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Significance: Near-infrared optical imaging methods have shown promise for monitoring response to neoadjuvant chemotherapy (NAC) for breast cancer, with endogenous contrast coming from oxy- and deoxyhemoglobin. Spatial frequency domain imaging (SFDI) could be used to detect this contrast in a low-cost and portable format, but it has limited imaging depth. It is possible that local tissue compression could be used to reduce the effective tumor depth. Aim: To evaluate the potential of SFDI for therapy response prediction, we aim to predict how changes to tumor size, stiffness, and hemoglobin concentration would be reflected in contrast measured by SFDI under tissue compression. Approach: Finite element analysis of compression on an inclusion-containing soft material is combined with Monte Carlo simulation to predict the measured optical contrast. Results: When the effect of compression on blood volume is not considered, contrast gain from compression increases with the size and stiffness of the inclusion and decreases with the inclusion depth. With a model of reduction of blood volume from compression, compression reduces imaging contrast, an effect that is greater for larger inclusions and stiffer inclusions at shallower depths. Conclusions: This computational modeling study represents a first step toward tracking tumor changes induced by NAC using SFDI and local compression.
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Neoplasias de la Mama , Método de Montecarlo , Neoplasias de la Mama/diagnóstico por imagen , Humanos , Femenino , Simulación por Computador , Espectroscopía Infrarroja Corta/métodos , Análisis de Elementos Finitos , Imagen Óptica/métodos , Fantasmas de Imagen , Modelos Biológicos , Hemoglobinas/análisisRESUMEN
OBJECTIVE: Colorectal cancer (CRC) is the fourth most common cancer in the UK. Patients with symptoms suggestive of CRC should be referred for urgent investigation. However, gastrointestinal symptoms are often non-specific and there is a need for suitable triage tools to enable prioritisation of investigations. In this study, the performance of the faecal immunochemical test (FIT), anaemia and the artificial intelligence algorithm ColonFlag were retrospectively examined and evaluated for their potential clinical benefits in patients who had been referred on an urgent lower gastrointestinal cancer pathway. DESIGN: All patients aged over 40 years referred in a 12-month period were included. After 6 months, clinical outcomes were determined and the performance of the triage tests was evaluated. RESULTS: A total of 3822 patients completed investigations and received a diagnosis. 143 had CRC, 126 high-risk adenomas (HRA). ColonFlag would have missed 27 CRC and 29 HRA. Faecal haemoglobin (f-Hb) at a cut-off of 10 µg/g would have missed 10 CRC and 26 HRA; f-Hb in combination with anaemia would have missed 2 CRC and 14 HRA. Using f-Hb in combination with ColonFlag would have missed only 1 CRC and 5 HRA and would have reduced the need for urgent referral by over 400 patients. CONCLUSION: ColonFlag has potential to assist detection of CRC and HRA, alone where no faecal sample is present and in combination with FIT and to reduce the need for urgent referral.
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Anemia , Inteligencia Artificial , Neoplasias Colorrectales , Detección Precoz del Cáncer , Hemoglobinas , Sangre Oculta , Humanos , Femenino , Masculino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Neoplasias Colorrectales/diagnóstico , Anemia/diagnóstico , Detección Precoz del Cáncer/métodos , Hemoglobinas/análisis , Algoritmos , Adulto , Heces/química , Triaje/métodos , Adenoma/diagnóstico , Adenoma/patología , Reino Unido/epidemiología , Derivación y Consulta/estadística & datos numéricos , Anciano de 80 o más AñosRESUMEN
BACKGROUND: Patients undergoing haemodialysis are more susceptible to infectious diseases, including periodontitis. This study aimed to investigate the Correlation between periodontal disease and serum markers in Yemeni haemodialysis patients. METHODS: A cross-sectional study was conducted on a sample of 70 haemodialysis patients. Patient interviews, clinical examinations, and laboratory tests were performed to collect data. Serum levels of albumin, calcium, phosphorus, haemoglobin, ferritin, and creatinine were measured, with separate measurements for cystatin C The association between categorical variables was assessed using the chi-square test and Pearson's correlation coefficient, considering a significance level of p < 0.05. RESULTS: Significant correlations were found between serum biomarkers and periodontal clinical parameters. Phosphorus, creatinine, albumin, ferritin, and creatinine levels correlated significantly with the Plaque Index (p < 0.001, p < 0.001, p = 0.015, p = 0.018, and p = 0.03). While the Ferritin level showed significant correlations with both the Plaque Index and Miller Classes (r = 0.281, p = 0.018 and r = 0.258, p = 0.031), respectively. The Calcium level showed a significant correlation with the Gingival Index (r = 0.266, p = 0.027). Cystatin C level was statistically correlated with mobility (r = 0.258, p = 0.031). Also, the result showed a significant correlation between Creatinine levels and Periodontitis (r = 0.26, p = 0.03). CONCLUSION: This study provides evidence of a strong association between periodontal disease and chronic kidney disease in Yemeni haemodialysis patients. The findings emphasize the significance of maintaining good oral health in the care of haemodialysis patients.
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Biomarcadores , Calcio , Creatinina , Cistatina C , Ferritinas , Enfermedades Periodontales , Fósforo , Diálisis Renal , Humanos , Biomarcadores/sangre , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Ferritinas/sangre , Creatinina/sangre , Cistatina C/sangre , Fósforo/sangre , Calcio/sangre , Enfermedades Periodontales/sangre , Adulto , Anciano , Hemoglobinas/análisis , Índice Periodontal , Índice de Placa Dental , Albúmina Sérica/análisisRESUMEN
BACKGROUND: Tacrolimus is a potent calcineurin inhibitor (CNI) that is principally used as a first-line immunosuppressant for the prophylaxis of allograft rejection in liver transplantation (LT) patients. In clinical practice, prescribing the optimal tacrolimus dosage is complicated by its narrow therapeutic index and high pharmacokinetic variability. Thus, performing therapeutic drug monitoring (TDM) of only tacrolimus may not provide optimal drug levels. However, other influential clinical factors affecting tacrolimus levels, such as hemoglobin (Hb), hematocrit, and total bilirubin (TBIL), should be considered while adjusting tacrolimus levels. This case report aims to introduce clinicians and their teams to taking the pharmacokinetic prediction equation into consideration for a better understanding of tacrolimus dosage adjustment during the early postoperative LT. CASE PRESENTATION: In this case report, an 18-year-old male patient of Thai ethnicity was admitted for orthotropic liver transplantation, and tacrolimus was prescribed as a cornerstone immunosuppressive agent. In the immediate postoperative period, which is the most challenging period in liver transplantation, the population pharmacokinetics predictive equation was clinically used to assist in dosage adjustment of tacrolimus by considering the significant clinical factors in this case. Hemoglobin and total bilirubin levels were deemed significant clinical factors affecting the oral clearance (CL/F) of tacrolimus. First, a decrease in the Hb concentration increases the free drug concentration and therefore increases the CL/F of tacrolimus. Second, an elevated TBIL decreases the biliary excretion of tacrolimus, resulting in a decrease in the CL/F of tacrolimus. Thus, dose optimization of tacrolimus would be accurate when taking the pharmacokinetic prediction equation into consideration. Moreover, the results may contribute to a better understanding of tacrolimus pharmacokinetic variability in each transplant patient during the immediate postoperative course. CONCLUSIONS: Hemoglobin and total bilirubin were significant clinical factors influencing the oral clearance of tacrolimus early after liver transplantation. A decrease in the hemoglobin concentration would increase the free drug concentration and therefore increase the oral clearance of tacrolimus. An elevated total bilirubin decreases the biliary excretion of tacrolimus, resulting in a decrease in the oral clearance of tacrolimus.
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Bilirrubina , Monitoreo de Drogas , Hemoglobinas , Inmunosupresores , Trasplante de Hígado , Tacrolimus , Humanos , Tacrolimus/farmacocinética , Tacrolimus/administración & dosificación , Masculino , Bilirrubina/sangre , Inmunosupresores/farmacocinética , Inmunosupresores/administración & dosificación , Adolescente , Hemoglobinas/análisis , Periodo Posoperatorio , Rechazo de Injerto/prevención & controlRESUMEN
BACKGROUND: After a 920-day hiatus, COVID-19 resurged in the Tibet Autonomous Region of China in August 2022. This study compares the characteristics of COVID-19 between high-altitude residents and newcomers, as well as between newcomers and lowlanders. METHODS: This multi-center cohort study conducted at the Third People's Hospital of Tibet Autonomous Region and Beijing University Shenzhen Hospital, included 520 high-altitude resident patients, 53 high-altitude newcomer patients, and 265 lowlander patients infected with the Omicron variant. Initially, we documented epidemiological, clinical, and treatment data across varying residency at admission. We compared the severity of COVID-19 and various laboratory indicators, including hemoglobin concentration and SpO2%, over a 14-day period from the date of the first positive nucleic acid test, as well as the differences in treatment methods and disease outcomes between highlanders and high-altitude newcomers. We also compared several characteristics of COVID-19 between high-altitude newcomers and lowlanders. Univariate analysis, multivariable logistic regression, and the generalized linear mixed model were utilized for the analysis. RESULTS: No fatalities were observed. The study found no significant differences in COVID-19 severity or in the physiological measures of hemoglobin concentration and SpO2% between high-altitude and lowland residents. Similarly, there were no statistically significant differences in the values or trends of hemoglobin and SpO2% between high-altitude residents and newcomers throughout the 14-day observation period. However, compared to age- and sex-matched lowlander patients (1:5 ratio), high-altitude newcomers exhibited higher heart rates, respiratory rates, and average hemoglobin concentrations, along with lower platelet counts. There were no significant differences in hospital stays between the two groups. CONCLUSIONS: High-altitude residents and newcomer patients exhibit clinical similarities. However, the clinical characteristics of high-altitude newcomers and lowlander patients differ due to the impact of the high-altitude environment. These results highlight potential considerations for public health strategies in high-altitude regions such as Tibet.
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Altitud , COVID-19 , SARS-CoV-2 , Humanos , COVID-19/epidemiología , Femenino , Masculino , Tibet/epidemiología , Adulto , Persona de Mediana Edad , Estudios de Cohortes , Anciano , Adulto Joven , Hemoglobinas/análisis , AdolescenteRESUMEN
BACKGROUND: This study aims to investigate the association between malnutrition and early childhood caries (ECC) and caries activity among children aged 3-5 years, in order to provide a theoretical basis for preventing and blocking ECC and improving malnutrition. METHODS: Children aged 3-5 years from six kindergartens in Zhao Xian, China were enrolled in this study. The decayed, missing, filled teeth (dmft) of all children were examined and recorded. The Cariostat method was used to detect dental caries activity, collect anthropometric data and measure haemoglobin concentration. Parents were asked to complete a questionnaire on the general characteristics and oral health behaviour of the participants. The "Growth Standards for Chinese Children Under 7 Years Old" was used to assess the nutritional status of all participating children. Wilcoxon rank sum test and multivariate logistic regression analysis were used to analyse and evaluate the relationship between ECC, caries activity and malnutrition. RESULTS: A total of 635 children who met the criteria were included in this study. After adjusting for confounding factors, logistic regression showed that the risk of ECC was significantly increased in underweight children compared with normal children (OR = 5.43, P < 0. 05); compared with normal children, the risk of ECC decreased in overweight and obese children (OR = 0.31, P < 0.001); underweight children had higher caries severity than normal weight children, and the difference was statistically significant (OR = 2.69, P < 0. 05); stunted children had higher caries severity than normal weight children and the difference was statistically significant (OR = 2.28, P < 0.05); underweight was positively associated with caries activity and the association was statistically significant (OR = 2.33, P < 0. 05); stunting was positively associated with caries activity and the association was statistically significant (OR = 2.1, P < 0.05); overweight and obesity were negatively associated with caries activity and the association was statistically significant (OR = 0.61, P < 0.05). CONCLUSIONS: The risk of ECC among children aged 3-5 years was positively associated with undernutrition and negatively associated with overnutrition. The severity of ECC among children aged 3-5 years was positively associated with undernutrition. The caries activity among children aged 3-5 years was positively associated with undernutrition and negatively associated with overnutrition.
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Índice CPO , Caries Dental , Humanos , Caries Dental/epidemiología , Preescolar , Masculino , Femenino , China/epidemiología , Desnutrición/complicaciones , Desnutrición/epidemiología , Delgadez/complicaciones , Sobrepeso/complicaciones , Estado Nutricional , Hemoglobinas/análisis , Factores de Riesgo , Índice de Masa Corporal , Obesidad/complicaciones , Obesidad/epidemiología , AntropometríaRESUMEN
OBJECTIVE: To analyse the clinical efficacy and adverse drug reactions (ADRs) of iron preparations. METHODS: A total of 374 patients with iron deficiency anaemia admitted to our hospital between 1 January and 31 December 2020 were included in this study. They were divided into 2 groups based on their medication regimens: Group A (n = 187) took oral ferrous succinate tablets, and Group B (n = 187) received intravenous iron sucrose. The remission of major symptoms, laboratory test results, ADRs and other related data were collected after 4 weeks of treatment. RESULTS: Compared with the pre-treatment baseline, haemoglobin (Hb), serum iron (SI), serum ferritin (SF) and the mean corpuscular volume (MCV) increased in both groups at 4 weeks of treatment (P < 0.05). After treatment, Group A had lower levels of Hb (108.41 ± 8.39 vs. 122.31 ± 6.04 g/L, t = 6.293, P < 0.001), SI (9.72 ± 4.24 vs. 15.62 ± 5.41 µmol/L, t = 5.482, P < 0.001) and SF (27.1 ± 10.82 vs. 39.82 ± 10.44 ug/L, t = 6.793, P < 0.001) compared with Group B. In contrast, there was no significant difference in the post-treatment level of MCV (P > 0.05). The overall response rate significantly differed between the 2 groups (78.61% vs. 90.91%, χ2 = 10.949, P < 0.001). The incidence of ADRs of both groups were similar, and the difference was not statistically significant (χ2 = 0.035, P = 0.851). CONCLUSION: Iron sucrose demonstrates favourable efficacy and safety in treating iron deficiency anaemia.
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Anemia Ferropénica , Sacarato de Óxido Férrico , Compuestos Ferrosos , Humanos , Masculino , Femenino , Sacarato de Óxido Férrico/administración & dosificación , Sacarato de Óxido Férrico/efectos adversos , Sacarato de Óxido Férrico/uso terapéutico , Estudios Retrospectivos , Persona de Mediana Edad , Anemia Ferropénica/tratamiento farmacológico , Anemia Ferropénica/sangre , Administración Oral , Adulto , Compuestos Ferrosos/administración & dosificación , Compuestos Ferrosos/efectos adversos , Compuestos Ferrosos/uso terapéutico , Comprimidos , Hemoglobinas/análisis , Resultado del Tratamiento , Administración Intravenosa , Hematínicos/administración & dosificación , Hematínicos/efectos adversos , Hematínicos/uso terapéutico , Anciano , Ferritinas/sangreRESUMEN
Tea consumption is avoided by some due to concerns about its potential to cause anemia. To clarify this impact, we assessed the association between tea intake and anemia in a Chinese prospective cohort study and by Mendelian randomization (MR). We analyzed associations of tea intake with anemia using data from the baseline (N = 30 085) and three subsequent follow-ups (the first: N = 17 898; the second: N = 10 435; the third: N = 5311) in the Guangzhou Biobank Cohort Study (GBCS). We also assessed the causal effect of tea intake on anemia, hemoglobin (Hgb) and hematocrit (Hct) using two-sample MR with summary statistics from relevant genome-wide association studies and the UK Biobank (N = 447 485). At the baseline, compared with never-drinkers, regular tea drinkers had higher levels of Hgb and Hct and a lower risk of anemia after adjustment for confounders (all P < 0.05; all P for trend ≤0.006). Prospectively, compared with never-drinkers, regular tea drinkers had higher Hgb (g L-1) (ß = 0.69; 95% CI, 0.28 to 1.10; P for trend <0.001) and Hct (%) (ß = 0.30; 95% CI, 0.19 to 0.41; P for trend <0.001), but no significant difference in anemia risk (OR = 0.91; 95% CI, 0.82 to 1.02; P for trend = 0.071). MR analyses showed no association between tea intake and anemia, Hgb and Hct. Through triangulation of evidence using a Chinese cohort and genetics, tea consumption appears unlikely to impact anemia risk.
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Anemia , Hemoglobinas , Análisis de la Aleatorización Mendeliana , Té , Humanos , Persona de Mediana Edad , Femenino , Masculino , Estudios Prospectivos , Anemia/epidemiología , Anciano , Hemoglobinas/metabolismo , Hemoglobinas/análisis , China/epidemiología , Adulto , Factores de Riesgo , Estudio de Asociación del Genoma Completo , Estudios de CohortesRESUMEN
This study demonstrates the use of computational methods to simulate the molecular dynamics involved in hemoglobin concentration sensing, utilizing Material Studio and the TCAD Silvaco device simulator. A non-invasive and flexible Graphene/MoS2 heterostructure has been proposed for sensing hemoglobin concentration in blood samples. The findings reveal a notable shift in the wavelength-dependent refractive index and extinction coefficient, as well as significant changes in the absorption coefficient and reflectivity of the Graphene/MoS2 heterostructure in response to different hemoglobin concentrations, specifically within an approximate range of 0.3 µm to 1 µm. Moreover, the spectral response of the heterostructure demonstrates that at a particular wavelength of approximately 600 nm, a maximum response is obtained. This wavelength can be considered optimal for detecting various levels of hemoglobin using this heterostructure. The anticipated outcome is a comprehensive understanding of the fundamental principles, ultimately resulting in the development of an exceptionally sensitive platform for detecting hemoglobin concentration.
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Disulfuros , Grafito , Hemoglobinas , Molibdeno , Grafito/química , Hemoglobinas/análisis , Hemoglobinas/química , Molibdeno/química , Humanos , Disulfuros/química , Disulfuros/sangre , Simulación de Dinámica Molecular , Técnicas Biosensibles/métodos , Técnicas Biosensibles/instrumentaciónRESUMEN
Because earlier studies have proven a link between hemoglobin, albumin, lymphocyte, and platelet (HALP) and pan-immune-inflammation value (PIV) scores and inflammation, we examined if these 2 markers had predictive value in patients with atrial fibrillation (AF). In the intensive care unit, 444 patients with and without AF were retrospectively analyzed. Patients with and without AF were compared with regard to their HALP and PIV scores. High and low categories of HALP and PIV scores were established based on the cutoff values. Furthermore, using receiver operating characteristic analysis, the mortality predictive efficacy of these scores was assessed in 230 patients with AF. Patients with AF had a significantly higher PIV score than those without AF; however, the HALP score found to be lower (Pâ <â .05 for all groups). The receiver operating characteristic analysis revealed that the HALP score exhibited a sensitivity of 66.7% and a specificity of 75.3% at a cutoff value of 2.037 (AUC: 0.753, Pâ <â .001). The PIV score cutoff value was 1062.7, but the sensitivity and specificity were both 55.7% and 55.8%, respectively (AUC: 0.571, Pâ <â .05). The mechanical ventilation requirement and in-hospital mortality rate were significantly higher in the high PIV (PIVâ >â 1062.7) and low HALP (HALPâ ≤â 2.037) groups. There is a significant association between the HALP and PIV scores assessed upon admission and critically ill patients with AF. Although the HALP score serves as a powerful prognostic factor for these patients, the PIV lacks the capability to predict mortality.
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Fibrilación Atrial , Mortalidad Hospitalaria , Inflamación , Humanos , Fibrilación Atrial/mortalidad , Fibrilación Atrial/sangre , Fibrilación Atrial/inmunología , Masculino , Femenino , Estudios Retrospectivos , Anciano , Pronóstico , Persona de Mediana Edad , Inflamación/sangre , Biomarcadores/sangre , Curva ROC , Valor Predictivo de las Pruebas , Unidades de Cuidados Intensivos/estadística & datos numéricos , Hemoglobinas/análisis , Albúmina Sérica/análisisRESUMEN
BACKGROUND: Chronic systemic inflammation has been proposed as the underlying mechanism of pain chronicity in several pain conditions. In spite of the growing evidence supporting the role of systemic inflammatory markers as a diagnostic tool, their role has not been analyzed in a well-defined group of temporomandibular disorders (TMD) patients until now. This study aimed to investigate the association between various clinical features and comorbidity levels of TMD in relation to hematological markers and seek its association with long-term treatment response. METHODS: Clinical features and hematological indices including those for systemic inflammation were assessed in TMD patients (n = 154). Examinations were re-done after 6 months of conservative treatment. Patients were divided into pain improved and unimproved groups based on ≥ 2 numeric rating scale improvement in pain intensity at 6 months for final analysis. RESULTS: The portion of patients with low lymphocyte-to-monocyte ratio (p = 0.026), total protein (p = 0.014), hemoglobin (p = 0.040), and mean corpuscular hemoglobin concentration (p = 0.042) values showed significant differences according to prognosis groups. Low hemoglobin levels were significantly associated with unfavorable response to long-term treatment (ß = 1.706, p = 0.018). High pre-treatment pain intensity (ß=-0.682, p < 0.001) and low Graded Chronic Pain Scale (ß = 1.620, p = 0.002) could predict significant pain improvement with long-term treatment. CONCLUSIONS: Hematologic assessment could be considered in addition to clinical examination to better determine long-term prognosis in TMD patients.
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Biomarcadores , Inflamación , Trastornos de la Articulación Temporomandibular , Humanos , Trastornos de la Articulación Temporomandibular/sangre , Femenino , Masculino , Biomarcadores/sangre , Adulto , Inflamación/sangre , Hemoglobinas/análisis , Persona de Mediana Edad , Dimensión del Dolor , Resultado del Tratamiento , Adulto JovenRESUMEN
In Bangladesh, groundwater, the principal source of drinking water, contains predominantly high levels of iron. Drinking groundwater is associated with good iron status in populations. Against this backdrop, iron supplementation is often associated with side effects, which reduces its intake compliance. However, the level of iron in groundwater is not consistent, and low levels exist in many areas of the country. In the present study, we examined the role of groundwater with a low concentration of iron in the prevention of anemia in Bangladeshi children. In 2018, a cross-sectional study was conducted in Bangladesh among children aged 2-5 years (n = 122) who drank groundwater containing a low level of iron (0-<2 mg/L). The combined intake of iron was calculated from the key sources-diet, groundwater, and the simulated intake of MNPs. The intakes of iron were compared against the standard reference intake. The children's hemoglobin levels were measured using a photometer. The combined intake of iron from diet, groundwater with low levels of iron, and the simulated consumption of low-iron MNP in children was 5.8 ± 2.0 and 6.9 ± 2.5 mg/day, comprising 193% and 169% of the Estimated Average Requirements in the 2-3-year-old and 4-5-year-old subgroups, respectively. The combined intake of bioavailable iron from dietary and low-iron groundwater was 0.42 ± 0.023 and 0.22 ± 0.019 mg/day in children exposed to groundwater concentrations of 0.8-<2.0 mg/L and 0.0-<0.8 mg/L, respectively (p < 0.001). The mean concentration of hemoglobin in the respective groups was 12.17 ± 0.94 g/dL and 11.91 ± 0.91 g/dL (p = 0.30). The combined intake of iron from diet and the low-iron groundwater was associated with maintenance of hemoglobin concentration at the non-anemic level in > 90% of the children. The findings highlight the protective influence of the low concentration of iron in the drinking groundwater against childhood anemia in Bangladesh.
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Agua Subterránea , Hierro , Población Rural , Humanos , Bangladesh/epidemiología , Agua Subterránea/química , Agua Subterránea/análisis , Estudios Transversales , Preescolar , Masculino , Femenino , Hierro/administración & dosificación , Hierro/sangre , Anemia Ferropénica/prevención & control , Anemia Ferropénica/epidemiología , Agua Potable/química , Agua Potable/análisis , Hemoglobinas/análisis , Suplementos Dietéticos , DietaRESUMEN
Significance: Hyperspectral cameras capture spectral information at each pixel in an image. Acquired spectra can be analyzed to estimate quantities of absorbing and scattering components, but the use of traditional fitting algorithms over megapixel images can be computationally intensive. Deep learning algorithms can be trained to rapidly analyze spectral data and can potentially process hyperspectral camera data in real time. Aim: A hyperspectral camera was used to capture 1216 × 1936 pixel wide-field reflectance images of in vivo human tissue at 205 wavelength bands from 420 to 830 nm. Approach: The optical properties of oxyhemoglobin, deoxyhemoglobin, melanin, and scattering were used with multi-layer Monte Carlo models to generate simulated diffuse reflectance spectra for 24,000 random combinations of physiologically relevant tissue components. These spectra were then used to train an artificial neural network (ANN) to predict tissue component concentrations from an input reflectance spectrum. Results: The ANN achieved low root mean square errors in a test set of 6000 independent simulated diffuse reflectance spectra while calculating concentration values more than 4000× faster than a conventional iterative least squares approach. Conclusions: In vivo finger occlusion and gingival abrasion studies demonstrate the ability of this approach to rapidly generate high-resolution images of tissue component concentrations from a hyperspectral dataset acquired from human subjects.
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Aprendizaje Profundo , Hemoglobinas , Imágenes Hiperespectrales , Melaninas , Humanos , Melaninas/análisis , Melaninas/química , Hemoglobinas/análisis , Imágenes Hiperespectrales/métodos , Método de Montecarlo , Dispersión de Radiación , Procesamiento de Imagen Asistido por Computador/métodos , Algoritmos , Redes Neurales de la Computación , Dedos/diagnóstico por imagenRESUMEN
AIM: Quantitative faecal haemoglobin (fHb) measurement by faecal immunochemical test (FIT) is a powerful biomarker for colorectal cancer (CRC) and is incorporated in referral, prioritisation and triage protocols for symptomatic cases in other countries. We report our use of FIT to prioritise new patient symptomatic cases referred for colorectal investigation. METHOD: Cases referred for investigation of new colorectal symptoms who were aged ≥50 years (≥40 years Maori/Pacific peoples), who would otherwise be triaged to non-urgent colonoscopy, were asked to provide a stool sample for FIT. Following FIT testing, cases were re-triaged to either urgent colonoscopy, non-urgent colonoscopy or computed tomography colonography (CTC) depending on fHb concentration (measured in micrograms haemoglobin per gram of stool [mcg/g]) and incorporating clinical judgement. At pathway initiation, cases already waiting for colonoscopy on the non-urgent new patient waiting list were approached first, and then new patient (NP) referrals for colonoscopy could be triaged to the pathway at the discretion of the triaging consultant. RESULTS: Out of 739 cases, 715 (97%) returned FIT samples, and 691 cases completed colorectal investigations. Overall FIT positivity ≥10mcg/g was 17.1%. Fifteen colorectal cancers (CRC) were detected (2.2%). The sensitivity and specificity of FIT ≥10mcg/g for CRC were 80.0% (54.0-93.7%) and 84.3 (81.4-86.9%) respectively. A total of 432 cases (62.5%) completed the pathway without recourse to colonoscopy, and the median time to CRC diagnosis for NP from referral was 25 days. CONCLUSION: FIT based prioritisation of cases referred with symptoms concerning for CRC is feasible and reduces time to CRC diagnosis.
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Colonoscopía , Neoplasias Colorrectales , Detección Precoz del Cáncer , Sangre Oculta , Derivación y Consulta , Triaje , Humanos , Neoplasias Colorrectales/diagnóstico , Persona de Mediana Edad , Femenino , Masculino , Anciano , Detección Precoz del Cáncer/métodos , Triaje/métodos , Hemoglobinas/análisis , Nueva Zelanda , Colonografía Tomográfica Computarizada , Heces/químicaRESUMEN
Robotic surgery provides precise control, allowing for optimal dissection and cutting of tissues while minimizing bleeding. However, a significant drop in hemoglobin (Hb) after robot-assisted radical prostatectomy (RARP) is often recorded. The current study aimed to examine the postoperative Hb drop and its predictive factors in prostate cancer (PCa) patients who underwent RARP. From our tertiary care center's prospectively maintained database, all PCa patients who underwent RARP from January 2022 to January 2023 were identified. For each patient, baseline, anesthesiologic, and surgical characteristics, as well as blood samples before and after surgery, were collected. Multivariable linear and logistic regression models were fitted to investigate potential predictive factors of linear Hb drop or Hb drop ≥ 2 g/dl between preoperative and postoperative day (POD) one, after RARP. Overall, 110 RARP patients were enrolled. Considering the Hb, the median preoperative and POD1 values were 14.6 and 12.7 g/dl respectively (∆ = 1.9, p < 0.001); between POD2 and POD3, no statistically significant difference was recorded (12.4 vs 12.5 g/dl, ∆ = 0.1, p = 0.1). After multivariable analyses, age, BMI, prostate volume, nerve-sparing approach, anesthesia time, intraoperative fluids, intraoperative blood loss, and intraoperative diuresis did not show a statistically significant predictive value (all p > 0.05). The current prospective study showed a statistically significant Hb drop until POD1. After that, a quick stabilization of the Hb value was recorded. This reduction was not correlated with pre- and intraoperative variables. These observations might play an important role in postoperative inpatient RARP management, in both large and low-volume centers.
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Hemoglobinas , Prostatectomía , Neoplasias de la Próstata , Procedimientos Quirúrgicos Robotizados , Humanos , Prostatectomía/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Masculino , Estudios Prospectivos , Hemoglobinas/análisis , Hemoglobinas/metabolismo , Persona de Mediana Edad , Neoplasias de la Próstata/cirugía , Anciano , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Periodo PosoperatorioRESUMEN
Objectives: To examine the effect of date fruit extract and honey in increasing haemoglobin levels in pregnant women. METHODS: The quasi-experimental study was conducted from July to August 2022 in Rumbai Pesisir Subdistric, Pekanbaru, Indonesia, and comprised anaemic pregnant women with haemoglobin levels <11gm/dl who were not consuming iron tablets or blood boosters. They were given honey and date extracts 2 tablespoons twice daily for two weeks. Haemoglobin level was checked at baseline and then at the end of each week of intervention. Data was analysed using SPSS version 20 and quantitative method by using bivariate analysis. RESULTS: Of the 50 women, 59(98%) were aged 20-35 years, and 1(2%) was aged >35 years. Besides, 21(42%) women were in the second trimester, 17(34%) in third, and 12(24%) in the first trimester of pregnancy. The increase in haemoglobin levels post-intervention was highly significant (p=0.0001). CONCLUSIONS: Date fruit extract and honey increased haemoglobin level of pregnant women.
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Hemoglobinas , Miel , Phoeniceae , Extractos Vegetales , Humanos , Femenino , Embarazo , Adulto , Hemoglobinas/análisis , Extractos Vegetales/uso terapéutico , Adulto Joven , Phoeniceae/química , Abejas , Complicaciones Hematológicas del Embarazo/sangre , Complicaciones Hematológicas del Embarazo/tratamiento farmacológico , Indonesia , Animales , Anemia/tratamiento farmacológicoRESUMEN
Body weight, body mass index (BMI), Nutrition Risk Screening 2002 (NRS2002), and prognostic nutritional index (PNI) are among vital nutrition status indices employed during cancer treatment. These have also been associated with levels of blood chemistry panels (BCPs), which are touted as significant indicators of disease prognosis. However, it remains unclear which nutrition status index better predicts future trends in specific BCPs. Using the records of 407 cancer patients, we retrospectively examined the potential of nutritional status indices at baseline for predicting changes in specific BCPs over a 6-week period. Generally, both serum biochemical parameters and nutrition status indices fluctuated over the study period among study participants. PNI was often linearly associated with blood cell counts (white blood cells [WBCs] and hemoglobin) compared with anthropometric-based nutrition status indices. Increase in body weight was protective against having abnormal lymphocyte levels at 6 weeks (odds ratio [OR]: 0.960-0.974; CI: 0.935-0.997; P < 0.05), while increase in baseline PNI was associated with 0.865-0.941 and 0.675-0.915 odds of having future abnormal WBC and lymphocyte levels, respectively. Increases in PNI were also protective against having future abnormal albumin levels (OR: 0.734-0.886) and 8.5-12.5% decreases in the odds of having an abnormal C-reactive protein level in subsequent visits. Changes in NRS2002 tended to be associated with the odds of having future abnormal blood glucose levels. In conclusion, the serum biochemistry-derived nutrition status index, PNI, is a more consistent measure as an early indicator to track the trends of future changes in the BCPs of cancer patients. This implies that PNI could be targeted as an early-warning measure with relevant preventive interventions for patients at risk of malnutrition.
Asunto(s)
Índice de Masa Corporal , Neoplasias , Evaluación Nutricional , Estado Nutricional , Humanos , Masculino , Femenino , Neoplasias/sangre , Estudios Retrospectivos , Persona de Mediana Edad , Pronóstico , Anciano , Adulto , Peso Corporal , Antropometría/métodos , Hemoglobinas/análisis , Recuento de LeucocitosRESUMEN
BACKGROUND: Reticulocyte haemoglobin equivalent (RET-He) is a useful tool for evaluating recent iron usage irrespective of inflammatory status. This study aims to establish a reference for RET-He among Hong Kong healthy children under the age of 5 years and to investigate the association between RET-He and various blood parameters. METHODS: A total of 946 children aged 2-48 months from July 2019 to December 2022 were recruited in this cross-sectional study. The RET-He and other haematological parameters were measured by the haematology analyser from Sysmex XN-9100/XN-1500. The ferritin test was performed with the electrochemiluminescence immunoassay. Interval 2.5th percentile to 97.5th percentile represented the normal RET-He ranges. Linear multiple regression analysis was performed to examine the relation between RET-He and various blood parameters. Receiver-operating characteristic curve analysis revealed the sensitivity and specificity of RET-He in identifying iron deficiency. RESULTS: The RET-He in the study population was approximately normally distributed. The age-specific lower limit of RET-He ranges from 25.81 pg (25-36 months) to 27.15 pg (13-24 months). RET-He was found to be lower in the age group 2-6 months (mean=29.47 pg) and 7-12 months (mean=29.41 pg). Changes in RET-He and haemoglobin in relation to age were observed in both sexes (both p<0.001). RET-He was influenced by age, some red blood cell parameters and reticulocyte concentrations (all p<0.05). A cut-off value of RET-He ≤27.8 pg was determined for identifying iron deficiency. CONCLUSIONS: RET-He levels varied with age, with a relatively lower level in infants than in other age groups. The value below the age-specific lower limit of the reference range of RET-He can be used as a limit for preliminary iron-deficiency screening.
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Hemoglobinas , Reticulocitos , Humanos , Valores de Referencia , Lactante , Masculino , Preescolar , Femenino , Estudios Transversales , Reticulocitos/metabolismo , Reticulocitos/citología , Hemoglobinas/análisis , Hong Kong/epidemiología , Anemia Ferropénica/sangre , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/epidemiología , Ferritinas/sangre , Pueblos del Este de AsiaRESUMEN
BACKGROUND: Previous studies reported that lead (Pb) exposure induced adverse health effects at high exposure concentrations, however, there have been limited data on sensitivity comparisons among different health outcomes at low blood Pb levels. OBJECTIVES: To compare sensitivity between blood parameters and a genotoxic biomarker among workers exposed to low blood Pb levels (< 20⯵g/dl), and to estimate a benchmark dose (BMD). METHODS: Pb-exposed workers were recruited from a lead-acid storage battery plant. Their blood lead levels (BLLs) were measured. Blood parameters and micronuclei (MN) frequencies were determined. Multivariate linear or Poisson regression was used to analyze relationships between blood parameters or MN frequencies with BLLs. Two BMD software were used to calculate BMD and its 95â¯% lower confidence limit (BMDL) for BLLs. RESULTS: The median BLL for 611 workers was 10.44⯵g/dl with the 25th and 75th percentile being 7.37 and 14.62⯵g/dl among all participants. There were significantly negative correlations between blood parameters and BLLs. However, MN frequencies correlated positively with BLLs (all P<0.05). Results from the two BMD software revealed that the dichotomous model was superior to the continuous model, and the BMDL for BLL derived from red blood cell (RBC) was 15.11⯵g/dl, from hemoglobin (HGB) was 8.50⯵g/dl, from mean corpuscular hemoglobin (MCH) was 7.87⯵g/dl, from mean corpuscular hemoglobin concentration (MCHC) was 3.98⯵g/dl, from mean corpuscular volume (MCV) was 11.44⯵g/dl, and from hematocrit (HCT) was 6.65⯵g/dl. The conservative BMDL obtained from the MN data was 7.52⯵g/dl. CONCLUSION: Our study shows that low dose Pb exposure caused decrease of blood parameters and increase of MN frequencies. The genotoxic biomarker was more sensitive than most blood parameters. BMDLs for BLL derived from MN frequencies and the red blood cell indicators should be considered as new occupational exposure limits. Our results suggest that MN assay can be considered as a part of occupational health examination items.
Asunto(s)
Biomarcadores , Plomo , Pruebas de Micronúcleos , Exposición Profesional , Humanos , Plomo/sangre , Plomo/toxicidad , Exposición Profesional/efectos adversos , Masculino , Adulto , Biomarcadores/sangre , Femenino , Persona de Mediana Edad , Adulto Joven , Hemoglobinas/análisisRESUMEN
Gestational hypertension is a dangerous condition that is sometimes fatal to the mother and her unborn off-spring. The strong connection between hypertension and hypoxia is emphasized by the currently rampaging SARS-Cov-2, which can induce similar conditions, in which hemolysis and the subsequent oxidative damage may release hemoglobin and tissue factor into the serum. To detect these dangerous proteins normally absent from serum, we mimic the molecular pathology of hypoxia, resulting in a synthesizable molecular machine around which a new bioassay can be designed to simultaneously detect the two proteins in a one-step and reagentless fashion. The "open bridge"-like probe can split into two upon ATP-induced cross-linking of hemoglobin to the probe. The covalently captured hemoglobin can subsequently use its peroxidase-like activity to induce a second cross-coupling between the probe and the tissue factor. A fluorescent probe-target covalent complex is formed, enabling thorough rinsing to minimize nonspecific interference. Finally, using hemoglobin's peroxidase activity to improve sensitivity, the assay has been successfully applied in detecting the two proteins in the periphery serum of pregnant women. These results may promise a near future application of the proposed method for providing an early warning for gestational hypoxia and hypertension, particularly under the stress of SARS-Cov-2.