Clinical effectiveness of posaconazole versus fluconazole as antifungal prophylaxis in hematology-oncology patients: a retrospective cohort study.

In preventing invasive fungal disease (IFD) in patients with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), clinical trials demonstrated efficacy of posaconazole over fluconazole and itraconazole. However, effectiveness of posaconazole has not been investigated in the United States in real-world setting outside the environment of controlled clinical trial. We performed a single-center, retrospective cohort study of 130 evaluable patients ≥18 years of age admitted to Duke University Hospital between 2004 and 2010 who received either posaconazole or fluconazole as prophylaxis during first induction or first reinduction chemotherapy for AML or MDS. The primary endpoint was possible, probable, or definite breakthrough IFD. Baseline characteristics were well balanced between groups, except that posaconazole recipients received reinduction chemotherapy and cytarabine more frequently. IFD occurred in 17/65 (27.0%) in the fluconazole group and in 6/65 (9.2%) in the posaconazole group (P = 0.012). Definite/probable IFDs occurred in 7 (10.8%) and 0 patients (0%), respectively (P = 0.0013). In multivariate analysis, fluconazole prophylaxis and duration of neutropenia were predictors of IFD. Mortality was similar between groups. This study demonstrates superior effectiveness of posaconazole over fluconazole as prophylaxis of IFD in AML and MDS patients. Such superiority did not translate to reductions in 100-day all-cause mortality.

Hemostatic assessment, treatment strategies, and hematology consultation in massive postpartum hemorrhage: results of a quantitative survey of obstetrician-gynecologists.

OBJECTIVE: To assess potential diagnostic and practice barriers to successful management of massive postpartum hemorrhage (PPH), emphasizing recognition and management of contributing coagulation disorders. STUDY DESIGN: A quantitative survey was conducted to assess practice patterns of US obstetrician-gynecologists in managing massive PPH, including assessment of coagulation. RESULTS: Nearly all (98%) of the 50 obstetrician-gynecologists participating in the survey reported having encountered at least one patient with "massive" PPH in the past 5 years. Approximately half (52%) reported having previously discovered an underlying bleeding disorder in a patient with PPH, with disseminated intravascular coagulation (88%, n=23/26) being identified more often than von Willebrand disease (73%, n=19/26). All reported having used methylergonovine and packed red blood cells in managing massive PPH, while 90% reported performing a hysterectomy. A drop in blood pressure and ongoing visible bleeding were the most commonly accepted indications for rechecking a "stat" complete blood count and coagulation studies, respectively, in patients with PPH; however, 4% of respondents reported that they would not routinely order coagulation studies. Forty-two percent reported having never consulted a hematologist for massive PPH. CONCLUSION: The survey findings highlight potential areas for improved practice in managing massive PPH, including earlier and more consistent assessment, monitoring of coagulation studies, and consultation with a hematologist.

Effect of rosemary (Rosmarinus officinalis) extract on weight, hematology and cell-mediated immune response of newborn goat kids

This study aimed at evaluating the effects of different levels of rosemary (Rosmarinus officinalis) extract on growth rate, hematology and cell-mediated immune response in Markhoz newborn goat kids. Twenty four goat kids (aged 7 +/- 3 days) were randomly allotted to four groups with six replicates. The groups included: control, T1, T2 and T3 groups which received supplemented-milk with 0, 100, 200 and 400mg aqueous rosemary extract per kg of live body weight per day for 42 days. Body weights of kids were measured weekly until the end of the experiment. On day 42, 10 ml blood samples were collected from each kid through the jugular vein. Cell-mediated immune response was assessed through the double skin thickness after intradermal injection of phyto-hematoglutinin (PHA) at day 21 and 42. No significant differences were seen in initial body weight, average daily gain (ADG) and total gain. However, significant differences in globulin (P <0.05), and white blood cells (WBC) (P <0.001) were observed. There were no significant differences in haemoglobin (Hb), packed cell volume (PCV), red blood cells (RBC), lymphocytes and neutrophils between the treatments. Skin thickness in response to intra dermal injection of PHA significantly increased in the treated groups as compared to the control group at day 42 (P< 0.01) with the T3 group showing the highest response to PHA injection. In conclusion, the results indicated that aqueous rosemary extract supplemented-milk had a positive effect on immunity and skin thickness of newborn goat kids.

Hematology and productive performance of nile tilapia (Oreochromis niloticus) naturally infected with Flavobacterium columnare

Columnaris disease is one of the main causes of mortality in tilapia rearing and is responsible for large economic losses worldwide. Hematology is a tool that makes it possible to study organisms' physiological responses to pathogens. It may assist in making diagnoses and prognoses on diseases in fish populations. The hematological variables of nile tilapia were studied in specimens with a clinical diagnosis of columnaris disease and in specimens that were disease-free. The total erythrocyte count, hemoglobin rate, hematocrit percentage, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), organic defense blood cell percentages (leukocytes and thrombocytes) and hepatosomatic and splenosomatic index were determined. The results showed that there were changes in the erythrocytic series and in organic defense blood cells, in the fish infected with the bacterium, with reductions in erythrocytic variables and significant increases in the numbers of circulating lymphocytes and neutrophils.

Hematology of Piaractus mesopotamicus fed diets supplemented with vitamins C and E, challenged by Aeromonas hydrophila

Piaractus mesopotamicus were fed diets supplemented with three vitamin C and/or E levels (zero, 250, and 500 mg vitamin/kg dry ration) and challenged with Aeromonas hydrophila. The fish were fed during the first 60 days with diets without vitamins C and E, in an attempt to reduce vitamin sources. After this period, test diets were offered during 60 days. At the end of the experiment, all fish were intraperitoneally injected with 6 x 10(6) Colony forming units (cfu) of A. hydrophila per fish. It was concluded that for pacu, vitamin C and E are essential for protection of erythrocytes. Vitamin C induces an increase in the number of circulating thrombocytes in a dose-response relation. However, just like vitamin deficiency should be avoided, excess vitamins can also cause damage to fish as observed in the hematocrit and hemoglobin values. Based on the hematological responses obtained, the recommended vitamin C and vitamin E levels for P mesopotamicus juveniles are 500 and 250 mg/kg feed, respectively. (C) 2007 Elsevier B.V. All rights reserved.

Performance and hematology of pacu fed diets supplemented with vitamins C and/or E

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Hematology of the Red-Capped Parrot (Pionopsitta pileata) and Vinaceous Amazon Parrot (Amazona vinacea) in Captivity

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Pulmonary tuberculosis: Hematology, serum biochemistry and the relation with the disease duration

The aim of the present study was to analyze the relationship between hematological and biochemical parameters and tuberculosis process activity time according to clinical complaint duration. It was a retrospective study analyzing medical records from 80 pulmonary tuberculosis patients at Botucatu Medical School University Hospital ( Botucatu, São Paulo State, Brazil), who were divided into 2 groups according to clinical complaint duration: Group 1 ( G1) - up to three months; Group 2 ( G2) - over three months. Parameters included: age, gender, bacilloscopy, erythrocyte sedimentation rate ( ESR), platelet count, alpha1-globulin, alpha2-globulin, gamma globulin, mucoprotein, alpha1-acid glycoprotein values, and the presence of risk factors such as smoking, alcoholism, drug addiction, sexual promiscuity, contact with tuberculosis carriers, and previous treatment. Groups were compared by calculating t and p, and Chi-square (X-2) and p. Comparisons revealed a tendency towards smoking with a higher frequency of smokers in G1 ( 0.05< p< 0.10). G1 also tended to present greater platelet values than G2 ( 0.05< p< 0.10) and presented significantly higher ESR values than G2 ( p< 0.05). Other factors did not show any significantly different behavior between groups ( p> 0.05). A correlation was found between ESR, platelet count, smoking and less than three months clinical duration.

Effect of age and abomasal puncture on peritoneal fluid, hematology, and serum biochemical analyses in young calves

The goals of this study were to evaluate techniques for collection of peritoneal fluid from calves, establish reference ranges for fibrinogen in peritoneal fluid during the 1st month of life, and determine if abomasal puncture would alter peritoneal fluid or hematologic variables. Twenty-two healthy Holstein calves underwent 3 peritoneal fluid collections on day 1, day 15, and day 30 of age. Fibrinogen concentration in peritoneal fluid was 0.20 g/dL and 0.10 g/dL (P < .05) for day 1 and day 30, respectively, and 0.10 at day 15 (P > .05) for calves without abomasal puncture. Plasma fibrinogen concentration was 0.60 g/dL and 0.70 g/dL (P < .05) for days 15 and 30, respectively, in calves without abomasal puncture. There were no significant differences (P <= .05) in peritoneal fluid and peripheral blood total protein and fibrinogen concentrations, specific gravity, total and differential cell count, or erythrocyte counts between calves with or without abomasal puncture. We concluded that the reference ranges established for fibrinogen and total protein concentration are important for accurate evaluation of peritoneal fluid in calves for further comparison with similar-aged animals with gastrointestinal-tract or abdominal-cavity disease. Additionally, accidental abomasal puncture does not alter values of fibrinogen, total protein, and nucleated cell Count in peritoneal fluid and does not cause apparent clinical abnormalities.

Prevalence, hematology and serum biochemistry in stray dogs naturally infected by Hepatozoon canis in São Paulo

Cães capturados nas ruas de quatro municípios do estado de São Paulo foram examinados para estudar a prevalência de Hepatozoon canis. Dos 222 animais, 13 (5.9%) encontravam-se infectados. Exames hematológicos realizados em nove animais evidenciaram três com anemia e um com leucocitose. A única alteração encontrada nos exames bioquímicos foi hiperglobulinemia.

Hematology of free-living marsh deer (Blastocerus dichotomus) from Southeast Brazil

This work reports basic hematologic values of a sample of a population of free-living marsh deer (Blastocerus dichotomus) living by the Parana River in Southeast Brazil. Hematologic values are presented separately for male, female, and young animals as well as for anesthetized and nonanesthetized cervids. Nonanesthetized deer restrained by physical means had significantly higher erythrocyte indices and total leukocyte counts. Comparisons of blood parameters of anesthetized animals of different ages and gender differed slightly, with only two significant differences observed: young animals had significantly higher red blood cell counts than adult males and a lower blood total protein content when compared to adult females. Results indicate that two main reference ranges for blood values should be considered for marsh deer, for blood obtained from anesthetized or physically restrained individuals.

Mebendazole treatment against Anacanthoras penilabiatus (Monogenea, Dactylogyridae) gill parasite of cultivated Piaractus mesopotamicus (Osteichthyes, Characidae) in Brazil. Efficacy and hematology

The present work evaluated the efficacy of mebendazole (MBZ) treatment against infections with the monogenean helminths Anacanthorus penilabiatus, gill parasites of young cultivated pacu, Piaractus mesopotamicus. A short-term bath treatment using 100, 200 and 500 mg MBZ/l of water for 10 and 30 min and a long-term-bath using 1, 10 and 100 mg MBZ/l of water for 24 h were utilized. Seven days after, fish were sacrificed and parasites counted. Concentrations of 500 and 200 mg MBZ/l for 10 and 30 min showed reduced efficacy (0.0 and 0.7%) and (14.2 and 11.0%), respectively. Nevertheless, 100 mg MBZ/l (10 min) and 10 nag MBZ/l (24 h) showed better efficacy (79.6 and 8 1.4%, respectively). Treatments for 24 h provoked increases in hematocrit, hemoglobin concentration and leukocyte number when compared to those untreated fish. Mebendazole treatments also provoked alterations in the defense blood cells especially in lymphocyte and thrombocyte numbers, when the fishes were submitted to 10 and 30 min baths.