Reticulocyte hemoglobin equivalent (Ret He) and assessment of iron-deficient states

Direct measurement of the reticulocyte hemoglobin content provides useful information for the diagnosis and treatment of iron-deficient states. We have examined direct measurements of reticulocyte and red cell hemoglobin content on the Sysmex XE 2100 (Ret He and RBC He respectively) and the Bayer ADVIA 2120 (CHr and CH respectively) analyzers. Good agreement was found between Ret He and CHr (Y = 1.04X − 1.06; r(2) = 0.88) and between the RBC He and CH parameters (Y = 0.93X + 1; r(2) = 0.84 n = 200) in pediatric patients and in normal adults (Ret He and CHr; Y = 1.06X − 0.43; r(2) = 0.83; n = 126; RBC He and CH; Y = 0.94X + 1; r(2) = 0.87; n = 126). In 1500 blood samples from patients on chronic dialysis, Ret He was compared with traditional parameters for iron deficiency (serum iron <40 μg/dl, Tsat <20%, ferritin <100 ng/ml, hemoglobin <11 g/dl) for identifying iron-deficient states. Receiver operator characteristic (ROC) curve analysis revealed values of the area under the curve for Ret He of 0.913 (P < 0.0001). With a Ret He cutoff level of 27.2 pg, iron deficiency could be diagnosed with a sensitivity of 93.3%, and a specificity of 83.2%. Ret He is a reliable marker of cellular hemoglobin content and can be used to identify the presence of iron-deficient states

L'America Latina e il laboratorio argentino

In questo libro curato da Andrea Riccardi , si riflette su che cosa \ue8 oggi la Chiesa in Cina, in Africa, nelle Americhe e non solo nel vecchio continente. Ci si interroga sulle sfide poste dal confronto tra religioni e sulle prospettive dei laici e dei credenti; sul delicato rapporto tra Vaticano e politica, sulla grande questione dei poveri nel contesto della nuova 'teologia della citt\ue0'

Fibrosis in the kidney: is a problem shared a problem halved?

Fibrotic disorders are commonplace, take many forms and can be life-threatening. No better example of this exists than the progressive fibrosis that accompanies all chronic renal disease. Renal fibrosis is a direct consequence of the kidney's limited capacity to regenerate after injury. Renal scarring results in a progressive loss of renal function, ultimately leading to end-stage renal failure and a requirement for dialysis or kidney transplantation

Effect of increased convective clearance by on-line hemodiafiltration on all cause and cardiovascular mortality in chronic hemodialysis patients – the Dutch CONvective TRAnsport STudy (CONTRAST): rationale and design of a randomised controlled trial [ISRCTN38365125]

BACKGROUND: The high incidence of cardiovascular disease in patients with end stage renal disease (ESRD) is related to the accumulation of uremic toxins in the middle and large-middle molecular weight range. As online hemodiafiltration (HDF) removes these molecules more effectively than standard hemodialysis (HD), it has been suggested that online HDF improves survival and cardiovascular outcome. Thus far, no conclusive data of HDF on target organ damage and cardiovascular morbidity and mortality are available. Therefore, the CONvective TRAnsport STudy (CONTRAST) has been initiated. METHODS: CONTRAST is a Dutch multi-center randomised controlled trial. In this trial, approximately 800 chronic hemodialysis patients will be randomised between online HDF and low-flux HD, and followed for three years. The primary endpoint is all cause mortality. The main secondary outcome variables are fatal and non-fatal cardiovascular events. CONCLUSION: The study is designed to provide conclusive evidence whether online HDF leads to a lower mortality and less cardiovascular events as compared to standard HD

INHIBITION OF DEGRANULATION OF POLYMORPHONUCLEAR LEUKOCYTES BY ANGIOGENIN AND ITS TRYPTIC FRAGMENT

Tschesche H, KOPP C, HORL WH, HEMPELMANN U. INHIBITION OF DEGRANULATION OF POLYMORPHONUCLEAR LEUKOCYTES BY ANGIOGENIN AND ITS TRYPTIC FRAGMENT. JOURNAL OF BIOLOGICAL CHEMISTRY. 1994;269(48):30274-30280.A degranulation inhibiting protein was purified to apparent homogeneity from plasma ultrafiltrates of patients with uremia using gel-permeation chromatography, ion-exchange chromatography, affinity chromatography on blue Sepharose, and ion-exchange chromatography on a Mono S HR 5/5 fast protein liquid chromatography column. The identity of the isolated degranulation inhibiting protein with angogenin was demonstrated by amino acid sequence determination, immunoblotting, and identical inhibitory activity effects on leukocyte degranulation. At concentrations in the nanomolar range, the protein inhibited spontaneous degranulation of polymorphonuclear leukocytes (PMNL) to 40%. The protein discharge of cells, which were preincubated with nanomolar concentrations of angiogenin and then stimulated with the chemotactic peptide formyl-norleucyl-leucyl-phenylalanyl-norleucyl-tyrosyl-leucine (FNLPNTL), was inhibited by 70%. Cellular functions such as chemotaxis, phagocytosis, and the oxidative respiratory burst were not obviously affected by angiogenin. A polyclonal antibody to human recombinant angiogenin abolished the inhibitory effect of the isolated protein upon PMNL. The same but reduced effect was induced by the disulfide C-39-C-92 containing tryptic angiogenin fragment L-H-G-G-S-P-W P-P-C-92-Q-Y-R G-L-T-S-P-C-39-K, indicating a new, so far unknown biologically active site of angiogenin which is different from the sites responsible for angiogenic or ribonucleolytic activity. Two synthetic peptides containing residues 83-95, one with S-92 instead of C-92, revealed the same inhibitory effect on the protein degranulation of PMNL as the entire tryptic fragment