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The Patient with Anemia and Iron Deficiency
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Haye H. van der Wal, Peter van der Meer
In routine clinical practice, anemia is diagnosed using hemoglobin or hematocrit levels as surrogate markers for a reduced red cell mass, which is the strict definition of anemia. The most commonly used definition for anemia is a hemoglobin concentration <12 g/dL (7.5 mmol/L) for women and <13 g/dL (8.1 mmol/L) for men.29 A distinction should be made between “true” anemia (i.e., reduced hemoglobin and erythrocyte count) and pseudo-anemia caused by fluid overload, leading to hemodilution (i.e., reduced hemoglobin with normal erythrocyte count).10,30,31 Therefore, hemoglobin levels should ideally be measured when the patient is in a euvolemic state. In patients with acute decompensated HF, the absolute change in hemoglobin during intravenous diuretic therapy—indicating hemoconcentration—is an independent predictor of mortality.1 Other hematological parameters, such as mean corpuscular volume (MCV), red cell distribution width, and reticulocyte count may be normal in anemic patients. In a large, observational cohort of chronic HF patients, MCV was often within the normal range and not significantly associated with either vitamin B12 or folate levels. Therefore, MCV should be used cautiously in the differential diagnosis of anemia in chronic HF patients.6
Genetics and genomics of exposure to high altitude
Published in Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson, Ward, Milledge and West's High Altitude Medicine and Physiology, 2021
Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson
Yi et al. (2010) analyzed sequence data from the exomes, the protein-coding portion, of 50 Tibetan genomes. Using this strategy, the investigators captured the coding sequences of 92% of all genes. Again, the EPAS1 gene among others was identified as a strong candidate for natural selection. In fact, the frequency of one variant of the EPAS1 gene differed between Tibetans and Han Chinese by 78% (87% versus 9%). This variant was associated with hemoglobin concentration and erythrocyte count, consistent with other reports mentioned below. An interesting conjecture raised by Yi et al. (2010) was that the Tibetan and Han Chinese populations diverged less than 3000 years ago, although more recent estimates suggest greater divergence times based on anthropological evidence for the date of settlements in Tibet (Aldenderfer 2011).
Pathophysiology of Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The changes in red blood cells with temperature elevation are usually less striking. Erythrocytosis occurs in the first stage as a result of hemoconcentration, whereas severe hyperthermia causes hemolysis and a consequent reduction in the erythrocyte count.
Traumatic lumbar punctures in diagnostic and intrathecal treatment punctures of pediatric hemato-oncology patients
Published in Pediatric Hematology and Oncology, 2022
Harri Sievänen, Päivi Lähteenmäki, Juho Kari, Sanna Halonen, Hanna Soukka, Vesa Eskola, Sauli Palmu
The erythrocyte count data from pediatric hemato-oncology LP procedures were identified from the hospital department codes (hemato-oncology population), while the data from other pediatric departments served as the reference data (reference population). The LP procedures in the hemato-oncology population were always performed in respective departments. The erythrocyte count was routinely determined from the second or third vial of the CSF sample in the hospital laboratories with standard cytometric methods. Besides the erythrocyte count, the collected data contained the date of the procedure, hospital department code, and patient’s age at the time of the procedure. For this study, the patients’ age range was confined to 1–18 years to reduce potential bias due to different age distributions in the study populations. Among the pediatric hemato-oncology patients, patients younger than one year were rare (∼5%), whereas more than half (∼55%) of the reference patients were this young. In total, the collected data comprised 2,507 LP procedures of 250 pediatric hemato-oncology patients and 2,617 LP procedures of 1,525 other pediatric patients.
Hematology reference intervals in 6–12-year-old children: the health-oriented pedagogical project (HOPP)
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Martin Frank Strand, Per Morten Fredriksen, Morten Lindberg
The increasing trend over age for Hb, hematocrit, erythrocyte count and MCV is similar to previous studies [4–6,16,17]. The reference limits for Hb found in this study are similar to previous studies [4,5]. The age partitioning required for Hb is largely dependent on the age span included [4,5]. There were no sex differences for Hb in our age span, and while others have found sex differences, these are after the age of 12 [5,6]. The reference limits for hematocrit, erythrocyte count and MCV were similar to previous studies [4,5]. While erythrocyte count required partitioning for age, both hematocrit and MCV required age and sex partitioning. While others have found age differences, the sex differences for hematocrit and MCV are more evident from 12 years of age [4–6]. MCH is only slightly increasing for 6–12 years old’s, while the trend for MCHC is flat, similar to previous findings [4,6]. There are some differences between the reference limits in this study and the studies by others, and this is likely due to the age span of the children included. Most studies include children from a much younger age in the lowest age partitioning. For instance, the lower Hb limit of 10.7 g/dL found by Aldrimer et al. in Sweden [5] is for the age partition of 6 months–7 years old. In a recent publication from the CALIPER study, Tahmasebi et al. reported a lower limit of 11.4 g/dL in 248 children age 4 to < 14 [18]. In the present study, the lower limit was 11.9 g/dL (6–8 years, n = 440) and 12.2 g/dL (9–12 years, n = 808).
Immunotoxicity studies of sulfolane following developmental exposure in Hsd:Sprague Dawley SD rats and adult exposure in B6C3F1/N mice
Published in Journal of Immunotoxicology, 2021
AtLee T. D. Watson, Victor J. Johnson, Michael I. Luster, Gary R. Burleson, Dawn M. Fallacara, Barney R. Sparrow, Mark F. Cesta, Michelle C. Cora, Keith R. Shockley, Matt D. Stout, Chad R. Blystone, Dori R. Germolec
At their scheduled termination, animals were randomized, rendered unconscious with carbon dioxide (CO2), and then blood was collected. Blood (∼250 µl) was collected from the retroorbital site and placed into tubes containing K2EDTA. Immediately following blood collection and before recovery of consciousness, the animal was returned to the CO2 chamber for euthanasia. The blood was analyzed the day of collection on an Advia 120 hematology analyzer using associated V.6.3.2-MS software (Siemens Medical Solutions USA, Inc., Malvern, PA). The following hematologic parameters were assessed: erythrocyte count, hematocrit, hemoglobin concentration, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, platelet count, reticulocyte count, and leukocyte count and differential.