SANTRAUKA GELEŽIES STOKOS IR LĖTINIŲ LIGŲ ANEMIJŲ LABORATORINIŲ DIAGNOSTINIŲ RODIKLIŲ PALYGINIMAS Tyrimo tikslas ir uždaviniai: Tirti geležies stokos ir lėtinių ligų anemiją atspindinčius klinikinius ir biocheminius laboratorinius rodiklius pacientų kraujyje. Palyginti anemiją, geležies metabolizmą ir uždegiminį procesą atspindinčius laboratorinius rodiklius geležies stokos anemijų (GSA) bei lėtinių ligų anemijų (LLA) grupėse. Įvertinti tiriamų rodiklių reikšmę anemijų diagnostikai. Tyrimo medžiaga ir metodai: Tirta 60 ligonių, gydytų Klaipėdos universitetinėje ligoninėje. Atlikus hematologinį kraujo tyrimą, nustačius eritrocitų nusėdimo greitį (ENG) bei atlikus biocheminį kraujo tyrimą (nustačius feritino, serumo geležies ir C-reaktyvaus baltymo (CRB) koncentracijas) 40 pacientų diagnozuota GSA, o 20 pacientų nustatyta LLA. Hematologinis kraujo tyrimas (hemoglobinas, hematokritas, eritrocitų skaičius, eritrocitų indeksai – VET, VHE, VEHK, ETV, trombocitų ir leukocitų skaičius) atliktas hematologiniu analizatoriumi Sysmex XE-2100, remiantis radio dažnio kitimo, tiesinės šviesos sklaidos, šoninės šviesos sklaidos, tėkmės citometrijos ir fluorescencijos metodais. ENG nustatytas remiantis standartiniu Westergren’o metodu. Serumo geležis nustatyta spektrofotometriniu, feritino ir CRB koncentacijos imunoturbidimetriniu metodu analizatoriumi ARCHITECT c 8000. Statistinių duomenų apskaičiavimui naudota kompiuterinė programa STATISTICA 7. Darbo rezultatai: Įvertinus anemiją... [toliau žr. visą tekstą] / SUMMARY Comparing iron deficiency anemia and anemia of chronic disease using laboratory diagnostic indices Objective. The objective of this work is to research iron deficiency anemia (IDA) and anemia of chronic disease (ACD) laboratory diagnostic indices. Comparison anemia, inflammation and iron metabolism process reflected parameters between IDA and ACD. Material and methods. The study investigated 40 persons with IDA and 20 persons with ACD treated in the Klaipeda University Hospital. In the analyzer ARCHITECT® c 8000 tested serum iron using ferene by spectrofotomecric, ferritin and CRP concentration by immunoturbidimetric method. Blood samples were collected in EDTA and analyzed using automated hematology analyzer (Sysmex XE-2100), according to the radio - frequency/direct-current detection method, hydro dynamic focusing, flow cytometry method and SLS-hemoglobin method. Obtained the results for CBC count, including values for hemoglobin, hematocrit, RBC count and RBC indices (MCV, MCH, MCHC, RDW), WBC count and differentiation and PLT count. Was measured the erythrocyte sedimentation rate according to the standard Westergren method. All statistical analyses, including 2 – tailed t-test (unpaired) and correlation analyses were performed using STATISTICA 7 (StatSoft, Inc. 2004). Results. Comparing IDA and ACD using anemia reflect laboratory diagnostic indices hemoglobin, hematocrit, RBC count and RBC indices. Detected, that the hemoglobin concentration, MCV, MCH, MCHC... [to full text]

Tarp įvairių amžiaus grupių žmonių gana dažnai pasitaikančios anemijos yra susiję su geležies (Fe) ir jos junginių stoka. Geležies koncentracijos nustatymo kraujo serume tyrimas yra reikšmingas rodiklis Fe stokos anemijos diagnostikoje. Tyrimo tikslas - įvertinti raudonojo kraujo rodiklių ir geležies koncentracijos kraujo serume pokyčius kaip geležies stokos anemijos žymenis. Tyrimo uždaviniai: įvertinti raudonojo kraujo rodiklių pokyčius ir jų reikšmę vertinant Fe koncentracijos kraujo serume kitimą, šių rodiklių pokyčius priklausomai nuo tiriamų pacientų lyties, amžiaus ir sezono. Medžiaga ir metodai. Ištirta VšĮ Rokiškio psichiatrijos ligoninės 150 pacientų. Nustatyta: eritrocitų skaičius (RBC), hematokritas (HCT), vidutinis eritrocito tūris (MCV), eritrocitų pasiskirstymas pagal dydį (RDW), hemoglobinas (Hb), vidutinis hemoglobino kiekis eritrocite (MCH), vidutinė hemoglobino koncentracija eritrocituose (MCHC), geležis (Fe). Tyrimai atlikti pusiau automatiniais analizatoriais: RBC - impedansinis, Hb – cianmethemoglobininis, HCT analizatorius apskaičiuoja daugindamas eritrocitų skaičių iš vidutinio eritrocitų tūrio, MCHC analizatorius apskaičiuoja dalindamas hemoglobino koncentraciją iš hematokrito, MCV analizatorius nustato tiesiogiai, RDW - išreiškiamas eritrocitų tūrio variacijos koeficientu, MCH yra santykis tarp hemoglobino koncentracijos ir eritrocitų skaičiaus, Fe – kinetinis. Rezultatai ir išvados. Tyrimo rezultatai parodė, kad 25% tiriamų asmenų geležies... [toliau žr. visą tekstą] / Frequent occurrences of anaemia among people of various age groups are caused by a shortage of iron (Fe) and its compounds. Testing of serum iron concentration is a significant indicator of Fe deficiency in diagnosing anaemia. The aim of the research is to assess changes in red blood cell indicators and in serum iron concentration as signs of iron-deficiency anaemia. Objectives of the research: to assess changes in red blood cell indicators and their importance in assessing changes in serum iron concentration; to assess changes in these indicators that depend on the sex and age of the patients and the season of the year. Material and methods. One hundred and fifty patients at the Rokiškis Psychiatric Hospital were tested. The following was determined: erythrocyte count (RBC), hematocrit (HCT), mean corpuscular volume (MCV), red blood cell distribution width (RDW), haemoglobin (Hb), mean corpuscular haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), and iron (Fe). Testing was carried out using semi-automatic analysers: RBC—impedance; Hb—cianmethaemoglobin; the HCT analyser calculates by multiplying the red blood cell count by the MCV value; the MCHC analyser calculates by dividing the haemoglobin concentration by the hematocrit; the MCV analyser makes a direct count; RDW is an expression of the coefficient of variation in red cell volume distribution; MCH is derived from the ratio between the amount of haemoglobin and the number of erythrocytes present; and... [to full text]

<p>Anemija predstavlja problem svetskih razmera sa značajnim zdravstvenim, socijalnim i ekonomskim konsekvencama. Iako je pre mnogo godina prepoznata kao javnozdravstveni problem, malo je učinjeno u uspostavljanju kontrole anemije i prevalenca je ostala neprihvatljivo visoka. Deficit gvožđa predstavlja najče&scaron;ći uzrok anemije, deca uzrasta od 6-24 meseca i adolescenti predstavljaju vulnerabilne grupe. Hepcidin je peptidni hormon niske molekularne težine koji ima ključnu ulogu u metabolizmu gvožđa. Cilj istraživanja je bio da se odredi serumska koncentracija hepcidina kod dece uzrasta od 6 meseci do 2 godine i adolescenata uzrasta od 11 do 19 godina koji boluju od sideropenijske anemije i uporedi sa serumskim koncentracijama hepcidina u kontrolnim grupama, kao i da se utvrdi njegova povezanost sa parametrima metabolizma gvožđa. Ispitivanjem je obuhvaćeno ukupno 173 ispitanika, 89 ispitanika koji su bolovali od sideropenijske anemije i 84 ispitanika koji nisu bolovali od sideropenijske anemije i koji su predstavljali kontrolnu grupu. Svim ispitanicima je venepunkcijom uzorkovana krv za određivanje kompletne krvne slike i prametara metabolizma gvožđa. ELISA metodom je određen nivo hepcidina u serumu. Ispitivanjem je utvrđeno da je koncentracija hepcidina statistički značajno niža u dece i adolescenata koji boluju od sideropenijske anemije u poređenju sa decom i adolescentima koji ne boluju od sideropenijske anemije. Potvrđena je pozitivna korelacija između koncentarcije serumskog hepcidina i gvožđa u serumu, feritina, srednjeg volumena eritrocita i saturacije transferina, a negativna korelacija između koncentracije serumskog hepcidina i transferina i broja retikulocita. Koncentracija transferina i nezasićeni kapacitet vezivanja gvožđa, ukupni kapacitet za vezivanje gvožđa i broj retikulocita su međusobno u pozitivnoj korelaciji, a korelacija koncentracije transferina sa parametrima saturacija transferina, koncentracije gvožđa i hemoglobina je negativna. Na vrednost serumskog hepcidina ne utiču niti pol niti uzrast ispitanika &scaron;to ga čini senzitivnijim pokazateljem stanja gvožđa u organizmu i pouzdanijim biolo&scaron;kim markerom u dijagnostici sideropenijske anemije.</p> / <p>Anemia represents a worldwide problem which leads to substantial health, social and economic issues. Although it was identified as a common health problem many years ago, not a lot has been done in controlling anemia and its prevalence has stayed unacceptably high. The iron deficit is the most frequent cause of anemia, 6-24 month-old children and adolescents are vulnerable groups. Hepcidin is a peptide hormone of a low molecular weight which has a main role in the iron metabolism. The aim of the research was to determine the serum concentration of hepcidin in children aged from 6 months to 2 years and in adolescents from the age of 11 to 19 which suffer from iron deficiency anemia and compare it with the serum concentration of hepcidin in the control groups, as well as to determine its connection with the parameters of the iron metabolism. The research included 173 examinees, 89 of them suffered from iron deficiency anemia and 84 did not suffer from iron deficiency anemia. The latter represented the control group. All the examinees had their blood sampled intravenously in order for full blood count results and parameters of iron metabolism to be determined. Also, ELISA method was used for establishing the level of hepcidin in the serum. The research showed that the concentration of hepticin is statistically lower in children and adolescents who suffer from iron deficiency anemia in comparison with children and adolescents who do not have this condition. The positive correlation between the level of serum hepcidin and iron in the serum, ferritin, the medium volume of erythrocytes and transferrin saturation was confirmed but the negative one occurred in the level of the serum hepcidin, transferrin and reticulocyte. Transferrin and the unsaturated capacity of iron binding, the total capacity of iron binding and reticulocytes are in a positive correlation but the correlation of transferrin with the parameters of transferrin saturation, iron and hemoglobin is negative. The sex and the age of the examinees do not influence the level of serum hepcidin which makes it a more sensitive indicator of the level of iron in the body. Besides this, serum hepcidin is a reliable biological marker in the iron deficiency anemia diagnosis.</p>

Tyrimo tikslas – išvystyti analitinę metodiką tinkamą geležies sulfato, folio rūgšties ir cianokobalamino įvertinimui jiems esant daugiakomponenčio vaistinio preparato sudėtyje. Uždaviniai: surinkti informaciją apie anemiją ir medicinoje vartojamus antianeminius preparatus; apžvelgti plačiausiai naudojamus folio rūgšties, cianokobalamino ir geležies tyrimo metodus; pasirinkta metodika atlikti daugiakomponenčio preparato Ferro-folgamma komponentų atskyrimą; pasirinktais metodais identifikuoti cianokobalaminą, folio rūgštį, geležies sulfate; atlikti folio rūgšties ir geležies kiekybinę analizę. Metodai: efektyvioji skysčių chromatografija, spektrofotometrija. Tyrimo objektas – vaistinis preparatas “Ferro-folgamma”, kurio vienoje kapsulėje yra 100 mg bevandenio dvivalentės geležies sulfato (atitinka 37 mg geležies), 5 mg folio rūgšties, 10 μg cianokobolamino. Tyrimo rezultatai. ESC su diodų matricos detektoriumi metodika atliktas folio rūgšties ir cianokobalaminio atskyrimas ir nustatymas. Vitaminų atskyrimas pasiektas naudojant 150×4.6 mm 3 µm ACE18 kolonėlę, judriąją fazę fluoracto rūgštį (0.1 proc.) ir acetonitrile, judrios fazės tekmės greičiui esant 1.0 ml/min. Folio rūgšties detekcija atlikta prie 287 nm ilgio bangos, nustatyta aptikimo riba – 0.04 µg/ml, kiekybinio nustatymo riba – 0.13 µg/ml. Cianokobalamino detekcija atlikta prie 360 nm bangos ilgio, nustatyta aptikimo riba – 0.474 µg/ml, kiekybinio nustatymo riba – 1.57 µg/ml. Spektrofotometriškai kiekybiškai nustatyta... [toliau žr. visą tekstą] / Aim – to develop an analytical method that would be suitable for evaluating iron sulphate, folic acid and cyanocobalamin in the multicomponental drug. Objectives: gather information about anemia and antianemic drugs used in medicine; review the most often used methods of folic acid, cyanocobalamin and iron; carry out the separation of “Ferro-folgamma” components; identify cyanocobalamin, folic acid and iron sulphate; carry out a quantitive determination of folic acid and iron. Methods: high-performance liquid chromatography, spectrophotometry. Object: preparation “Ferro-folgamma” containing 100 mg anhydrous iron sulphate (37 mg of iron), 5 mg folic acid and 10 μg cyanocobalamin. Results: Identification and determination of folic acid and cyanocobalamin in pharmaceutical preparation was developed using HPLC with photodiode array detector (PDA). Folic acid and cyanocobalamin were separated on a ACE18 column (150×4.6 mm, 3 µm particle size) with a gradient elution of mobile phase consisting of 0.1% trifluoroacetic acid and acetonitrile. The separation was achieved with a flow rate of 1.0 ml/min. Detection of folic acid was performed at 287 nm wavelength, limit of detection – 0.04 µg/ml, limit of quantification – 0.13 µg/ml. Detection of cyanocobalamin was performed at 360 nm wavelength, limit of detection – 0.474 µg/ml, limit of quantification – 1.57 µg/ml. The absorbance of the iron complex was measured spectrophotometrically at 423 nm. Conclusions: HPLC/PDA method for... [to full text]

<p>Hronična bubrežna bolest (HBB) je globalni zdravstveni problem ne toliko zbog svoje masovnosti, koliko zbog hroničnog, progresivnog toka i udrženosti sa značajnim komorbiditetima. Anemija u sklopu HBB povezana je sa smanjenim kvalitetom života, povećanjem kardiovaskularnog morbiditeta, kognitivnim poremećajima, povećanjem broja hospitalizacija i sa povećanim mortalitetom. Incidencija anemije raste sa napredovanjem HBB, tako da u petom stadijumu zahvata gotovo sve obolele. Hepcidin je centralni regulator metabolizma gvožđa u organizmu, koji može uticati na razvoj i lečenje anemije u sklopu HBB. Cilj istraživanja je bio da se utvrdi nivo hepcidina kod ispitivanih bolesnika, kao i njegova povezanost sa parametrima metabolizma gvožđa, markerima inflamacije i odgovorom na agense za stimulaciju eritropoeze (ESA). Istovremeno smo želeli da utvrdimo koji faktori utiču na nivo hemoglobina u ispitivanoj populaciji, kao i &scaron;ta utiče na indeks rezistencije na eritropoetin (ERI). U ispitivanje je uključeno 77 bolesnika koji su lečeni hroničnim programom hemodijalize, tokom najmanje tri meseca pre uključivanja u ispitivanje. Ispitanicima je metodom ELISA određen nivo hepcidina u serumu. Ostali ispitivani podaci su dobijeni anamnezom, fizikalnim pregledom, analizom medicinske dokumentacije i standardnim laboratorijskim ispitivanjima. Sprovedenim ispitivanjem smo utvrdili postojanje pozitivne korelacije između serumskog nivoa hepcidina i interleukina-6, dok ostali ispitivani parametri inflamacije nisu korelirali sa nivoom hepcidina. Od parametara metabolizma gvožđa, sa serumskim nivoom hepcidina pozitivno su korelirali nivo gvožđa u serumu, feritin i saturacija transferina, dok je utvrđena negativna korelacija sa transferinom i ukupnim kapacitetom za vezivanje gvožđa. Serumski nivo hepcidina pozitivno je korelirao sa prosečnom nedeljnom dozom ESA. Nije utvrđena korelacija sa ERI, ukupnom dužinom lečenja sa ESA, kao ni sa vrstom ESA. Od svih ispitivanih parametara koji su značajno korelirali sa nivoom hepcidina u serumu, multivarijantna analiza je izdvojila jedino nivo feritina kao signifikantan i nezavisan činilac. Hemoglobin u krvi bolesnika koji su uključeni u ispitivanje nezavisno pozitivno korelira sa vrednostima leukocita i albumina u serumu. Vrednosti ERI u ispitivanoj grupi pozitivno koreliraju sa paratiroidnim hormonom, a negativno sa vrednostima leukocita i indeksom telesne mase.</p> / <p>Chronic kidney disease (CKD) is a global health problem not so much because of its massiveness, as a chronic, progressive course and association with significant comorbidities. Anemia associated with the CKD leads to reduced quality of life, increase in cardiovascular morbidity, cognitive impairment, an increase in the number of hospitalizations and increased mortality. The incidence of anemia increases with the progression of CKD, and in the fifth stage affects almost all the patients. Hepcidin is a central regulator of iron metabolism in the body, which may affect the development and treatment of anemia in CKD. The aim of this study was to determine the level of hepcidin in the patients, as well as its association with parameters of iron metabolism, markers of inflammation and response to erythropoiesis-stimulating agents (ESA). Also, we wanted to determine what factors influence the level of hemoglobin in the study population, as well as what affects the erythropoietin resistance index (ERI). The study included 77 patients who were treated with chronic hemodialysis for at least three months prior to inclusion in the study. Serum hepcidin levels were determined by the ELISA procedure. Other test data were obtained by anamesis, physical examination, analysis of medical history and standard laboratory tests. In our study we have found a positive correlation between serum levels of hepcidin and interleukin-6, while the other parameters of inflammation did not correlate with the level of hepcidin. Serum hepcidin levels were positively correlated values of serum iron, ferritin, transferring saturation, and negatively correlated with transferring and total iron binding capacity. Serum hepcidin levels positively correlated with average weekly dose of ESA. There was no correlation with ERI, the total length of treatment with ESA, as well as the type of ESA. Of all the tested parameters that were significantly correlated with the level of hepcidin in serum, multivariate analysis has allocated only ferritin level as a significant and independent factor. The hemoglobin in the blood of the patients involved in the study, positively correlated with the values of the white cell count and serum albumin. ERI values in the study group positively correlated with parathyroid hormone, and negatively with the values of leukocytes and body mass index.</p>

ABBREVIATIONS A – amniocentesis DA – deceleration angle FMH – fetomaternal haemorrhage MCA – middle cerebral artery MoM – multiples of median PI – pulsatility index PSV – peak systolic velocity RI – resistance index SA – splenic artery SGA – small for gestational age HDN – haemolytic disease of newborn 1. INTRODUCTION Rhesus alloimmunization occurs when a rhesus negative woman has an immunologic response to a paternally derived red-cell antigen that is foreign to the mother and inherited by the fetus. Rhesus alloimmunization and haemolytic disease of the newborn continues to occur as a serious complication of pregnancy despite well-organized antenatal antiD prophylaxis programs. At the Perinatal Center of Kaunas University of Medicine the incidence has remained stable at around 60 cases of alloimmunized pregnancies and from 30 to 40 cases of haemolytic disease of newborn annually. Perinatal mortality in cases of rhesus alloimmunization has been estimated to be at around 1 to 3.5 percent. Due to failure to apply or comply with antiD prophylaxis guidelines and limitations of the prophylaxis rhesus sensitization continues to occur. Rhesus alloimmunization is diagnosed when the test of a rhesus negative woman for red cell alloantibodies is positive. Prognosis for the fetus and perinatal outcomes depends much on how severely the fetus is affected by the disease at the time of diagnosis. The main pathological entity of the disease is fetal red blood cell destruction and... [to full text]

In this study, we demonstrated that membrane immunofluorescence (MIF) with canine erythrocytes is a much more sensitive diagnostic technique compared with the Coombs test to detect auto-antibodies on RBC. We also demonstrate how the evaluation of the MIF test can be made more precisely which results in a more clear interpretation. Till nowadays the Evans syndrome (combined thrombocytopenia and anemia) is not very well diagnosed in dogs. Only a few studies with low animal numbers tested auto-antibodies on RBC and thrombocytes. Here we describe the frequency of Evans syndrome based on the evaluation of a large data set with 557 dogs. The novelty of the thesis also lies in making a research of the amount of CICs in sera of AIHA/AITP patients is described as well as the cytotoxic potential of patient’s sera for canine leucocytes. These new aspects of diagnosis (AIHA) and pathogenesis (AIHA/AITP) are not only relevant for dogs but also for humans and can be used for better differential diagnosis in medicine. The new findings with respect to circulating immune complexes and cytotoxicity are also offer new therapeutic concepts. Besides, the study has resulted in the characterization of monoclonal antibodies which allow for the detection of so far undetectable canine differentiation antigens (CD molecules) on canine erythrocytes (CD235) and thrombocytes (CD42a). The identified mAbs are useful in the identification of relevant target structures for autoantibodies on these cells.