. From these results, a high dose of rHuEPO is capable of improving the anemia in W/WV mice that had EPO receptors with lowered affinity, indicating the possible effectiveness of rHuEPO in anemic patients with EPO receptor abnormality.

The association between hematological parameters and metabolic syndrome in Iranian men: A single center large-scale study.

PubMed

Ahmadzadeh, Jamal; Mansorian, Behnam; Attari, Mohammad Mirza-Aghazadeh; Mohebbi, Ira; Naz-Avar, Raha; Moghadam, Karaim; Ghareh-Bagh, Seyyed Adel Khoshbou

Some studies have demonstrated that metabolic syndrome is associated with hematological parameters. The present study explores the relationship between hematological parameters and numbers of metabolic syndrome conditions in Iranian men. This cross-sectional study included 11,114 participants who were professional drivers of commercial motor vehicles, and were enrolled in the Iranian Health Surveys between 2014 and 2016. Diagnosis of metabolic syndrome was made according to International Diabetes Federation criteria. Clinical data, including anthropometric measurements and serum parameters, were collected. Odds ratios for hematological parameters and metabolic syndrome were calculated using binary logistic regression models. We found that hemoglobin; platelet, and white blood cell counts increased with increasing numbers of metabolic syndrome components (p<0.05 for all). The odds ratio of metabolic syndrome significantly increased across successive quartiles of platelet (1.00, 1.25, 1.29, and 1.51) and white blood cell counts (1.00, 1.51, 1.79, and 2.11) with the lowest quartile as the referent group. Similar associations for hemoglobin and hematocrit in the top quartile were also observed. We did not observe any significant difference in the mean of neutrophil count, mean platelet volume (MPV), red cell distribution width, or platelet distribution width among participants with or without metabolic syndrome. Our findings indicate that high levels of major hematological parameters such as hemoglobin, hematocrit, as well as platelet and white blood cell counts could be novel indicators for the development of metabolic syndrome. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Anemia and Dental Caries in Pregnant Women: a Prospective Cohort Study.

PubMed

Costa, Elisa Miranda; Azevedo, Juliana A P; Martins, Rafiza F M; Alves, Cláudia M C; Ribeiro, Cecília C C; Thomaz, Erika B A F

2017-06-01

The objective was to evaluate the effect of anemia during pregnancy on the risk of dental caries development in pregnant women. A prospective cohort including a sample of pregnant women in a prenatal care unit of São Luís, Brazil, was done. The incidence of dental caries during pregnancy, according to Nyvad's criteria, was the outcome. The main independent variables were serum iron, ferritin, hemoglobin, erythrocyte, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW). Pregnant women (n = 121) were evaluated at two moments: up to 16th week of gestational age (T1) and in the last trimester of pregnancy (T2). Crude and adjusted associations were estimated by the incidence ratio risk (IRR) and respective 95% confidence intervals (95%CI). After adjustment, higher serum concentrations of ferritin (IRR = 0.97, 95%CI 0.95-0.99) in T1, and Fe (IRR = 0.99, 95%CI 0.98-0.99), ferritin (IRR = 0.99, 95%CI 0.98-0.99), erythrocyte (IRR = 0.71, 95%CI 0.50-0.99), hemoglobin (IRR = 0.84, 95%CI 0.73-0.96), hematocrit (IRR = 0.93, 95%CI 0.88-0.98), MCV (IRR = 0.91, 95%CI 0.86-0.96), and MCH (IRR = 0.83, 95%CI 0.74-0.93) in T2, were associated with fewer incidence of dental caries in pregnant women. Iron deficiency anemia during pregnancy is a risk factor for the incidence of dental caries in these women.

Physiological and hematological changes in Chum Salmon artificially infected with Erythrocytic Necrosis virus

USGS Publications Warehouse

Haney, D.C.; Hursh, D.A.; Mix, M.C.; Winton, J.R.

1992-01-01

Chum salmon Oncorhynchus keta were injected with erythrocytic necrosis virus (ENV) to study the physiological and hematological consequences of ENV infection. Infected and control fish were held in pathogen-free seawater and sampled for 5 weeks. Physiological tests included measures of plasma cortisol, glucose, protein, and osmolality; blood lactic acid; and liver glycogen. In general, ENV-infected fish had lower plasma glucose and blood lactic acid, and higher liver glycogen concentrations than did control fish. Hematological tests included red and white blood cell (RBC and WBC) counts, hematocrit, measurement of blood hemoglobin concentration, and a determination of erythrocyte fragility. Infected fish had lower RBC counts, hematocrits, and hemoglobin concentrations; higher WBC counts; and less fragile erythrocytes than did control fish. The hematology data indicated that erythrocytes of infected fish had higher mean corpuscular volume, depressed mean corpuscular hemoglobin concentration, and slightly lower mean corpuscular hemoglobin. Erythrocytic inclusions were observed in the cytoplasm of RBCs from infected fish. The infection progressed steadily through week 4, after which the fish appeared to begin recovering. In a second study, fish were infected with ENV for 3 weeks, and recovery from a stress challenge test was measured. Plasma glucose concentrations and osmclality were higher in infected fish, whereas plasma cortisol and blood lactate were only slightly elevated. These studies indicate that chum salmon withstood the effects of ENV infection without in-eversible physiological consequences. However, when subjected to a stress challenge test, infected fish recovered more slowly than control fish and had increased osmoregulatory difficulties.

The immunotoxicity of 3,3{prime},4,4{prime},5-pentachlorobiphenyl (PeCB) and tributyltin (TBT) in channel catfish, Ictalurus punctatus

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rice, C.D.; Banes, M.M.; Hurt, K.L.

1994-12-31

There is considerable evidence that planar PCBs and Tributyltin (TBT) may be immunotoxic to fish. Apparently the immune system is a target organ for both compounds in rodents. The mechanisms of action are different as PeCB immunotoxicity is associated with cytosolic Ah-R binding and induction of several nuclear response elements while TBT immunotoxicity is associated with membrane perturbation and layered calcium homeostasis. The authors have investigated the effects of a single i.p. dose of PeCB and TBT at 0.01, 0.1, 1.0 mg/kg on several innate immune responses including non-specific cytotoxic cell activity, neutrophil activation, and lymphocyte mitogenesis, as well asmore » baseline hematology at days 3 and 7 post treatment. Hematocrits were affected in TBT treated fish at 1.0 mg/kg while neutrophilia and leukopenia were noted at 0.01 and 1.0 mg/kg. These observations are typical of stress hemograms. PeCB had no adverse effect on hematocrits or leukocyte % but did induce neutrophilia at 1.0 mg/kg. Neutrophil activation was suppressed in both PeCB and TBT treated animals but only at 1.0 mg/kg. NCC activity was suppressed at all three doses of PECB but only 1.0 mg/kg in TBT treated animals. Lymphocyte mitogenesis was affected by both compounds but only at 1.0 mg/kg. A note of interest is that both compounds have the same molecular weight and therefore their immunotoxic effects can be compared on a {micro}mole/kg basis.« less

Blood transfusion reduction with intravenous iron in gynecologic cancer patients receiving chemotherapy.

PubMed

Dangsuwan, Penkae; Manchana, Tarinee

2010-03-01

To compare the incidence of repeated red blood cell (RBC) transfusion in anemic gynecologic cancer patients receiving platinum-based chemotherapy comparing intravenous and oral iron. Forty-four anemic gynecologic cancer patients (hemoglobin level below 10 mg/dl) who required RBC transfusion were stratified and randomized according to baseline hemoglobin levels and chemotherapy regimen. Study group received 200 mg of intravenous iron sucrose and control group received oral ferrous sulphate 600 mg/day. RBC transfusion requirement in the consecutive cycle of chemotherapy was the primary outcome. Quality of life was evaluated by validated Thai version of the Functional Assessment of Cancer Therapy-Anemia (FACT-An). In a total of the 44 patients, there were 22 patients in each group. Five patients (22.7%) in the study group and 14 patients (63.6%) in the control group required RBC transfusion in consecutive cycle of chemotherapy (p=0.01). No significant difference in baseline hemoglobin and hematocrit levels was demonstrated in both groups. Significantly higher mean hemoglobin and hematocrit levels after treatment were reported in the study group (10.0+/-0.8 g/dl and 30.5+/-2.4%) than the control group (9.5+/-0.9 g/dl and 28.4+/-2.7%). No significant change of total FACT-An scores was noted between before and after treatment in both groups. No serious adverse events were reported and there was no significant difference among adverse events between both groups. Intravenous iron is an alternative treatment for anemic gynecologic cancer patients receiving platinum-based chemotherapy and reduces the incidence of RBC transfusion without serious adverse events.

Neither Hematocrit Normalization nor Exercise Training Restores Oxygen Consumption to Normal Levels in Hemodialysis Patients

PubMed Central

Stray-Gundersen, James; Parsons, Dora Beth; Thompson, Jeffrey R.

2016-01-01

Patients treated with hemodialysis develop severely reduced functional capacity, which can be partially ameliorated by correcting anemia and through exercise training. In this study, we determined perturbations of an erythroid-stimulating agent and exercise training to examine if and where limitation to oxygen transport exists in patients on hemodialysis. Twenty-seven patients on hemodialysis completed a crossover study consisting of two exercise training phases at two hematocrit (Hct) values: 30% (anemic) and 42% (physiologic; normalized by treatment with erythroid-stimulating agent). To determine primary outcome measures of peak power and oxygen consumption (VO2) and secondary measures related to components of oxygen transport and utilization, all patients underwent numerous tests at five time points: baseline, untrained at Hct of 30%, after training at Hct of 30%, untrained at Hct of 42%, and after training at Hct of 42%. Hct normalization, exercise training, or the combination thereof significantly improved peak power and VO2 relative to values in the untrained anemic phase. Hct normalization increased peak arterial oxygen and arteriovenous oxygen difference, whereas exercise training improved cardiac output, citrate synthase activity, and peak tissue diffusing capacity. However, although the increase in arterial oxygen observed in the combination phase reached a value similar to that in healthy sedentary controls, the increase in peak arteriovenous oxygen difference did not. Muscle biopsy specimens showed markedly thickened endothelium and electron–dense interstitial deposits. In conclusion, exercise and Hct normalization had positive effects but failed to normalize exercise capacity in patients on hemodialysis. This effect may be caused by abnormalities identified within skeletal muscle. PMID:27153927

EVALUATION OF THE CHELATING EFFECT OF METHANOLIC EXTRACT OF CORIANDRUM SATIVUM AND ITS FRACTIONS ON WISTAR RATS POISONED WITH LEAD ACETATE

PubMed Central

Téllez-López, Miguel Ángel; Mora-Tovar, Gabriela; Ceniceros-Méndez, Iromi Marlen; García-Lujan, Concepción; Puente-Valenzuela, Cristo Omar; Vega-Menchaca, María del Carmen; Serrano-Gallardo, Luis Benjamín; Garza, Rubén García; Morán-Martínez, Javier

2017-01-01

Background: The rate of lead poisoning has decreased in recent years due to increased health control in industries that use this metal. However, it is still a public health problem worldwide. The use of various plants with chelating properties has been a topic of research today. In traditional medicine, it is said that Coriandrum sativum has chelating properties, but there is no scientific evidence to support this fact. The purpose of this research is to evaluate the chelating effect of methanol extract of coriander and its fractions on Wistar rats intoxicated with lead. Materials and Methods: In this research, male Wistar rats were poisoned with 50 mg/kg of lead acetate and treated with 50 mg/kg of methanol extract and its fractions. The extract and its fractions were administered to four treatment groups. Positive and negative controls were established. Hemoglobin, hematocrit and lead concentrations were analyzed; liver was evaluated histologically in control and treatment groups. Results: The methanol extract of coriander presented a LD50 >1000 mg/dL. The group administered with the methanol extract showed significant difference in the levels of hemoglobin and hematocrit compared to the negative control group. Lead concentration in treatment groups showed a decrease compared to the positive control. Histological evaluation of tissue showed less damage in groups administered with methanolic extract and its fractions compared to the positive control which presented structural alterations. Conclusion: Coriander extracts protect liver and lower lead concentration in rats intoxicated with lead in contrast to the positive control group. PMID:28573226

Can Tranexamic Acid Reduce Blood Loss during Major Cardiac Surgery? A Pilot Study.

PubMed

Compton, Frances; Wahed, Amer; Gregoric, Igor; Kar, Biswajit; Dasgupta, Amitava; Tint, Hlaing

2017-09-01

We examined the effectiveness of tranexamic acid in preventing intraoperative blood loss during major cardiac surgery. Out of initial 81 patients undergoing major cardiac surgery (both coronary artery bypass and valve repair procedures) at our teaching hospital, sixty-seven patients were selected for this study. We compared estimated blood loss, decrease in percent hemoglobin and hematocrit following surgery between two groups of patients (none of them received any blood product during surgery), one group receiving no tranexamic acid (n=17) and another group receiving tranexamic acid (n=25). In the second study, we combined these patients with patients receiving modest amounts of blood products (1-2 unit) and compared these parameters between two groups of patients (25 patients received no tranexamic acid, 42 patients received tranexamic acid). In patients who received no blood product during surgery, those who received no tranexamic acid showed statistically significant (independent t-test two tailed at p <0.05) reduced estimated blood loss (mean: 713.5 mL, SD: 351.6, n=17) compared to those who received tranexamic acid (mean: 987.2 mL, SD: 459.9, n=25). We observed similar results when the patients receiving no blood products and patients receiving modest amount of blood products were combined based on the use of tranexamic acid or not. No statistically significant difference was observed in percent reduced hemoglobin or hematocrit following surgery in any group of patients. We conclude that intraoperative antifibrinolytic therapy with tranexamic acid does not reduce intraoperative blood loss during major cardiac surgery which contradicts popular belief. © 2017 by the Association of Clinical Scientists, Inc.

Matched cohort study of topical tranexamic acid in cementless primary total hip replacement.

PubMed

Sanz-Reig, Javier; Mas Martinez, Jesus; Verdu Román, Carmen; Morales Santias, Manuel; Martínez Gimenez, Enrique; Bustamante Suarez de Puga, David

2018-03-29

Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P < 0.001). The mean total blood loss was 769 in topical tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase. A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group.

Two-dimensional simulation of red blood cell motion near a wall under a lateral force

NASA Astrophysics Data System (ADS)

Hariprasad, Daniel S.; Secomb, Timothy W.

2014-11-01

The motion of a red blood cell suspended in a linear shear flow adjacent to a fixed boundary subject to an applied lateral force directed toward the boundary is simulated. A two-dimensional model is used that represents the viscous and elastic properties of normal red blood cells. Shear rates in the range of 100 to 600 s-1 are considered, and the suspending medium viscosity is 1 cP. In the absence of a lateral force, the cell executes a tumbling motion. With increasing lateral force, a transition from tumbling to tank-treading is predicted. The minimum force required to ensure tank-treading increases nonlinearly with the shear rate. Transient swinging motions occur when the force is slightly larger than the transition value. The applied lateral force is balanced by a hydrodynamic lift force resulting from the positive orientation of the long axis of the cell with respect to the wall. In the case of cyclic tumbling motions, the orientation angle takes positive values through most of the cycle, resulting in lift generation. These results are used to predict the motion of a cell close to the outer edge of the cell-rich core region that is generated when blood flows in a narrow tube. In this case, the lateral force is generated by shear-induced dispersion, resulting from cell-cell interactions in a region with a concentration gradient. This force is estimated using previous data on shear-induced dispersion. The cell is predicted to execute tank-treading motions at normal physiological hematocrit levels, with the possibility of tumbling at lower hematocrit levels.

Effects of pH, lactate, hematocrit and potassium level on the accuracy of continuous glucose monitoring (CGM) in pediatric intensive care unit.

PubMed

Marics, Gábor; Koncz, Levente; Eitler, Katalin; Vatai, Barbara; Szénási, Boglárka; Zakariás, David; Mikos, Borbála; Körner, Anna; Tóth-Heyn, Péter

2015-03-19

Continuous glucose monitoring (CGM) originally was developed for diabetic patients and it may be a useful tool for monitoring glucose changes in pediatric intensive care unit (PICU). Its use is, however, limited by the lack of sufficient data on its reliability at insufficient peripheral perfusion. We aimed to correlate the accuracy of CGM with laboratory markers relevant to disturbed tissue perfusion. In 38 pediatric patients (age range, 0-18 years) requiring intensive care we tested the effect of pH, lactate, hematocrit and serum potassium on the difference between CGM and meter glucose measurements. Guardian® (Medtronic®) CGM results were compared to GEM 3000 (Instrumentation laboratory®) and point-of-care measurements. The clinical accuracy of CGM was evaluated by Clarke Error Grid -, Bland-Altman analysis and Pearson's correlation. We used Friedman test for statistical analysis (statistical significance was established as a p < 0.05). CGM values exhibited a considerable variability without any correlation with the examined laboratory parameters. Clarke, Bland-Altman analysis and Pearson's correlation coefficient demonstrated a good clinical accuracy of CGM (zone A and B = 96%; the mean difference between reference and CGM glucose was 1,3 mg/dL, 48 from the 780 calibration pairs overrunning the 2 standard deviation; Pearson's correlation coefficient: 0.83). The accuracy of CGM measurements is independent of laboratory parameters relevant to tissue hypoperfusion. CGM may prove a reliable tool for continuous monitoring of glucose changes in PICUs, not much influenced by tissue perfusion, but still not appropriate for being the base for clinical decisions.

Muscle remodeling in relation to blood supply: implications for seasonal changes in mitochondrial enzymes.

PubMed

McClelland, G B; Dalziel, A C; Fragoso, N M; Moyes, C D

2005-02-01

We investigated if seasonal changes in rainbow trout muscle energetics arise in response to seasonal changes in erythrocyte properties. We assessed if skeletal muscle mitochondrial enzymes changed (1) acutely in response to changes in erythrocyte abundance, or (2) seasonally when we altered the age profile of erythrocytes. Rainbow trout were treated with pheynylhydrazine, causing a 75% reduction in hematocrit within 4 days. After erythropoiesis had returned hematocrit to normal, treated and control fish were subjected to a seasonal cold acclimation regime to assess the impact of erythrocyte age on skeletal muscle remodeling. Anemia (i.e. phenylhydrazine treatment) did not alter the specific activities (U g(-1) tissue) of mitochondrial enzymes in white or red muscle. Anemic pretreatment did not alter the normal pattern of cold-induced mitochondrial proliferation in skeletal muscle, suggesting erythrocyte age was not an important influence on seasonal remodeling of muscle. Anemia and cold acclimation both induced a 25-30% increase in relative ventricular mass. The increase in relative ventricular mass with phenylhydrazine treatment was accompanied by a 35% increase in DNA content (mg DNA per ventricle), suggesting an increase in number of cells. In contrast, the increase in ventricular mass with cold temperature acclimation occurred without a change in DNA content (mg DNA per ventricle), suggesting an increase in cell size. Despite the major increases in relative ventricular mass, neither anemia nor seasonal acclimation had a major influence on the specific activities of a suite of mitochondrial enzymes in heart. Collectively, these studies argue against a role for erythrocyte dynamics in seasonal adaptive remodeling of skeletal muscle energetics.

Evaluation of the Spectra Optia apheresis system for mononuclear cell (MNC) collection in G-CSF mobilized and nonmobilized healthy donors: results of a multicenter study.

PubMed

Karafin, Matthew S; Graminske, Sharon; Erickson, Paulette; Walters, Mark C; Scott, Edward P; Carter, Scott; Padmanabhan, Anand

2014-10-01

The Spectra Optia apheresis system is a newer centrifugation-based device that in comparison with the COBE Spectra includes features that enhance procedure automation and usability. In this FDA-approved three-center two-arm observational study we characterized the performance of the Spectra Optia for collection of MNCs and CD34+ cells from nonmobilized and granulocyte-colony stimulating factor (G-CSF) mobilized healthy donors, respectively. There were a total of 15 evaluable subjects in each arm. Key performance indicators included collection efficiency of MNCs/CD34+ cells, product purity and cellular viability. For nonmobilized donors, median MNC collection efficiency, platelet collection efficiency, product hematocrit and granulocyte contamination were 57%, 12%, 4%, and 1.7%, respectively. For mobilized donors, median MNC collection efficiency, CD34+ cell collection efficiency, platelet collection efficiency, product hematocrit and granulocyte contamination were 61%, 77%, 19%, 4%, and 15%, respectively. Average WBC viability in the mobilized products was 99%. There was one severe (grade 3) adverse event related to citrate toxicity. This study demonstrates that the Spectra Optia can be used for safe and efficacious collection of MNCs, and results obtained are in line with expectations on collection efficiency and product characteristics. Adverse events were limited to those that are well documented in the stem-cell mobilization and leukapheresis process. As of the time of this writing, FDA 510(k) approval for use of the Spectra Optia device for MNC collection was achieved in the US based partly on the results of this study. © 2014 Wiley Periodicals, Inc.

Late-onset hypogonadism: the advantages of treatment with human chorionic gonadotropin rather than testosterone.

PubMed

La Vignera, Sandro; Condorelli, Rosita Angela; Cimino, Laura; Russo, Giorgio Ivan; Morgia, Giuseppe; Calogero, Aldo E

2016-01-01

The traditional pharmacological treatment of patients with late onset hypogonadism (LOH) is represented by different formulations of testosterone (T) or alternatively by the extractive human chorionic gonadotropin (HCG). The hormone replacement treatment (HRT) is associated with the potential increase of hematocrit, serum concentrations of prostate-specific antigen (PSA) and prostate volume. Moreover, the gynecomastia represent a condition frequently associated with HRT. Recent evidences showed the role of leydig cells in the 25-hydroxylation of vitamin D and the elevated frequency of hypovitaminosis D among LOH patients. Finally, another important aspect of LOH is represented by the frequency of secondary infertility due to age or to traditional HRT. This study evaluated 40 LOH patients treated for 6 months with extractive HCG (n = 10 patients) and three different formulations of T: transdermal (n = 10 patients), undecaonate (n = 10 patients) and enantate (n = 10 patients). Hormonal, anthropometric, metabolic and sperm parameters were evaluated and compared. Moreover, the main safety parameters and the results of the main questionnaires were evaluated. After treatment, HCG group showed serum concentrations of 25-OH-vitamin D significantly higher (p < 0.05) and serum concentrations of oestrogens significantly lower (p < 0.05) compared with other groups. Moreover, they showed a mean value of hematocrit, PSA and prostate volume significantly lower (p < 0.05) compared with other groups. Finally, all the groups treated with T showed a significant reduction (p < 0.05) of sperm density and of percentage of spermatozoa with progressive motility compared with HCG group.

Reductions in Central Venous Pressure by Lower Body Negative Pressure or Blood Loss Elicit Similar Hemodynamic Responses

DTIC Science & Technology

2014-05-29

echolamines, hematocrit, hemoglobin, arginine vasopressin, and blood gases. LBNP consisted of 5-min stages at 0, 15, 30, and 45 mmHg of suction. BL consisted...release of volume-regulating hormones such as arginine vasopressin (1, 2, 11, 18, 24, 37). Therefore, it is plausible that blood analyte responses to LBNP...regression analyses. A sample size of 8 subjects (age 32 3 yr; height 185.3 1.8 cm; weight 91.3 3.4 kg; BMI 26.6 0.8 kg/m2) was used for ANOVA

OSMOTIC PROPERTIES OF HUMAN RED CELLS.

PubMed

SAVITZ, D; SIDEL, V W; SOLOMON, A K

1964-09-01

The hematocrit method as a technique for determining red cell volume under anisotonic conditions has been reexamined and has been shown, with appropriate corrections for trapped plasma, to provide a true measure of cell volume. Cell volume changes in response to equilibration in anisotonic media were found to be much less than those predicted for an ideal osmometer; this anomalous behavior cannot be explained by solute leakage or by the changing osmotic coefficient of hemoglobin, but is quantitatively accounted for by the hypothesis that 20 per cent of intracellular water is bound to hemoglobin and is unavailable for participation in osmotic shifts.

Effect of simulated weightlessness on the immune system in rats

NASA Technical Reports Server (NTRS)

Caren, L. D.; Mandel, A. D.; Nunes, J. A.

1980-01-01

Rats suspended in a model system designed to simulate many aspects of weightlessness were immunized with sheep red blood cells. Parameters measured on these and control rats included titers of anti-sheep red blood cell antibodies, serum immunoglobulin levels, spleen and thymus weights, hematocrits, and leukocyte differential counts on peripheral blood. No significant differences were found between test and weight-bearing, harnessed controls; however, the thymuses of animals in both these groups were significantly smaller than untreated cage controls. The lack of an effect of simulated weightlessness on the immune system is an interesting result, and its significance is discussed.

Passenger fluid volumes measured before and after a prolonged commercial jet flight.

NASA Technical Reports Server (NTRS)

Johnson, P. C.; Carpentier, W. R.; Driscoll, T. B.; Lapinta, C. K.; Rummel, J. A.; Sawin, C. F.

1972-01-01

Interstitial and intracellular fluid volumes were calculated from measured plasma volume, extracellular volume and total body water of six subjects before and after a 24-hour commercial overseas flight. No change occurred in these spaces or in peripheral hematocrit or total serum protein concentration. The subjective feeling of dehydration and the actual swelling of the lower extremities characteristically found among passengers at the end of a long trip of this type seems to represent a shift in body fluids to the dependent portions of the body rather than water retention or a decrease in the intravascular water volume.

Heparin as a pharmacologic intervention to induce positive scintiscan in occult gastrointestinal bleeding

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chaudhuri, T.K.; Brantly, M.

1984-04-01

The value of using heparin as a pharmacologic intervention to induce a positive scintiscan was studied in a patient with chronic occult gastrointestinal bleeding. When all standard diagnostic tests (upper and lower gastrointestinal series, upper and lower endoscopy, and conventional noninterventional Tc-99m RBC imaging) fail to detect and localize gastrointestinal bleeding in a patient who has definite clinical evidence (guaiac positive stool and dropping hemoglobin, hematocrit) of chronic occult gastrointestinal oozing, heparin may be used (with proper precaution) as a last resort to aid in the scintigraphic detection and localization of chronic occult gastrointestinal bleeding.

Use of a computer model in the understanding of erythropoietic control mechanisms

NASA Technical Reports Server (NTRS)

Dunn, C. D. R.

1978-01-01

During an eight-week visit approximately 200 simulations using the computer model for the regulation of erythopoiesis were carries out in four general areas: with the human model simulating hypoxia and dehydration, evaluation of the simulation of dehydration using the mouse model. The experiments led to two considerations for the models. Firstly, a direct relationship between erythropoietin concentration and bone marrow sensitivity to the hormone and, secondly, a partial correction of tissue hypoxia prior to compensation by an increased hematocrit. This latter change in particular produced a better simuation of the effects of hypoxia on plasma erythropoietin concentrations.

Coagulability and Rheology: Hematologic Benefits From Exercise, Fish, and Aspirin. Implications for Athletes and Nonathletes.

PubMed

Eichner, E R

1986-10-01

In brief: Physical activity makes the blood more fluid and less likely to clot. The healthy hematologic adaptations to exercise (enhanced fibrinolysis, expanded plasma volume, decreased hematocrit, increased red cell deformability, and decreased blood viscosity) seem to enhance the delivery of oxygen and decrease the risk of thrombosis. Regular exercise, then, by changing the blood, may offer the elite athlete enhanced performance and the general population reduced risk of heart attack. Increased amounts of fish in the diet and-for selected persons-low-dose aspirin, may be useful antithrombotic adjuncts to exercise.

Acute lead poisoning in two users of illicit methamphetamine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Allcott, J.V. III; Barnhart, R.A.; Mooney, L.A.

1987-07-31

Acute lead poisoning can present a difficult diagnostic dilemma, with symptoms that mimic those of hepatitis, nephritis, and encephalopathy. The authors report two cases in intravenous methamphetamine users who presented with abnormal liver function values, low hematocrit values, basophilic stippling of red blood cells, and elevated blood lead levels. Both patients excreted large amounts of lead in their urine after treatment with edetic acid, followed by resolution of their symptoms. Lead contamination was proved in one drug sample. Basophilic stippling of the red blood cells was the one key laboratory result that led to the definitive diagnosis in both cases.

Pseudopolycythemia, pseudothrombocytopenia, and pseudoleukopenia due to overfilling of blood collection vacuum tubes.

PubMed

Pewarchuk, W; VanderBoom, J; Blajchman, M A

1992-01-01

A patient blood sample with an unexpectedly high hemoglobin level, high hematocrit, low white blood cell count, and low platelet count was recognized as being spurious based on previously available data. Repeated testing of the original sample showed a gradual return of all parameters to expected levels. We provide evidence that the overfilling of blood collection vacuum tubes can lead to inadequate sample mixing and that, in combination with the settling of the cellular contents in the collection tubes, can result in spuriously abnormal hematological parameters as estimated by an automated method.

Negative-Pressure Wound Therapy: A Hemostatic Adjunct for Control of Coagulopathic Hemorrhage in Large Soft Tissue Wounds

DTIC Science & Technology

2012-01-01

65.6 (2.05) 64.6 (1.7) 69.4 (2.6) 63.8 (0.8) 0.20 Hemoglobin level , g/dL 10.4 (0.12) 4.6 (0.23) 4.3 (0.18) 4.5 (0.17) 4.4 (0.13) 0.50 Hematocrit ...and level of negative pressure, wound filter, and wound contact layer. This modality creates a wound environment of subat- mospheric pressure (j50 to...inhibitory factors such as collagenases and inflammatory cytokines, (2) decreasing the level of bacteria, (3) improving blood flow in the wound bed and

Plasma volume methodology: Evans blue, hemoglobin-hematocrit, and mass density transformations

NASA Technical Reports Server (NTRS)

Greenleaf, J. E.; Hinghofer-Szalkay, H.

1985-01-01

Methods for measuring absolute levels and changes in plasma volume are presented along with derivations of pertinent equations. Reduction in variability of the Evans blue dye dilution technique using chromatographic column purification suggests that the day-to-day variability in the plasma volume in humans is less than + or - 20 m1. Mass density determination using the mechanical-oscillator technique provides a method for measuring vascular fluid shifts continuously for assessing the density of the filtrate, and for quantifying movements of protein across microvascular walls. Equations for the calculation of volume and density of shifted fluid are presented.

Uptake and retention of dietary cadmium in mallard ducks

USGS Publications Warehouse

White, D.H.; Finley, M.T.

1978-01-01

Adult mallard ducks fed 0, 2, 20, or 200 ppm of cadmium chloride in the diet were sacrificed at 30-day intervals and tissues were analyzed for cadmium. No birds died during the study and body weights did not change. The liver and kidney accumulated the highest levels of cadmium. Tissue residues were significantly correlated in all treatment groups and residues increased with treatment level. Hematocrits and hemoglobin concentrations were normal in all groups throughout the study. Little cadmium accumulated in eggs of laying hens, but egg production was suppressed in the group fed 200 ppm.

Statistical methods for estimating normal blood chemistry ranges and variance in rainbow trout (Salmo gairdneri), Shasta Strain

USGS Publications Warehouse

Wedemeyer, Gary A.; Nelson, Nancy C.

1975-01-01

Gaussian and nonparametric (percentile estimate and tolerance interval) statistical methods were used to estimate normal ranges for blood chemistry (bicarbonate, bilirubin, calcium, hematocrit, hemoglobin, magnesium, mean cell hemoglobin concentration, osmolality, inorganic phosphorus, and pH for juvenile rainbow (Salmo gairdneri, Shasta strain) trout held under defined environmental conditions. The percentile estimate and Gaussian methods gave similar normal ranges, whereas the tolerance interval method gave consistently wider ranges for all blood variables except hemoglobin. If the underlying frequency distribution is unknown, the percentile estimate procedure would be the method of choice.

Open heart operations without transfusion using a multimodality blood conservation strategy in 50 Jehovah's Witness patients: implications for a "bloodless" surgical technique.

PubMed

Rosengart, T K; Helm, R E; DeBois, W J; Garcia, N; Krieger, K H; Isom, O W

1997-06-01

Blood transfusion persists as an important risk of open heart operations despite the recent introduction of a variety of new pharmacologic agents and blood conservation techniques as independent therapies. A comprehensive multimodality blood conservation program was developed to minimize this risk. To provide a strategy for operating without transfusion, this program was prospectively applied to 50 adult patients who are Jehovah's Witnesses and have undergone open heart operation at our institution since 1992. The blood conservation program used for these patients included the use of high-dose erythropoietin (800 U/kg load, 500 U/kg every other day), aprotinin (6 million U total dose full Hammersmith regimen), "maximal" volume intraoperative autologous blood donation, intraoperative cell salvage, continuous shed blood reinfusion, and drawing as few blood specimens as possible. Procedures performed included first-time coronary bypass operations (n = 30) and more complex operations, including reoperations, valve replacements, and multiple valve replacements with or without coronary bypass (n = 20). Despite the absence of transfusion, the mean discharge hematocrit in these patients was greater than 30 percent, and there was no anemia-related mortality rate in this group. The overall in-hospital mortality for the group was 4 percent. A subset analysis was performed between the 30 first-time coronary bypass patients (group 1) and a control group of 30 consecutive patients who were not Jehovah's Witnesses but had undergone first-time coronary bypass during the same period (group 2). The blood conservation program described in the previous paragraph was not used in group 2 patients and specific transfusion criteria were prospectively applied. The chest tube output in group 1 patients was less than 40 percent of that for group 2 patients at all points measured after operation (p < 0.01). Postoperative hematocrit levels in group 1 were greater than those for group 2, despite the absence of red blood cell transfusion and despite a significantly lower admission hematocrit and red blood cell mass in group 1. The average length of stay and ancillary costs for the two groups were equivalent. Although group 1 and 2 patients were well matched for preoperative transfusion risk factors, none of the group 1 patients required transfusion, but 17 (57 percent) group 2 patients met transfusion criteria and received 3.0 +/- 4.8 U (mean plus or minus standard deviation) of homologous blood or blood products. These results suggest that even complex open heart operations can be performed without homologous transfusion by optimally applying available blood conservation techniques. More generalized application of these measures may increasingly allow "bloodless" operations in all patients.

Challenges in diagnosis and management of giant solitary fibrous tumour of pleura: a case report.

PubMed

Tan, Jessica H Y; Hsu, Anne A L

2016-08-08

Majority of patients with solitary fibrous tumours of the pleura (SFTP) are asymptomatic. Acute presentation with symptoms resulting from mass effect due to rapid expansion of tumour size has not been reported before. This report chronicles the case of a giant SFTP in a 76-year-old lady who presented with acute onset of haemoptysis, left-sided pleuritic chest pain and hoarseness of voice. Her chest radiograph showed a large left upper hemithorax mass with an ipsilateral effusion. Computed tomography (CT) scan of the thorax confirmed the presence of a pleural-based mass lesion in the left apex measuring 9.7 cm with close apposition to the aortic arch. The mass demonstrated neovascularization and there was also presence of a moderate-sized heterogeneous-appearing left pleural effusion. Thoracocentesis yielded deeply haemoserous pleural fluid with a pleural aspirate hematocrit closely approaching that of peripheral blood hematocrit and alongside a 2 unit decrease in haemoglobin, was indicative of a haemothorax. Repeat CT 10 days from initial presentation showed reduction in size of the left apical mass as well as resolution of the left effusion. This was consistent with the occurrence of an intra-tumoural bleed resulting in rapid increase in the size of the SFTP, causing rupture of superficial blood vessels on the tumour surface (haemothorax) and consequential compression of the lung parenchyma (haemoptysis) and left recurrent laryngeal nerve (hoarseness of voice). The patient eventually underwent an uneventful surgical resection. A benign SFTP can present acutely with compressive symptoms as a result of spontaneous intra-tumoural bleed causing sudden increase in its size. It is important to allow temporal regression of these acute changes before deciding on surgical resectability.

Effects of Pleurotomy on Respiratory Sequelae after Internal Mammary Artery Harvesting

PubMed Central

Iyem, Hikmet; Islamoglu, Fatih; Yagdi, Tahir; Sargin, Murat; Berber, Ozbek; Hamulu, Ahmet; Buket, Suat; Durmaz, Isa

2006-01-01

The preservation of pleural integrity during mammary artery harvesting may decrease atelectasis and pleural effusion during the postoperative period. We designed this retrospective study to evaluate the effects on postoperative pulmonary function of pleural integrity versus opened pleura, in patients who receive a left internal mammary artery graft. The study group consisted of 1,141 patients who underwent elective coronary artery bypass grafting. The patients were retrospectively evaluated and divided into 2 groups: those who underwent internal mammary artery harvesting with opened pleura (n=873) or with pleural integrity (n=268). To monitor pleural effusion and atelectasis, chest radiography was performed routinely 1 day before operation and on the 2nd, 5th, and 7th postoperative days. The preoperative, after extubation, and 1st postoperative day values of partial oxygen pressure (PaO2), partial carbon dioxide pressure (PaCO2), and oxygen (O2) saturation were recorded for comparison, as was the hematocrit. The mean age of the patients was 57.4 ± 8.81 years. There were no significant differences between the groups in mean values of PaO2, PaCO2, O2 saturation, and hematocrit after extubation or on the 1st postoperative day. Atelectasis on the 5th and 7th postoperative days, pleural effusion on the 2nd, 5th, and 7th days, and postoperative bleeding were significantly less in the group with preserved pleural integrity. We showed that preservation of pleural integrity during internal mammary artery harvesting decreases postoperative bleeding, pleural effusion, and atelectasis. We conclude that preservation of pleural integrity, when possible, can decrease these postoperative complications of coronary artery bypass grafting. PMID:16878610

Blood rheology adjustments in rats after a program of intermittent exposure to hypobaric hypoxia.

PubMed

Esteva, Santiago; Panisello, Pere; Torrella, Joan Ramon; Pagés, Teresa; Viscor, Ginés

2009-01-01

Intermittent hypobaric hypoxia (IHH) exposure induces a rise in hemoglobin concentration and an increase in erythrocyte mass in both rats and humans. Although this response increases blood oxygen transport capacity, paradoxically, it could impair blood flow and gas exchange because of the blood viscosity alterations associated with the rising hematocrit. In the present study, male rats were subjected to an IHH program consisting of a daily 4-h session for 5 days/week until they had completed 22 days of hypoxia exposure in a hypobaric chamber at a simulated altitude of 5000 m. Blood samples were taken at the end of the exposure period (H) and at 20 (P20) and 40 (P40) days after the end of the program and were compared to control (C) maintained at sea- level pressure. Apparent blood viscosity (eta(a)) and plasma viscosity (eta(p)) were measured in a cone-plate microviscometer. Although the hematocrit significantly increased in the H group, blood apparent viscosity did not differ among groups, ranging from 7.67 to 6.57 mPa*sec at a shear rate of 90 sec(-1). Relative blood viscosity showed a clear increase (about 27%) in H rats, mainly due to the significant decrease in plasma viscosity. This finding could be interpreted as a compensatory response, which reduced the effect of increased erythrocyte mass volume on whole-blood viscosity. Oxygen delivery index and blood oxygen potential transport capacity remained unchanged in all groups. These data indicate that the IHH program has a deep but transitory effect on red cell parameters and a moderate effect on blood rheological behavior.

The effect of blood transfusion on short-term, perioperative outcomes in elective spine surgery.

PubMed

Seicean, Andreea; Alan, Nima; Seicean, Sinziana; Neuhauser, Duncan; Weil, Robert J

2014-09-01

Studies in various surgical procedures have shown that transfusion of red blood cells (RBC) increases the risk of postoperative morbidity and mortality. Impact of blood transfusion in patients undergoing spine surgery is not well-described. We assessed the impact of intra and postoperative transfusion on postoperative morbidity and mortality in patients undergoing elective spine surgery. We used the American College of Surgeons' National Surgical Quality Improvement Program to identify a retrospective cohort of 36,901 adult patients who underwent elective spine surgery between 2006 and 2011. Patients who received intra or postoperative transfusion (n=3262) were matched to those who did not using propensity scores. Logistic regression predicted adverse postoperative outcomes. We conducted sensitivity analysis in a subset of patients in whom the number of intraoperatively transfused units of RBC or whole blood was known. Upon matching, preoperative hematocrit, length of surgery, and percentage of spinal fusion surgery were not significantly different between transfused and non-transfused patients. After matching, transfusion remained adversely associated with prolonged length of stay (LOS) in hospital (odds ratio [OR] 2.6, 95% confidence interval [CI] 2.3-2.9), postoperative complications (OR 1.6, 95% CI 1.4-1.9), and an increased 30 day return to operation room (OR 1.7, 95% CI 1.3-2.2). Transfusion of even one unit of blood intraoperatively was associated with prolonged LOS (OR 2.0, 95% CI 1.5-2.6) and minor complications (OR 2.4, 95% CI 1.3-4.3). Therefore, transfusion of RBC or whole blood, even a single unit, increased LOS and postoperative morbidity in patients undergoing elective spine surgery, independent of preoperative hematocrit level and patient comorbidities. Copyright © 2014 Elsevier Ltd. All rights reserved.

Platelets Drive Thrombus Propagation in a Hematocrit and Glycoprotein VI-Dependent Manner in an In Vitro Venous Thrombosis Model.

PubMed

Lehmann, Marcus; Schoeman, Rogier M; Krohl, Patrick J; Wallbank, Alison M; Samaniuk, Joseph R; Jandrot-Perrus, Martine; Neeves, Keith B

2018-05-01

The objective of this study was to measure the role of platelets and red blood cells on thrombus propagation in an in vitro model of venous valvular stasis. A microfluidic model with dimensional similarity to human venous valves consists of a sinus distal to a sudden expansion, where for sufficiently high Reynolds numbers, 2 countercurrent vortices arise because of flow separation. The primary vortex is defined by the points of flow separation and reattachment. A secondary vortex forms in the deepest recess of the valve pocket characterized by low shear rates. An initial fibrin gel formed within the secondary vortex of a tissue factor-coated valve sinus. Platelets accumulated at the interface of the fibrin gel and the primary vortex. Red blood cells at physiological hematocrits were necessary to provide an adequate flux of platelets to support thrombus growth out of the valve sinus. A subpopulation of platelets that adhered to fibrin expose phosphatidylserine. Platelet-dependent thrombus growth was attenuated by inhibition of glycoprotein VI with a blocking Fab fragment or D-dimer. A 3-step process regulated by hemodynamics was necessary for robust thrombus propagation: First, immobilized tissue factor initiates coagulation and fibrin deposition within a low flow niche defined by a secondary vortex in the pocket of a model venous valve. Second, a primary vortex delivers platelets to the fibrin interface in a red blood cell-dependent manner. Third, platelets adhere to fibrin, activate through glycoprotein VI, express phosphatidylserine, and subsequently promote thrombus growth beyond the valve sinus and into the bulk flow. © 2018 American Heart Association, Inc.

Hematocrit Levels, Blood Testing, and Blood Transfusion in Infants After Heart Surgery.

PubMed

Delgado-Corcoran, Claudia; Wolpert, Katherine H; Lucas, Kathryn; Bodily, Stephanie; Presson, Angela P; Bratton, Susan L

2016-11-01

To determine whether judicious blood testing impacts timing or amount of packed RBC transfusions in infants after heart surgery. A retrospective study comparing before and after initiation of a quality improvement process. A university-affiliated cardiac ICU at a tertiary care children's hospital. Infants less than 1 year old with Risk Adjustment for Congenital Heart Surgery category 4, 5, 6, or d-transposition of great arteries (Risk Adjustment for Congenital Heart Surgery 3) consecutively treated during 2010 through 2013. A quality improvement process implemented in 2011 to decrease routine laboratory testing after surgery. Fifty-two infants preintervention and 214 postintervention had similar age, weight, proportion of cyanotic lesions, and surgical complexity. Infants with single versus biventricular physiology were compared separately. The number of laboratory tests per patient adjusted for cardiac ICU length of stay (laboratory tests/patient/day) was significantly lower in postintervention populations for single and biventricular groups (9 vs 15 and 10 vs 15, respectively; p < 0.001). The proportion of single ventricle patients transfused post- and preintervention was not statistically different (72% vs 90%; p = 0.130). Transfusion in the biventricular groups was the same over time (65% vs 65%). Time to first transfusion was significantly longer in the postintervention single ventricle group (4 vs 1 d; p < 0.001), and was not statistically different in the biventricular patients (4 vs 7 d; p = 0.058). The median hematocrit level at first transfusion was significantly lower (37% vs 40%; p = 0.004) postintervention in the cyanotic population, but did not differ in the biventricular group (31% vs 31%; p = 0.840). In infants after heart surgery, blood testing targeted to individual needs significantly decreased the number of blood tests, but did not significantly decrease postoperative blood transfusion.

Characterization and minimization of the stress response to trapping in free-ranging wolves (Canis lupus): insights from physiology and behavior.

PubMed

Santos, Nuno; Rio-Maior, Helena; Nakamura, Mónia; Roque, Sara; Brandão, Ricardo; Álvares, Francisco

2017-09-01

Wildlife capture is an essential management tool that induces a reactive homeostasis response in the captured animals. The aim of this study was to characterize the reactive homeostatic response to trapping in free-ranging wolves and assess the mitigation achieved by reducing the duration of restraint. Making use of wolves captured for ecological research as a model for wildlife acute stress, we characterize 25 reactive homeostasis mediators and we assess the effect on these mediators of reducing the duration of restraint in trap by using remote trap activation alarms. Free-ranging wolves trapped by leg-hold snares (n = 15) showed higher stress leukogram, tissue injury and hematocrit; while lower glucose, ions and cardiac rate compared with captive wolves. They also showed higher leukocyte count and creatine kinase; but lower hematocrit, cardiac rate and rectal body temperature compared to wolves captured by darting from a helicopter. Daily distance travelled was significantly lower up to day 12 post-capture compared to the remainder of the telemetry follow-up and this effect was more noticeable on the nocturnal distance travelled. Reducing the duration of restraint on trap significantly lowered the stress leukogram and dehydration. Daily distance travelled during the night by wolves captured using trap-alarms was significantly lower only up to day 4 post-capture compared to up to day 28 for wolves captured without trap-alarms. The capture method and duration of restraint influence the reactive homeostasis response of free-ranging wolves. Technological solutions that reduce the duration of restraint on trap significantly dampen this influence. Wildlife trapping actions should strive to minimize the delay from capture to manipulation.

Hematological parameters of human immunodeficiency virus positive pregnant women on antiretroviral therapy in Aminu Kano Teaching Hospital Kano, North Western Nigeria.

PubMed

Abdulqadir, Ibrahim; Ahmed, Sagir Gumel; Kuliya, Aisha Gwarzo; Tukur, Jamilu; Yusuf, Aminu Abba; Musa, Abubakar Umar

2018-01-01

Human immunodeficiency virus (HIV) scourge continues to affect young women within the reproductive age group and pregnancy is a recognized indication for the use antiretroviral (ARV) drugs among HIV-positive women. The aim is to determine the combined effect of pregnancy, HIV and ARV drugs on the hematological parameters of the pregnant women. This was a comparative cross-sectional study conducted among 70 each of HIV-positive and negative pregnant women. Bio-demographic and clinical data were extracted from the client folder and 4 ml of blood sample was obtained from each participant. Full blood count was generated using Swelab automatic hematology analyzer while reticulocyte count and erythrocyte sedimentation rate (ESR) were conducted manually. Data analysis was performed using SPSS version software 16 while P < 0.05 was considered statistically significant. Pregnant women with HIV had statistically significant lower hematocrit and white blood cell (WBC) and higher ESR than pregnant women without HIV ( P < 0.000). There was no statistically significant difference between the two groups in terms of platelet and reticulocyte ( P > 0.05). However, among HIV positive pregnant women, those with CD4 count <350/μL had statistically significant lower WBC and lymphocyte count than those with CD4 count ≥350/μL ( P < 0.05), whereas, those on zidovudine (AZT)-containing treatment had statistically significant lower hematocrit and higher mean cell volume than those on non-AZT-containing treatment ( P < 0.05), but there was no statistically significant difference in any of the hematological parameters ( P > 0.050) between women on first- and second-line ARV regimens. There is a significant difference in terms of hematological parameters between HIV-positive and HIV-negative pregnant women in this environment.

Comparison of stored red blood cell washing techniques for priming extracorporeal circuits.

PubMed

Sasaki, Jun; Tirotta, Christopher; Lim, Hyunsoo; Kubes, Kathleen; Salvaggio, Jane; Hannan, Robert; Burke, Redmond; Ojito, Jorge

2018-03-01

The aim of this study was to compare three different blood washing techniques and describe the differences for the composition of the washed red blood cells (RBC). Stored RBCs less than 5 days old were washed using three different techniques. 1) Washing with normal saline with the COBE Model 2991 blood processor in the blood bank (BB-S). 2) Washing with normal saline with the Continuous AutoTransfusion System (C.A.T.S) in the operating room (OR-S). 3) Washing with Plasma-Lyte with the C.A.T.S in the operating room (OR-PL). Then, we compared the values for hemoglobin (Hb), hematocrit (Hct), blood volume, RBC volume, lactate, glucose, sodium and potassium of the three different groups. Forty-five units of RBCs were washed and analyzed (15 for each technique). The OR-S RBCs, when compared to the BB-S RBCs, had lower hemoglobin (g/dL) (22.8 vs 24.1, p=0.006), lower hematocrit (%) (67 vs 71, p=0.006), higher RBC volume (ml) (161 vs 130, p<0.001), higher glucose (mg/dL) (185 vs 46, p<0.001) and lower sodium (mmol/L) (153 vs 158, p<0.001). When compared to the OR-S RBCs, the OR-PL RBCs showed higher potassium (mmol/L) (5.3 vs 2, p<0.001) and lower sodium (mmol/L) (129 vs 153, p<0.001). RBCs washed with an autotransfusion device had a higher RBC volume and more physiological levels of glucose and sodium when compared with the blood processor in the blood bank. It can be an alternative option to use RBCs washed with an autotransfusion device for priming the extracorporeal circuits utilized in patients undergoing cardiac surgery.

Comparative study of topical vs. intravenous tranexamic acid regarding blood loss in total knee arthroplasty.

PubMed

Zekcer, Ari; Priori, Ricardo Del; Tieppo, Clauber; Silva, Ricardo Soares da; Severino, Nilson Roberto

2017-01-01

To compare topical vs. intravenous tranexamic acid (TA) in total knee arthroplasty regarding blood loss and transfusion. Ninety patients were randomized to receive TA intravenously (20 mg/kg in 100 mL of saline; group IV), topically (1.5 g in 50 mL of saline, sprayed over the operated site, before release of the tourniquet; topical group), or intravenous saline (100 mL with anesthesia; control group). The volume of drained blood in 48 h, the amount of transfused blood, and the serum levels of hemoglobin and hematocrit before and after surgery were evaluated. The groups were similar for gender, age, weight, laterality, and preoperative hemoglobin and hematocrit levels ( p  > 0.2). The hemoglobin level dropped in all groups when comparing the preoperative and the 48-h evaluations: the control group decreased 3.8 mg/dL on average, while the IV group had a decrease of 3.0, and the topical group, of 3.2 ( p  = 0.019). The difference between the control and IV groups was confirmed by Bonferroni test ( p  = 0.020). The difference between the control group and the topical group was not significant ( p  = 0.130), although there was less reduction in hemoglobin in the topical group; the comparison between the IV group and the topical group was also not significant ( p  = 1.000). Using topic and IV tranexamic acid decreased blood loss and the need for transfusion in total knee arthroplasty. Topical application showed results similar to IV use regarding the need for blood transfusion, but without the possible side effects of IV administration.

Numerical simulation of oxygen delivery to muscle tissue in the presence of hemoglobin-based oxygen carriers.

PubMed

Patton, Jaqunda N; Palmer, Andre F

2006-01-01

This work represents a culmination of research on oxygen transport to muscle tissue, which takes into account oxygen transport due to convection, diffusion, and the kinetics of simultaneous reactions between oxygen and hemoglobin and myoglobin. The effect of adding hemoglobin-based oxygen carriers (HBOCs) to the plasma layer of blood in a single capillary surrounded by muscle tissue based on the geometry of the Krogh tissue cylinder is examined for a range of HBOC oxygen affinity, HBOC concentration, capillary inlet oxygen tension (pO(2)), and hematocrit. The full capillary length of the hamster retractor muscle was modeled under resting (V(max) = 1.57 x 10(-4) mLO(2) mL(-1) s(-1), cell velocity (v(c)) = 0.015 cm/s) and working (V(max) = 1.57 x 10(-3) mLO(2) mL(-1) s(-1), v(c) = 0.075 cm/s) conditions. Two spacings between the red blood cell (RBC) and the capillary wall were examined, corresponding to a capillary with and without an endothelial surface layer. Simulations led to the following conclusions, which lend physiological insight into oxygen transport to muscle tissue in the presence of HBOCs: (1) The reaction kinetics between oxygen and myoglobin in the tissue region, oxygen and HBOCs in the plasma, and oxygen and RBCs in the capillary lumen should not be neglected. (2) Simulation results yielded new insight into possible mechanisms of oxygen transport in the presence of HBOCs. (3) HBOCs may act as a source or sink for oxygen in the capillary and may compete with RBCs for oxygen. (4) HBOCs return oxygen delivery to muscle tissue to normal for varying degrees of hypoxia (inlet capillary pO(2) < 30 mmHg) and anemia (hematocrit < 46%) for the hamster model.

Muscle strength differ between patients with diabetes and controls following heart surgery.

PubMed

Boban, Marko; Barisic, Mijana; Persic, Viktor; Zekanovic, Drazen; Medved, Igor; Zulj, Marinko; Vcev, Aleskandar

2016-01-01

The aim of our study was to analyze muscle strength in patients with recent surgical treatment for ischemic and combined ischemic-valvular heart disease, based on existence of diabetes mellitus. Connections existing between muscle strength and patient characteristics or conventional diagnostic tests were analyzed as well. Study prospectively included consecutive patients scheduled for cardiovascular rehabilitation 0-3months after heart surgery. Diagnostics covered drug utilization, anthropometrics, demographics, echocardiography, conventional laboratory, echocardiography, bioelectrical impedance analysis (BIA), and hand grip test (HGT). HGT was analyzed for dominant hand. Patients with diabetes had significantly weaker muscle strength on HGT than controls; 29.4±12.2kg vs. 38.2±14.7kg (p=0.029), respectively. ROC analysis for HGT and existence of diabetes mellitus were significant; ≤40kg had sensitivity of 89.7% (95%CI: 72.6-97.8), specificity 43.7% (31.9-56.0); AUC 0.669 (0.568-0.760); p=0.002. HGT significantly correlated with hematocrit (Rho CC=0.247; p=0.013), whilst other laboratory or echocardiographic parameters were insignificant (all p>0.05). HGT also correlated with body weight (Rho CC=0.510; p<0.001); height (Rho CC=0.632; p<0.001); waist circumference (Rho CC=0.388; p<0.001); waist-to-hip ratio (Rho CC=0.274; p=0.006) and BIA (Rho CC=-0.412; p<0.001). In postoperative recovery of patients with diabetes, muscle strength assessed by HGT is decreased and in relation with nutritional status. Clinically resourceful connections of HGT were also found to hematocrit and utilization of loop diuretics. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of intraoperative fluid management on outcome after intraabdominal surgery.

PubMed

Nisanevich, Vadim; Felsenstein, Itamar; Almogy, Gidon; Weissman, Charles; Einav, Sharon; Matot, Idit

2005-07-01

The debate over the correct perioperative fluid management is unresolved. The impact of two intraoperative fluid regimes on postoperative outcome was prospectively evaluated in 152 patients with an American Society of Anesthesiologists physical status of I-III who were undergoing elective intraabdominal surgery. Patients were randomly assigned to receive intraoperatively either liberal (liberal protocol group [LPG], n = 75; bolus of 10 ml/kg followed by 12 ml x kg(-1) x h(-1)) or restrictive (restrictive protocol group [RPG], n = 77; 4 ml x kg(-1) x h(-1)) amounts of lactated Ringer's solution. The primary endpoint was the number of patients who died or experienced complications. The secondary endpoints included time to initial passage of flatus and feces, duration of hospital stay, and changes in body weight, hematocrit, and albumin serum concentration in the first 3 postoperative days. The number of patients with complications was lower in the RPG (P = 0.046). Patients in the LPG passed flatus and feces significantly later (flatus, median [range]: 4 [3-7] days in the LPG vs. 3 [2-7] days in the RPG; P < 0.001; feces: 6 [4-9] days in the LPG vs. 4 [3-9] days in the RPG; P < 0.001), and their postoperative hospital stay was significantly longer (9 [7-24] days in the LPG vs. 8 [6-21] days in the RPG; P = 0.01). Significantly larger increases in body weight were observed in the LPG compared with the RPG (P < 0.01). In the first 3 postoperative days, hematocrit and albumin concentrations were significantly higher in the RPG compared with the LPG. In patients undergoing elective intraabdominal surgery, intraoperative use of restrictive fluid management may be advantageous because it reduces postoperative morbidity and shortens hospital stay.

Design of microfluidic channels for magnetic separation of malaria-infected red blood cells

PubMed Central

Wu, Wei-Tao; Martin, Andrea Blue; Gandini, Alberto; Aubry, Nadine; Massoudi, Mehrdad; Antaki, James F.

2016-01-01

This study is motivated by the development of a blood cell filtration device for removal of malaria-infected, parasitized red blood cells (pRBCs). The blood was modeled as a multi-component fluid using the computational fluid dynamics discrete element method (CFD-DEM), wherein plasma was treated as a Newtonian fluid and the red blood cells (RBCs) were modeled as soft-sphere solid particles which move under the influence of drag, collisions with other RBCs, and a magnetic force. The CFD-DEM model was first validated by a comparison with experimental data from Han et al. 2006 (Han and Frazier 2006) involving a microfluidic magnetophoretic separator for paramagnetic deoxygenated blood cells. The computational model was then applied to a parametric study of a parallel-plate separator having hematocrit of 40% with a 10% of the RBCs as pRBCs. Specifically, we investigated the hypothesis of introducing an upstream constriction to the channel to divert the magnetic cells within the near-wall layer where the magnetic force is greatest. Simulations compared the efficacy of various geometries upon the stratification efficiency of the pRBCs. For a channel with nominal height of 100 µm, the addition of an upstream constriction of 80% improved the proportion of pRBCs retained adjacent to the magnetic wall (separation efficiency) by almost 2 fold, from 26% to 49%. Further addition of a downstream diffuser reduced remixing, hence improved separation efficiency to 72%. The constriction introduced a greater pressure drop (from 17 to 495 Pa), which should be considered when scaling-up this design for a clinical-sized system. Overall, the advantages of this design include its ability to accommodate physiological hematocrit and high throughput – which is critical for clinical implementation as a blood-filtration system. PMID:27761107

Subchronic rat inhalation study with Skydrol 500B-4 fire resistant hydraulic fluid.

PubMed

Healy, C E; Nair, R S; Ribelin, W E; Bechtel, C L

1992-03-01

Skydrol 500B-4 fire resistant hydraulic fluid, a proprietary phosphate ester mixture composed principally of dibutyl phenyl phosphate (DBPP) and tributyl phosphate (TBP) and used as a commercial airline hydraulic fluid, was evaluated in an inhalation toxicity study of Sprague-Dawley rats. Target exposure levels used in the study were 0, 5, 100, and 300 mg/m3, and exposures were maintained for 6 hr/day, 5 days/week. Mass median aerodynamic diameters determined for particles in the mid- and high-exposure inhalation chambers were 2.85 microns and 3.31 microns, with geometric standard deviations of 1.99 microns and 1.92 microns, respectively. The percentage of particles less than 10 microns in diameter were 96.4% in the mid-exposure chamber and 95.5% in the high-exposure chamber. After 6 weeks of Skydrol exposure, 10 rats/sex/group were euthanized and then assessed for indications of possible chemical toxicity. Another 15 rats/sex/group were studied for a total of 13 weeks of exposure. The only clinical sign of chemical toxicity was the observation of a reddish nasal discharge with accompanying oral salivation in mid- and high-exposure animals of both sexes, indicative of an irritant response. Statistically significant reduced body weights; increased absolute and relative liver weights; and decreased erythrocyte counts, hemoglobin levels, and hematocrit values were observed in high-exposure female rats euthanized after 13 weeks of Skydrol exposure. High-exposure male rats also had increased absolute and relative liver weights and decreased hematocrit values after 13 weeks. Plasma cholinesterase levels were decreased in high-exposure female rats both 6 and 13 weeks after the study was initiated.(ABSTRACT TRUNCATED AT 250 WORDS)

Bioimpedance Identifies Body Fluid Loss after Exercise in the Heat: A Pilot Study with Body Cooling

PubMed Central

Gatterer, Hannes; Schenk, Kai; Laninschegg, Lisa; Schlemmer, Philipp; Lukaski, Henry; Burtscher, Martin

2014-01-01

Purpose Assessment of post-exercise changes in hydration with bioimpedance (BI) is complicated by physiological adaptations that affect resistance (R) and reactance (Xc) values. This study investigated exercise-induced changes in R and Xc, independently and in bioelectrical impedance vector analysis, when factors such as increased skin temperature and blood flow and surface electrolyte accumulation are eliminated with a cold shower. Methods Healthy males (n = 14, 24.1±1.7 yr; height (H): 182.4±5.6 cm, body mass: 72.3±6.3 kg) exercised for 1 hr at a self-rated intensity (15 BORG) in an environmental chamber (33°C and 50% relative humidity), then had a cold shower (15 min). Before the run BI, body mass, hematocrit and Posm were measured. After the shower body mass was measured; BI measurements were performed continuously every 20 minutes until R reached a stable level, then hematocrit and Posm were measured again. Results Compared to pre-trial measurements body mass decreased after the run and Posm, Hct, R/H and Xc/H increased (p<0.05) with a corresponding lengthening of the impedance vector along the major axis of the tolerance ellipse (p<0.001). Changes in Posm were negatively related to changes in body mass (r = −0.564, p = 0.036) and changes in Xc/H (r = −0.577, p = 0.041). Conclusions Present findings showed that after a bout of exercise-induced dehydration followed by cold shower the impedance vector lengthened that indicates fluid loss. Additionally, BI values might be useful to evaluate fluid shifts between compartments as lower intracellular fluid loss (changed Xc/R) indicated greater Posm increase. PMID:25279660

Hematology and clinical chemistry of sea otters vaptured in Prince William Sound, Alaska following the Exxon Valdez Oil Spill

USGS Publications Warehouse

Rebar, A.H.; Ballachey, Brenda E.; Bruden, D.L.; Kloecker, Kimberly A.

1996-01-01

Hematologic and serum chemical analyses were performed on sea otter blood samples collected from 31 adult males, 63 adult females, and 42 pups captured in western Prince William Sound (oiled area), and 12 adult males, 40 adult females, and 15 pups captured in eastern Prince William Sound (unoiled area) in 1989 and 1990. Hematologic differences between eastern and western adult males were minimal. Both hematocrits and hemoglobins were higher in western than eastern otters but the biological significance of this is equivocal. Western males had higher absolute eosinophil counts, suggesting possible systemic hypersensitivity reactions. Western males had higher serum protein and serum globulin levels than eastern males, suggesting greater antigenic stimulation (more inflammatory and/or infectious conditions). There were no differences in hematologic parameters between eastern and western female otters. Some chemistry changes were present, but the degree of difference was small. Total protein and serum globulin levels were slightly higher in western females, a finding also seen in adult males. Mean levels of liver enzymes for western females were somewhat higher than for the eastern otters, suggesting the possibility of subclinical liver disease. As a group, western pup hematocrits, hemoglobins, and red cell counts were significantly lower than those of eastern pups. From a biological perspective, these reductions were minimal but supported by individual animal data. The red cell data suggest a mild anemia in western pups; however, the degree of anemia was minimal, so that biological significance was equivocal. Other hematologic and clinical chemical differences between eastern and western pups were not striking and were also of equivocal biological significance.

The effect of extreme spring weather on body condition and stress physiology in Lapland longspurs and white-crowned sparrows breeding in the Arctic.

PubMed

Krause, Jesse S; Pérez, Jonathan H; Chmura, Helen E; Sweet, Shannan K; Meddle, Simone L; Hunt, Kathleen E; Gough, Laura; Boelman, Natalie; Wingfield, John C

2016-10-01

Climate change is causing rapid shifts in temperature while also increasing the frequency, duration, and intensity of extreme weather. In the northern hemisphere, the spring of 2013 was characterized as extreme due to record high snow cover and low temperatures. Studies that describe the effects of extreme weather on phenology across taxa are limited while morphological and physiological responses remain poorly understood. Stress physiology, as measured through baseline and stress-induced concentrations of cortisol or corticosterone, has often been studied to understand how organisms respond to environmental stressors. We compared body condition and stress physiology of two long-distance migrants breeding in low arctic Alaska - the white-crowned sparrow (Zonotrichia leucophrys) and Lapland longspur (Calcarius lapponicus) - in 2013, an extreme weather year, with three more typical years (2011, 2012, and 2014). The extended snow cover in spring 2013 caused measureable changes in phenology, body condition and physiology. Arrival timing for both species was delayed 4-5days compared to the other three years. Lapland longspurs had reduced fat stores, pectoralis muscle profiles, body mass, and hematocrit levels, while stress-induced concentrations of corticosterone were increased. Similarly, white-crowned sparrows had reduced pectoralis muscle profiles and hematocrit levels, but in contrast to Lapland longspurs, had elevated fat stores and no difference in mass or stress physiology relative to other study years. An understanding of physiological mechanisms that regulate coping strategies is of critical importance for predicting how species will respond to the occurrence of extreme events in the future due to global climate change. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Effect of Repeated Whole Blood Donations on Aerobic Capacity and Hemoglobin Mass in Moderately Trained Male Subjects: A Randomized Controlled Trial.

PubMed

Meurrens, Julie; Steiner, Thomas; Ponette, Jonathan; Janssen, Hans Antonius; Ramaekers, Monique; Wehrlin, Jon Peter; Vandekerckhove, Philippe; Deldicque, Louise

2016-12-01

The aims of the present study were to investigate the impact of three whole blood donations on endurance capacity and hematological parameters and to determine the duration to fully recover initial endurance capacity and hematological parameters after each donation. Twenty-four moderately trained subjects were randomly divided in a donation (n = 16) and a placebo (n = 8) group. Each of the three donations was interspersed by 3 months, and the recovery of endurance capacity and hematological parameters was monitored up to 1 month after donation. Maximal power output, peak oxygen consumption, and hemoglobin mass decreased (p < 0.001) up to 4 weeks after a single blood donation with a maximal decrease of 4, 10, and 7%, respectively. Hematocrit, hemoglobin concentration, ferritin, and red blood cell count (RBC), all key hematological parameters for oxygen transport, were lowered by a single donation (p < 0.001) and cumulatively further affected by the repetition of the donations (p < 0.001). The maximal decrease after a blood donation was 11% for hematocrit, 10% for hemoglobin concentration, 50% for ferritin, and 12% for RBC (p < 0.001). Maximal power output cumulatively increased in the placebo group as the maximal exercise tests were repeated (p < 0.001), which indicates positive training adaptations. This increase in maximal power output over the whole duration of the study was not observed in the donation group. Maximal, but not submaximal, endurance capacity was altered after blood donation in moderately trained people and the expected increase in capacity after multiple maximal exercise tests was not present when repeating whole blood donations.

Chemopreventive efficacy and pharmacokinetics of curcumin in the min/+ mouse, a model of familial adenomatous polyposis.

PubMed

Perkins, Sarah; Verschoyle, Richard D; Hill, Kirsti; Parveen, Ifat; Threadgill, Michael D; Sharma, Ricky A; Williams, Marion L; Steward, William P; Gescher, Andreas J

2002-06-01

Curcumin, the major yellow pigment in turmeric, prevents the development of adenomas in the intestinal tract of the C57Bl/6J Min/+ mouse, a model of human familial APC. To aid the rational development of curcumin as a colorectal cancer-preventive agent, we explored the link between its chemopreventive potency in the Min/+ mouse and levels of drug and metabolites in target tissue and plasma. Mice received dietary curcumin for 15 weeks, after which adenomas were enumerated. Levels of curcumin and metabolites were determined by high-performance liquid chromatography in plasma, tissues, and feces of mice after either long-term ingestion of dietary curcumin or a single dose of [(14)C]curcumin (100 mg/kg) via the i.p. route. Whereas curcumin at 0.1% in the diet was without effect, at 0.2 and 0.5%, it reduced adenoma multiplicity by 39 and 40%, respectively, compared with untreated mice. Hematocrit values in untreated Min/+ mice were drastically reduced compared with those in wild-type C57Bl/6J mice. Dietary curcumin partially restored the suppressed hematocrit. Traces of curcumin were detected in the plasma. Its concentration in the small intestinal mucosa, between 39 and 240 nmol/g of tissue, reflects differences in dietary concentration. [(14)C]Curcumin disappeared rapidly from tissues and plasma within 2-8 h after dosing. Curcumin may be useful in the chemoprevention of human intestinal malignancies related to Apc mutations. The comparison of dose, resulting curcumin levels in the intestinal tract, and chemopreventive potency suggests tentatively that a daily dose of 1.6 g of curcumin is required for efficacy in humans. A clear advantage of curcumin over nonsteroidal anti-inflammatory drugs is its ability to decrease intestinal bleeding linked to adenoma maturation.

The Benefits and Challenges of an Interfaced Electronic Health Record and Laboratory Information System: Effects on Laboratory Processes.

PubMed

Petrides, Athena K; Bixho, Ida; Goonan, Ellen M; Bates, David W; Shaykevich, Shimon; Lipsitz, Stuart R; Landman, Adam B; Tanasijevic, Milenko J; Melanson, Stacy E F

2017-03-01

- A recent government regulation incentivizes implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR with their laboratory information system (LIS). - To determine the impact of an interfaced EHR-LIS on laboratory processes. - We analyzed several different processes before and after implementation of an interfaced EHR-LIS: the turnaround time, the number of stat specimens received, venipunctures per patient per day, preanalytic errors in phlebotomy, the number of add-on tests using a new electronic process, and the number of wrong test codes ordered. Data were gathered through the LIS and/or EHR. - The turnaround time for potassium and hematocrit decreased significantly (P = .047 and P = .004, respectively). The number of stat orders also decreased significantly, from 40% to 7% for potassium and hematocrit, respectively (P < .001 for both). Even though the average number of inpatient venipunctures per day increased from 1.38 to 1.62 (P < .001), the average number of preanalytic errors per month decreased from 2.24 to 0.16 per 1000 specimens (P < .001). Overall there was a 16% increase in add-on tests. The number of wrong test codes ordered was high and it was challenging for providers to correctly order some common tests. - An interfaced EHR-LIS significantly improved within-laboratory turnaround time and decreased stat requests and preanalytic phlebotomy errors. Despite increasing the number of add-on requests, an electronic add-on process increased efficiency and improved provider satisfaction. Laboratories implementing an interfaced EHR-LIS should be cautious of its effects on test ordering and patient venipunctures per day.

Oxygen binding properties, capillary densities and heart weights in high altitude camelids.

PubMed

Jürgens, K D; Pietschmann, M; Yamaguchi, K; Kleinschmidt, T

1988-01-01

The oxygen binding properties of the blood of the camelid species vicuna, llama, alpaca and dromedary camel were measured and evaluated with respect to interspecific differences. The highest blood oxygen affinity, not only among camelids but of all mammals investigated so far, was found in the vicuna (P50 = 17.6 Torr compared to 20.3-21.6 Torr in the other species). Low hematocrits (23-34%) and small red blood cells (21-30 microns 3) are common features of all camelids, but the lowest values are found in the Lama species. Capillary densities were determined in heart and soleus muscle of vicuna and llama. Again, the vicuna shows exceptional values (3720 cap/mm2 on average in the heart) for a mammal of this body size. Finally, heart weight as percent of body weight is higher in the vicuna (0.7-0.9%) than in the other camelids studied (0.5-0.7%). The possibility that these parameters, measured in New World tylopodes at sea level, are not likely to change considerably with transfer to high altitude, is discussed. In the vicuna, a unique combination of the following features seems to be responsible for an outstanding physical capability at high altitude: saturation of blood with oxygen in the lung is favored by a high blood oxygen affinity, oxygen supply being facilitated by low diffusion distances in the muscle tissue. Loading, as well as unloading, of oxygen is improved by a relatively high oxygen transfer conductance of the red blood cells, which is due to their small size and which compensates the negative effect of a low hematocrit on the oxygen conductance of blood.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of electrothermal bipolar vessel sealing system and electrocautery in selective neck dissection.

PubMed

Ozturk, Kerem; Kaya, Isa; Turhal, Goksel; Ozturk, Arin; Gursan, Gulce; Akyildiz, Serdar

2016-11-01

The use of LigaSure™ vessel sealing system in head and neck surgery was reported to be reliable and safe, providing sufficient hemostasis and reducing operating time. The aim of this study was to evaluate efficacy of this technique in patients undergoing selective neck dissections. This study was carried out as a prospective controlled study at an otolaryngology department of a tertiary medical center between July 2013 and July 2015. Twenty-five patients older than 18 years who underwent unilateral selective neck dissection for head and neck cancer were included in the study. In the control group (group 2, 10 patients) only monopolar and bipolar diathermy was used; in the Ligasure group (group 1, 15 patients) Ligasure was used for hemostasis and dissection in addition to the conventional techniques. Cervical lymphadenectomy time, operation time, preoperative hemoglobin levels, preoperative hematocrit levels, postoperative hemoglobin levels, postoperative hematocrit levels, total neck drainage and drain removal time were analyzed and compared between the groups. Median operation time in group 1 and 2 were 95 min (IQR = 35) and 142.5 min (IQR = 63), respectively. Median cervical lymphadenectomy time in group 1 and 2 were 55 min (IQR = 23) and 102.5 min (IQR = 49), respectively. Median operation time and cervical operation time were significantly lower in group 1 (p < 0.05). In conclusion, LigaSure™ vessel sealing system is a safe, efficacious technique and significantly lowers cervical lymphadenectomy and operation time in selective neck dissections compared to controls. Given the superb hemostatic properties, this technique should be in the surgeon's armamentarium when possible.

Potassium-based algorithm allows correction for the hematocrit bias in quantitative analysis of caffeine and its major metabolite in dried blood spots.

PubMed

De Kesel, Pieter M M; Capiau, Sara; Stove, Veronique V; Lambert, Willy E; Stove, Christophe P

2014-10-01

Although dried blood spot (DBS) sampling is increasingly receiving interest as a potential alternative to traditional blood sampling, the impact of hematocrit (Hct) on DBS results is limiting its final breakthrough in routine bioanalysis. To predict the Hct of a given DBS, potassium (K(+)) proved to be a reliable marker. The aim of this study was to evaluate whether application of an algorithm, based upon predicted Hct or K(+) concentrations as such, allowed correction for the Hct bias. Using validated LC-MS/MS methods, caffeine, chosen as a model compound, was determined in whole blood and corresponding DBS samples with a broad Hct range (0.18-0.47). A reference subset (n = 50) was used to generate an algorithm based on K(+) concentrations in DBS. Application of the developed algorithm on an independent test set (n = 50) alleviated the assay bias, especially at lower Hct values. Before correction, differences between DBS and whole blood concentrations ranged from -29.1 to 21.1%. The mean difference, as obtained by Bland-Altman comparison, was -6.6% (95% confidence interval (CI), -9.7 to -3.4%). After application of the algorithm, differences between corrected and whole blood concentrations lay between -19.9 and 13.9% with a mean difference of -2.1% (95% CI, -4.5 to 0.3%). The same algorithm was applied to a separate compound, paraxanthine, which was determined in 103 samples (Hct range, 0.17-0.47), yielding similar results. In conclusion, a K(+)-based algorithm allows correction for the Hct bias in the quantitative analysis of caffeine and its metabolite paraxanthine.

Airway mechanics and lung tissue viscoelasticity: effects of altered blood hematocrit in the pulmonary circulation.

PubMed

Peták, Ferenc; Fodor, Gergely H; Babik, Barna; Habre, Walid

2016-07-01

The contribution of the hematocrit (Hct) of the blood in the pulmonary vasculature to the overall lung mechanics has not been characterized. We therefore set out to establish how changes of the Hct level in the pulmonary circulation affect the airway and lung tissue viscoelastic properties. The Hct level of the blood in an isolated perfused rat lung model was randomly altered. Intermediate (26.5%), followed by low (6.6%) or normal (43.7%), Hct was set in two consecutive sequences. The pulmonary capillary pressure was maintained constant throughout the experiment, and the pulmonary hemodynamic parameters were monitored continuously. The airway resistance (Raw), the viscous (G) and elastic (H) parameters, and the hysteresivity (η = G/H) of the lung tissues were obtained from measurements of forced oscillatory input impedance data. Raw was not affected by the alterations of the Hct levels. As concerns the lung tissues, the decrease of Hct to intermediate or low levels resulted in close to proportional decreases in the viscoelastic parameters G [16.5 ± 7.7% (SD), 12.1 ± 9.5%, P < 0.005] and H (13.2 ± 8.6%, 10.8 ± 4.7%, P < 0.001). No significant changes in η were detected in a wide range of Hct, which indicates that coupled processes cause alterations in the resistive and elastic properties of the lungs following Hct changes in the pulmonary circulation. The diminishment of the viscous and elastic parameters of the pulmonary parenchyma following a reduction of blood Hct demonstrates the significant contribution of the red blood cells to the overall lung viscoelasticity. Copyright © 2016 the American Physiological Society.

In Vitro Evaluation of the Link Between Cell Activation State and Its Rheological Impact on the Microscale Flow of Neutrophil Suspensions

PubMed Central

Akenhead, Michael L.; Horrall, Nolan M.; Rowe, Dylan; Sethu, Palaniappan; Shin, Hainsworth Y.

2015-01-01

Activated neutrophils have been reported to affect peripheral resistance, for example, by plugging capillaries or adhering to the microvasculature. In vivo and ex vivo data indicate that activated neutrophils circulating in the blood also influence peripheral resistance. We used viscometry and microvascular mimics for in vitro corroboration. The rheological impact of differentiated neutrophil-like HL-60 promyelocytes (dHL60s) or human neutrophil suspensions stimulated with 10 nM fMet-Leu-Phe (fMLP) was quantified using a cone-plate rheometer (450 s−1 shear rate). To evaluate their impact on microscale flow resistance, we used 10-μm Isopore® membranes to model capillaries as well as single 200 × 50 μm microchannels and networks of twenty 20 × 50 μm microfluidic channels to mimic noncapillary microvasculature. Stimulation of dHL60 and neutrophil populations significantly altered their flow behavior as evidenced by their impact on suspension viscosity. Notably, hematocrit abrogated the impact of leukocyte activation on blood cell suspension viscosity. In micropore filters, activated cell suspensions enhanced flow resistance. This effect was further enhanced by the presence of erythrocytes. The resistance of our noncapillary microvascular mimics to flow of activated neutrophil suspensions was significantly increased only with hematocrit. Notably, it was elevated to a higher extent within the micronetwork chambers compared to the single-channel chambers. Collectively, our findings provide supportive evidence that activated neutrophils passing through the microcirculation may alter hemodynamic resistance due to their altered rheology in the noncapillary microvasculature. This effect is another way neutrophil activation due to chronic inflammation may, at least in part, contribute to the elevated hemodynamic resistance associated with cardiovascular diseases (e.g., hypertension and hypercholesterolemia). PMID:26065495

A Review of Commercially Available Point-of-Care Devices to Concentrate Bone Marrow for the Treatment of Osteoarthritis and Focal Cartilage Lesions.

PubMed

Gaul, Florian; Bugbee, William D; Hoenecke, Heinz R; D'Lima, Darryl D

2018-04-01

Objective Mesenchymal stem cells (MSCs) are a promising cell-based therapy treatment option for several orthopedic indications. Because culture expansion of MSC is time and cost intensive, a bedside concentration of bone marrow (BM) aspirate is used as an alternative. Many commercial systems are available but the available literature and knowledge regarding these systems is limited. We compared different point-of-care devices that concentrate BM (BMC) by focusing on technical features and quality parameters to help surgeons make informed decisions while selecting the appropriate device. Methods We compared published data on the BMC devices of Arteriocyte, Arthrex, Celling Biosciences, EmCyte, Exactech, ISTO Tech, Harvest Tech/Terumo BCT, and Zimmer/BIOMET regarding technical features (centrifugation speed/time, input/output volume, kit components, type of aspiration syringes, filter usage) and quality parameters of their final BMC product (hematocrit, concentration of platelets and total nucleated cells, concentration of MSC and connective tissue progenitor cells). Results The systems differ significantly in their technical features and centrifugation parameters. Only the fully automated systems use universal kits, which allow processing different volumes of BM. Only the Arthrex system allows selection of final hematocrit. There was no standardized reporting method to describe biologic potency. Conclusions Based on the data obtained in this review, recommending a single device is not possible because the reported data could not be compared between devices. A standardized reporting method is needed for valid comparisons. Furthermore, clinical outcomes are required to establish the true efficacy of these systems. We are conducting additional studies for more careful comparison among the devices.

A comparison of single and multiple stressor protocols to assess acute stress in a coastal shark species, Rhizoprionodon terraenovae.

PubMed

Hoffmayer, Eric R; Hendon, Jill M; Parsons, Glenn R; Driggers, William B; Campbell, Matthew D

2015-10-01

Elasmobranch stress responses are traditionally measured in the field by either singly or serially sampling an animal after a physiologically stressful event. Although capture and handling techniques are effective at inducing a stress response, differences in protocols could affect the degree of stress experienced by an individual, making meaningful comparisons between the protocols difficult, if not impossible. This study acutely stressed Atlantic sharpnose sharks, Rhizoprionodon terraenovae, by standardized capture (rod and reel) and handling methods and implemented either a single or serial blood sampling protocol to monitor four indicators of the secondary stress response. Single-sampled sharks were hooked and allowed to swim around the boat until retrieved for a blood sample at either 0, 15, 30, 45, or 60 min post-hooking. Serially sampled sharks were retrieved, phlebotomized, released while still hooked, and subsequently resampled at 15, 30, 45, and 60 min intervals post-hooking. Blood was analyzed for hematocrit, and plasma glucose, lactate, and osmolality levels. Although both single and serial sampling protocols resulted in an increase in glucose, no significant difference in glucose level was found between protocols. Serially sampled sharks exhibited cumulatively heightened levels for lactate and osmolality at all time intervals when compared to single-sampled animals at the same time. Maximal concentration differences of 217.5, 9.8, and 41.6 % were reported for lactate, osmolality, and glucose levels, respectively. Hematocrit increased significantly over time for the single sampling protocol but did not change significantly during the serial sampling protocol. The differences in resultant blood chemistry levels between implemented stress protocols and durations are significant and need to be considered when assessing stress in elasmobranchs.

Plasma cytokines can help to identify the development of severe acute pancreatitis on admission

PubMed Central

Deng, Li-Hui; Hu, Cheng; Cai, Wen-Hao; Chen, Wei-Wei; Zhang, Xiao-Xin; Shi, Na; Huang, Wei; Ma, Yun; Jin, Tao; Lin, Zi-Qi; Jiang, Kun; Guo, Jia; Yang, Xiao-Nan; Xia, Qing

2017-01-01

Abstract Severe acute pancreatitis (AP) is associated with high morbidity and mortality. Early severity stratification remains a challenging issue to overcome to improve outcomes. We aim to find novel plasma cytokines for the early identification of severe AP according to the revised Atlanta criteria. In this prospective observational study, 30 cytokines, screened semiquantitatively with a human multicytokine array, were submitted to quantitative determination using either microparticle-based multiplex immunoassays analyzed on a Luminex 100 platform or enzyme-linked immunosorbent assay kits. The cytokine profiles of patients and the discriminative value of cytokines for severe AP were analyzed. Plasma samples of 70 patients with AP (20 mild, 30 moderately severe, and 20 severe) were selected in this study if they were admitted within 48 hours of the onset of symptoms. Plasma from healthy volunteers was collected as the healthy control. Growth differentiation factor-15 (GDF-15) and pentraxin 3 (PTX3) on admission were independent prognostic markers for the development of severe AP and had higher discriminative powers than conventional markers (GDF-15 vs hematocrit, P = .003; GDF-15 vs C-reactive protein, P = .037; GDF-15 vs creatinine, P = .048; GDF-15 vs Acute Physiology and Chronic Health Evaluation II, P = .007; PTX3 vs hematocrit, P = .006; PTX3 vs C-reactive protein, P = .047; PTX3 vs Acute Physiology and Chronic Health Evaluation II, P = .011; PTX3 vs Bedside Index for Severity in Acute Pancreatitis, P = .048). Plasma GDF-15 and PTX3 can help to identify the development of severe AP on admission. Future work should validate their accuracy in a larger, multicenter patient cohort. PMID:28700471

Treatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research.

PubMed

Ondeck, Nathaniel T; Fu, Michael C; Skrip, Laura A; McLynn, Ryan P; Su, Edwin P; Grauer, Jonathan N

2018-03-01

Despite the advantages of large, national datasets, one continuing concern is missing data values. Complete case analysis, where only cases with complete data are analyzed, is commonly used rather than more statistically rigorous approaches such as multiple imputation. This study characterizes the potential selection bias introduced using complete case analysis and compares the results of common regressions using both techniques following unicompartmental knee arthroplasty. Patients undergoing unicompartmental knee arthroplasty were extracted from the 2005 to 2015 National Surgical Quality Improvement Program. As examples, the demographics of patients with and without missing preoperative albumin and hematocrit values were compared. Missing data were then treated with both complete case analysis and multiple imputation (an approach that reproduces the variation and associations that would have been present in a full dataset) and the conclusions of common regressions for adverse outcomes were compared. A total of 6117 patients were included, of which 56.7% were missing at least one value. Younger, female, and healthier patients were more likely to have missing preoperative albumin and hematocrit values. The use of complete case analysis removed 3467 patients from the study in comparison with multiple imputation which included all 6117 patients. The 2 methods of handling missing values led to differing associations of low preoperative laboratory values with commonly studied adverse outcomes. The use of complete case analysis can introduce selection bias and may lead to different conclusions in comparison with the statistically rigorous multiple imputation approach. Joint surgeons should consider the methods of handling missing values when interpreting arthroplasty research. Copyright © 2017 Elsevier Inc. All rights reserved.

Genome-wide association study of red blood cell traits in Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos

PubMed Central

Morrison, Jean V.; Brown, Lisa; Schurmann, Claudia; Chen, Diane D.; Liu, Yong Mei; Auer, Paul L.; Taylor, Kent D.; Papanicolaou, George; Kurita, Ryo; Nakamura, Yukio; Loos, Ruth J. F.; North, Kari E.; Thornton, Timothy A.; Pankratz, Nathan; Bauer, Daniel E.

2017-01-01

Prior GWAS have identified loci associated with red blood cell (RBC) traits in populations of European, African, and Asian ancestry. These studies have not included individuals with an Amerindian ancestral background, such as Hispanics/Latinos, nor evaluated the full spectrum of genomic variation beyond single nucleotide variants. Using a custom genotyping array enriched for Amerindian ancestral content and 1000 Genomes imputation, we performed GWAS in 12,502 participants of Hispanic Community Health Study and Study of Latinos (HCHS/SOL) for hematocrit, hemoglobin, RBC count, RBC distribution width (RDW), and RBC indices. Approximately 60% of previously reported RBC trait loci generalized to HCHS/SOL Hispanics/Latinos, including African ancestral alpha- and beta-globin gene variants. In addition to the known 3.8kb alpha-globin copy number variant, we identified an Amerindian ancestral association in an alpha-globin regulatory region on chromosome 16p13.3 for mean corpuscular volume and mean corpuscular hemoglobin. We also discovered and replicated three genome-wide significant variants in previously unreported loci for RDW (SLC12A2 rs17764730, PSMB5 rs941718), and hematocrit (PROX1 rs3754140). Among the proxy variants at the SLC12A2 locus we identified rs3812049, located in a bi-directional promoter between SLC12A2 (which encodes a red cell membrane ion-transport protein) and an upstream anti-sense long-noncoding RNA, LINC01184, as the likely causal variant. We further demonstrate that disruption of the regulatory element harboring rs3812049 affects transcription of SLC12A2 and LINC01184 in human erythroid progenitor cells. Together, these results reinforce the importance of genetic study of diverse ancestral populations, in particular Hispanics/Latinos. PMID:28453575

Comparison of Spectra Optia and COBE Spectra apheresis systems' performances for red blood cell exchange procedures.

PubMed

Kim, Jaehyup; Joseph, Ranjit; Matevosyan, Karen; Sarode, Ravi

2016-12-01

Spectra Optia (Terumo BCT, Lakewood, CO) was FDA approved for red blood cell exchange (RBCx) procedures in January 2014 and is expected to replace COBE spectra (Terumo BCT) very soon in the USA. The performance characteristics of these devices for Isovolemic Hemodilution (IHD-RBCx) procedure were compared in this study. A total of 114 IHD-RBCx procedures from 19 patients were analyzed. For every patient, three procedures on each device with similar pre-procedure hematocrits were compared. Pre and post procedure laboratory parameters compared were hemoglobin S (HbS), hematocrits (Hct), platelet counts and fraction of cells remaining (FCR). Statistical analysis was performed using t-test adjusted by the Holm-Bonferroni method to reduce family-wise error rate. There were no significant differences between these two devices in regards to HbS, Hct, FCR and platelet counts (p = > 0.05). However, rinseback volume (124.2 ± 8.9 ml) and normal saline replacement volume during IHD phase (296.1 ± 97.2 ml) were lower in Spectra Optia as compared to COBE Spectra (337 ± 33.8 ml and 326.6 ± 105.2 ml, p value <0.001 and 0.030 respectively). Spectra Optia had a longer run time (107.1 ± 15.9 min vs 123.8 ± 19.6 min, p value <0.001) overall. Performance characteristics of Spectra Optia for HbS, Hct and FCR were similar to COBE Spectra for IHD-RBCx. IHD-RBCx procedure on Optia required less normal saline replacement volume and rinse back volume but with overall longer procedure run time. Copyright © 2016. Published by Elsevier Ltd.

Effect of cilostazol on platelet reactivity among patients with peripheral artery disease on clopidogrel therapy.

PubMed

Hernandez-Suarez, Dagmar F; Núñez-Medina, Hector; Scott, Stuart A; Lopez-Candales, Angel; Wiley, Jose M; Garcia, Mario J; Melin, Kyle; Nieves-Borrero, Karid; Rodriguez-Ruiz, Christina; Marshall, Lorraine; Duconge, Jorge

2018-03-28

Antiplatelet therapy with clopidogrel is recommended to reduce cardiovascular events in patients with peripheral artery disease (PAD); however, clopidogrel efficacy has not been adequately studied in this patient population. Therefore, we aimed to determine the effects of cilostazol therapy on platelet reactivity among PAD patients on clopidogrel. We performed a cross-sectional pilot study of 46 Puerto Rican patients diagnosed with PAD. The cohort was divided based on use of clopidogrel and cilostazol (n=24) or clopidogrel alone (n=22). Platelet function was measured ex vivo using the VerifyNow P2Y12 assay. Genomic DNA was extracted from peripheral blood samples using the QIAamp DNA Blood Midi Kit, which was subjected to candidate variant genotyping (CYP2C19, ABCB1, PON1 and P2RY12) using TaqMan quantitative polymerase chain reaction assays. All analyses were performed using SAS version 9.4 (SAS Institute). Among all enrolled patients, 18 (39%) had high on-treatment platelet reactivity (HTPR). The mean platelet reactivity was 207±53 (range, 78-325) with higher P2Y12 reaction units in the non-cilostazol group, 224±45 vs. 191±55 on the cilostazol group (p=0.03). No significant differences were observed in the clinical or genetic variables between the two groups. A multiple regression analysis determined that history of diabetes mellitus (p=0.03), use of cilostazol (p=0.03) and hematocrit (p=0.02) were independent predictors of platelet reactivity. In Puerto Rican PAD patients on clopidogrel therapy, history of diabetes mellitus, use of cilostazol and hematocrit are independent predictors of platelet reactivity. Adjunctive cilostazol therapy may enhance clopidogrel efficacy among PAD patients with HTPR.

Effects of a TASER® conducted energy weapon on the circulating red-blood-cell population and other factors in Sus scrofa.

PubMed

Jauchem, James R; Bernhard, Joshua A; Cerna, Cesario Z; Lim, Tiffany Y; Seaman, Ronald L; Tarango, Melissa

2013-09-01

In previous studies hematocrit has been consistently increased in an anesthetized animal model after exposures to TASER(®) conducted energy weapons (CEWs). In the present study we analyzed changes in blood cell counts and red blood cell membrane proteins following two 30-s applications of a TASER C2 device (which is designed for civilian use). Hematocrit increased significantly from 33.2 ± 2.4 (mean ± SD) to 42.8 ± 4.6 % immediately after CEW exposure of eleven pigs (Sus scrofa). Red blood cell count increased significantly from 6.10 ± 0.55 × 10(12)/L to 7.45 ± 0.94 × 10(12)/L, and mean corpuscular volume increased significantly from 54.5 ± 2.4 fl to 57.8 ± 2.6 fl. Mean corpuscular hemoglobin concentration decreased significantly from 20.5 ± 0.7 to 18.5 ± 0.6 mM. Thirty protein spots (from two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis, selected for detailed comparison) exhibited greater densities 30-min post-exposure compared with pre-exposure values. A greater number of echinocytes were observed following CEW exposure. On the basis of these results it appears that, during the strong muscle contractions produced by TASER CEWs, a specific population of red blood cells (RBCs) may be released from the spleen or other reservoirs within the body. The total time of CEW exposure in the present study was relatively long compared with exposures in common law-enforcement scenarios. Despite statistically significant changes in red blood cell counts (and other measures directly related to RBCs), the alterations were short-lived. The transient nature of the changes would be likely to counteract any potentially detrimental effects.

Comparison of whole body and tissue blood volumes in rainbow trout (Salmo gairdneri) with 125I bovine serum albumin and 51Cr-erythrocyte tracers

USGS Publications Warehouse

Gingerich, W.H.; Pityer, R.A.

1989-01-01

Total, packed cell and, plasma volume estimates were made for the whole body and selected tissues of rainbow trout by the simultaneous injection of radiolabelled trout erythrocyte (51Cr-RBC) and radioiodinated bovine serum albumin (125I-BSA) tracers. Blood volumes were estimated with both markers separately by the tracer-hematocrit method and as the combination of the 51Cr-RBC packed cell and 125I-BSA plasma volumes. Mean whole body blood volume was significantly less when calculated from the 51Cr-RBC tracer data (3.52±0.78 ml/100 g; ±SD) than when calculated with the 125I-BSA tracer (5.06±0.86 ml/100 g) or as the sum of the two volumes combined (4.49±0.60 ml/100 g). The whole body hematocrit (28±5%), estimated as the quotient of the 51Cr-RBC volume divided by the sum of the 125I-BSA and the 51Cr-RBC volumes, also was significantly less than the dorsal aortic microhematocrit (36±4%). Estimates of total blood volumes in most tissues were significantly smaller when calculated from the51Cr-RBC data than when calculated by the other two methods. Tissue blood volumes were greatest in highly vascularized and well perfused tissues and least in poorly vascularized tissues. The relative degree of vascularization among tissues generally remained the same regardless of whether the red cell or the plasma tracer was used to calculated blood volume. It is not clear whether the expanded plasma volume is the result of the distribution of erythrocyte-poor blood into the secondary circulation or the result of extravascular exchange of plasma proteins.

Outcomes of Patients Undergoing Primary Fontan Operation Beyond First Decade of Life.

PubMed

Talwar, Sachin; Singh, Sukhjeet; Sreenivas, Vishnubhatla; Kapoor, Kulwant Singh; Gupta, Saurabh Kumar; Ramakrishnan, Sivasubramanian; Kothari, Shyam Sunder; Saxena, Anita; Juneja, Rajnish; Choudhary, Shiv Kumar; Airan, Balram

2017-07-01

Studies on older patients undergoing primary Fontan operation (FO) are limited, with conflicting results. We review our experience with these patients beyond the first decade of life. Between January 2000 and December 2014, a total of 105 patients ≥10 years of age (mean 15.6 ± 4.9, range 10-31, median 15 years) underwent primary FO without a prior bidirectional superior cavopulmonary anastomosis (Bidirectional Glenn [BDG]). Mean preoperative New York Heart Association (NYHA) class was 2.2 ± 0.57. Operative procedure was extra-cardiac FO in 62 patients (8 were fenestrated). Forty-three had a lateral tunnel FO (26 were fenestrated). There were 11 (10.5%) early deaths. Fourteen of the 94 early survivors experienced prolonged pleural effusions, 7 had arrhythmias, and 2 had thromboembolic events. Two patients underwent Fontan takedown. On univariate analysis, NYHA functional class III, mean pulmonary artery (PA) pressure ≥15 mm Hg, hematocrit ≥60%, preoperative ventricular dysfunction, and atrioventricular valve regurgitation (AVVR) were associated with early mortality. Median follow-up was 78 (mean 88.9 ± 6.3) months. In 94 survivors, 6 (6.4%) late deaths were encountered. At last follow-up, 81 (86.2%) survivors were in NYHA class I. Actuarial survival was 84.7% ± 3.7% at 5, 10, and 15 years. Carefully selected adolescents and young adults can safely undergo the primary FO. However, persistent pleural effusions, arrhythmias, thromboembolic events, and the need for reoperation mandate regular follow-up in such patients. Preoperative NYHA functional class III, mean PA pressure ≧ 15 mm Hg, hematocrit ≥ 60%, ventricular dysfunction, and AVVR were associated with early mortality, suggesting that primary FO should be avoided in such patients.

Effects of carbon dioxide exposure on intensively cultured rainbow trout Oncorhynchus mykiss: Physiological responses and fillet attributes

USGS Publications Warehouse

Danley, M.L.; Kenney, P.B.; Mazik, P.M.; Kiser, R.; Hankins, J.A.

2005-01-01

Rainbow trout Oncorhynchus mykiss (261.6 ?? 24.7 g initial weight, mean ?? SEM) at 13.1 ?? 0.2 C were exposed for 94 d to one of three CO2 treatments: control (22.1 ?? 2.8 mg/L), medium (34.5 ?? 3.8 mg/L), or high (48.7 ?? 4.4 mg/L). Trout were checked daily for survival, and fish were sampled at 0, 28, 56, and 84 d for physiological responses, growth, and fillet quality assessments. Trout were also challenged to a 15-min crowding stress at 93 d to assess their ability to initiate a stress response during hypercapnia. Chronically exposed trout showed nearly 100% survival through 84 d exposure (1 of 1,500 fish died). Growth and physiological results showed that increasing elevated CO2 concentrations result in corresponding decreased growth rates and CO2-specific physiological parameters: The medium and high CO2 treatments had significantly slower growth and subsequently smaller fish by 84 d. Exposed trout also showed significantly (P < 0.05) decreased plasma chloride for medium and high CO2 treatments compared to the control from 28 through 84 d. Decreased growth and smaller fish in the medium and high CO2 treatments resulted in correspondingly smaller fresh and smoked fillet weights. Chronic CO2 exposure did not result in notable changes in ultimate muscle pH. Exposure to 15-min crowding stress at 93 d resulted in significant changes in hematocrit, plasma cortisol, glucose, and chloride for all treatment groups. CO2-specific changes were detected in hematocrit, plasma cortisol, and plasma chloride responses following the 15-min crowding stress. ?? Copyright by the World Aquaculture Society 2005.

Electrotransfer of Plasmid Vector DNA into Muscle

NASA Astrophysics Data System (ADS)

Miyazaki, Satsuki; Miyazaki, Jun-Ichi

Wolff et al. (1990) first reported that plasmid DNA injected into skeletal muscle is taken up by muscle cells and the genes in the plasmid are expressed for more than two months thereafter, although the transfected DNA does not usually undergo chromosomal integration (Wolff et al., 1991, 1992). However, the relatively low expression levels attained by this method have hampered its applications for uses other than as a DNA vaccine (Davis et al., 1995). There are a number of reports analyzing the conditions that affect the efficiency of gene transfer by intramuscular DNA injection and assessing the fine structures of expression plasmid vectors that may affect expression levels (Davis et al., 1993; Liang et al., 1996; Norman et al., 1997). Furthermore, various attempts were done to improve the efficiency of gene transfer by intramus cular DNA injection. Consequently, regenerating muscle was shown to produce 80-fold or more protein than did normal muscle, following injection of an expression plas-mid. Muscle regeneration was induced by treatment with cardiotoxin or bupivacaine (Wells, 1993; Vitadello et al., 1994). We previously demonstrated that by combining a strong promoter and bupivacaine pretreatment intramuscular injection of an IL-5 expression plasmid results in IL-5 production in muscle at a level sufficient to induce marked proliferation of eosinophils in the bone marrow and eosinophil infiltration of various organs (Tokui et al., 1997). It was also reported that a single intramuscular injection of an erythropoietin expression plasmid produced physiologically significant elevations in serum erythropoietin levels and increased hematocrits in adult mice (Tripathy et al., 1996). Hematocrits in these animals remained elevated at >60% for at least 90 days after a single injection. However, improvements to this method have not been sufficient to extend its applications including clinical use.

Chronic Diarrhea in Dogs - Retrospective Study in 136 Cases.

PubMed

Volkmann, M; Steiner, J M; Fosgate, G T; Zentek, J; Hartmann, S; Kohn, B

2017-07-01

Chronic diarrhea (CD) is common in dogs, and information on frequency and distribution of primary and secondary causes is lacking. To evaluate underlying causes and predictors of outcome in dogs with CD. One hundred and thirty-six client-owned dogs with CD (≥3 weeks duration). Retrospective review of medical records (Small Animal Clinic, Freie Universität Berlin, Germany, 09/2009-07/2011). Quantification of final diagnoses and comparison of clinical aspects including disease severity and clinicopathological abnormalities among dogs with clinical remission (either complete [gastrointestinal signs absent] or partial [clinical improvement of gastrointestinal signs and reduced episodes with shortened duration]), and those without recovery. Ninety percent of dogs were diagnosed with a primary enteropathy: inflammatory (71%; of those 66% dietary responsive, 23% idiopathic, 11% antibiotic responsive), infectious (13%), neoplastic (4%), and in one dog each mechanical disease or systemic vasculitis. Secondary causes were diagnosed in 10% of dogs: exocrine pancreatic (6%), endocrine (2%), and in one dog each hepatic, renal, and cardiac disease. In total, 87% of dogs had clinical remission, whereas 13% died or did not respond to treatment: Lack of recovery was frequently recorded for dogs with primary inflammatory (idiopathic) or neoplastic disease and was significantly associated with increased disease severity scores (P = .005), anemia (hematocrit < 40%, P < .001), severe hypoalbuminemia (serum albumin <2.0 g/dL, P = .008), and severe hypocobalaminemia (serum cobalamin concentration <200 pg/mL, P = .006). Inflammatory enteropathies and particularly those of dietary origin were the most common causes of CD in dogs. Findings support the usefulness of hematocrit, and serum albumin and cobalamin concentration as prognostic markers in dogs with CD. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

When Should Abdominal Computed Tomography Be Considered in Patients with Lower Rib Fractures?

PubMed

Jeroukhimov, Igor; Hershkovitz, Yehuda; Wiser, Itay; Kessel, Boris; Ayyad, Mohammed; Gatot, Inbar; Shapira, Zahar; Jeoravlev, Svetlana; Halevy, Ariel; Lavy, Ron

2017-05-01

Lower rib fractures are considered as a marker of intra-abdominal organ injury. Abdominal computed tomography (CT) is the "gold standard" examination for patients with lower rib fractures. However, the reported incidence of concomitant intra-abdominal injuries (IAI) is 20%-40%. The purpose of this study was to evaluate the incidence of intra-abdominal organ injuries in blunt trauma patients with lower rib fractures. Medical charts and radiology reports of patients with lower rib (from the 8th to 12th rib) fractures admitted to our center during a 6-year period were retrospectively reviewed. Patients were divided into two groups. Group I included patients with intra-abdominal injury (IAI) diagnosed either by CT or on urgent laparotomy, and Group II included those with normal abdominal CT scans. Data included demographics, mechanism of injury, laboratory tests, radiology results including number and location of fractured ribs, and incidence of IAI. Overall 318 patients were included in the study. Fifty-seven patients (17.9%) had 71 IAIs compared with 265 (82.1%) patients with no IAI. Logistic regression identified age younger than 55 years (relative risk [RR] = 7.2; 95% confidence interval [CI] 3.1-16.8; p = 0.001), bilateral rib fractures (RR = 3.9; 95% CI 1.1-13.5; p = 0.03) and decreased levels of hematocrit (RR = 2.4; 95% CI 1.2-4.8; p = 0.016) as independent risk factors for the presence of IAI. Abdominal CT should be considered in blunt trauma patients with lower rib fractures who are younger than 55 years of age and have bilateral rib fractures and decreased levels of hematocrit on admission. Copyright © 2016 Elsevier Inc. All rights reserved.

The effects of copper on blood and biochemical parameters of rainbow trout (Oncorhynchus mykiss)

USGS Publications Warehouse

Dethloff, G.M.; Schlenk, D.; Khan, S.; Bailey, H.C.

1999-01-01

Metals are released into aquatic systems from many sources, often at sublethal concentrations. The effects of sublethal concentrations of metals on fish are not entirely understood. The objective of this study was to determine the hematological and biochemical effects of a range of copper concentrations (6.4, 16.0, 26.9 ??g Cu/L) on rainbow trout (Oncorhynchus mykiss) over a prolonged period of time. Trout were exposed to copper, and, at intervals of 3, 7, 14, and 21 days, selected parameters were evaluated. Hemoglobin, hematocrit, plasma glucose, and plasma cortisol levels were elevated in trout exposed to 26.9 ??g Cu/L at day 3 and then returned to levels comparable to control fish. Plasma protein and lactate levels were not significantly altered in trout from any copper treatment. Hepatic copper concentration and hepatic metallothionein mRNA expression were consistently elevated in trout exposed to 26.9 ??g Cu/L. Both of these parameters stabilized by day 3, with only hepatic copper concentration showing a further increase at day 21. Hepatic copper concentration and hepatic metallothionein mRNA expression appear to be robust indicators of copper exposure. Most blood-based parameters evaluated appear to be associated with a transitory, nonspecific stress response. The return of elevated hematological and biochemical parameters to control levels after 3 days and thestabilization of hepatic metallothionein mRNA expression and copper concentration over a similar time period suggested acclimation to dissolved copper at 26.9 ??g/L. Further analysis of the data on blood-based parameters indicated that certain parameters (hemoglobin, hematocrit, plasma glucose, plasma cortisol) may be useful in field monitoring.

Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy.

PubMed

Santos, Ana Célia Oliveira dos; Almeida, Ana Maria Rampeloti

2013-01-01

Even with current highly active antiretroviral therapy, individuals with AIDS continue to exhibit important nutritional deficits and reduced levels of albumin and hemoglobin, which may be directly related to their cluster of differentiation 4 (CD4) cell counts. The aim of this study was to characterize the nutritional status of individuals with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and relate the findings to the albumin level, hemoglobin level and CD4 cell count. Patients over 20 years of age with AIDS who were hospitalized in a university hospital and were receiving antiretroviral therapy were studied with regard to clinical, anthropometric, biochemical and sociodemographic characteristics. Body mass index, percentage of weight loss, arm circumference, triceps skinfold and arm muscle circumference were analyzed. Data on albumin, hemoglobin, hematocrit and CD4 cell count were obtained from patient charts. Statistical analysis was performed using Fisher's exact test, Student's t-test for independent variables and the Mann-Whitney U-test. The level of significance was set to 0.05 (α = 5%). Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 17.0 software for Windows. Of the 50 patients evaluated, 70% were male. The prevalence of malnutrition was higher when the definition was based on arm circumference and triceps skinfold measurement. The concentrations of all biochemical variables were significantly lower among patients with a body mass index of less than 18.5kg/m2. The CD4 cell count, albumin, hemoglobin and hematocrit anthropometric measures were directly related to each other. These findings underscore the importance of nutritional follow-up for underweight patients with AIDS, as nutritional status proved to be related to important biochemical alterations.

Experimental increase in baseline corticosterone level reduces oxidative damage and enhances innate immune response

PubMed Central

Pătraș, Laura; Pap, Péter L.; Vincze, Orsolya; Mureșan, Cosmin; Németh, József; Lendvai, Ádám Z.

2018-01-01

Glucocorticoid (GC) hormones are significant regulators of homeostasis. The physiological effects of GCs critically depend on the time of exposure (short vs. long) as well as on their circulating levels (baseline vs. stress-induced). Previous experiments, in which chronic and high elevation of GC levels was induced, indicate that GCs impair both the activity of the immune system and the oxidative balance. Nonetheless, our knowledge on how mildly elevated GC levels, a situation much more common in nature, might influence homeostasis is limited. Therefore, we studied whether an increase in GC level within the baseline range suppresses or enhances condition (body mass, hematocrit and coccidian infestation) and physiological state (humoral innate immune system activity and oxidative balance). We implanted captive house sparrows Passer domesticus with either 60 days release corticosterone (CORT) or control pellets. CORT-treated birds had elevated baseline CORT levels one week after the implantation, but following this CORT returned to its pre-treatment level and the experimental groups had similar CORT levels one and two months following the implantation. The mass of tail feathers grown during the initial phase of treatment was smaller in treated than in control birds. CORT implantation had a transient negative effect on body mass and hematocrit, but both of these traits resumed the pre-treatment values by one month post-treatment. CORT treatment lowered oxidative damage to lipids (malondialdehyde) and enhanced constitutive innate immunity at one week and one month post-implantation. Our findings suggest that a relatively short-term (i.e. few days) elevation of baseline CORT might have a positive and stimulatory effect on animal physiology. PMID:29432437

Validation and Application of a Dried Blood Spot Ceftriaxone Assay

PubMed Central

Page-Sharp, Madhu; Nunn, Troy; Salman, Sam; Moore, Brioni R.; Batty, Kevin T.; Davis, Timothy M. E.

2015-01-01

Dried blood spot (DBS) antibiotic assays can facilitate pharmacokinetic/pharmacodynamic (PK/PD) studies in situations where venous blood sampling is logistically and/or ethically problematic. In this study, we aimed to develop, validate, and apply a DBS ceftriaxone assay. A liquid chromatography-tandem mass spectroscopy (LC-MS/MS) DBS ceftriaxone assay was assessed for matrix effects, process efficiency, recovery, variability, and limits of quantification (LOQ) and detection (LOD). The effects of hematocrit, protein binding, red cell partitioning, and chad positioning were evaluated, and thermal stability was assessed. Plasma, DBS, and cell pellet ceftriaxone concentrations in 10 healthy adults were compared, and plasma concentration-time profiles of DBS and plasma ceftriaxone were incorporated into population PK models. The LOQ and LOD for ceftriaxone in DBS were 0.14 mg/liter and 0.05 mg/liter, respectively. Adjusting for hematocrit, red cell partitioning, and relative recovery, DBS-predicted plasma concentrations were comparable to measured plasma concentrations (r > 0.95, P < 0.0001), and Bland-Altman plots showed no significant bias. The final population PK estimates of clearance, volume of distribution, and time above threshold MICs for measured and DBS-predicted plasma concentrations were similar. At 35°C, 21°C, 4°C, −20°C, and −80°C, ceftriaxone retained >95% initial concentrations in DBS for 14 h, 35 h, 30 days, 21 weeks, and >11 months, respectively. The present DBS ceftriaxone assay is robust and can be used as a surrogate for plasma concentrations to provide valid PK and PK/PD data in a variety of clinical situations, including in studies of young children and of those in remote or resource-poor settings. PMID:26438505

Benzene exposure from the BP refinery flaring incident alters hematological and hepatic functions among smoking subjects.

PubMed

D'Andrea, Mark A; Reddy, G Kesava

2017-10-06

To evaluate the health effects of benzene exposure among smoking subjects from a prolonged flaring incident that occurred at the British Petroleum (BP) refinery in Texas City, USA. The study included smoking subjects who had been exposed and unexposed to the benzene release. Using medical charts, clinical data including white blood cell (WBC) counts, platelet counts, hemoglobin, hematocrit, blood urea nitrogen (BUN), creatinine, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in the case of smoking subjects exposed to benzene was reviewed and analyzed. A total of 791 tobacco smoking subjects (benzene-exposed: N = 733, unexposed: N = 58) were included. Benzene-exposed subjects had significantly higher levels of WBC (×103/μl) counts (8±2.1 vs. 7.5±1.6, p = 0.003) and platelet (×103/μl) counts (263.7±69.7 vs. 222.9±44.3, p = 0.000) as compared with the unexposed subjects. The mean hemoglobin, hematocrit, BUN, and creatinine levels did not differ significantly between the benzene-exposed and -unexposed smoking subjects. Serum levels of ALP (IU/l) was significantly elevated in the benzene-exposed subjects compared with the unexposed subjects (84.5±16.9 vs. 73.8±15.9, p = 0.002). Similarly, benzene-exposed subjects had significantly higher levels of AST and ALT as compared with those unexposed subjects. Despite a smoking history, residents exposed to benzene from the prolonged BP flaring incident experienced significant alterations in hematological and hepatic functions indicating their vulnerability to the risk of developing hepatic or blood related disorders. Int J Occup Med Environ Health 2017;30(6):849-860. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Risk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyurea

PubMed Central

Alvarez-Larrán, Alberto; Pérez-Encinas, Manuel; Ferrer-Marín, Francisca; Hernández-Boluda, Juan Carlos; Ramírez, María José; Martínez-López, Joaquín; Magro, Elena; Cruz, Yasmina; Mata, María Isabel; Aragües, Pilar; Fox, María Laura; Cuevas, Beatriz; Montesdeoca, Sara; Hernández-Rivas, José Angel; García-Gutiérrez, Valentín; Gómez-Casares, María Teresa; Steegmann, Juan Luis; Durán, María Antonia; Gómez, Montse; Kerguelen, Ana; Bárez, Abelardo; García, Mari Carmen; Boqué, Concepción; Raya, José María; Martínez, Clara; Albors, Manuel; García, Francesc; Burgaleta, Carmen; Besses, Carlos

2017-01-01

Hematocrit control below 45% is associated with a lower rate of thrombosis in polycythemia vera. In patients receiving hydroxyurea, this target can be achieved with hydroxyurea alone or with the combination of hydroxyurea plus phlebotomies. However, the clinical implications of phlebotomy requirement under hydroxyurea therapy are unknown. The aim of this study was to evaluate the need for additional phlebotomies during the first five years of hydroxyurea therapy in 533 patients with polycythemia vera. Patients requiring 3 or more phlebotomies per year (n=85, 16%) showed a worse hematocrit control than those requiring 2 or less phlebotomies per year (n=448, 84%). There were no significant differences between the two study groups regarding leukocyte and platelet counts. Patients requiring 3 or more phlebotomies per year received significantly higher doses of hydroxyurea than the remaining patients. A significant higher rate of thrombosis was found in patients treated with hydroxyurea plus 3 or more phlebotomies per year compared to hydroxyurea with 0–2 phlebotomies per year (20.5% vs. 5.3% at 3 years; P<0.0001). In multivariate analysis, independent risk factors for thrombosis were phlebotomy dependency (HR: 3.3, 95%CI: 1.5–6.9; P=0.002) and thrombosis at diagnosis (HR: 4.7, 95%CI: 2.3–9.8; P<0.0001). The proportion of patients fulfilling the European LeukemiaNet criteria of resistance/intolerance to hydroxyurea was significantly higher in the group requiring 3 or more phlebotomies per year (18.7% vs. 7.1%; P=0.001) mainly due to extrahematologic toxicity. In conclusion, phlebotomy requirement under hydroxyurea therapy identifies a subset of patients with increased proliferation of polycythemia vera and higher risk of thrombosis. PMID:27686377

Effect of a high-fructose diet on glucose tolerance, plasma lipid and hemorheological parameters during oral contraceptive administration in female rats.

PubMed

Olatunji, Lawrence Aderemi; Oyeyipo, Ibukun Peter; Usman, Taofeek Oluwamayowa

2013-01-01

Oral contraceptive (OC) use and increased fructose feeding have been associated with altered cardiometabolic effects. The effect of increased dietary fructose during OC use on cardiometabolic parameters is unknown. We investigated the effects of a high-fructose diet on body weight gain, fasting blood glucose, glucose tolerance, plasma lipid and hemorheological parameters in female rats treated with a combination of OC steroids (norgestrel/ethinyl estradiol; NEE). Rats were given (p.o.) vehicle, high-dose NEE (10.0 μg norgestrel/1.0 μg ethinyl estradiol) or low-dose NEE (1.0 μg norgestrel/0.1 μg ethinyl estradiol) with or without high dietary fructose daily for 6 weeks. Results demonstrated that high-dose NEE but not low-dose NEE treatment led to significant increases in hematocrit, blood viscosity, and decreases in body weight gain, glucose tolerance, and plasma HDL-cholesterol level. Both NEE treatments resulted in significant increases in plasma viscosity and triglyceride. Increased dietary fructose without NEE treatment produced significant increases in fasting blood glucose, hematocrit, blood and plasma viscosities, while increased dietary fructose significantly potentiated the effects on blood and plasma viscosities observed during NEE treatment. Conversely, the effects of NEE treatment on body weight gain, glucose tolerance, plasma triglyceride and HDL-cholesterol were significantly attenuated. In conclusion, the results indicate that increase in dietary fructose may worsen abnormal blood rheology. The results also demonstrate that increased dietary fructose may not impact negatively on glucose and lipid metabolisms during OC use. The findings imply that fructose-enriched diet might be an important consideration during OC use regarding blood rheological properties.

Direct Numerical Simulation of Cellular-Scale Blood Flow in 3D Microvascular Networks.

PubMed

Balogh, Peter; Bagchi, Prosenjit

2017-12-19

We present, to our knowledge, the first direct numerical simulation of 3D cellular-scale blood flow in physiologically realistic microvascular networks. The vascular networks are designed following in vivo images and data, and are comprised of bifurcating, merging, and winding vessels. Our model resolves the large deformation and dynamics of each individual red blood cell flowing through the networks with high fidelity, while simultaneously retaining the highly complex geometric details of the vascular architecture. To our knowledge, our simulations predict several novel and unexpected phenomena. We show that heterogeneity in hemodynamic quantities, which is a hallmark of microvascular blood flow, appears both in space and time, and that the temporal heterogeneity is more severe than its spatial counterpart. The cells are observed to frequently jam at vascular bifurcations resulting in reductions in hematocrit and flow rate in the daughter and mother vessels. We find that red blood cell jamming at vascular bifurcations results in several orders-of-magnitude increase in hemodynamic resistance, and thus provides an additional mechanism of increased in vivo blood viscosity as compared to that determined in vitro. A striking result from our simulations is negative pressure-flow correlations observed in several vessels, implying a significant deviation from Poiseuille's law. Furthermore, negative correlations between vascular resistance and hematocrit are observed in various vessels, also defying a major principle of particulate suspension flow. To our knowledge, these novel findings are absent in blood flow in straight tubes, and they underscore the importance of considering realistic physiological geometry and resolved cellular interactions in modeling microvascular hemodynamics. Copyright © 2017 Biophysical Society. Published by Elsevier Inc. All rights reserved.

Cerebral oximetry during cardiac surgery: the association between cerebral oxygen saturation and perioperative patient variables.

PubMed

Apostolidou, Ioanna; Morrissette, Greg; Sarwar, Muhammad F; Konia, Mojca R; Kshettry, Vibhu R; Wahr, Joyce A; Lobbestael, Aaron A; Nussmeier, Nancy A

2012-12-01

This "real-world" study was designed to assess the patterns of regional cerebral oxygen saturation (rSO(2)) change during adult cardiac surgery. A secondary objective was to determine any relation between perioperative rSO(2) (baseline and during surgery) and patient characteristics or intraoperative variables. Prospective, observational, multicenter, nonrandomized clinical study. Cardiac operating rooms at 3 academic medical centers. Ninety consecutive adult patients presenting for cardiac surgery with or without cardiopulmonary bypass. Patients received standard care at each institution plus bilateral forehead recordings of cerebral oxygen saturation with the 7600 Regional Oximeter System (Nonin Medical, Plymouth, MN). The average baseline (before induction) rSO(2) was 63.9 ± 8.8% (range 41%-95%); preoperative hematocrit correlated with baseline rSO(2) (0.48% increase for each 1% increase in hematocrit, p = 0.008). The average nadir (lowest recorded rSO(2) for any given patient) was 54.9 ± 6.6% and was correlated with on-pump surgery, baseline rSO(2), and height. Baseline rSO(2) was found to be an independent predictor of length of stay (hazard ratio 1.044, confidence interval 1.02-1.07, for each percentage of baseline rSO(2)). In cardiac surgical patients, lower baseline rSO(2) value, on-pump surgery, and height were significant predictors of nadir rSO(2), whereas only baseline rSO(2) was a predictor of postoperative length of stay. These findings support previous research on the predictive value of baseline rSO(2) on length of stay and emphasize the need for further research regarding the clinical relevance of baseline rSO(2) and intraoperative changes. Copyright © 2012 Elsevier Inc. All rights reserved.

Visualizing ultrasound through computational modeling

NASA Technical Reports Server (NTRS)

Guo, Theresa W.

2004-01-01

The Doppler Ultrasound Hematocrit Project (DHP) hopes to find non-invasive methods of determining a person s blood characteristics. Because of the limits of microgravity and the space travel environment, it is important to find non-invasive methods of evaluating the health of persons in space. Presently, there is no well developed method of determining blood composition non-invasively. This projects hopes to use ultrasound and Doppler signals to evaluate the characteristic of hematocrit, the percentage by volume of red blood cells within whole blood. These non-invasive techniques may also be developed to be used on earth for trauma patients where invasive measure might be detrimental. Computational modeling is a useful tool for collecting preliminary information and predictions for the laboratory research. We hope to find and develop a computer program that will be able to simulate the ultrasound signals the project will work with. Simulated models of test conditions will more easily show what might be expected from laboratory results thus help the research group make informed decisions before and during experimentation. There are several existing Matlab based computer programs available, designed to interpret and simulate ultrasound signals. These programs will be evaluated to find which is best suited for the project needs. The criteria of evaluation that will be used are 1) the program must be able to specify transducer properties and specify transmitting and receiving signals, 2) the program must be able to simulate ultrasound signals through different attenuating mediums, 3) the program must be able to process moving targets in order to simulate the Doppler effects that are associated with blood flow, 4) the program should be user friendly and adaptable to various models. After a computer program is chosen, two simulation models will be constructed. These models will simulate and interpret an RF data signal and a Doppler signal.

New microfluidic-based sampling procedure for overcoming the hematocrit problem associated with dried blood spot analysis.

PubMed

Leuthold, Luc Alexis; Heudi, Olivier; Déglon, Julien; Raccuglia, Marc; Augsburger, Marc; Picard, Franck; Kretz, Olivier; Thomas, Aurélien

2015-02-17

Hematocrit (Hct) is one of the most critical issues associated with the bioanalytical methods used for dried blood spot (DBS) sample analysis. Because Hct determines the viscosity of blood, it may affect the spreading of blood onto the filter paper. Hence, accurate quantitative data can only be obtained if the size of the paper filter extracted contains a fixed blood volume. We describe for the first time a microfluidic-based sampling procedure to enable accurate blood volume collection on commercially available DBS cards. The system allows the collection of a controlled volume of blood (e.g., 5 or 10 μL) within several seconds. Reproducibility of the sampling volume was examined in vivo on capillary blood by quantifying caffeine and paraxanthine on 5 different extracted DBS spots at two different time points and in vitro with a test compound, Mavoglurant, on 10 different spots at two Hct levels. Entire spots were extracted. In addition, the accuracy and precision (n = 3) data for the Mavoglurant quantitation in blood with Hct levels between 26% and 62% were evaluated. The interspot precision data were below 9.0%, which was equivalent to that of a manually spotted volume with a pipet. No Hct effect was observed in the quantitative results obtained for Hct levels from 26% to 62%. These data indicate that our microfluidic-based sampling procedure is accurate and precise and that the analysis of Mavoglurant is not affected by the Hct values. This provides a simple procedure for DBS sampling with a fixed volume of capillary blood, which could eliminate the recurrent Hct issue linked to DBS sample analysis.

Alterations of erythrocyte rheology and cellular susceptibility in end stage renal disease: Effects of peritoneal dialysis.

PubMed

Ertan, Nesrin Zeynep; Bozfakioglu, Semra; Ugurel, Elif; Sinan, Mukaddes; Yalcin, Ozlem

2017-01-01

In this study, we investigated the effects of peritoneal dialysis on hemorheological and hematological parameters and their relations with oxidant and antioxidant status of uremic patients. Hemorheological parameters (erythrocyte deformability, erythrocyte aggregation, osmotic deformability, blood and plasma viscosity) were measured in patients with renal insufficiency undergoing peritoneal dialysis (PD) and volunteers. Erythrocyte deformability, osmotic deformability and aggregation in both autologous plasma and 3% dextran 70 were measured by laser diffraction ektacytometry. Enzyme activities of glutathione peroxidase, superoxide dismutase and catalase were studied in erythrocytes; lipid peroxidation was studied by measuring the amount of malondialdehyde in both erythrocytes and plasma samples. Blood viscosity at native hematocrit was significantly lower in PD patients at all measured shear rates compared to controls, but it was high in PD patients at corrected (45%) hematocrit. Erythrocyte deformability did not show any difference between the two groups. Osmotic deformability was significantly lower in PD patients compared to controls. Aggregation index values were significantly high in PD patients in plasma Catalase and glutathione peroxidase activities in erythrocytes were decreased in PD patients whereas superoxide dismutase activity was increased compared to controls. Malondialdehyde was significantly increased in erythrocytes and plasma samples of PD patients which also shows correlations with aggregation parameters. It has been concluded that erythrocytes in PD patients are more prone to aggregation and this tendency could be influenced by lipid peroxidation activity in patient's plasma. These results imply that uremic conditions, loss of plasma proteins and an increased risk of oxidative stress because of decreasing levels of antioxidant enzymes affect erythrocyte rheology during peritoneal dialysis. This level of distortion may have crucial effects, impairing the blood flow dynamics and causing inadequate microcirculatory perfusion.

In Vitro Evaluation of the Link Between Cell Activation State and Its Rheological Impact on the Microscale Flow of Neutrophil Suspensions.

PubMed

Akenhead, Michael L; Horrall, Nolan M; Rowe, Dylan; Sethu, Palaniappan; Shin, Hainsworth Y

2015-09-01

Activated neutrophils have been reported to affect peripheral resistance, for example, by plugging capillaries or adhering to the microvasculature. In vivo and ex vivo data indicate that activated neutrophils circulating in the blood also influence peripheral resistance. We used viscometry and microvascular mimics for in vitro corroboration. The rheological impact of differentiated neutrophil-like HL-60 promyelocytes (dHL60s) or human neutrophil suspensions stimulated with 10 nM fMet-Leu-Phe (fMLP) was quantified using a cone-plate rheometer (450 s(-1) shear rate). To evaluate their impact on microscale flow resistance, we used 10-μm Isopore® membranes to model capillaries as well as single 200 × 50 μm microchannels and networks of twenty 20 × 50 μm microfluidic channels to mimic noncapillary microvasculature. Stimulation of dHL60 and neutrophil populations significantly altered their flow behavior as evidenced by their impact on suspension viscosity. Notably, hematocrit abrogated the impact of leukocyte activation on blood cell suspension viscosity. In micropore filters, activated cell suspensions enhanced flow resistance. This effect was further enhanced by the presence of erythrocytes. The resistance of our noncapillary microvascular mimics to flow of activated neutrophil suspensions was significantly increased only with hematocrit. Notably, it was elevated to a higher extent within the micronetwork chambers compared to the single-channel chambers. Collectively, our findings provide supportive evidence that activated neutrophils passing through the microcirculation may alter hemodynamic resistance due to their altered rheology in the noncapillary microvasculature. This effect is another way neutrophil activation due to chronic inflammation may, at least in part, contribute to the elevated hemodynamic resistance associated with cardiovascular diseases (e.g., hypertension and hypercholesterolemia).

A reappraisal of the benefit-risk profile of hydroxyurea in polycythemia vera: A propensity-matched study.

PubMed

Barbui, Tiziano; Vannucchi, Alessandro Maria; Finazzi, Guido; Finazzi, Maria Chiara; Masciulli, Arianna; Carobbio, Alessandra; Ghirardi, Arianna; Tognoni, Gianni

2017-11-01

The use of hydroxyurea (HU) as first line therapy in polycythemia vera (PV) has been criticized because no solid demonstration that this drug prevents thrombosis or prolongs survival has been so far produced. Here we present the outcomes of a large cohort of patients with PV included in the European Collaborative Low-dose Aspirin (ECLAP) study. We selected 1,042 patients who, during the follow-up, had received only phlebotomy (PHL) or HU to maintain the hematocrit level < 45%. To assure comparability, we conducted a propensity score matching analysis. The two groups (PHL n = 342 and HU n = 681) were well balanced for the parameters included in the propensity score (overall balance: χ 2  = 2.44, P = 0.964). Over a comparable period of follow-up (PHL = 29.9 vs. HU = 34.7 months), we documented an advantage of HU over PHL consistently significant with respect to the incidence of fatal/non-fatal cardiovascular (CV) events (5.8 vs. 3.0 per 100 person-years in PHL vs. HU group, P = 0.002) and myelofibrosis transformation that was only experienced by patients of PHL group. Evolution to acute leukemia was registered in three patients (two in PHL and one in HU group). The excess of mortality and total CV events in the PHL patients was restricted to the high-risk group, and, compared with HU cases, was significant higher in the PHL patients who failed to reach the hematocrit target < 0.45% (P = 0.000). In conclusion, this analysis provides reliable and qualified estimates of the therapeutic profile of HU and PHL treatments for future experimental studies and for the management of PV in clinical practice. © 2017 Wiley Periodicals, Inc.

Risk of thrombosis according to need of phlebotomies in patients with polycythemia vera treated with hydroxyurea.

PubMed

Alvarez-Larrán, Alberto; Pérez-Encinas, Manuel; Ferrer-Marín, Francisca; Hernández-Boluda, Juan Carlos; Ramírez, María José; Martínez-López, Joaquín; Magro, Elena; Cruz, Yasmina; Mata, María Isabel; Aragües, Pilar; Fox, María Laura; Cuevas, Beatriz; Montesdeoca, Sara; Hernández-Rivas, José Angel; García-Gutiérrez, Valentín; Gómez-Casares, María Teresa; Steegmann, Juan Luis; Durán, María Antonia; Gómez, Montse; Kerguelen, Ana; Bárez, Abelardo; García, Mari Carmen; Boqué, Concepción; Raya, José María; Martínez, Clara; Albors, Manuel; García, Francesc; Burgaleta, Carmen; Besses, Carlos

2017-01-01

Hematocrit control below 45% is associated with a lower rate of thrombosis in polycythemia vera. In patients receiving hydroxyurea, this target can be achieved with hydroxyurea alone or with the combination of hydroxyurea plus phlebotomies. However, the clinical implications of phlebotomy requirement under hydroxyurea therapy are unknown. The aim of this study was to evaluate the need for additional phlebotomies during the first five years of hydroxyurea therapy in 533 patients with polycythemia vera. Patients requiring 3 or more phlebotomies per year (n=85, 16%) showed a worse hematocrit control than those requiring 2 or less phlebotomies per year (n=448, 84%). There were no significant differences between the two study groups regarding leukocyte and platelet counts. Patients requiring 3 or more phlebotomies per year received significantly higher doses of hydroxyurea than the remaining patients. A significant higher rate of thrombosis was found in patients treated with hydroxyurea plus 3 or more phlebotomies per year compared to hydroxyurea with 0-2 phlebotomies per year (20.5% vs. 5.3% at 3 years; P<0.0001). In multivariate analysis, independent risk factors for thrombosis were phlebotomy dependency (HR: 3.3, 95%CI: 1.5-6.9; P=0.002) and thrombosis at diagnosis (HR: 4.7, 95%CI: 2.3-9.8; P<0.0001). The proportion of patients fulfilling the European LeukemiaNet criteria of resistance/intolerance to hydroxyurea was significantly higher in the group requiring 3 or more phlebotomies per year (18.7% vs. 7.1%; P=0.001) mainly due to extrahematologic toxicity. In conclusion, phlebotomy requirement under hydroxyurea therapy identifies a subset of patients with increased proliferation of polycythemia vera and higher risk of thrombosis. Copyright© Ferrata Storti Foundation.

Comparative growth outcome of preterm neonate fed post-discharge formula and breast milk after discharge.

PubMed

Chotigeat, Uraiwan; Vongpakorn, Jarinthorn

2014-06-01

To evaluate the post-discharge growth, laboratory outcome, neurodevelopment and safety of post-discharge formula in comparison to breast milk. A prospective cohort of preterm infants, who were discharged on breast milk or post-discharge formula (PDF) were studied. Demographic data, post-discharge growth, laboratory outcome, neurodevelopment and complications were recorded. These infants were followed-up at 40 weeks' postmenstrual age (PMA) 2, 4 and 6 months' corrected age. The present study was conducted for 22 months (from September 1, 2011-May 31, 2013). Seventeen infants were enrolled in the study, 7 in the breastfed group and 10 in the PDF group. Mean maternal age in breastfed group were significantly younger compared with PDF-fed group. PDF-fed infants were longer with statistical significantly at 40 weeks PMA and 4 months' corrected age (p < 0.05). At 2 months' corrected age, babies in breast milk group were significantly heavier compared to those in PDF group. Conversely, those in PDF group were heavier than the breastfed group at 4 months' corrected age (p < 0.05). There was no difference of head circumference between groups at follow-up. A higher serum phosphorus and lower serum alkaline phosphatase were related to improve suspected osteopenia of prematurity at 2 months' corrected age in PDF group (p = 0.007). Hematocrit was higher in the PDF group than breastfed group, which was statistically significant at 40 weeks' postmenstrual age and 6 months' corrected age. There were no significant diferences in developmental screening in both groups. Post-discharge formula may improve growth, hematocrit and reduce suspected osteopenia of prematurity. However neurodevelopment outcome and complications were similar to both groups.

Quantification of Rifapentine, a Potent Antituberculosis Drug, from Dried Blood Spot Samples Using Liquid Chromatographic-Tandem Mass Spectrometric Analysis

PubMed Central

Parsons, Teresa L.; Marzinke, Mark A.; Hoang, Thuy; Bliven-Sizemore, Erin; Weiner, Marc; Mac Kenzie, William R.; Dorman, Susan E.

2014-01-01

The quantification of antituberculosis drug concentrations in multinational trials currently requires the collection of modest blood volumes, centrifugation, aliquoting of plasma, freezing, and keeping samples frozen during shipping. We prospectively enrolled healthy individuals into the Tuberculosis Trials Consortium Study 29B, a phase I dose escalation study of rifapentine, a rifamycin under evaluation in tuberculosis treatment trials. We developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for quantifying rifapentine in whole blood on dried blood spots (DBS) to facilitate pharmacokinetic/pharmacodynamic analyses in clinical trials. Paired plasma and whole-blood samples were collected by venipuncture, and whole blood was spotted on Whatman protein saver 903 cards. The methods were optimized for plasma and then validated for DBS. The analytical measuring range for quantification of rifapentine and its metabolite was 50 to 80,000 ng/ml in whole-blood DBS. The analyte was stable on the cards for 11 weeks with a desiccant at room temperature and protected from light. The method concordance for paired plasma and whole-blood DBS samples was determined after correcting for participant hematocrit or population-based estimates of bias from Bland-Altman plots. The application of either correction factor resulted in acceptable correlation between plasma and whole-blood DBS (Passing-Bablok regression corrected for hematocrit; y = 0.98x + 356). Concentrations of rifapentine may be determined from whole-blood DBS collected via venipuncture after normalization in order to account for the dilutional effects of red blood cells. Additional studies are focused on the application of this methodology to capillary blood collected by finger stick. The simplicity of processing, storage, shipping, and low blood volume makes whole-blood DBS attractive for rifapentine pharmacokinetic evaluations, especially in international and pediatric trials. PMID:25182637

Hematocrit-Independent Quantitation of Stimulants in Dried Blood Spots: Pipet versus Microfluidic-Based Volumetric Sampling Coupled with Automated Flow-Through Desorption and Online Solid Phase Extraction-LC-MS/MS Bioanalysis.

PubMed

Verplaetse, Ruth; Henion, Jack

2016-07-05

A workflow overcoming microsample collection issues and hematocrit (HCT)-related bias would facilitate more widespread use of dried blood spots (DBS). This report describes comparative results between the use of a pipet and a microfluidic-based sampling device for the creation of volumetric DBS. Both approaches were successfully coupled to HCT-independent, fully automated sample preparation and online liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) analysis allowing detection of five stimulants in finger prick blood. Reproducible, selective, accurate, and precise responses meeting generally accepted regulated bioanalysis guidelines were observed over the range of 5-1000 ng/mL whole blood. The applied heated flow-through solvent desorption of the entire spot and online solid phase extraction (SPE) procedure were unaffected by the blood's HCT value within the tested range of 28.0-61.5% HCT. Enhanced stability for mephedrone on DBS compared to liquid whole blood was observed. Finger prick blood samples were collected using both volumetric sampling approaches over a time course of 25 h after intake of a single oral dose of phentermine. A pharmacokinetic curve for the incurred phentermine was successfully produced using the described validated method. These results suggest that either volumetric sample collection method may be amenable to field-use followed by fully automated, HCT-independent DBS-SPE-LC-MS/MS bioanalysis for the quantitation of these representative controlled substances. Analytical data from DBS prepared with a pipet and microfluidic-based sampling devices were comparable, but the latter is easier to operate, making this approach more suitable for sample collection by unskilled persons.

ACUTE PANCREATITIS GRAVITY PREDICTIVE FACTORS: WHICH AND WHEN TO USE THEM?

PubMed Central

FERREIRA, Alexandre de Figueiredo; BARTELEGA, Janaina Alves; URBANO, Hugo Corrêa de Andrade; de SOUZA, Iure Kalinine Ferraz

2015-01-01

Introduction: Acute pancreatitis has as its main causes lithiasic biliary disease and alcohol abuse. Most of the time, the disease shows a self-limiting course, with a rapid recovery, only with supportive treatment. However, in a significant percentage of cases, it runs with important local and systemic complications associated with high mortality rates. Aim: To present the current state of the use of these prognostic factors (predictive scores) of gravity, as the time of application, complexity and specificity. Method: A non-systematic literature review through 28 papers, with emphasis on 13 articles published in indexed journals between 2008 and 2013 using Lilacs, Medline, Pubmed. Results: Several clinical, laboratory analysis, molecular and image variables can predict the development of severe acute pancreatitis. Some of them by themselves can be determinant to the progression of the disease to a more severe form, such as obesity, hematocrit, age and smoking. Hematocrit with a value lower than 44% and serum urea lower than 20 mg/dl, both at admission, appear as risk factors for pancreatic necrosis. But the PCR differentiates mild cases of serious ones in the first 24 h. Multifactorial scores measured on admission and during the first 48 h of hospitalization have been used in intensive care units, being the most ones used: Ranson, Apache II, Glasgow, Iget and Saps II. Conclusion: Acute pancreatitis is a disease in which several prognostic factors are employed being useful in predicting mortality and on the development of the severe form. It is suggested that the association of a multifactorial score, especially the Saps II associated with Iget, may increase the prognosis accuracy. However, the professional's preferences, the experience on the service as well as the available tools, are factors that have determined the choice of the most suitable predictive score. PMID:26537149

Red blood cells in sports: effects of exercise and training on oxygen supply by red blood cells

PubMed Central

Mairbäurl, Heimo

2013-01-01

During exercise the cardiovascular system has to warrant substrate supply to working muscle. The main function of red blood cells in exercise is the transport of O2 from the lungs to the tissues and the delivery of metabolically produced CO2 to the lungs for expiration. Hemoglobin also contributes to the blood's buffering capacity, and ATP and NO release from red blood cells contributes to vasodilation and improved blood flow to working muscle. These functions require adequate amounts of red blood cells in circulation. Trained athletes, particularly in endurance sports, have a decreased hematocrit, which is sometimes called “sports anemia.” This is not anemia in a clinical sense, because athletes have in fact an increased total mass of red blood cells and hemoglobin in circulation relative to sedentary individuals. The slight decrease in hematocrit by training is brought about by an increased plasma volume (PV). The mechanisms that increase total red blood cell mass by training are not understood fully. Despite stimulated erythropoiesis, exercise can decrease the red blood cell mass by intravascular hemolysis mainly of senescent red blood cells, which is caused by mechanical rupture when red blood cells pass through capillaries in contracting muscles, and by compression of red cells e.g., in foot soles during running or in hand palms in weightlifters. Together, these adjustments cause a decrease in the average age of the population of circulating red blood cells in trained athletes. These younger red cells are characterized by improved oxygen release and deformability, both of which also improve tissue oxygen supply during exercise. PMID:24273518