Search Results (33)

Cancer is a leading cause of death in humans and dogs. Several erythrocyte and platelet characteristics (indices and morphology) have shown promise as indicators of metastasis in humans. Similar studies have not been performed in dogs. This study evaluated erythrocyte and platelet characteristics measured on the Advia 2120i in 59 tumor-bearing dogs with carcinoma or sarcoma. Tumor-bearing dogs with and without intracavitary hemorrhage that underwent complete post-mortem and histopathology examinations were compared to healthy age-controlled dogs. Carcinoma- and sarcoma-bearing dogs without hemorrhage were compared. All tumor-bearing dogs without hemorrhage or metastasis were compared to those with metastasis, and characteristics were evaluated as indicators of metastasis. Tumor-bearing dogs without intracavitary hemorrhage (n = 49) had decreased hematocrit (p = 0.002) and reticulocyte hemoglobin content (p = 0.022), and increase in anisocytosis (p = 0.002), polychromasia (p = 0.002), macrocytosis (p = 0.032), codocytes (p = 0.022), absolute reticulocyte count (p = 0.035), platelet concentration (p = 0.002), plateletcrit (p = 0.022), and platelet volume distribution width (p = 0.022) compared to healthy dogs (n = 20). In tumor-bearing dogs with intracavitary hemorrhage (n = 10), additional significant differences were reflective of acute hemorrhage. No difference in characteristics between carcinoma- and sarcoma-bearing dogs without hemorrhage was identified. After correction for multiple comparisons, no differences in erythrocyte or platelet characteristics were identified between tumor-bearing dogs without intracavitary hemorrhage and metastasis and those without metastasis. Significant differences in characteristics exist between tumor-bearing dogs and healthy dogs. Based on the limited number of dogs in this preliminary study, no red blood cell or platelet characteristics were associated with metastatic disease in tumor-bearing dogs without hemorrhage. Full article

Background/Objectives: Therapeutic drug monitoring (TDM) of immunosuppressants is essential in treating pediatric kidney diseases; however, repeated venipuncture is burdensome in children. We evaluated whether minimally invasive fingerstick capillary sampling combined with liquid chromatography–tandem mass spectrometry (LC-MS/MS) provides results analytically comparable to those of conventional venous sampling. Methods: Capillary whole blood (2.8 µL) was collected via fingersticks from pediatric patients receiving mycophenolate mofetil, with or without tacrolimus (TAC) or cyclosporine A (CsA). Drug concentrations were quantified using a previously validated simultaneous LC-MS/MS method and compared with conventional venous sampling using linear regression and Bland–Altman analyses. Results: Seventy-four paired samples from 21 patients were analyzed. Strong correlations were observed between capillary and venous samples for mycophenolic acid (MPA), TAC, and CsA (R² > 0.90). Hematocrit correction improved agreement for MPA. Bland–Altman analyses demonstrated acceptable bias across analytes. Conclusions: Fingerstick-based microvolume sampling combined with LC-MS/MS provides analytically reliable immunosuppressant quantification in pediatric patients. Although larger clinical validation is required, this minimally invasive approach may reduce procedural burden and may support future outpatient or home-based TDM strategies. Full article

Hematocrit (HCT) fluctuations and ambient temperature variations are two critical interference factors limiting the accuracy of electrochemical glucose test strips in self-monitoring of blood glucose (SMBG). In this study, a high-precision screen-printed glucose sensor incorporating in situ impedance-based HCT correction and temperature compensation was developed. The system employs a time-division multiplexing strategy, integrating a normalized thermodynamic model and an in situ impedance-based HCT correction algorithm, to achieve synergistic decoupling and precise compensation of temperature and HCT interferences. Experimental results demonstrate that after multi-parameter synergistic correction, the system exhibits excellent stability across a wide temperature range (10–35 °C) and a broad HCT range (10–70%). The accuracy indicators significantly surpass ISO 15197:2013 standards. In contrast, uncorrected measurements showed deviations ranging from approximately −80% to +30% due to HCT fluctuations. This multiple correction strategy effectively resolves systematic errors in whole blood testing without increasing electrode complexity or requiring pretreatment steps, providing a robust technical solution for high-precision, low-cost personal glucose monitoring. Full article

The physiological and hematological responses to exercise and the corresponding adaptations in high-level sports have become an important issue, from both the health and the physical performance points of view. This study investigated the fluctuations in physiological and hematological variables of young swimmers throughout a training season. Twelve well-trained male swimmers (age: 14 ± 0.3 y) participated in the study. Measurements were carried out at the beginning of the training season (T1) and pre and post the taper of each of the two competitive periods (i.e., T2, T3 for the first training macrocycle, and T4, T5 for the second macrocycle, respectively). At each of the above time points, maximum oxygen uptake (VO_2max) was estimated, and blood samples were collected before and 1 h post a maximal 400 m swimming testing to measure hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin corpuscular (MCHC), platelets (PLT), red blood cells (RBCs), and albumin (Alb). Adjustment for exercise-induced plasma volume changes was performed before all data analyses. Analysis of variance (ANOVA) with repeated measures followed by Bonferroni post hoc analyses was used for statistics. Multiple correlations with Bonferroni correction were also performed. Significant improvement of performance from T1 to the end of the study was recorded. Moreover, significant changes in lactate concentration ([La⁻]) with significant decrease at T3 and increase at T4 were also observed. Significant interaction (pre–post-test × test condition) for Hct, Hb, MCV, MCH, and RBCs; the main effect of test condition for Hct, MCV, MCHC, PLT, and Alb; and pre–post-test for Hct, Hb, MCV, MCHC, and RBCs were observed. No significant changes for VO_2max and HR were recorded (p > 0.05). Significant correlations between MCV and MCH at T1, T2, T4, and Hct and Hb at T1, T4, T5 were found. These results indicate that swimming training throughout a season induces both acute and long-term effects on the physiological and hematological profile of young swimmers. These findings provide fundamental information about the effects of the training volume and intensity on physical performance and might be utilized as a useful source for future studies to further characterize the systemic and performance signature of training-induced adaptations during a competitive season in swimmers. Full article

Background/Objectives: Dried blood spot (DBS) sampling, a technique for collecting capillary blood samples, is widely used in therapeutic drug monitoring, pharmacokinetic and toxicology research, newborn screening, and population health because it enables simple, non-invasive sampling across large cohorts. However, it presents several challenges, mainly due to the effect of hematocrit (HCT), which can influence the quantification of analytes. Methods: A combination of methods was developed to estimate the HCT and blood volume in DBS samples. Image analysis and hemoglobin (Hb) quantification using UV-VIS spectrometry were used for HCT estimation, and conductivity was used to determine blood volume. DBS samples from five donors were prepared with HCT between 0.2 and 0.6 and were used to prepare calibrators and quality control samples. The developed methods were applied to 23 samples obtained from ten adult patients with inflammatory bowel disease. Results: The methods for HCT determination using image analysis or Hb measurements were linear (r² > 0.994), with acceptable accuracy (90.3–102.2%) and precision (<7.4%). Moreover, the conductivity method was linear (r² = 0.999) and enabled accurate (96.8–100%) and precise (<5.65%) determination of blood volume in DBS samples. All three methods were in good agreement with the reference values in patient samples. Finally, strategies to correct HCT- and volume-related bias in DBS samples were proposed for analytes with different blood cell-to-plasma partition coefficients. Conclusions: We accurately and precisely estimated HCT in DBS samples using image analysis and Hb determination, and the volume of blood in DBS using conductivity measurement. We evaluated different approaches and derived an optimal procedure for HCT-bias correction. Full article

Background/Objectives: Therapeutic drug monitoring (TDM) is essential for optimizing immunosuppressive therapy in solid-organ transplant recipients by maintaining efficacy, while minimizing adverse effects. However, conventional TDM relies on venous sampling and separate assays for tacrolimus (TAC) in whole blood and mycophenolic acid (MPA) in plasma, thereby increasing patient burden and procedural complexity. To address these limitations, we investigated the clinical utility of a microvolume, liquid-phase microsampling device (MSW2™) in combination with liquid chromatography–tandem mass spectrometry (LC-MS/MS). Methods: We established and applied an LC-MS/MS method for simultaneous quantification of TAC, MPA, and mycophenolic acid β-D-glucuronide (MPAG) using only 2.8 µL of whole blood collected with MSW2™, which eliminates drying or extraction steps. Hematocrit-based correction was applied to estimate plasma MPA concentrations from whole-blood measurements. The method was evaluated in 60 renal transplant recipients with paired venous samples for comparison. Analytical performance was assessed using regression, Bland–Altman analyses, predictive metrics, and stability testing under different storage conditions. Results: Microsampled and venous concentrations were strongly correlated (R² > 0.95). Estimated plasma MPA concentrations derived from whole blood closely approximated plasma concentrations (bias < 5%). Reducing the sample volume from 5.6 µL to 2.8 µL improved precision and increased the success rate of blood collection from 72.9% to 94.0%. All analytes remained stable for up to 72 h at ≤25 °C. Conclusions: This approach enables accurate, simultaneous quantification of multiple immunosuppressants from trace blood volumes. By reducing sampling burden and simplifying logistics, it provides a clinically feasible and patient-centered strategy for precision TDM, supporting broader implementation of limited sampling strategies and expanding applicability to pediatric, home-based, and telemedicine settings. Full article

Background: Psychological distress is common in hemodialysis patients and is linked to worse clinical outcomes and lower quality of life. Nutritional and inflammatory disturbances may impact emotional well-being. Gender likely acts as a biological and psychosocial modifier. This study examined the link between depression, anxiety, and stress in hemodialysis patients and a broad range of biochemical markers, focusing on gender as a main factor. Methods: A cross-sectional study included 54 adults on maintenance hemodialysis at a hospital in Madrid, Spain. Emotional distress was measured using the DASS-21. Predialysis biochemical markers assessed were β₂-microglobulin, albumin, hemoglobin, hematocrit, phosphorus, potassium, iron, calcium, and vitamin D. Statistical analyses included Spearman correlations, HC3-robust regressions with Gender × Biomarker interactions, false discovery rate correction (q = 0.10), penalized regressions (ridge/LASSO), partial least squares structural equation modeling (PLS-SEM), and mixed-cluster analysis. Results: Women reported higher depression, anxiety, and stress, and had lower albumin, calcium, and vitamin D (p < 0.05). Depression was independently linked to female gender, lower calcium, and the Gender × β₂-microglobulin interaction (adjusted R² = 0.30). In PLS-SEM analysis, a latent global psychological distress measure was directly related to β₂-microglobulin and inversely related to albumin and calcium (R² = 0.47). Nutritional markers partly mediated the gender–distress link. Cluster analysis found three biopsychosocial profiles: metabolically balanced, catabolic–emotional, and resilient–compensated. Conclusions: Gender shapes the relationships among inflammation, nutrition, and psychological distress in hemodialysis. Including gender-sensitive emotional and nutritional assessments in nephrology nursing could foster more personalized and practical care. Findings highlight the value of gender-aware psycho-nutritional screening in dialysis. Full article

Background: Continuous monitoring of hemoglobin (HB) and hematocrit (HCT) during hemodialysis could improve fluid management and patient safety. The Fresenius 5008 dialysis machine includes an ultrasound-based sensor that estimates HB and HCT values, though its accuracy compared to standard laboratory measurements remains unclear. Methods: This exploratory observational study assessed the agreement between sensor-derived and laboratory-derived HB and HCT values in 20 patients at the start of hemodiafiltration. A total of 177 paired blood samples were collected. Results: Sensor values significantly underestimated laboratory HB (9.61 vs. 11.31 g/dL) and HCT (27% vs. 34%) (p < 8 × 10⁻²⁵). Correlations were strong for both parameters (HB: r = 0.788; HCT: r = 0.876). Regression analyses revealed consistent proportional bias. Applying a fixed correction of +1.69 g/dL for HB and +7.55% for HCT eliminated the statistical differences and reduced intercepts in regression models. Bland–Altman plots confirmed improved agreement post-correction. Albumin levels correlated modestly with error magnitude. Conclusions: HB and HCT values from the Fresenius 5008 sensor are strongly correlated with laboratory data but are systematically underestimated at treatment start, likely due to hemodilution. Applying fixed correction factors improves accuracy and supports the sensor’s use for real-time monitoring. Full article

The hemostatic system in the newborn is a complex entity, characterized by dynamism in its development; therefore, the correct measurement of its potential is challenging. In this narrative review, we analyzed the current knowledge of the “developmental hemostasis” of the newborn; we also studied the performance of routine coagulation tests in its evaluation, with considerations about the establishment of neonatal age-specific normal ranges and about the role of preanalytical variables, in particular, hematocrit (which could represent an important cause of error); we also focused on the increasing importance of viscoelastic coagulation tests, which are becoming increasingly widespread (especially in some settings such as intensive care unit) and are able to quickly provide information about the hemostatic function of the newborn, even if they lack adequate standardization in the neonatal period. Full article

Immunosuppressants are essential for preventing allograft rejection; however, they require therapeutic drug monitoring to maintain efficacy and to prevent severe complications such as opportunistic infections. Calcineurin inhibitors (CIs) are primarily distributed in red blood cells, whereas mycophenolic acid (MPA) and its metabolites are found in plasma. These differences necessitate separate analyses for each drug, increasing laboratory workload, analytical complexity, and patient burden. We developed a liquid chromatography–tandem mass spectrometry method for simultaneous quantification of CIs such as tacrolimus (Tac), everolimus (Eve), sirolimus (Sir), cyclosporine A (CycA) and MPA in 2.8-µL whole-blood samples, with a hematocrit-based correction to estimate plasma-equivalent MPA concentrations. Performance of this method was assessed by comparison with conventional immunoassay results using linear regression and Bland–Altman analyses, demonstrating excellent agreement, with strong linearity (R² > 0.995) at <2 to 35 ng/mL for three CIs, 26.0 to 1866 ng/mL for CycA, and 0.1 to 50 μg/mL for MPA. Furthermore, MPA and tacrolimus concentrations closely aligned with routine clinical results (R² > 0.900), indicating high accuracy and reproducibility. This new approach may be particularly beneficial for hospitalized patients with limited venous access, pediatric populations, and in remote care settings where frequent blood sampling is challenging because of simultaneous quantification and fewer sample volume requirements. Full article

Background/Objectives: Postpartum depression (PPD), the most common and prevalent psychiatric disorder after birth, is a prevalent yet underdiagnosed psychiatric condition that remains insufficiently understood, particularly in terms of its biological basis. While epidemiological data are extensive, few studies have systematically investigated their underlying biological mechanisms. The purpose of this study was to explore the potential links between blood biomarker levels and postpartum depressive symptoms, contributing to the development of a unified biological model of PPD. Methods: We conducted a cross-sectional study between 2023 and 2025 at a tertiary academic hospital in Timisoara, Romania, involving 860 postpartum women recruited at hospital discharge (1–2 weeks after childbirth). The participants completed the Edinburgh Postnatal Depression Scale (EPDS) and provided peripheral blood samples, which were analyzed using standardized protocols. The blood levels of pregnancy-related hormones (estrogen and progesterone), vitamin D, biochemical markers of inflammatory response (white blood cell count, C-reactive protein, fibrinogen, neutrophil count, lymphocyte count, and ferritin), anemia indicators (hemoglobin, red blood cell count, hematocrit, and ferritin), thyroid hormones (TSH, FT3, and FT4) and markers of coagulation abnormalities (D-dimer, platelets, fibrinogen, APTT, and INR) were evaluated. The data were analyzed with JASP v0.19.3. The statistical methods included multivariate linear regression, the Kruskal–Wallis and Mann–Whitney U tests, and Spearman correlation, with significance set at p < 0.05. Results: The analysis revealed that postpartum depression (PPD) is associated with distinct biological profiles, reflecting the unique hormonal and physiological changes in the peripartum period. Significant associations were identified between EPDS scores and the levels of estrogen, progesterone, thyroid hormones (TSH, FT3, and FT4), inflammatory markers (CRP and ferritin), vitamin D, and coagulation parameters (APTT and INR). These findings support the notion that PPD has a multifactorial biological basis and highlight the potential of these biomarkers as early predictors of risk. Conclusions: Integrating biochemical assessments into postpartum care may enhance early identification and inform targeted preventive interventions, such as hormone monitoring, vitamin D and iron supplementation, or thyroid function correction. Full article

Background: The combination of ivacaftor, tezacaftor and elexacaftor (ETI) is approved for patients with cystic fibrosis (CF) aged two years and older and at least one F508del mutation in the CFTR gene. Variability in ETI treatment response has been repeatedly reported, and its reasons are unclear and understudied. Objectives: We present a novel liquid chromatography–tandem mass spectrometry (LC–MS/MS) method for the rapid and simultaneous quantification of ETI in plasma, dried plasma spots (DPS), and whole blood volumetric absorptive microsampling (VAMS). Methods: The method utilizes a rapid extraction protocol with 200 μL methanol after the addition of deuterated internal standards. Chromatographic separation was achieved using a reversed-phase Hypersil Gold aQ column (Thermo Fisher Scientific). The method was validated according to ICH (International Council on Harmonisation) guidelines M10 for bioanalytical method validation, demonstrating linearity in the concentration range 0.020–12.000 µg/mL. It was also proved accurate and reproducible with no matrix effect. This method was applied to anonymized samples from patients undergoing ETI treatment: eight plasma and DPS and five VAMS samples were analyzed. Results: ETI concentrations measured in plasma and DPS were interchangeable, whereas ETI concentrations in VAMS were lower than in plasma, as expected for molecules with high plasma protein binding (99%). A correction factor based on the hematocrit value was used to calculate the equivalent plasma concentration from VAMS concentrations. Conclusions: This method is suitable for pharmacokinetic (PK) studies and could facilitate the centralization of samples to specialized laboratories, supporting multicenter studies. Full article

Dried blood spots (DBSs) are formed by collecting a small sample of blood on specialized filter paper and allowing it to dry naturally. Various domains of life sciences and drug research extensively use DBSs as a sampling technique. The “Hematocrit (Ht) effect” affects assay bias, and several strategies have been put forth to deal with it, including the correction of quantified concentrations using an appropriate correction factor. The approach was previously applied, following the utilization of an image processing algorithm developed in Matlab^® to derive a reliable equation correlating DBS areas to Ht% values. The present work looks more closely at the application of image analysis to the evaluation of Ht in DBS samples. Utilizing image analysis software, DBS samples with known Ht values were processed. Preparation of cards has followed a previously developed protocol for the appropriate formation of uniform area DBSs, irrespective of Ht. The resulting areas showed close resemblance to the respective theoretical areas calculated by applying the correlation equation. Following that, the equation was utilized to determine the Ht values for each sample, and a comprehensive comparison of measured versus calculated Ht was carried out using various statistical approaches for method comparison. The results demonstrated a strong correlation, suggesting the method’s viability in estimating Ht for unknown DBS samples. Full article

Background and Objectives: This retrospective study aimed to evaluate the efficacy of preoperative blood transfusions in correcting anemia for pediatric patients with congenital malformations (CMs) versus those with acute abdomen (AA) conditions. The study hypothesized that the response to transfusions might vary significantly between these groups due to the differences in the underlying pathology and clinical status. Methods: The study included 107 pediatric patients admitted to Timisoara ‘Louis Turcanu’ Emergency Hospital for Children between January 2015 and May 2023, who required blood transfusions for preoperative anemia. Hemoglobin (HGB), hematocrit (HCT), and red blood cell counts (RBC) were assessed at admission, 48 h post-transfusion, and at discharge. Statistical analyses, including Student’s t-test, Pearson correlation, and chi-square tests, were utilized to compare outcomes between the groups. The study population was divided into 53 children with CM and 54 with AA. Results: Initial analyses showed that children with CM had statistically significantly higher baseline HGB (8.54 ± 1.00 g/dL vs. 7.87 ± 1.02 g/dL, p = 0.001) and HCT (26.07 ± 3.98% vs. 23.95 ± 2.90%, p = 0.002) compared to those with AA. Post-transfusion, children with CM exhibited a greater increase in HGB, with the highest increases noted in patients with central nervous system defects (mean increase of 3.67 g/dL, p = 0.038). In contrast, the increases in HGB for children with AA were less pronounced, with the highest being 2.03 g/dL in those with peritonitis (p = 0.078). Conclusions: No significant gender differences were noted in response to transfusion. Children with congenital malformations respond more effectively to preoperative blood transfusions compared to those with acute abdomen conditions. These findings suggest that differential transfusion strategies may be required based on the underlying medical condition to optimize the management of preoperative anemia in pediatric patients. Tailoring transfusion approaches according to specific patient needs and conditions could enhance clinical outcomes and resource utilization in pediatric surgical settings. Full article

Anemia is the most common extraintestinal symptom of colorectal cancer, with a prevalence of 30–75%. While the preoperative anemia in this patient population has been well studied and its correction 4–6 weeks prior to surgery is recommended when feasible, there is a paucity of data regarding the management of postoperative anemia, which has a prevalence of up to 87% in these patients. To address this issue, we conducted an observational cohort study of surgically treated postoperative anemic patients with colorectal cancer. The objective of this study was to evaluate the effect of intravenous ferric carboxymaltose on the correction of postoperative anemia by postoperative day 30 (POD30). The primary outcome was the change in hemoglobin on POD30, while the secondary outcomes were the change in iron and other laboratory parameters, postoperative complications and transfusions. The results demonstrated that patients treated with intravenous iron exhibited a significant increase in hemoglobin levels by POD30, along with a concomitant increase in hematocrit, ferritin, and transferrin saturation levels, compared to the control group. The findings imply that patients undergoing colorectal cancer surgery with anemia that was not corrected in the preoperative setting may benefit from early postoperative intravenous iron infusion. Full article