A New Parameter for Erythropoiesis: The Relationship of Immature Reticulocyte Fraction Values in Cord Blood with Clinical Factors and Reference Values for Newborns

Aim: The immature reticulocyte fraction (IRF) is a new parameter for the reticulocyte maturity index, representing an independent parameter of erythropoiesis that may be useful to better assess erythropoietic activity in neonates. In this study, the relationship between IRF values and clinical features in newborns was investigated and reference values were obtained. Material and Methods: Newborns between 28-40 weeks of gestation were included in this prospective study. At birth, maternal venous and cord blood samples were obtained for measurements of complete blood count (CBC), blood gases, and plasma concentrations of various biochemical parameters. Results: A total of 123 newborns, 99 term and 24 preterm, were included in the study. When the laboratory characteristics of the premature and term babies were compared according to their gestational weeks, while the median IRF value of cord blood was higher in term babies than in premature babies (p=0.039), other laboratory findings did not differ significantly. The median IRF value was 0.52 (range, 0.15-1.00) in term infants and 0.34 (range, 0.16-0.76) in preterm infants. IRF reference values for the term and preterm newborns were determined in cord blood. Moderately positive correlations were observed between the IRF levels and both the RDW (r=0.423, p<0.001) and the CRP (r=0.389, p<0.001) levels. Conclusion: The results of this study showed that newborns' IRF values were not affected by maternal variables and changed with the week of birth. The results of this study might be considered a guide for future studies using IRF value in newborns

Investigation of the relationship between umbilical cord blood İRF level and perinatal events

YÖK Tez ID: 448747Yenidoğanda hematopoez yetişkin bireylerden farklılık göstermektedir. Son yıllarda teknolojideki son ilerlemeler ile klinisyenlere daha kesin retikülosit sayımları ve önemli değer taşıyabilecek yeni retikülosit parametreleri kullanıma girmiştir. Eritropoezin bağımsız bir parametresini temsil eden, yeni bir parametre olan retikülosit olgunluk indeksi veya IRF, gelecek için büyük bir ümit vermektedir. Bu çalışmada yenidoğanlarda IRF' nin klinikte kullanımı için bebeklerin ve annelerinin klinik ve demografik özelliklerine göre kullanılabilir referans aralıklarının oluşturulması planlamıştır. Çalışmaya Kırıkkale Üniversitesi Tıp Fakültesi Hastanesinde doğan çalışmaya alınma kriterlerini taşıyan 123 bebek dahil edilmiştir. Doğumhanede çalışmaya alınan tüm bebeklerden umbilikal venöz kan örneği kordon klemplendikten hemen sonra plasenta tarafından uygun tüplere alınarak laboratuvara gönderilmiştir. Tam kan ve IRF parametreleri için Beckman Coulter LH 780 ®, Kan gazı parametreleri için Siemens Rapidlab 348 ® kullanılmıştır. Çalışmaya 59' u kız, 64' ü erkek olmak üzere 123 bebek alınmıştır. Bebeklerin 24' ü preterm, 99' u term olarak doğmuş, doğumların 32' si normal doğum ile, 91' i sezaryen ile gerçekleşmiştir. Bebeklerin doğum persantillerine bakıldığında 19' u SGA, 98'i AGA, 6' sı LGA bebekti. Annelerin 10' unda preeklampsi, 7' sinde diyabet, 4' ünde çoğul gebelik, 14' ünde sigara öyküsü vardır. Bebeklerin gestasyonel haftası dışındaki değişkenlere göre kord kanı IRF değeri arasında anlamlı bir fark yoktur. Term bebeklerde ortanca IRF değeri preterm bebeklerden daha yüksek bulunmuştur. Grup genelinde ortanca IRF değeri ve referans aralığı sırasıyla 0.51 ve 0.16-0.85, preterm grupta 0.34 ve 0.16-0.73, term grupta 0.52 ve 0.17-0.89 bulunmuştur. Değişkenlere göre diğer tam kan ve kan gazı parametreleri arasında anlamlı farklılıklar bulunmaktadır. Çalışma sonuçlarının literatürdeki benzer çalışma grubuna sahip yayınların sonuçları ile benzer sonuçlar, farklı çalışma grubuna sahip yayınlar ile farklı sonuçlar göstermesi pediatrik grup için farklı referans değerlerinin gerekliliğini göstermiştir. Anahtar Sözcükler: Umbilikal kord kanı, yenidoğan, yeni parametre, immatür retikülosit fraksiyonu, IRFNewborn hematopoiesis show differences from adults. By the advances in technology, exact reticulocyte counts and new reticulocyte parameters can be calculated which carry significant value to clinicians. A new parameter, IRF -reticulocyte maturity index- which representing an independent parameter of erythropoiesis gives a great hope for the future. In this study, establishment of reference intervals of IRF for newborns was planned for use in the clinics according to available clinical and demographic characteristics of the baby and mother. Study was conducted at the Kirikkale University Medical Faculty Hospital with 123 newborn who carry criteria of inclusion. Umblical venous blood samples are taken into suitable tubes immediately after cord clamping in the delivery room and send to the hospital laboratory. Beckman Coulter LH 780 ® is used the CBC and IRF parameters and Siemens Rapidlab 348 for blood gas parameters. For the reference ranges, 2.5 and 97.5 percentiles were used. Study group was consisted of 59 female and 64 male newborns. 24 of the babies born as preterm and 99 of the babies as term. 32 of the babies born with vaginal birth while 91 of them with caesarean section. As percentiles of birth, 19 of the baby was SGA, 98 of them AGA and 6 of them LGA. There was a history of preeclampsia in 10 mothers, diabetes in 7 mothers, multiple pregnancy in 4 mothers and smoking in 14 mothers. There was no significant difference between groups for IRF, but gestational week. Term newborns have higher median IRF values than preterm ones. IRF median value and reference range was 0.51 and 0.16-0.85 for general group, 0.34 and 0.16-0.73 for preterm newborns and 0.52 ve 0.17-0.89 for term newborns, respectively. There was significant differences between groups for CBC and blood gas parameters. The results of this study showed that newborns need their special reference ranges for IRF by showing similar results with the literature which has similar study populations while showing differences from the literature which has not similar study populations. vi Keywords: Umbilical cord blood, newborn, new parameters, immature reticulocyte fraction, IR

Umbilikal kord kanı IRF değerinin perinatal olaylar ile ilişkisinin araştırılması

Tez (Tıpta Uzmanlık) -- Kırıkkale Üniversitesi108756

Amylase/creatinine clearance ratio in diabetic ketoacidosis: a case report

WOS: 000345022900035PubMed: 25153214Diabetic ketoacidosis (DKA) accompanies any other intra-abdominal pathology. Serum amylase/lipase levels are commonly used in order to rule out acute pancreatitis in patients having abdominal pain in DKA. A more specific and noninvasive diagnostic tool - amylase/creatinine clearance ratio (ACCR) - can be used to rule out pancreatitis in patients with DKA. A 14-year-old girl was admitted with abdominal pain and nausea. She had been followed up for type 1 diabetes mellitus for the last 5 years. The serum amylase levels were increased up to 687 U/L (normal: 28-120 U/L) on the third day of hospitalization. Simultaneous serum and urinary amylase concentrations were measured, and ACCR was calculated (1.2%). The diagnosis of pancreatitis was ruled out. The serum amylase levels decreased in the following days, and she was discharged. ACCR determination is a simple and specific test to diagnose pancreatitis, especially in patients with DKA