RESUMO

Resumo As doenças cardiovasculares (DCV) são a principal causa de morte em todo o mundo, o que gera um fardo económico significativo de bilhões por ano no sistema de saúde. A inflamação crônica é conhecida por sua importância na patogênese da aterosclerose e das DCV. Atualmente, os índices hematológicos inflamatórios, obtidos através dos resultados do hemograma completo (HC), têm sido caracterizados como potenciais fatores prognósticos para mortalidade nas DCV. Esses índices são calculados a partir da contagem de neutrófilos, linfócitos, plaquetas e monócitos, são de fácil acesso, possuem cálculos simples e têm baixo custo, o que facilita sua aplicação na prática. O objetivo deste trabalho foi preparar uma síntese de estudos que investigaram a relação dos índices hematológicos com o risco cardiovascular e mortalidade. A busca foi realizada nas bases de dados PubMed, Scopus, Embase, Web of Science e Biblioteca Virtual em Saúde (BVS). Foram selecionados estudos que investigaram a associação entre índices hematológicos inflamatórios com risco cardiovascular e mortalidade. Foram obtidos 1.470 estudos na busca, sendo apenas 23 elegíveis. Descobrimos que o índice hematológico mais associado à mortalidade geral, eventos cardiovasculares e mortalidade cardiovascular foi o índice de inflamação imunológica sistêmica (SII), seguido pelo índice de resposta inflamatória sistêmica (SIRI). Os índices inflamatórios hematológicos mostraram-se vantajosos para triagem e identificação de pacientes com alto risco cardiovascular e risco de mortalidade, podendo ser úteis no direcionamento do tratamento desses pacientes, na obtenção de informações sobre prognóstico e na melhoria da estratificação de risco.

Abstract Cardiovascular diseases (CVDs) are the leading cause of death worldwide, which generates a significant economic burden of billions per year on the healthcare system. Chronic inflammation is known for its importance in the pathogenesis of atherosclerosis and CVDs. Currently, inflammatory hematologic indices, obtained through the results of the complete blood count (CBC), have been characterized as potential prognostic factors for mortality in CVD. These indexes are calculated from neutrophil, lymphocyte, platelet, and monocyte counts, are easily accessible, have simple calculations, and have low cost, which facilitates their application in practice. The aim of this paper was prepare a synthesis of studies that investigated the relationship of inflammatory hematologic indices with cardiovascular risk and mortality. The search was been conducted in PubMed, Scopus, Embase, Web of Science, and Virtual Health Library (VHL) databases. Studies that investigated the association between inflammatory hematologic indices with cardiovascular risk and mortality were been selected. 1,470 studies were obtained in the search, with only 23 being eligible. We found that the hematological index most associated with overall mortality, cardiovascular events, and cardiovascular mortality was the systemic immune-inflammation index (SII) followed by the systemic inflammatory response index (SIRI). The hematological inflammatory indices proved advantageous for screening and identifying patients who have high cardiovascular risk and mortality risk, and may be useful in directing the treatment of these patients, obtaining information about prognosis, and improving risk stratification.

RESUMO

Bovine mastitis is an important and costly disease to dairy cattle. Diagnostic methods usually performed in Brazil are somatic cell counts (SCC) and milk microbiology. Low bacteria shedding in milk implies no colony growth in microbiological tests and false negative results. Streptococcus agalactiae and Staphylococcus aureus are principal pathogens of mixed mastitis. However, S. agalactiae has a higher bacterial release from the mammary gland than S. aureus, affecting microbiological sensitivity to diagnose S. aureus. This study aimed to estimate the SCC and total bacterial count (TBC) from cows according to pathogen isolated in milk and to evaluate variation in S. aureus diagnosis by a microbiological test during S. agalactiae treatment, which is called blitz therapy. Both S. agalactiae and S. aureus presented high SCC means, although S. agalactiae showed shedding of bacteria 2.3 times greater than S. aureus. Microbiological sensitivity to S. aureus increased for 5 months during S. agalactiae treatment. The prevalence of S. agalactiae fell after 5 months of therapeutic procedures. The prevalence of S. aureus increased to 39.0. The results showed that due to high sensitivity, the polymerase chain reaction (PCR) could be used at the beginning of blitz therapy with the goal of S. agalactiae eradication from the dairy herd.

RESUMO

Blood count is crucial for assessing bone marrow's cell production and differentiation during infections, gaging disease severity, and monitoring therapeutic responses. The profile of blood count in chronic forms of paracoccidioidomycosis (PCM) has been insufficiently explored. To better understand the changes in hematological cells in different stages of the PCM chronic form, we evaluated the blood count, including immature blood cells in automated equipment, before and during the treatment follow-up of 62 chronic PCM patients. Predominantly male (96.8%) with an average age of 54.3 (standard deviation SD 6.9) years, participants exhibited pre-treatment conditions such as anemia (45.2%), monocytosis (38.7%), and leukocytosis (17.7%), which became less frequent after clinical cure. Anemia was more prevalent in severe cases. Notably, hemoglobin and reticulocyte hemoglobin content increased, while leukocytes, monocytes, neutrophils, immature granulocytes, and platelets decreased. Chronic PCM induced manageable hematological abnormalities, mainly in the red blood series. Monocytosis, indicating monocytes' role in PCM's immune response, was frequent. Post-treatment, especially after achieving clinical cure, significant improvements were observed in various hematological indices, including immature granulocytes and reticulocyte hemoglobin content, underscoring the impact of infection on these parameters.

RESUMO

Aim: To assess the effect of cashew nut flour on the hematological parameters of children living with HIV-AIDS. Method: A 32-week randomized, blind clinical trial conducted at a specialized outpatient clinic. Children aged 2-12 years were allocated to intervention groups (IGs) (n = 11) receiving 12 g/day of cashew nut flour and control groups (CGs) (n = 9) receiving 12 g/day of carboxymethyl cellulose. Parameters of erythrocytes, leukocytes, platelets, and lipid profiles were evaluated. Results: In the IG, the elevation and reduction of leukocyte and lipid profile biomarkers, respectively, were not statistically significant (p > 0.05). A clinically and statistically significant increase in mean corpuscular hemoglobin concentration was observed in the CG (p = 0.018), with a large effect size (Cohen's d = 0.9). There were no statistically significant changes in platelet counts among participants (p = 0.18). The effect size for white blood cell count, low-density lipoprotein cholesterol, very low-density lipoprotein, and triglycerides was moderate in the IG compared to the CG. Conclusion: Cashew nut flour supplementation may increase levels of leukocytes and lipid profile parameters in children living with HIV. Brazilian Clinical Trials Registry (REBEC): U1111.1276.6591.

RESUMO

This study evaluated the economic impacts caused by mastitis in a small dairy farm with similar characteristics and production to most dairy farms in southern Brazil and investigated if climatic variations influenced mastitis occurrence in the region. A farm with, on average, 45 lactating Holstein cattle was monitored from November 2021 to October 2022, and data on mastitis cases, bulk tank milk somatic cell count, animal treatment costs, milk production, animal disposal costs, and production losses were collected. Monthly averages of temperature, relative humidity (RH), and rainfall in the region were obtained. The greatest loss was related to the drop in milk production, resulting in 63.8% of total losses, followed by animal disposal (29.5%), milk disposal (4.6%), and treating animals with mastitis (2.0%), totaling a 10.6% reduction in the annual gross income. There were negative correlations between the clinical mastitis rate and monthly RH and between subclinical mastitis and temperature; the occurrence of subclinical mastitis and average RH were positively correlated. Our findings showed that mastitis negatively impacted the economy and that climate influenced mastitis occurrence.

Assuntos

RESUMO

Experimental and clinical studies have indicated a potential role of the protein S100ß in the pathogenesis and phenotype of neurodegenerative diseases. However, its impact on spinocerebellar ataxia type 2 (SCA2) remains to be elucidated. The objective of the study is to determine the serum levels of S100ß in SCA2 and its relationship with molecular, clinical, cognitive, and peripheral inflammatory markers of the disease. Serum concentrations of S100ß were measured by enzyme-linked immunosorbent assay in 39 SCA2 subjects and 36 age- and gender-matched controls. Clinical scores of ataxia, non-ataxia symptoms, cognitive dysfunction, and some blood cell count-derived inflammatory indices were assessed. The SCA2 individuals manifested S100ß levels similar to the control group, at low nanomolar concentrations. However, the S100ß levels were directly associated with a better performance of cognitive evaluation within the SCA2 cohort. Moreover, the S100ß levels were inversely correlated with most peripheral inflammatory indices. Indeed, the neutrophil-to-lymphocyte ratio significantly mediated the effect of serum S100ß on cognitive performance, even after controlling for the ataxia severity in the causal mediation analysis. Our findings suggested that, within physiologic concentrations, the protein S100ß exerts a neuroprotective role against cognitive dysfunction in SCA2, likely via the suppression of pro-inflammatory mechanisms.

Assuntos

RESUMO

This study addresses the hypothesis that different acute stressors can cumulatively decrease milk yield. In fact, in a time of global warming, the impact of environmental stress and farm management practices on milk production remains unclear. In this context, our objective was to investigate the effect of acute and cumulative stress on gene expression in mammary tissue and their interactions with physiological responses and milk yield in Saanen goats. Thirty lactating goats were subjected to two treatments: (1) control (CT), in which goats were maintained following a habitual routine under comfort conditions; (2) stress (ST), in which the goats were subjected to different types of environmental stress: heat stress, adrenocorticotropic hormone administration, hoof care management, and exposure to rain. These stressors were performed sequentially, with one stress per day on four consecutive lactation days, to evaluate their effect on milk quality and milk yield. Our results showed that compared to CT goats, cumulative stress increased the gene expression of glucocorticoid receptor (GR), interferon-gamma (IFN-γ), superoxide dismutase (SOD), and catalase (CAT) in mammary tissue, which are indicators of cortisol action, inflammatory response, and antioxidant enzymes. Furthermore, the acute challenges imposed on ST goats changed their rectal temperature and respiratory frequency and increased cortisol, glucose, cholesterol, triglycerides, and high-density lipoprotein release in plasma when compared to CT goats. Although these physiological and metabolic responses restore homeostasis, ST goats showed lower milk yield and higher somatic cell count in milk than CT goats. In conclusion, the results confirmed our initial hypothesis that different acute stressors cumulatively decrease the milk yield in Saanen goats.

RESUMO

Introduction: Dermatological consultations represent a great part of the small animal medical clinic routine. Canine atopic dermatitis (CAD) is a common skin disease that affects a significant amount of dogs, making it a relevant consideration in clinical practice. The role of the endocannabinoid system on skin homeostasis has been described and its deregulation contributes to dermatopathies. Its function in specialized skin cells reveals an expressive therapeutic potential. Due to the difficulties and the growing scientific evidence of the therapeutic benefits of cannabis on animals, this work aimed to evaluate the anti-inflammatory effects of cannabis-derived oil in the treatment of CAD. Methods: Fourteen canines diagnosed with CAD were divided into two groups: T: full spectrum high cannabidiol (CBD) cannabis oil, 2,5 mg/kg; and C: control group (treated with olive oil alone). The effectiveness was evaluated based on the degree of pruritus, dermatological evaluation (CADESI-4) and histopathological evaluation of the skin including mast cell count. Results: Despite the theoretical basis, there were no significant results obtained between the compared treatments. Discussion: Thus, it can be concluded that although full spectrum high cannabinoids therapy presents a promising approach to immunological diseases, further research is required in order to establish the actual effective cannabinoid ratio within the myriad possible combinations and for multi-target therapy of CAD.

RESUMO

BACKGROUND: Intracameral antibiotics, such as moxifloxacin and cefuroxime, are safe to corneal endothelial cells and effective prophylaxis of endophthalmitis after cataract surgery. Corneal endothelial cells decrease in density after cataract surgery. Any substance used in the anterior chamber may affect corneal endothelial cells and lead to a greater decrease in density. This study wants to determine the percentage of endothelial cell loss after cataract extraction by phacoemulsification with off-label intracameral injection of moxifloxacin and dexamethasone (Vigadexa®). METHODS: An observational retrospective study was performed. The clinical records of patients undergoing cataract surgery by phacoemulsification plus intracameral injection of Vigadexa® were analyzed. Endothelial cell loss (ECL) was calculated using preoperative and postoperative endothelial cell density. The relation of endothelial cell loss with cataract grade using LOCS III classification, total surgery time, total ultrasound time, total longitudinal power time, total torsional amplitude time, total aspiration time, estimated fluid usage, and cumulative dissipated energy (CDE) was studied using univariate linear regression analysis and logistic regression analysis. RESULTS: The median loss of corneal endothelial cells was 4.6%, interquartile range 0 to 10.4%. Nuclear color and CDE were associated with increased ECL. ECL>10% was associated with age and total ultrasound time in seconds. CONCLUSIONS: The endothelial cell loss after the intracameral use of Vigadexa® at the end of cataract surgery was similar to the reported in other studies of cataract surgery without the use of intracameral prophylaxis for postoperative endophthalmitis (POE). This study confirmed the association of CDE and nuclear opalescence grade with postoperative corneal endothelial cell loss.

RESUMO

Background and Aim: Bovine mastitis is one of the most costly and prevalent diseases in dairy herds, which can be prevented and controlled through proper milking practices, diagnosis, and elimination of chronic animals, among others. Contagious pathogens such as Staphylococcus aureus and environmental pathogens such as Escherichia coli and Klebsiella spp. can affect cows and milk for human consumption, generating a public health risk. This study aimed to estimate the prevalence of herds with somatic cell count (SCC) ≥200,000 cells/mL, S. aureus, E. coli, and Klebsiella spp., in bulk tank milk (BTM) and its associated risk factors in Colombian dairy cow herds. Materials and Methods: A cross-sectional probabilistic study was carried out in 150 dairy herds located in the north of the Antioquia province. A single visit per herd was conducted, during which three BTM samples were aseptically collected. General data and milking practices were collected through an epidemiological survey applied in each herd. Results: The prevalence of S. aureus, E. coli, and Klebsiella spp. were 14% (21/150), 2% (3/150), and 8% (12/150), respectively. Moreover, 95% of the herds presented an SCC of ≥200,000 cells/mL. Practices such as in-paddock milking, change of milker during the last month, use of disposable gloves, and hand disinfection were associated with increased prevalence of S. aureus, whereas proper dipping was a protective factor. Proper washing and disinfection of the milking machine, use of chlorinated disinfectants for hand hygiene, and use of disposable gloves decreased the prevalence of E. coli and Klebsiella spp. Bulk tank SCC increased in herds with 30-60 milking cows, herds with >60 milking cows, and herds with a change of milker during the last month. Hand disinfection and dipping decreased the SCC. Conclusion: Staphylococcus aureus, E. coli, and Klebsiella spp. were prevalent in BTM from dairy cow herds. The risk of S. aureus isolation was higher in herds with an in-paddock milking system. The risk of E. coli and Klebsiella spp. isolation were higher in herds with >60 milking cows, with a change of milker during the last month. Processes such as avoiding changing the milker and greater control in medium and large herds could improve the SCC in BTM.

RESUMO

Long COVID affects many individuals following acute coronavirus disease 2019 (COVID-19), and hematological changes can persist after the acute COVID-19 phase. This study aimed to evaluate these hematological laboratory markers, linking them to clinical findings and long-term outcomes in patients with long COVID. This cross-sectional study selected participants from a 'long COVID' clinical care program in the Amazon region. Clinical data and baseline demographics were obtained, and blood samples were collected to quantify erythrogram-, leukogram-, and plateletgram-related markers. Long COVID was reported for up to 985 days. Patients hospitalized in the acute phase had higher mean red/white blood cell, platelet, and plateletcrit levels and red blood cell distribution width. Furthermore, hematimetric parameters were higher in shorter periods of long COVID than in longer periods. Patients with more than six concomitant long COVID symptoms had a higher white blood cell count, a shorter prothrombin time (PT), and increased PT activity. Our results indicate there may be a compensatory mechanism for erythrogram-related markers within 985 days of long COVID. Increased levels of leukogram-related markers and coagulation activity were observed in the worst long COVID groups, indicating an exacerbated response after the acute disturbance, which is uncertain and requires further investigation.

Assuntos

RESUMO

Microencapsulation is an alternative to increase the survival capacity of microorganisms, including Yarrowia lipolytica, a widely studied yeast that produces high-value metabolites, such as lipids, aromatic compounds, biomass, lipases, and organic acids. Thus, the present study sought to investigate the effectiveness of different wall materials and the influence of the addition of salts on the microencapsulation of Y. lipolytica, evaluating yield, relationship with cell stability, ability to survive during storage, and in vitro application of ruminant diets. The spray drying process was performed via atomization, testing 11 different compositions using maltodextrin (MD), modified starch (MS) and whey protein concentrate (WPC), Y. lipolytica (Y. lipo) cells, tripolyphosphate (TPP), and sodium erythorbate (SE). The data show a reduction in the water activity value in all treatments. The highest encapsulation yield was found in treatments using MD + TPP + Y. lipo (84.0%) and WPC + TPP + Y. lipo (81.6%). Microencapsulated particles showed a survival rate ranging from 71.61 to 99.83% after 24 h. The treatments WPC + Y. lipo, WPC + SE + Y. lipo, WPC + TPP + Y. lipo, and MD + SE + Y. lipo remained stable for up to 105 days under storage conditions. The treatment WPC + SE + Y. lipo (microencapsulated yeast) was applied in the diet of ruminants due to the greater stability of cell survival. The comparison between the WPC + SE + Y. lipo treatment, wall materials, and the non-microencapsulated yeast showed that the microencapsulated yeast obtained a higher soluble fraction, degradability potential, and release of nutrients.

Assuntos

RESUMO

There are no studies reporting the effects of Salmonella enterica subsp. enterica serovar Infantis (S. Infantis) on intestinal architecture and immunoglobulin serum levels in chickens. Here, we measured these parameters and hypothesized whether probiotic administration could modulate the observed outcomes. Two-hundred 1-day-old COBB 500 male chicks were allocated into four groups: (I) the control, (II) the group treated with L. fermentum, (III) the group exposed to S. Infantis, and (IV) the group inoculated with both bacteria. At 11 days post infection, blood was gathered from animals which were then euthanized, and samples from the small intestine were collected. Intestinal conditions, as well as IgA and IgM serum levels, were assessed. S. Infantis reduced villus-height-to-crypt-depth (VH:CD) ratios in duodenal, jejunal, and ileal sections compared to control conditions, although no differences were found regarding the number of goblet cells, muc-2 expression, and immunoglobulin concentration. L. fermentum improved intestinal measurements compared to the control; this effect was also evidenced in birds infected with S. Infantis. IgM serum levels augmented in response to the probiotic in infected animals. Certainly, the application of L. fermentum elicited positive outcomes in S. Infantis-challenged chickens and thus must be considered for developing novel treatments designed to reduce unwanted infections.

RESUMO

BACKGROUND: The role of peripheral inflammation in spinocerebellar ataxia type 2 (SCA2) is unknown. OBJECTIVE: The objective of this study was to identify peripheral inflammation biomarkers and their relationship with the clinical and molecular features. METHODS: Blood cell count-derived inflammatory indices were measured in 39 SCA2 subjects and their matched controls. Clinical scores of ataxia, nonataxia, and cognitive dysfunction were assessed. RESULTS: The neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the Systemic Inflammation Index (SII), and the Aggregate Index of Systemic Inflammation (AISI) were significantly increased in SCA2 subjects compared with controls. The increases in PLR, SII, and AISI were even observed in preclinical carriers. NLR, PLR, and SII were correlated with the Scale for the Assessment and Rating of Ataxia speech item score rather than with the total score. The NLR and SII were correlated with the nonataxia and the cognitive scores. CONCLUSIONS: Peripheral inflammatory indices are biomarkers in SCA2, which may help to design future immunomodulatory trials and advance our understanding of the disease. © 2023 International Parkinson and Movement Disorder Society.

Assuntos

RESUMO

SUMMARY OBJECTIVE: The aim of this study was to assess the relation of systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index with disease activity, functional status, and general health status in ankylosing spondylitis. METHODS: Patients with ankylosing spondylitis and healthy volunteers were included in this cross-sectional study. Demographic data; disease activity measurements such as the Bath Ankylosing Spondylitis Disease Activity Index, the Ankylosing Spondylitis Disease Activity Score with C-reactive protein, and the Ankylosing Spondylitis Disease Activity Score with erythrocyte sedimentation rate; functional status such as the Bath Ankylosing Spondylitis Functional Index; and general health status such as the Assessment of Spondyloarthritis International Society Health Index of the patients were recorded. C-reactive protein, erythrocyte sedimentation rate, platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, monocyte to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index values were recorded. Patients were grouped as active and remission according to the Bath Ankylosing Spondylitis Disease Activity Index score and as inactive-low and high-very high disease activity according to the Ankylosing Spondylitis Disease Activity Score. The correlation of laboratory parameters with disease-related parameters was tested. RESULTS: The indexes were significantly higher in patients compared to controls (p<0.001, for platelet to lymphocyte ratio p=0.03). No significant differences existed in any blood cell-derived indexes among patient groups categorized by disease activity (p<0.05 for all). Systemic immune inflammation index was weakly correlated with Ankylosing Spondylitis Disease Activity Score with C-reactive protein (ρ=0.197 and p=0.049) and Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate (ρ=0.201 and p=0.045). Systemic immune inflammation index was not correlated with Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and Assessment of Spondyloarthritis International Society Health Index. No correlation was found between other indexes and disease-related variables. Platelet to lymphocyte ratio, systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index showed a weak positive correlation with C-reactive protein and erythrocyte sedimentation rate (ρ=0.200-0.381). CONCLUSION: Systemic immune inflammation index, systemic inflammation response index, and systemic inflammation aggregate index can be used to indicate systemic inflammatory burden in ankylosing spondylitis patients. However, these indexes are not effective in indicating patients' disease activity, general health status, and functional status.

RESUMO

ABSTRACT Objective This study aimed to compare the hematological parameters released by hematological analyzers with those released in customer reports. Methods We conducted a descriptive study in the laboratories of a medium-sized municipality in the state of Minas Gerais registered in the National Register of Health Establishments. Interviews were conducted using a questionnaire to obtain information regarding the parameters released by the analyzers and those available in the customer's report. Results Sixteen laboratories were evaluated, and none of them released all the parameters obtained from the hematological analyzers to customers. The red blood cell distribution width was released in 88% of the laboratories, atypical lymphocytes in 70%, mean platelet volume in 50%, platelet distribution width and platelet count in 20%. No laboratory released information on reticulocytes, fraction of immature reticulocytes and immature granulocytes, nucleated erythrocyte count, immature platelet fraction and reticulocyte hemoglobin, and large platelet rate. Conclusion All evaluated clinical analysis laboratories had at least one parameter that was not released in the customer's report despite being released by the hematological analyzers. The lack of knowledge on the part of professionals about the clinical importance of each parameter of the complete blood count results in a loss in patient assessment, and it is important to include these parameters in the complete blood count report.

RESUMO

Introducción: La insuficiencia renal crónica es un trastorno en el que las funciones renales disminuyen de forma progresiva e irreversible. Debido a esta disminución, los riñones pierden su capacidad de eliminar los residuos, concentrar la orina y mantener los niveles adecuados de electrolitos en la sangre. Objetivo: Actualizar los conocimientos para el establecimiento del diagnóstico precoz en el tratamiento de la anemia en pacientes con insuficiencia renal crónica Método: Se realizó una búsqueda bibliográfica de artículos científicos e información en las bases de datos de MEDLINE, Scopus, Redalyc y Latindex, a su vez se complementa con literatura médica encontrada en plataformas digitales como Google Académico. De 68 artículos identificados, se seleccionaron 16 publicaciones que cumplían con los criterios de inclusión, exclusión y de la Declaración PRISMA. Resultados: El diagnóstico de la anemia se debe enfocar en el hemograma, reticulocitos, estado del hierro, vitamina B12 y ácido fólico, mientras que la terapia se basa en el uso de hierro, agentes estimuladores de eritropoyesis y en ciertos casos eritropoyetina. Conclusiones: Brindar un tratamiento precoz y óptimo a los pacientes con insuficiencia renal crónica disminuye el riesgo de aparición de anemia normocítica normocrómica de tipo hipoproliferativa.

Introduction: Chronic kidney failure is a disorder in which kidney functions decrease progressively and irreversibly. Due to this decrease, the kidneys lose their ability to eliminate waste, concentrate urine, and maintain adequate levels of electrolytes in the blood. Objective: To update knowledge for the establishment of early diagnosis in the treatment of anemia in patients with chronic renal failure Method: A bibliographic search of scientific articles and information was carried out in the MEDLINE, Scopus, Redalyc and Latindex databases, to In turn, it is complemented with medical literature found on digital platforms such as Google Scholar. Of 68 articles identified, 16 publications were selected that met the inclusion, exclusion and PRISMA Statement criteria. Results: The diagnosis of anemia should focus on the blood count, reticulocytes, iron status, vitamin B12 and folic acid, while therapy is based on the use of iron, erythropoiesis-stimulating agents and in certain cases erythropoietin. Conclusions: Providing early and optimal treatment to patients with chronic renal failure reduces the risk of developing hypoproliferative normocytic normochromic anemia.

Introdução: A insuficiência renal crônica é um distúrbio no qual as funções renais diminuem de forma progressiva e irreversível. Devido a essa diminuição, os rins perdem a capacidade de eliminar resíduos, concentrar a urina e manter níveis adequados de eletrólitos no sangue. Objetivo: Atualizar conhecimentos para o estabelecimento do diagnóstico precoce no tratamento da anemia em pacientes com insuficiência renal crônica Método: Foi realizada pesquisa bibliográfica de artigos e informações científicas nas bases de dados MEDLINE, Scopus, Redalyc e Latindex, para por sua vez, é complementado com literatura médica encontrada em plataformas digitais como o Google Scholar. Dos 68 artigos identificados, foram selecionadas 16 publicações que atenderam aos critérios de inclusão, exclusão e Declaração PRISMA. Resultados: O diagnóstico de anemia deve centrar-se no hemograma, reticulócitos, estado de ferro, vitamina B12 e ácido fólico, enquanto a terapia é baseada no uso de ferro, agentes estimuladores da eritropoiese e em certos casos eritropoietina. Conclusões: Fornecer tratamento precoce e ideal a pacientes com insuficiência renal crônica reduz o risco de desenvolver anemia normocítica normocítica hipoproliferativa.

RESUMO

SUMMARY OBJECTIVE: This study aimed to evaluate the effect of the neutrophil-to-lymphocyte ratio on the differentiation of benign and malignant masses in the submandibular triangle. METHODS: We retrospectively evaluated 48 patients who underwent surgery for submandibular gland masses between January 2013 and February 2023. The patient's age, gender, preoperative complete blood count and imaging findings, postoperative histopathological diagnosis, and hemogram data were analysed. Patients were evaluated according to their postoperative histopathological diagnoses and categorised into four main groups: sialolithiasis, sialadenitis, benign tumours, and malignant tumours. Benign submandibular gland disease formations were evaluated under group B and malignant tumour formations under group M. RESULTS: A preoperative fine needle aspiration biopsy was performed on 19 patients due to sialadenitis, pleomorphic adenoma, and malignant diseases other than sialolithiasis. One patient died among the patients with malignant disease and the remaining 7 patients were compared with the benign group of 40 patients regarding preoperative and postoperative neutrophil-to-lymphocyte ratio. In the benign group, the neutrophil-to-lymphocyte ratio was 2.64 preoperatively and decreased to 2.34 in the first postoperative year. The preoperative neutrophil-to-lymphocyte ratio decreased from 4.79 to 1.77 postoperatively in the malignant group. A statistically significant difference was observed (p<0.05). CONCLUSION: This is the first study to demonstrate that the neutrophil-to-lymphocyte ratio can be used as a biomarker in submandibular gland masses and has prognostic significance in malignant masses. In addition to fine needle aspiration biopsy results, neutrophil-to-lymphocyte ratio can be used as a biomarker.

RESUMO

ABSTRACT Objective: To compare reference intervals (RI) of blood counts of Brazilian adults with and without sickle cell trait (SCT). Methods: Cross-sectional study, based on the National Health Survey, 2014-2015, composed of 8,952 individuals. The sample of patients with SCT was composed of 234 adults. The RIs of adults with and without SCT were compared in the study "Reference values for laboratory tests of blood count in the Brazilian adult population: National Health Survey", by Rosenfeld et al. (2019). The parametric method and the Student's t test were used for comparison (p≤0.05). Results: There were statistically significant differences between RIs of adults with and without SCT as far as sex is concerned for hemoglobin, MCV, MCH, MCHC, white blood cells, absolute lymphocytes, mean platelet volume and RDW; At all ages, for white blood cells and RDW in men and for MCV, MCH, MCHC, mean platelet volume and RDW in women; Between 18 to 59 years, for MCH, MCV, MCHC, neutrophils, lymphocytes and platelets in men and in women for lymphocytes, red blood cells, white blood cells, neutrophils, eosinophils, monocytes and platelets; From 60 years old on, for hemoglobin and hematocrit in men and in women for hematocrit, white blood cells, neutrophils and platelets; In white, black and brown people for white blood cells, neutrophils and platelets (p<0.05). Conclusion: Brazilian adults with SCT had lower counts of hemoglobin, MCV, MCH, MCHC, white blood cells and higher RDW than without SCT. The results show the importance of genetic counseling and further research to support the proper management of this condition in Brazil.

RESUMO Objetivo: Comparar intervalos de referência (IR) de hemograma de adultos brasileiros com e sem traço falciforme (HbAS). Métodos: Estudo transversal, com a base de dados da Pesquisa Nacional de Saúde, entre 2014-2015, composta por 8.952 indivíduos; 234 adultos constituíram a amostra com HbAS. Comparou-se IR de adultos com e sem HbAS do estudo "Valores de referência para exames laboratoriais de hemograma da população adulta brasileira: Pesquisa Nacional de Saúde", de Rosenlfed e colaboradores (2019). Utilizaram-se o método paramétrico para estabelecer os IR e o teste t de Student para comparação (p≤0,05). Resultados: Houve diferenças estatisticamente significativas entre IR de adultos com e sem HbAS nos homens e mulheres para hemoglobina, VCM, HCM, CHCM, glóbulos brancos, linfócitos absolutos, volume plaquetário médio e RDW; em todas as idades para glóbulos brancos e RDW nos homens e para VCM, HCM, CHCM, volume plaquetário médio e RDW nas mulheres; entre 18 a 59 anos para HCM, VCM, CHCM, neutrófilos, linfócitos e plaquetas nos homens e nas mulheres para linfócitos, glóbulos vermelhos, glóbulos brancos, neutrófilos, eosinófilos, monócitos e plaquetas; a partir de 60 anos para hemoglobina e hematócrito nos homens e nas mulheres para hematócrito, glóbulos brancos, neutrófilos e plaquetas; nas raças branca, preta e parda para glóbulos brancos, neutrófilos e plaquetas (p<0,05). Conclusão: Adultos brasileiros com HbAS tiveram menores contagens de hemoglobina, VCM, HCM, CHCM, glóbulos brancos e maiores de RDW que sem HbAS. Os resultados mostram a importância do aconselhamento genético e de pesquisas para subsidiar o manejo adequado desta condição no Brasil.

RESUMO

ABSTRACT Objective: To estimate the reference intervals (RIs) of complete blood count parameters in the Brazilian adult population. Methods: Cross-sectional study, with data from the National Health Survey (Pesquisa Nacional de Saúde - PNS), between 2014-2015. The final sample consisted of 2,803 adults. To establish the RIs, exclusion criteria were applied, outliers were removed and partitions were made by gender, age, and race/skin color. The non-parametric method was adopted. Differences were assessed using the Mann Whitney and Kruskal Wallis tests (p≤0.05). Results: There were statistically significant differences for the following hematological parameters based on gender, red blood cells, hemoglobin, hematocrit, MCH, MCHC, eosinophils and absolute monocytes, neutrophils and platelets (p≤0.05). When analyzed by age, the RIs were statistically different in females for hematocrit, MCV, white blood cells and RDW and in males for red blood cells, white blood cells, eosinophils, mean platelet volume, MCV, RDW, and MCH (p≤0.05). For race/color, there were differences in the RIs for parameters of hemoglobin, MCH, MCHC, white blood cells and mean platelet volume, neutrophils and absolute eosinophils (p≤0.05). Conclusion: The differences found in the RIs of some in blood count parameters in Brazilian adults reaffirm the importance of having their own laboratory reference standards. The results can support a more accurate interpretation of tests, adequate identification and disease prevention in Brazil.

RESUMO Objetivo: Estimar os intervalos de referência (IR) de parâmetros de hemograma completo na população adulta brasileira. Métodos: Estudo transversal, com dados da Pesquisa Nacional de Saúde (PNS), entre 2014-2015. A amostra final constitui-se de 2.803 adultos. Para estabelecer os IR, aplicou-se critérios de exclusão, removeram-se outliers e foram feitos particionamentos por sexo, idade e raça/cor da pele. Adotou-se o método não paramétrico. As diferenças foram avaliadas pelos testes Mann Withney e Kruskal Wallis (p≤0,05). Resultados: Houve diferenças estatisticamente significativas nos IR segundo sexo para glóbulos vermelhos, hemoglobina, hematócrito, HCM, CHCM, eosinófilos, monócitos, neutrófilos absolutos e plaquetas (p≤0,05). Quando analisados por idade, houve diferenças nos IR de mulheres para hematócrito, VCM, glóbulos brancos e RDW, e nos homens em glóbulos vermelhos, glóbulos brancos, eosinófilos, volume plaquetário médios, VCM, RDW e HCM (p≤0,05). Para raça/cor, houve diferenças nos IR de hemoglobina, HCM, CHMC, glóbulos brancos e volume plaquetário médio, neutrófilos e eosinófilos absolutos (p≤0,05). Conclusão: As diferenças encontradas nos IR de alguns parâmetros de hemograma nos adultos brasileiros, reafirmam a importância de se ter padrões laboratoriais próprios de referência. Os resultados podem subsidiar a interpretação mais precisa dos exames, identificação adequada e a prevenção de doenças no Brasil.