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Immunomediated thrombocytopenia is a systemic metabolic disorder in which the platelet count falls below reference values, as the patient's immune system destroys them. The main clinical signs in thrombocytopenia are petechial, hemorrhages, ecchymoses and suffusions. Hematomas can also occur in coagulation disorders. The diagnosis is based on clinical findings and hematological examinations. The treatment consists of the use of corticosteroids and immunosuppressants, delaying cell destruction, and may last for months, not always obtaining a cure for the disease. The present work reports the use of therapy with allogeneic mesenchymal stem cells, derived from the adipose tissue of dogs, for the treatment of chronic immunomediated thrombocytopenia, with an evolution of more than one year, in a Pinscher dog. The alternative treatment showed a good evolution, keeping platelets within the reference values during the treatment, giving the patient quality of life and removing the need for continuous medication for homeostasis after treatment. RESUMO A trombocitopenia imunomediada é uma desordem metabólica sistêmica, na qual a contagem plaquetária fica abaixo dos valores de referência, pois o sistema imunológico do paciente a destrói. O principal sinal clínico na trombocitopenia são hemorragias, petequiais, equimoses e sufusões. Hematomas podem ocorrer também em alterações da coagulação. O diagnóstico baseia-se nos achados clínicos e nos exames hematológicos. O tratamento consiste na utilização de corticosteroides e imunossupressores, o que retarda a destruição celular, mas pode se prolongar por meses, nem sempre obtendo cura da doença. O presente trabalho relata a utilização da terapia com células-tronco mesenquimais alogênicas, oriundas do tecido adiposo de cães, para tratamento de trombocitopenia imunomediada crônica, com evolução de mais de um ano, em um cão da raça Pinscher. O tratamento alternativo revelou boa evolução, pois manteve as plaquetas dentro dos valores de referência durante o tratamento, o que proporcionou qualidade de vida ao paciente e tornou desnecessárias medicações de uso contínuo para a homeostase após o tratamento.

RESUMEN Objetivos. Evaluar la variación de los perfiles hematológicos antes, durante y después del tratamiento de pacientes infectados con malaria no complicada por Plasmodium vivax (Pv) y P. falciparum (Pf) en una población de la región Loreto. Materiales y métodos. El estudio se realizó entre 2010 y 2012, en Zungarococha (Iquitos). Los 425 participantes tuvieron tres visitas (visita 1-día 0-antes del tratamiento, visita 2-día 7-durante tratamiento, visita 3-día 28-después del tratamiento), hemograma completo, diagnóstico microscópico y molecular (PCR). Resultados. En la primera visita, se encontraron 93 (21,9%) positivos a Pv y 34 (8,0%) a Pf. Todos los positivos mostraron una reducción en los indicadores hematológicos de hematocrito, recuento de glóbulos blancos (RGB), neutrófilos abastonados y segmentados, eosinófilos y plaquetas (p

Identificar pacientes que possuem um risco maior de morte é crucial para definir a classificação de risco apropriada, tratamento e prognóstico, os quais podem resultar em um resultado favorável. O objetivo deste estudo foi avaliar se o prolongamento dos tempos de protrombina, tromboplastina parcialmente ativada e trombocitopenia são indicadores para o risco de óbito de pacientes caninos hospitalizados. O estudo retrospectivo utilizando os registros médicos (2014 a 2018) do Laboratório de Análises Clínicas Veterinárias na Universidade Federal do Rio Grande do Sul identificou 218 pacientes. Cães que apresentavam uma única alteração em exames laboratoriais não diferiram do controle. Grupos compostos de pacientes com múltiplas alterações mostraram um risco de óbito três vezes maior que o grupo controle e uma incidência cumulativa de óbito maior que 29%. Identifying patients who have a higher risk of death is crucial to define appropriate risk classification, treatment and prognosis, which can result in a favorable outcome. The objective of this retrospective study was to evaluate whether the prolongation of prothrombin times, activated partial thromboplastin, and thrombocytopenia are indicators of death risk in hospitalized canine patients. A retrospective study using medical records (2014-2018) of the Laboratory of Veterinary Clinical Analysis at the Federal University of Rio Grande do Sul identified 218 patients. Dogs having a single disorder in laboratory tests did not differ from the control. Groups presenting patients with multiple changes showed three times more death risk than the control group and a cumulative incidence of death higher than 29%. Identificar a los pacientes con mayor riesgo de muerte es crucial para definir la clasificación de riesgo, el tratamiento y el pronóstico adecuados, lo que puede dar lugar a un resultado favorable. El objetivo de este estudio fue evaluar si la prolongación de los tiempos de protrombina, la tromboplastina parcialmente activada y la trombocitopenia son indicadores del riesgo de muerte en perros hospitalizados. El estudio retrospectivo con registros médicos (2014 a 2018) del Laboratorio de Análisis Clínico Veterinario de la Universidad Federal de Rio Grande do Sul identificó a 218 pacientes. Los pacientes con un solo cambio en las pruebas de laboratorio no difirieron del control. Los grupos que presentaron pacientes con múltiples cambios mostraron un riesgo de muerte tres veces mayor que el grupo control y una incidencia acumulada de muerte mayor al 29%.

Preeclampsia, a human pregnancy syndrome, is characterized by elevated blood pressure and proteinuria after the 20th week of gestation. Its etiology remains unknown, and its pathophysiological mechanisms are related to placental hypoperfusion, endothelial dysfunction, inflammation, and coagulation cascade activation. Recently, the role of the complement system has been considered. This syndrome is one of the main causes of maternal and fetal mortality and morbidity. This article discusses the hypothesis of preeclampsia being triggered by the occurrence of inadequate implantation of the syncytiotrophoblast, associated with bleeding during the first stage of pregnancy and with augmented thrombin generation. Thrombin activates platelets, increasing the release of antiangiogenic factors and activating the complement system, inducing the membrane attack complex (C5b9). Immature platelet fraction and thrombin generation may be possible blood biomarkers to help the early diagnosis of preeclampsia. Resumo A pré-eclâmpsia, uma síndrome da gestação humana, é caracterizada por elevação da pressão arterial e proteinúria patológica após a 20ª semana de gestação. Sua etiologia permanece desconhecida, e seus mecanismos fisiopatológicos estão relacionados à hipoperfusão placentária, disfunção endotelial, inflamação, e ativação da cascata de coagulação. Recentemente, o papel do sistema do complemento foi considerado. Essa síndrome é uma das principais causas de morbidade e mortalidade materna e fetal. Este artigo discute a hipótese de a pré-eclâmpsia ser desencadeada pela ocorrência da implantação inadequada do sinciciotrofoblasto, associada ao sangramento durante o primeiro trimestre da gravidez com aumento da geração de trombina. A trombina ativa plaquetas, aumentando a liberação de fatores antiangiogênicos na circulação e ativando o sistema do complemento, especialmente o complexo de ataque de membrana (C5b9). Portanto, a fração de plaquetas imaturas e a geração de trombina podem ser possíveis biomarcadores sanguíneos para auxílio no diagnóstico precoce da pré-eclâmpsia.

RESUMO Introdução: Essa revisão sistemática foi conduzida para avaliar se a associação da aplicação da injeção de agregados plaquetários quando comparada a outras terapias faciais favorece no rejuvenescimento facial em pacientes adultos. Métodos: A pesquisa buscou ensaios clínicos randomizados que compararam uso de técnicas de rejuvenescimento facial isoladas com as mesmas técnicas aliadas à injeção de agregados plaquetários. A busca foi realizada em bases de dados indexadas e literatura cinzenta. A ferramenta de risco de viés da “Cochrane Collaboration” foi aplicada para a avaliação da qualidade dos estudos. Resultados: Foram identificados 7137 artigos. Apenas quatro estudos permaneceram na síntese qualitativa, e os demais foram considerados com risco indefinido de viés nos domínios chaves. Conclusão: Existem poucos estudos na literatura que comparam o uso de agregados plaquetários em rejuvenescimento facial e os que estão disponíveis têm risco de viés “indefinido” ou “alto”. Há necessidade de realizar mais estudos clínicos bem delineados que comparem o uso de injeção de agregados plaquetários associados ou não às técnicas de rejuvenescimento facial. ABSTRACT Introduction: This systematic review was conducted to assess whether the use of a platelet aggregate injection with or without associated facial rejuvenation techniques favors facial rejuvenation in adult patients. Methods: Randomized clinical trials that compared the use of techniques for facial rejuvenation alone with the same techniques coupled with the injection of platelet aggregates were searched. The search was performed in indexed databases and in the gray literature. The Cochrane Collaboration bias risk tool was applied to assess the quality of the studies. Results: In total, 7137 articles were identified. Only four studies remained in the qualitative synthesis, and the others were considered as having undefined bias risk in the key domains. Conclusion: There are few studies in the literature that compare the use of platelet aggregates in facial rejuvenation and those that are available have a risk of “undefined” or “high” bias. There is a need for more well-designed clinical studies comparing the use of platelet aggregate injection with or without associated facial rejuvenation techniques.

La trombocitopenia inducida por heparina (TIH) es un trastorno mediado por el sistema inmunitario causado por anticuerpos que reconocen complejos del factor plaquetario 4 y la heparina. La trombosis es una característica central e impredecible de este síndrome. A pesar del manejo óptimo, la morbilidad y la mortalidad de la enfermedad por trombosis siguen siendo altas. El estado hipercoagulable en TIH es biológicamente distinto de otros trastornos trombofílicos en que las complicaciones clínicas son directamente atribuibles a los complejos inmunes ultra grandes (CIUG) circulantes. En algunos individuos, los CIUG provocan respuestas procoagulantes celulares no controladas que culminan en trombosis. Hasta la fecha, los factores de riesgo clínicos y biológicos asociados con el riesgo trombótico en TIH siguen siendo esquivos. Esta revisión resumirá nuestra comprensión actual de la trombosis en TIH con atención a sus características clínicas, mecanismos celulares

IntroductionIntra-articular infiltration of plasma rich in growth factors (PRGF) and adipose mesenchymal stromal cells (AMSCs) are known to inhibit osteoarthritis progression. However, in severely affected patients, the treatment cannot reach the deeper layers of the articular cartilage; thus, its potential is limited. To overcome this limitation, intra-osseous infiltrations have been suggested. The purpose of this study is to assess the impact of intra-osseous infiltration therapies on serum biomarkers of osteoarthritis and to assess cartilage regeneration macroscopically.Materials and methodsA total of 80 rabbits were divided into four groups based on the intra-osseous treatment administered on the day of surgery: control, PRGF, AMSCs and a combination of PRGF + AMSCs. In addition, all groups received a single intra-articular administration of PRGF on the same day. Serum biomarker levels were measured before infiltration and 28-, 56-, and 84-days post infiltration, and macroscopical assessment was conducted at 56- and 84-days follow-up post infiltration.ResultsIn the PRGF + AMSCs group, significantly lower concentrations of hyaluronic acid and type II collagen cleavage neoepitope were recorded at all time points during the study, followed by PRGF, AMSCs and control groups. Regarding macroscopical assessment, lower scores were obtained in PRGF + AMSCs group at all study times.DiscussionThe results suggest that the combination of intra-articular PRGF with intra-osseous PRGF or AMSCs achieves better results in rabbits with acute chondral defects and that intra-osseous infiltration is a safe procedure.

Platelets are cytoplasmic fragments of megakaryocytes, cells present in the bone marrow, which are key players in hemostasis. Adequate platelet kinetics, with a balance between production, activation, and apoptosis, is essential to maintain the stability of this process. Hemostasis imbalance due to different causes results in changes in the number and/or function of platelets. In immune thrombocytopenia (ITP), this imbalance leads to a reduction in the number of platelets. In COVID-19, the imbalance results in platelet hyperactivation with consequent immunothrombotic dysregulation. Recently, in addition to counting the number of platelets, the analysis of other platelet parameters, including mean platelet volume (MPV), immature platelet fraction (IPF), absolute number of platelets, immature platelets (AIPC), platelet cell count (PCT), large platelet ratio (P-LCR), and PDW (platelet distribution amplitude) are performed using more advanced automated equipment. The aim of this study was to evaluate IPF (%), AIPC (× 109 /L), and MPV (fL) in ITP diagnosis and platelet changes present in the pathophysiology of COVID-19. EDTA-containing whole blood samples from patients diagnosed with ITP (41 patientes) and from patients diagnosed with COVID-19 (152 patients) were analyzed for the determination of these markers in the XE5000 analyzer. Samples from blood donors were used as the healthy control group. Results showed that a cutoff of 6.4% for IPF can be used as a laboratory marker for the diagnosis of ITP. In the case of COVID-19, results showed that patients requiring intensive care had a median of 6.20% (4.70–8.53) and 14.98x109 /L (11.15–21.25) for IPF and AIPC, respectively. For patients with COVID-19 without intensive treatment, the values obtained were 5.30% (3.20–6.80) and 13.39x109 /L (8.64–18.93). For the control group without COVID-19, the values were 3.40% (2.55–4.85) and 7.78x109 /L (5.58–9.97). The MPV values were 10.4 fL (9.90–11.10), 9.80 fL (9.30–10.40), and 10.1 fL (9.65–11.00) for the control group, patients with COVID-19 without intensive treatment, and those in need of intensive treatment, respectively. The results suggest that these markers can be used to assess the severity of COVID-19. Our results show that once platelet parameters are standardized with defined reference values, they can be useful in clinical practice for confirmatory diagnostic purposes in the case of ITP or for the assessment of the severity and follow-up of the disease in the case of COVID19. As plaquetas são fragmentos citoplasmáticos dos megacariócitos, células presentes na medula óssea, as quais são peças-chave na hemostasia. A adequada cinética plaquetária, com equilíbrio entre produção, ativação e apoptose é fundamental para manutenção da estabilidade desse processo. O desequilíbrio da hemostasia por diferentes causas, resulta em prejuízo na quantidade e/ou função das plaquetas. Na trombocitopenia imune (PTI) esse desequilíbrio leva a uma redução no número de plaquetas, enquanto na COVID-19 ocorre uma hiperativação plaquetária com consequente desregulação imunotrombótica. Atualmente, em adição a avaliação do número de plaquetas, os equipamentos automatizados permitem também realizar a análise de outros parâmetros plaquetários, entre eles o volume plaquetário médio (VPM), a fração de plaquetas imaturas (IPF), o número absoluto de plaquetas imaturas (AIPC), o plaquetócrito (PCT), a razão de grandes plaquetas (P-LCR), e a amplitude de distrubuição das plaquetas (PDW). O objetivo deste estudo foi avaliar IPF, AIPC e o VPM no diagnóstico da PTI e nas alterações plaquetárias presentes na fisiopatologia da COVID-19. Foram analisadas amostras de sangue total com EDTA proveniente de pacientes diagnosticados com PTI (41 indivíduos) e de pacientes diagnosticados com COVID-19 (152 indivíduos), para a determinação destes marcadores no equipamento XE5000 da Sysmex. Como grupo controle saudável foram utilizadas amostras de doadores de sangue. Nossos resultados mostraram que um ponto de corte de 6,4% para o IPF pode ser utilizado como marcador laboratorial para diagnóstico de PTI. No caso da COVID-19, nossos resultados mostraram que pacientes com COVID-19 que necessitaram de tratamento intensivo apresentaram uma mediana de 6,20% (4,70- 8,53) e 14,98x109 /L (11,15-21,25) para IPF e AIPC, respectivamente. Para os pacientes com COVID-19 sem necessidade de tratamento intensivo os valores obtidos foram de 5,30 % (3,20–6,80) e 13,39 x109 /L (8,64-18,93). Já para o grupo controle, sem COVID-19, os valores foram de 3,40% (2,55 – 4,85) e 7,78 x109 /L (5,58-9,97). Os valores de VPM foram de 10,40 fL (9,90 – 11,10), 9,80 fL (9,30-10,40) e 10,10 fL (9,65 – 11,00), para grupo controle, pacientes com COVID-19 sem e com necessidade de tratamento intensivo, respectivamente. Esses resultados sugerem que esses marcadores possam ser utilizados como auxiliares na avaliação da gravidade da COVID-19. Nossos resultados mostram que esses parâmetros plaquetários, uma vez padronizados e com valores de referência definidos, possam ser úteis na prática clínica com finalidade diagnóstica confirmatória no caso da PTI ou para avaliação da gravidade e acompanhamento da COVID-19.

La preclampsia es una complicación obstétrica frecuente a nivel mundial. En esta entidad ocurre un aumento en el consumo y activación de plaquetas, lo que lleva a síntesis de plaquetas de mayor tamaño y mayor agregación plaquetaria (1,2). Por lo cual se realiza la medición del volumen plaquetario medio (VPM), que aumenta a medida que se incrementa el tamaño plaquetario, y ancho de distribución eritrocitaria (RWD), el cual indica la heterogeneidad entre los tamaños de las células (3). Por otro lado, la leucocitosis en la preeclampsia es a expensas de los neutrófilos que junto con toda la cascada inflamatoria son los encargados de las alteraciones endoteliales vasculares (4). Debido a los expuesto anteriormente, el presente estudio se realizó para determinar criterios pronósticos para la preeclampsia, basados en el cuadro hemático utilizando específicamente los valores del NRL (índice de neutrófilos linfocitos), VPM (volumen plaquetario medio y RWD (ancho de distribución de glóbulos rojos), siendo esta una herramienta de bajo costo y fácil acceso para todo el personal de la salud y para la población de gestantes. 1. Portada 2. Tabla de contenido 3. Resumen 4. Identificación y formulación del problema 5. Objetivos e hipótesis 5.1 Objetivo genera 5.2 Objetivos específicos 5.3 Hipótesis 5.3.1 Hipótesis nula 5.3.2 Hipótesis alterna 6. Metodología 6.1 Tipo y diseño general del estudio 6.2 Población 6.3 Diseño muestral 6.4 Tamaño de muestra 6.5 Criterios de inclusión y exclusión 6.5.1 Inclusión 6.5.2 Exclusión 6.6 Plan de recolección de información 6.7 Fuentes de información 6.8 Instrumentos de recolección de la información 6.9 Definición de las variables 7.0 Plan de análisis 7.1 Procesamiento obtención información 7.2 Estrategias para suprimir amenazas 7.2.1 Control sesgos y errores 7.3 Análisis estadístico 8. Aspectos éticos 9. Resultados 10. Discusión 11. Conclusión 12. Referencias bibliográficas 13. tablas de resultados Preeclampsia is a common obstetric complication worldwide. In this entity, there is an increase in the consumption and activation of platelets, which leads to the synthesis of larger platelets and greater platelet aggregation (1,2). Therefore, the mean platelet volume (MPV) is measured, which increases as platelet size increases, and erythrocyte distribution width (RWD), which indicates heterogeneity between cell sizes (3). On the other hand, leukocytosis in preeclampsia is at the expense of neutrophils which, together with the entire inflammatory cascade, are responsible for vascular endothelial alterations (4). Due to the above, the present study was carried out to determine prognostic criteria for preeclampsia, based on the complete blood count, using specifically the values ​​of the NRL (lymphocyte neutrophil index), MPV (mean platelet volume) and RWD (red blood cell distribution width). red), being this a low-cost and easily accessible tool for all health personnel and for the pregnant population. Especialización

Tesis - Doctorado en Ciencias de la Salud - Universidad nacional de Córdoba. Facultad de Ciencias Médicas. Secretaria de Graduados en Ciencias de la Salud, 2022 La transfusión de plaquetas (PQT) es necesaria para prevenir y tratar las hemorragias en pacientes trombocitopénicos o con disfunción plaquetaria grave. En Argentina, la mayor parte del suministro de sangre depende de los donantes de reemplazo familiares, ya que las donaciones altruistas y habituales son excepcionales. Este es el principal motivo por el que los donantes de PQT son escasos. En este contexto, la implementación de un programa de captación de donantes de PQT es fundamental a fin de contar con una fuente permanente de PQT para satisfacer las necesidades de la práctica clínica. Por otro lado, aunque la trombocitopenia fetal y neonatal aloinmune (FNAIT), provocada por la aloinmunización materna frente a los antígenos PQT fetales heredados del padre que sean diferentes de los maternos, ha sido reconocida como la principal causa de morbilidad y mortalidad hemorrágica primaria en fetos y recién nacidos, los programas de cribado para detectar embarazos de riesgo aún no se han implementado en ningún país. El objetivo principal de este trabajo fue implementar y validar técnicas moleculares para la genotipificación de antígenos plaquetarios humanos (HPA), a los fines de contar con herramientas moleculares a nivel regional, y constituir el primer registro de donantes de PQT en Argentina. Para ello, se reclutó a donantes de sangre voluntarios y altruistas que asistieron a la Fundación Banco Central de Sangre desde julio de 2016 a julio de 2017, y se caracterizó su genotipo HPA. Además, con el objetivo de resaltar la importancia de diagnosticar la FNAIT en los entornos de atención de la salud fetal y perinatal y demostrar la utilidad de las herramientas moleculares en el diagnóstico precoz de esta entidad clínica, se realizó un estudio de frecuencia de genotipos HPA en 200 mujeres embarazadas de nuestro medio que se encontraban cursando el primer semestre de embarazo y se evaluó la incidencia de casos de FNAIT. Los resultados de la implementación y verificación de las técnicas moleculares se correlacionaron un 100 % con los resultados de referencia esperados. Se reclutó y caracterizó una cohorte de 500 donantes y se creó la primera base de datos con sus genotipos HPA. Asimismo, se identificó a 8/500 donantes (1,6%) HPA-1a negativos y se describen, por primera vez, las variantes alélicas de los sistemas HPA-4b, -6b y -9b en nuestra población. En el estudio de gestantes se detectaron los alelos más frecuentemente asociados a FNAIT 14 en población caucásica. Se identificaron 3/200 (1,5%) mujeres embarazadas HPA-1a- negativas, detectándose incompatibilidad entre el neonato y su madre en dos casos. Solo uno de los neonatos requirió transfusión de PQTS. Además de estos casos, se detectaron otros 3 casos de FNAIT: uno debido a incompatibilidad en el sistema HPA-3, otro en el sistema HPA-15 y un tercer caso en el sistema HPA-1. Las técnicas moleculares implementadas en esta tesis para la genotipificación HPA han demostrado ser herramientas confiables y robustas para aplicarse tanto en la realización de estudios de genotipificación a gran escala, como así también, para estudiar situaciones clínicas concretas, como la FNAIT. Los esfuerzos realizados en este trabajo de tesis para el reclutamiento, caracterización y registro de donantes voluntarios de PQT, culminaron en la obtención de la primera fuente sostenible de PQT para transfusiones compatibles del país. Sorprendentemente, identificamos un mayor porcentaje de donantes HPA-1a-negativos en comparación con los datos previamente obtenidos en la población de Argentina. Este trabajo constituye el primer reporte de genotipos HPA de baja frecuencia en población de mujeres embarazada y de casos de FNAIT confirmados por evidencia molecular en Argentina, indicando la relevancia del diagnóstico precoz de esta entidad clínica. Dado que el retraso en el diagnóstico de FNAIT podría tener consecuencias graves en el feto y en los recién nacidos, las estrategias para abordar la salud materna, fetal y perinatal, así como las políticas de prevención dirigidas a reducir la morbilidad y mortalidad fetal y neonatal, deben enfocarse en implementar programas para identificar embarazos de riesgo y así reducir las complicaciones relacionadas con la trombocitopenia en fetos y recién nacidos. Platelet (PLT) transfusion is necessary to prevent and treat haemorrhages in thrombocytopenic patients or those with severe platelet dysfunction. In Argentina, blood supplies from voluntary non‐remunerated blood donors remain dependent on family replacement donors since altruistic repetitive donations are exceptional. This is the main reason why PLT donors are very scarce. In this context, the implementation of a PLT donor recruitment program is essential to have a permanent source of PLTs to fulfil clinical needs. On the other hand, even though Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) caused by maternal alloimmunization against fetal PLT antigens inherited from the father but absent in the mother constitutes the main cause of primary haemorrhagic morbidity and mortality in fetuses and newborns, screening programs to detect pregnancies at risk have not been implemented in any country so far. The main objective of this study was to implement and validate molecular techniques for genotyping of human platelet antigens (HPA) in order to have local molecular tools and establish the first PQT-donor registry in Argentina. For this purpose, voluntary and altruistic blood donors who attended at the Fundación Banco Central de Sangre from July 2016 to July 2017 were recruited and their HPA genotype was characterized. In addition, in order to highlight the importance of diagnosing FNAIT in fetal and perinatal health care settings and demonstrate the usefulness of molecular tools in early diagnosis of this clinical entity, we analysed the frequency of HPA genotypes in 200 pregnant women going through the first semester of pregnancy and the incidence of FNAIT. The results of the implementation and verification of the molecular techniques correlated 100% with the expected reference results. A cohort of 500 donors was recruited and characterized, and the first registry of HPA-genotypes was elaborated. Likewise, 8/500 HPA- 1a negative donors (1.6%) were identified and allelic variants of the HPA-4b, -6b and -9b systems were described for the first time in Argentina. In the study of pregnant women, the alleles most frequently associated with FNAIT were detected in the Caucasian population. Three out of 200 (1.5%) HPA-1a-negative pregnant women were identified, detecting incompatibility between neonate and mother in two cases. Only one of the neonates required 16 PLT transfusion. In addition, other 3 cases of FNAIT were detected; one was due to incompatibility in the HPA-3 system, another in HPA-15 system, and the third case in the HPA-1 system. Molecular techniques implemented in this thesis for HPA genotyping have proven to be reliable and robust tools to be applied in large-scale genotyping studies and to study specific clinical situations, such as FNAIT. The efforts made in this thesis work for recruitment, characterization and registration of voluntary PLT donors culminated in the creation of the first sustainable source of PQTS for compatible transfusions in Argentina. Surprisingly, we identified a higher percentage of HPA-1a-negative donors compared to previous data of the Argentine population. This work constitutes the first report of low frequency HPA genotypes in a population of pregnant women and FNAIT cases confirmed by molecular evidence in Argentina, indicating the relevance of its early diagnosis. Given that the delay in detection of FNAIT could have serious consequences on fetuses and newborns, strategies to improve maternal, fetal and perinatal health, as well as prevention policies to reduce fetal and neonatal morbidity and mortality should focus on implementing programs to identify pregnancies at risk and thus, reduce complications related to thrombocytopenia in fetuses and newborns. Platelet (PLT) transfusion is necessary to prevent and treat haemorrhages in thrombocytopenic patients or those with severe platelet dysfunction. In Argentina, blood supplies from voluntary non‐remunerated blood donors remain dependent on family replacement donors since altruistic repetitive donations are exceptional. This is the main reason why PLT donors are very scarce. In this context, the implementation of a PLT donor recruitment program is essential to have a permanent source of PLTs to fulfil clinical needs. On the other hand, even though Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) caused by maternal alloimmunization against fetal PLT antigens inherited from the father but absent in the mother constitutes the main cause of primary haemorrhagic morbidity and mortality in fetuses and newborns, screening programs to detect pregnancies at risk have not been implemented in any country so far. The main objective of this study was to implement and validate molecular techniques for genotyping of human platelet antigens (HPA) in order to have local molecular tools and establish the first PQT-donor registry in Argentina. For this purpose, voluntary and altruistic blood donors who attended at the Fundación Banco Central de Sangre from July 2016 to July 2017 were recruited and their HPA genotype was characterized. In addition, in order to highlight the importance of diagnosing FNAIT in fetal and perinatal health care settings and demonstrate the usefulness of molecular tools in early diagnosis of this clinical entity, we analysed the frequency of HPA genotypes in 200 pregnant women going through the first semester of pregnancy and the incidence of FNAIT. The results of the implementation and verification of the molecular techniques correlated 100% with the expected reference results. A cohort of 500 donors was recruited and characterized, and the first registry of HPA-genotypes was elaborated. Likewise, 8/500 HPA- 1a negative donors (1.6%) were identified and allelic variants of the HPA-4b, -6b and -9b systems were described for the first time in Argentina. In the study of pregnant women, the alleles most frequently associated with FNAIT were detected in the Caucasian population. Three out of 200 (1.5%) HPA-1a-negative pregnant women were identified, detecting incompatibility between neonate and mother in two cases. Only one of the neonates required 16 PLT transfusion. In addition, other 3 cases of FNAIT were detected; one was due to incompatibility in the HPA-3 system, another in HPA-15 system, and the third case in the HPA-1 system. Molecular techniques implemented in this thesis for HPA genotyping have proven to be reliable and robust tools to be applied in large-scale genotyping studies and to study specific clinical situations, such as FNAIT. The efforts made in this thesis work for recruitment, characterization and registration of voluntary PLT donors culminated in the creation of the first sustainable source of PQTS for compatible transfusions in Argentina. Surprisingly, we identified a higher percentage of HPA-1a-negative donors compared to previous data of the Argentine population. This work constitutes the first report of low frequency HPA genotypes in a population of pregnant women and FNAIT cases confirmed by molecular evidence in Argentina, indicating the relevance of its early diagnosis. Given that the delay in detection of FNAIT could have serious consequences on fetuses and newborns, strategies to improve maternal, fetal and perinatal health, as well as prevention policies to reduce fetal and neonatal morbidity and mortality should focus on implementing programs to identify pregnancies at risk and thus, reduce complications related to thrombocytopenia in fetuses and newborns. 2024-10-05 Fil: Blanco, Sebastián. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Instituto de Virología Dr. José María Vanella; Argentina.

Introduction: Apheresis is a procedure where blood from a single donor is withdrawn, separated into red blood cells, plasma and platelets. Plateletpheresis is important in the transfusion therapy of cancer patients, reducing the chances of transfusion-related diseases and transfusion reactions. Objective: To present a comparative analysis of the apheresis collection procedures of a hemotherapy service between the years 2017 and 2018, the initial period of its implementation. Methods: 162 apheresis protocols from the blood collection sector of the Transfusion Unit of the University Hospital were used in this study. This is a retrospective, observational study, with a review of data from apheresis donation procedures. Results: 62 apheresis procedures were performed, totaling 200 blood components during the research period. The highest incidence of donors was male (93%) compared to female (7%). We identified 49 cases of adverse reactions to donation (30.2%), the most frequent being: hematoma at the puncture site (40.81%) and lip tingling (38.78%), followed by vasovagal reaction ( 16.33%). Conclusion: The implementation of platelet collection by apheresis in the hemotherapy service promoted greater support for the care of patients with high transfusion needs, agility and improvement in the quality of the blood component offered. Introducción: La aféresis es un procedimiento donde se extrae sangre de un solo donante, se separa en glóbulos rojos, plasma y plaquetas. La plaquetaféresis es importante en la terapia de transfusión de pacientes con cáncer, ya que reduce las posibilidades de enfermedades relacionadas con la transfusión y reacciones a la transfusión. Objetivo: Presentar un análisis comparativo de los procedimientos de recolección de aféresis de un servicio de hemoterapia entre los años 2017 y 2018, período inicial de su implementación. Métodos: en este estudio se utilizaron 162 protocolos de aféresis del sector de extracción de sangre de la Unidad de Transfusión del Hospital Universitario. Este es un estudio observacional retrospectivo, con una revisión de los datos de los procedimientos de donación por aféresis. Resultados: se realizaron 62 procedimientos de aféresis, totalizando 200 componentes sanguíneos durante el período de investigación. La mayor incidencia de donantes fue masculina (93%) frente a femenina (7%). Identificamos 49 casos de reacciones adversas a la donación (30,2%), siendo las más frecuentes: hematoma en el sitio de punción (40,81%) y hormigueo labial (38,78%), seguido de reacción vasovagal (16,33%). Conclusión: La implementación de la recolección de plaquetas por aféresis en el servicio de hemoterapia promovió mayor apoyo para la atención de pacientes con altas necesidades transfusionales, agilidad y mejoría en la calidad del hemocomponente ofrecido. Introdução: A aférese é um procedimento onde o sangue de um único doador é retirado, separado em hemácias, plasma e plaquetas. A plaquetaférese é importante na terapêutica transfusional de pacientes com câncer, diminuindo as chances de doenças relacionadas à transfusão e reações transfusionais. Objetivo: Apresentar uma análise comparada dos procedimentos de coleta por aférese de um serviço de hemoterapia entre os anos 2017 e 2018, período inicial de sua implantação. Métodos: 162 protocolos de aférese do setor de coleta de sangue da Unidade Transfusional do Hospital Universitário foram utilizados neste estudo. Trata-se, de um estudo retrospectivo, observacional, com revisão de dados dos procedimentos de doação por aférese. Resultados: 62 procedimentos por aférese foram realizados totalizando 200 hemocomponentes durante o período da pesquisa. A maior incidência de doadores foi do sexo masculino (93%) em comparação ao sexo feminino (7%). Identificou-se 49 casos de reações adversas à doação (30,2%), sendo as mais frequentes: hematoma em local de punção (40,81%) e formigamento labial (38,78%), seguindo de reação vaso-vagal (16,33%). Conclusão: A implantação da coleta de plaquetas por aférese no serviço de hemoterapia promoveu maior suporte ao atendimento de pacientes com alta necessidade transfusional, agilidade e melhoria na qualidade do hemocomponente ofertado.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq Programa Institucional de Incentivo à Qualificação Profissional - PIIQP Melanoma is a type of cancer that, when it develops into the metastatic form, is very aggressive and makes conventional antitumor treatments less effective. Activated platelets are involved in tumor progression through cellular interactions and secretion of nucleosides and nucleotides, such as ATP, ADP, and adenosine. The extracellular concentration of these substances is controlled by enzymes that make up the purinergic system and are present on the cell surface. Nucleotides and nucleoside interact with receptors on the surface of cells and platelets and are recognized as purinergic receptors. Clopidogrel bisulfate (CB) is na inhibitor of the P2Y12 purinergic receptor, so it can be used to inhibit platelet activation. Thus, this project aimed to investigate the effect of BC in vitro and in vivo on tumor progression and modulation of enzymes of the purinergic pathway (CD39, CD73, E-ADA) in platelets. The in vitro study was performed with B16-F10 cells treated with 7 concentrations of CB and assessed after 24h, 48h, and 72h. The in vivo study was conducted with mice (C57BL-6), which were divided into 4 groups: negative control (C); melanoma control (M); treated with CB (BC); with melanoma treated with BC (M+BC). Cancer induction in the groups with melanoma was performed by administration of B16-F10 cells by intraperitoneal route. After 2 days, treatment with BC at a dose of 30mg/kg/day was initiated by gavage for 12 days. At the end of this period, the animals were anesthetized and euthanized by exsanguination for evaluation of parameters such as tumor nodule count, organ weight, blood count, quantification of plasma biomarkers: lactate dehydrogenase (LDH); nitric oxide (ON); and reactive oxygen species (ROS), and assessment of the activity of enzymes of the purinergic system (NTPDase, 5'-nucleotidase, E-ADA) in platelets. In in vitro B16-F10 cultures, BC decreased proliferation in 72 h and increased cell cytotoxicity at doses greater than 30 μM. In vivo, the treatment decreased tumor nodule count, increased NO levels, and decreased LDH activity. However, BC treatment was not effective in reducing the systemic effects of induction, as reflected in blood count and organ weights. Higher activity of purinergic enzymes in platelets was also observed compared to the untreated groups. Thus, BC treatment appears to reduce potential alterations associated with tumor progression, suggesting a beneficial effect in the treatment of melanoma. O melanoma é um tipo de câncer que ao evoluir para a forma metastática apresenta grande agressividade e torna os tratamentos antitumorais tradicionais menos eficazes. As plaquetas ativadas participam da progressão tumoral, através das interações celulares e da secreção de nucleotídeos e nucleosídeo, assim como, ATP, ADP e adenosina. A concentração extracelular dessas substâncias é controlada por enzimas que compõem o sistema purinérgico e estão presentes na superfície celular. Nucleotídeos e nucleosídeos interagem com receptores presentes na superfície de células e plaquetas e são reconhecidos como receptores purinérgicos. O bissulfato de clopidogrel (BC) é um inibidor do receptor purinérgico P2Y12, podendo então ser utilizado para inibir a ativação das plaquetas. Assim, esse projeto teve como objetivo avaliar o efeito do BC in vitro e in vivo na progressão tumoral e na modulação das enzimas das vias purinérgicas (CD39, CD73, E-ADA) em plaquetas. O estudo in vitro foi conduzido com células B16-F10 tratadas com 7 concentrações de CB e avaliadas em 24h, 48h e 72h. O in vivo foi realizado com camundongos, C57BL-6, divididos em 4 grupos: controle negativo (C); controle melanoma (M); tratado com BC (BC); com melanoma tratado com BC (M+BC). A indução do câncer nos grupos com melanoma foi realizada a partir da administração de células B16-F10 via intraperitoneal. Após 2 dias, foi iniciado o tratamento com BC em 30mg/kg/dia por gavagem, durante 12 dias. Ao final deste período, os animais foram anestesiados e eutanasiados por exsanguinação para avaliação de parâmetros como: números de nódulos tumorais, peso dos órgãos, hemograma, quantificação de biomarcadores no plasma: lactato desidrogenase (LDH); óxido nítrico (ON); e espécies reativas de oxigênio (ROS) e avaliação da atividade de enzimas do sistema purinérgico (NTPDase, 5’-nucleotidase, E-ADA) em plaquetas. Nas culturas B16-F10 in vitro em 72h o BC reduziu a proliferação e aumentou a citotoxicidade das células em dosagens superiores a 30 μM. No in vivo o tratamento reduziu o número de nódulos tumorais, aumentou os níveis de NO e reduziu a atividade da LDH. No entanto, o tratamento com BC não foi eficiente em reduzir os efeitos sistêmicos da indução refletidos pelo hemograma e peso dos órgãos. Também foi observada uma maior atividade das enzimas purinérgicas das plaquetas quando comparadas aos grupos não tratados. Dessa forma, o tratamento com BC parece rreduzir possíveis alterações relacionadas à progressão tumoral, sugerindo um efeito benéfico no tratamento do melanoma.

Objective To present an innovative device that applies the double centrifugation method to obtain platelet-rich plasma (PRP), assessing whether there was an effective increase in the concentration of platelets. Method Ten volunteers underwent blood collection. The samples were separated in 20 ml syringes, sealed and subjected to the double centrifugation protocol at 1,100 revolutions per minute (rpm) for 15 minutes, resulting in the separation of red blood cells, plasma with platelets, and leukocytes. Then, 10 ml syringes were added to remove 9 ml, respecting the “buffy coat” parameter, collecting 8 ml above and 1 ml below for the second centrifugation and transferring again to the 20 ml syringe. The plasma was again centrifuged at 1,550 rpm for 10 minutes; as a result, it was divided into two parts: at the top, consisting of low platelet plasma (LPP), and at the bottom, by the platelet button. Part of the LPP was discarded, leaving only 3 ml with the platelet button. The cells were then counted. Results This innovative device was able to increase the concentration of platelets by almost three times compared with the baseline. In addition, the preparation time for the PRP was adequate, lasting only 35 to 40 minutes. Conclusions Platelet-rich plasma was successfully obtained by the double centrifuge protocol, allowing its clinical use. In addition, obtaining through the presented device promotes greater applicability in the preparation of PRP in specific centers, furthermore, being a quick and economical way to obtain PRP. Resumo Objetivo Apresentar um dispositivo inovador que aplique o método de centrifugação dupla para obter plasma rico em plaquetas (PRP), avaliando se houve um aumento efetivo na concentração de plaquetas. Método Dez voluntários foram submetidos a coleta de sangue. As amostras foram separadas em seringas de 20 mL, seladas e submetidas ao protocolo de centrifugação dupla a 1.100 revoluções por minuto (rpm) por 15 minutos, resultando na separação de hemácias, plasma com plaquetas e leucócitos. Em seguida, foram adicionadas seringas de 10 mL para remover 9 mL, tendo como parâmetro a "buffy coat", coletando 8 mL acima e 1 mL abaixo para a segunda centrifugação e transferindo novamente para a seringa de 20 mL. O plasma foi novamente centrifugado a 1.550 rpm por 10 minutos; como resultado, foi dividido em duas partes: na parte superior, consistindo em plasma pobre em plaquetas (PPP), e na parte inferior, pelo botão plaquetário. Parte do PPP foi descartada, restando apenas 3 mL com o botão de plaquetas. As células foram então contadas. Resultados Este dispositivo inovador foi capaz de aumentar a concentração de plaquetas em quase 3 vezes relação a linha de base. Além disso, o tempo de preparo do PRP foi adequado, com duração de apenas 35 a 40 minutos. Conclusões O PRP foi obtido com sucesso pelo protocolo de centrifugação dupla, permitindo seu uso clínico. Além disso, a obtenção através do dispositivo apresentado promove maior aplicabilidade no preparo do PRP em centros específicos, além de ser, uma forma rápida e econômica de obter PRP.

Our results do not support any effect of FVIII on platelet function in patients with severe HA treated under the regime of prophylaxis.

Dissertação (mestrado) — Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, 2022. Introdução: O tratamento de lesões crônicas acarreta elevados custos aos sistemas de saúde, como também reduz a qualidade de vida das pessoas por elas acometidas. Visando a melhoria no tratamento de lesões crônicas é possível que o uso da FLA proporcione resposta clínica favorável, com maior precocidade no reparo tecidual, uma vez que os concentrados plaquetários autólogos podem potencializar a estimulação do processo fisiológico da cicatrização e auxiliar na regeneração de diversos tecidos. Objetivo: Avaliar o efeito da aplicação tópica semanal da fibrina leucoplaquetária autóloga no processo de reparação de lesões crônicas. Metodologia: Trata-se de um estudo clínico experimental, controlado, randomizado, descritivo, comparativo e sem cegamento, realizado no Serviço Ambulatorial de Enfermagem em Estomaterapia (SAEE) do Hospital Universitário de Brasília, UnB – DF. O estudo foi composto por dois grupos, sendo eles: o grupo Controle (n=15) e o grupo Intervenção / FLA (n=15). Os parâmetros qualitativos e quantitativos das lesões de ambos os grupos eram obtidos pelo mesmo observador, uma vez por semana e ao longo de três meses. Nas análises qualitativas foram considerados os tecidos expostos (superficiais e/ou profundos), sua mensuração (área, perímetro e borda das lesões), as características macroscópicas das lesões e a evolução do desfecho (cura das lesões). Resultados: A análise dos dados mostrou que: 1) houve predomínio de mulheres em ambos os grupos, controle e FLA; 2) não houve diferenças entre os grupos quanto à faixa etária, índice de massa corporal, total de lesões, etiologia das lesões e presença de comorbidades; 3) o tratamento convencional ou FLA, bem como o tempo de tratamento não afetaram as características macroscópicas das lesões relativas à presença e intensidade da dor, odor, borda das lesões, área perilesão, exsudato; 4) o tratamento com a FLA aumentou o percentual de epitelização das lesões com 4, 8 ou 12 semanas de tratamento e com 8 semanas para o grupo controle; 5) o tratamento convencional não afetou o tecido de granulação, enquanto que no grupo tratado com a FLA houve maior percentual de tecido de granulação com 12 semanas; 6) não houve diferença na área das lesões para os indivíduos do grupo tratado convencionalmente, enquanto que para o grupo tratado com a FLA houve redução na área das lesões decorridos 4 ou 8 semanas do tratamento; 7) a FLA aumentou o percentual de indivíduos que tiveram redução na área das lesões, mas não alterou o tempo para o fechamento das lesões/cura até 12 semanas de tratamento. Conclusão: O conjunto dos resultados indicou que a fibrina leucoplaquetária autóloga favorece o processo de cicatrização/reparação de lesões crônicas vasculares antecipando a cura. Por se tratar de um tratamento de baixo custo e de performance potencialmente superior aos tratamentos convencionais, pode diminuir o quadro álgico dos indivíduos tratados com consequente melhoria na qualidade de vida desses pacientes. Introduction: The treatment of chronic injuries entails high costs for health systems, as well as reducing the life quality of people affected by them. Aiming at improving the treatment of chronic wounds, it is possible that the use of L-PRF provides a favorable clinical response, with greater precocity in tissue repair, since autologous platelet concentrates can potentiate the stimulation of the physiological healing process and assist in the regeneration of various tissues. Objective: Evaluate the effect of weekly topical application of Leukocyte- and Platelet-Rich Fibrin in the repair process of chronic wounds. Methodology: This is an experimental, controlled, randomized, descriptive, comparative and unblinded clinical study, carried out at the Outpatient Service of Nursing in Stomatherapy (SAEE) of the University Hospital of Brasília, UnB - DF. The study was composed of two groups, namely: Control group (n=15) and Intervention/L-PRF group (n=15). The qualitative and quantitative parameters of the wounds in both groups were obtained by the same observer, once a week and for three months. In the qualitative analysis, the exposed tissues (superficial and/or deep), their measurement (area, perimeter and edge of the wounds), the macroscopic characteristics of the wounds and the evolution of the outcome (healing of the wounds) were considered. Results: Data analysis showed that: 1) there was a predominance of women in both groups, control and L-PRF; 2) there were no differences between the groups in terms of age, body mass index, total number of wounds, etiology of lesions and presence of comorbidities; 3) conventional or L-PRF treatment, as well as treatment time, did not affect the macroscopic characteristics of the wounds regarding the presence and intensity of pain, odor, lesion edges, periwound area, exudate; 4) treatment with L-PRF increased the percentage of epithelialization of wounds at 4, 8 or 12 weeks of treatment and at 8 weeks for the control group; 5) the conventional treatment did not affect the granulation tissue, while in the group treated with L-PRF there was a higher percentage of granulation tissue at 12 weeks; 6) there was no difference in the wound’s area for individuals in the conventional treatment group, while for the group treated with L-PRF there was a reduction in the area of wounds after 4 or 8 weeks of treatment; 7) L-PRF increased the percentage of individuals who had a reduction in the wound area, but did not change the time for wound closure/healing up to 12 weeks of treatment. Conclusion: The set of results indicated that Leukocyte- and Platelet-Rich Fibrin favors the healing/repair process of chronic vascular lesions, anticipating healing. Because it is a low-cost treatment and potentially superior to conventional treatments, can reduce the pain of treated individuals with a consequent improvement in the quality of life of these patients.

Este artículo se encuentra disponible en la página web de la revista en la siguiente URL: https://www.frontiersin.org/articles/10.3389/fvets.2022.954516/full

Objectives: The most common disease of anus is hemorrhoids. The definition of external hemorrhoids suggests the acute phase, often characterized by thrombosis or edema. External thrombosed hemorrhoid is a specific complication. In this study, we aimed to investigate the effects of different platelet parameters in the presence of internal or external thrombosed hemorrhoids. Methods: Patients examined were divided into two groups: Group 1: Thrombosed hemorrhoids group (THG), Group 2: Hemorrhoidectomy group (HG). Demographic and clinical data were identified. In terms of laboratory findings, preoperative hemoglobin, hematocrit and all platelet parameters were recorded. Main results: Fifty-two patients in THG, and 75 patients in HG were included in the study. In female sex and young age group, the risk of developing thrombosed hemorrhoids was statistically significant (p= 0.029, p= 0.039, respectively). When the platelet parameters were evaluated; while PDW was higher in THG (p= 0.008), any significant difference could not found in all other values (p> 0.05). Thrombosed hemorrhoids were mostly (59.25%) found to be located in the left laterodorsal part of anus. Conclusion: Internal hemorrhoids are frequently seen in the ages of 45–65 with similar rates in both sexes, while external thrombosed hemorrhoids occur at a younger age ( 0,05). A maioria das hemorróidas trombosadas (59,25%) localizava-se na região lateral-dorsal esquerda do ânus. Conclusão: As hemorróidas internas são frequentemente vistas nas idades de 45 a 65 anos com taxas semelhantes em ambos os sexos, enquanto as hemorróidas externas trombosadas ocorrem em uma idade mais jovem (

O objetivo deste trabalho foi avaliar a estabilidade dos parâmetros hematológicos em diferentes tempos de armazenamento e temperatura. Utilizou-se sangue total de 7 cães (Canis lupus familiaris), hígidos. As amostras foram divididas em 2 alíquotas de 2 mL acondicionadas em tubos de EDTA- K3, conservadas em temperatura ambiente a 22ºC e sob refrigeração 4ºC, nos seguintes intervalos de tempo T0h, T6h, T12h, T24h, T48h. Os exames foram realizados em analisador hematológico SDH-3 VET®. As variáveis hematológicas se mostraram estáveis ao longo do tempo com exceção das hemácias que sofreram variação no T12h em temperatura ambiente e as plaquetas que no T6h em temperatura ambiente e sob refrigeração mantiveram-se abaixo do intervalo de referência. Conclui-se que as amostras de cães analisados pela tecnologia de impedância, mais especificamente pelo equipamento labtest SDH-3 VET®, mostraram-se estáveis por 48 horas para contagem de hemácias, concentração de hemoglobina, hematócrito e leucócitos totais, porém a contagem de plaquetas deverá ser realizada com amostras colhidas em até 6 horas.

SUMMARY BACKGROUND Easily accessible, inexpensive, and widely used laboratory tests that demonstrate the severity of COVID-19 are important. Therefore, in this study, we aimed to investigate the relationship between mortality in COVID-19 and platelet count, Mean Platelet Volume (MPV), and platelet distribution width. METHODS In total, 215 COVID-19 patients were included in this study. The patients were divided into two groups. Patients with room air oxygen saturation < 90% were considered as severe COVID-19, and patients with ≥90% were considered moderate COVID-19. Patient medical records and the electronic patient data monitoring system were examined retrospectively. Analyses were performed using the SPSS statistical software. A p-value

Introduction: Although primary immune thrombocytopenia (ITP) is rare in childhood, it is the most frequent cause of thrombocytopenia. There have been attempts to establish risk factors to predict the progression of the disease in order to optimise its management, which has changed in recent years due to, among other reasons, specialised care. Material and methods: A retrospective, observational and analytical study was conducted on patients diagnosed with ITP over a 3-year period in a Paediatric Haematology specialist clinic. Results: From the epidemiological, clinical and analytical point of view, the characteristics of this group are similar to others. Most of the patients (23/31, 74.2 %) had ITP for less than 12 months, with there being no serious complications related to the disease or the treatment received. It was established that risk factors were related to being slowly evolving (lower event-free survival (EFS)) with no statistical significance, female gender, age over 10 years, leukopenia absence of initial severe thrombocytopenia, and non-specialised care. The absence of a history of infection was significantly related to a lower EFS. Conclusions: The epidemiological and analytical risk factors for a slowly evolving ITP are the same that described in the literature. Patients treated before the beginning of specialised care also had a lower EFS. These data seem to support the current recommendation that rare diseases should be managed in specialised units. Resumen: Introducción: La trombopenia inmune primaria (PTI) es poco frecuente en la infancia, pero es la causa más habitual de trombopenia. Se han intentado establecer factores de riesgo para predecir su evolución, con el objetivo de poder optimizar su manejo, que se ha modificado en los últimos años, debido entre otros factores, a una atención más especializada. Material y métodos: Estudio retrospectivo, observacional y analítico de los pacientes con PTI, en un periodo de 3 años, en una consulta especializada en Hematología Pediátrica. Resultados: Desde el punto de vista epidemiológico, clínico y analítico, las características de esta serie son similares a las de otros grupos. La mayoría de los pacientes (23/31; 74.2 %) presentaron una PTI de duración menor de 12 meses, sin complicaciones graves relacionadas con la enfermedad ni con el tratamiento. Se establecieron como factores de riesgo relacionados con una evolución tórpida (supervivencia libre de eventos (SLE) menor), sin alcanzar la significación estadística, el sexo femenino, la edad mayor de 10 años, la leucopenia, la ausencia de trombopenia grave inicial y la atención no especializada. La ausencia de antecedente de infección se relacionó significativamente con una SLE menor. Conclusiones: Los factores de riesgo de evolución tórpida de PTI epidemiológicos y analíticos de este estudio coinciden con los descritos en la literatura. Presentaron una SLE menor los pacientes tratados antes del inicio de la atención especializada. Estos datos parecen apoyar la recomendación actual de que las enfermedades poco frecuentes, como ésta, se controlen en unidades especializadas.

Aim: The use of recombinant human platelet-derived growth factor–BB (rhPDGF) has received Food and Drug Administration approval for the treatment of periodontal and orthopedic bone defects and dermal wound healing. Many studies have investigated its regenerative potential in a variety of other oral clinical indications. The aim of this systematic review was to assess the efficacy, safety, and clinical benefit of recombinant human platelet-derived growth factor (rhPDGF) use for alveolar bone and/or soft tissue regeneration. Material and Methods: Comprehensive electronic and manual literature searches according to the PRISMA guidelines were performed to identify interventional and observational studies evaluating the regenerative applications of rhPDGF-BB. The primary outcomes were the safety, efficacy, and overall clinical benefit of rhPDGF use in oral regenerative procedures. Results: Sixty-three human clinical studies (mean ± SD follow-up period of 10.7 ± 3.3 mo) were included in the qualitative analysis. No serious adverse effects were reported in any of the 63 studies, aside from the postoperative complications routinely associated with surgical therapy. Use of rhPDGF was shown to be beneficial when combined with allografts, xenografts, and alloplasts (the latter tricalcium phosphate [β-TCP]) for the treatment of periodontal defects and gingival recession. The use of rhPDGF also led to favorable clinical outcomes when combined with allografts or xenografts for guided bone regeneration (GBR) and alveolar ridge preservation. While favorable clinical results support the use of the combination of rhPDGF plus allograft or xenograft for GBR, ARP, and sinus floor augmentation, current data support the use of rhPDGF and alloplasts (e.g., β-TCP) only in periodontal defects and gingival recession. Conclusions: Based on the clinical evidence, rhPDGF is safe and provides clinical benefits when used in combination with bone allografts, xenograft, or β-TCP for the treatment of intrabony and furcation periodontal defects and gingival recession or when used with allografts or xenograft for GBR and ARP (PROSPERO CRD42020142446). Knowledge Transfer Statement: Clinicians should be aware that rhPDGF is a safe and effective approach for the treatment of intrabony and furcation periodontal defects and gingival recession or when used with allografts or xenograft for bone regeneration and alveolar ridge preservation. With consideration of cost and patient preference, this result could lead to more appropriate therapeutic decisions.

IntroductionPlatelet-rich plasma (PRP) is an autologous plasma with platelet (PLT) concentration above that of whole blood (WB). PLTs contain growth factors (GFs) that promote tissular repair.ObjectivesTo determine and compare the concentrations of PLT, red blood cells (RBC) and white blood cells (WBC) between WB samples, PRP and platelet poor plasma (PPP) samples; and to analyze the concentrations of platelet-derived growth factor BB (PDGF-BB) and transforming growth factor β1 (TGF-β1) in the PRP and PPP of healthy adult cats using a standardized protocol with PRGF®-Endoret® characteristics.Material and MethodsWB was collected from 30 cats. PRP was obtained following three centrifugation protocols using PRGF®-Endoret® technology: 255, 260, and 265 g for 10 min each. The cellular components, RBC, WBC, PLT, and the concentrations of PDGF-BB and TGF-β1 in the PRP and PPP fractions were determined for each protocol.ResultsPLTs in the PRP fraction were statistically higher than WB, with no statistical differences between PPP and WB. In PRP fraction, PLT concentration was increased 1.4 times on average at 255 g; 1.3 times at 260 g and, 1.5 times at 265 g without statistical differences among them. The mean platelet volume (MPV) was significantly higher in WB compared to PRP and PPP fractions without significant differences between protocols. Compared to WB, the number of RBCs and WBCs was reduced by 99% and by more than 95% in PRP and PPP respectively, without significant differences between protocols. PDGF-BB concentrations were statistically higher in PRP than in PPP fractions, however, TGF-ß1 concentrations did not vary between fractions at 260 g. Comparing the three protocols within PRP and PPP fractions, no differences in PDGF-BB and TGF-ß1 concentrations were observed.Clinical RelevanceThe study shows scientific evidence regarding the obtention of PRP in cats using the PRGF®-Endoret® technology for the quantification of PDGF-BB and TGF-ß1. At 265 g for 10 min, PLT concentration was increased 1.5 times with unnoticeable erythrocytes and leukocytes in the samples. These results clearly show that the PRGF®-Endoret® methodology is suitable to obtain PRP in cats. Further studies are needed to determine the clinical efficacy of the obtained PGRF in the treatment of different pathologies in cats.

El servicio de Hemoterapia y Banco de Sangre proporciona, en forma oportuna, estos componentes sanguíneos que son las plaquetas, para ser transfundidas a aquellos pacientes que requieren trasplante de médula ósea, aquellos con diferentes hemopatías y otras patologías mediante concentrados de plaquetas simples (CPs) y los CPA, siendo; estos últimos son considerados con más beneficio para el paciente, porque contienen un número mucho mayor de plaquetas por unidad y también por ser de un único donante. Si se trata de procesos hemorrágicos, las plaquetas ejercen acción sobre los vasos sanguíneos afectados y forman el tapón plaquetario, gracias a su capacidad para agregarse unas con otras, lo que permite prevenir la pérdida de sangre. Una vez que se ha sido reparada la lesión, las plaquetas retraen el coágulo y permiten la fluidez de la sangre de forma libre en el vaso sanguíneo.

La enfermedad de Parkinson (EP) es una enfermedad neurodegenerativa cuyo diagnóstico sigue siendo clínico, evidenciándose a través de sus manifestaciones clínicas, cuando ya ha ocurrido una gran destrucción neuronal. La dopamina (DA) es el principal neurotransmisor involucrado en la patogénesis de la EP y su déficit es la principal causa de sus síntomas y signos. Sus principales metabolitos, el DOPAC y especialmente el DOPAL, son extremadamente tóxicos y, por tanto, deben ser almacenados en el interior de las vesículas secretoras (VS) de las neuronas dopaminérgicas. Se ha observado que tanto las VS de estas neuronas como los gránulos densos de las plaquetas comparten mecanismos similares de acumulación de aminas biógenas: DA y serotonina (5-HT), respectivamente. Estudiar la capacidad de captación, acumulación y liberación de 5-HT en plaquetas de sangre periférica podría correlacionarse con lo que sucede a nivel central en las neuronas dopaminérgicas. Este trabajo se ha centrado en dichas tareas, reconvocando para ello a voluntarios sanos con análisis de 5-HT en plaquetas alterado que participaron entre 2019 y 2021 en el estudio llevado a cabo por nuestro laboratorio, además de reclutar a otros nuevos voluntarios, tanto clínicamente sanos como a pacientes con EP. Posteriormente, se realizaron diferentes experimentos de captación y liberación de 5-HT en el laboratorio para estudiar el comportamiento de la 5-HT en estos contextos y compararlos con pacientes con EP. Así, a través de los citados ensayos podrían encontrarse marcadores preclínicos de la EP, constituyendo el análisis funcional de 5-HT en plaquetas un método de diagnóstico precoz de esta enfermedad. Parkinson's disease (PD) is a neurodegenerative disease whose diagnosis remains clinical, evidenced by its clinical manifestations, when a great neuronal destruction has already occurred. Dopamine (DA) is the main neurotransmitter involved in the pathogenesis of PD and its deficiency is the main cause of its symptoms and signs. Its main metabolites, DOPAC and especially DOPAL, are extremely toxic and, therefore, must be stored inside the secretory vesicles (VS) of dopaminergic neurons. It has been observed that both the VS of these neurons and the dense granules of platelets share similar mechanisms for the accumulation of biogenic amines: DA and serotonin (5-HT), respectively. Studying the uptake, accumulation and release capacity of 5-HT in peripheral blood platelets could be correlated with what happens centrally in dopaminergic neurons. This work has focused on these tasks, reconvening healthy volunteers with altered platelet 5-HT analysis who participated between 2019 and 2021 in the study carried out by our laboratory and also recruiting other new volunteers, both clinically healthy and patients with PD. Subsequently, different 5-HT uptake and release experiments were performed in the laboratory to study the behavior of 5-HT in these contexts and compare them with patients with PD. Thus, through the aforementioned tests, preclinical markers of PD could be found, constituting the functional analysis of 5-HT in platelets a method of early diagnosis of this disease.

O presente trabalho foi realizado com apoio da Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - Brasil (CAPES) - C?digo de Financiamento 001. Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2022-11-29T22:32:10Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) daniel_macedo_lucena.pdf: 1339816 bytes, checksum: fa5d32d43f50b062fda94ef3bfb896ef (MD5) Approved for entry into archive by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2022-11-29T22:32:56Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) daniel_macedo_lucena.pdf: 1339816 bytes, checksum: fa5d32d43f50b062fda94ef3bfb896ef (MD5) Made available in DSpace on 2022-11-29T22:32:56Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) daniel_macedo_lucena.pdf: 1339816 bytes, checksum: fa5d32d43f50b062fda94ef3bfb896ef (MD5) Previous issue date: 2022 Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) A CoViD-19 ? uma doen?a que teve seus primeiros casos na cidade de Wuhan na China em dezembro de 2019, sendo causada pela infec??o pelo coronav?rus da s?ndrome respirat?ria aguda grave 2 (SARS-CoV-2). Essa doen?a se espalhou por todo o mundo causando, em alguns casos, problemas respirat?rios e de coagula??o, em decorr?ncia de uma resposta inflamat?ria exacerbada, levando diversos indiv?duos infectados ao ?bito. Estudos indicam que indiv?duos com obesidade possuem maior chance de desenvolver a CoViD-19 grave, tendo problemas respirat?rios e de coagula??o mais severos. Isso possa ocorrer devido ao ac?mulo de tecido adiposo, que pode contribuir para um ambiente pr?-inflamat?rio agravado e de maior replica??o viral. Al?m disso, indiv?duos com obesidade geralmente apresentam outras comorbidades e possuem complica??es respirat?rias, logo esses indiv?duos s?o mais vulner?veis ? infec??o do pelo SARS-CoV-2. Nesse estudo foram comparados marcadores inflamat?rios (contagem de leuc?citos, neutr?filos, linf?citos, mon?citos, eosin?filos, bas?filos) e de coagula??o como o tempo de protrombina e tromboplastina parcialmente ativada (TP e APTT) e contagem de plaquetas, entre indiv?duos eutr?ficos e indiv?duos com sobrepeso e obesidade com CoViD-19 leve ou grave durante a fase aguda da doen?a. A gravidade da CoViD-19 foi determinada de acordo com os crit?rios da Organiza??o Mundial de Sa?de. Participaram do estudo 98 volunt?rios, sendo desses 63 com CoViD-19 leve e 35 com CoViD-19 grave. Trinta e dois pacientes eram eutr?ficos e 66 tinham sobrepeso ou obesidade. Nossos resultados mostram que a contagem de neutr?filos foi maior e a de linf?citos menor (p < 0,05, Anova two-way, com post hoc de Sidak) nos pacientes com CoViD-19 grave, independente do excesso de peso. J? a contagem de mon?citos e de plaquetas foi menor apenas nos pacientes com excesso de peso com CoViD-19 grave comparados aos casos com a forma leve da doen?a (p < 0,05, Anova two-way, com post hoc de Sidak). Conclu?mos com esse estudo que existem diferen?as de percentual e contagem de c?lulas circulantes relacionadas a resposta imunol?gica e de coagula??o entre indiv?duos com CoViD-19 leve e CoViD-19 grave na fase aguda da doen?a, e que o sobrepeso e obesidade contribuem para altera??es espec?ficas na CoViD-19 grave. Disserta??o (Mestrado) ? Programa Multic?ntrico de P?s-gradua??o em Ci?ncias Fisiol?gicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2022. CoViD-19, the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2), had its first cases in the city of Wuhan in China in December 2019. It had spread throughout the world, causing, in some cases, respiratory and clotting problems, as the result of an exacerbated inflammatory response, leading many infected individuals to death. Studies indicate that individuals with obesity are more likely to develop severe CoViD-19, having more severe respiratory and clotting problems. It is hypothesized that this may be due to the accumulation of adipose tissue, which may contribute to an exacerbated pro-inflammatory environment and increased viral replication. In addition, individuals with obesity usually have other comorbidities and respiratory complications, so these individuals are more vulnerable to SARS-CoV-2 infection. In this study, inflammatory markers (leucocyte, neutrophil, lymphocyte, monocyte, eosinophil and basophil counts) and coagulation markers, such as prothrombin and partially activated thromboplastin time and platelet count, were compared between eutrophic and individuals with overweight and obesity with mild or severe CoViD-19 during the acute phase of the disease. The severity of CoViD-19 was determined according to World Health Organization criteria. A total of 98 volunteers participated in the study, of which 63 had mild CoViD-19 and 35 had severe CoViD-19. Thirty-two patients were eutrophic and 66 were overweight or had obesity. Our results show that neutrophil counts were higher, and lymphocyte were lower (p < 0.05, two-way ANOVA, Sidak's post hoc) in patients with severe CoViD-19, regardless of weight excess. On the other hand, monocyte and platelet counts were lower only in patients with overweight/obesity with severe CoViD-19 compared to cases with the mild form of the disease (p < 0.05, two-way ANOVA, Sidak's post hoc). We conclude from this study that there are differences in the percentage and counts of circulating cells related to the immune and coagulation response between individuals with mild and severe CoViD-19 in the acute phase of the disease, and that overweight and obesity contribute to specific changes in severe Covid-19.

Las plaquetas se emplean en distintos ámbitos clínicos por su capacidad de detener hemorragias, pero también por participar en inflamación y regeneración de heridas. En esta tesis doctoral se evalúa el proteoma de las vesículas extracelulares liberadas por los concentrados de plaquetas durante el almacenamiento con el fin de identificar marcadores de lesión plaquetaria. Además, se incluye un exhaustivo estudio proteómico del secretoma liberado por las membranas de fibrina ricas en plaquetas y leucocitos (L-PRF) empleadas para acelerar la cicatrización de heridas. A su vez se analiza el efecto del secretoma sobre fibroblastos, osteoblastos y células madre mesenquimales, implicados en procesos de regeneración de heridas, aportando conocimiento sobre el potencial terapéutico de las membranas L-PRF. 2023-02-23

La enfermedad de Parkinson idiopática (EP) es el síndrome parkinsoniano más común en la población, sin embargo, a pesar de su frecuencia, actualmente su diagnóstico sigue siendo clínico y por tanto, bastante tardío, pues cuando aparece la clínica motora ya existe una gran destrucción neuronal. En la patogenia de la EP están implicados la dopamina (DA) y sus principales metabolitos, DOPAC y DOPAL. Estas sustancias son citotóxicas, por lo que es necesario que sean almacenadas dentro de vesículas secretoras (VS) en las neuronas dopaminérgicas. Se ha evidenciado que uno de los posibles inicios de esta enfermedad puede ser un aumento de DA en el citosol neuronal debido a una incorrecta acumulación en dichas VS. La correcta captación y acumulación de aminas biógenas en VS se consigue gracias a la acción de transportadores vesiculares, que son comunes a otros gránulos de secreción de células periféricas como las plaquetas y su neurotransmisor, la serotonina (5-HT). Con este hecho y, dada la imposibilidad de utilizar neuronas humanas, se propone el estudio del comportamiento de la 5-HT en plaquetas como método diagnóstico de la EP. Por otra parte, existen numerosos estudios que demuestran el inicio de EP en sujetos que presentaban síntomas no motores (SNM), años antes de la aparición de los síntomas motores (SM). El objetivo del presente trabajo es correlacionar los resultados del denominado “test de serotonina” en plaquetas con la presencia o no de SNM en sujetos con EP y sanos. De forma que se podría empezar a demostrar la eficacia de esta prueba como método diagnóstico precoz de la EP. Idiopathic Parkinson's disease (PD) is the most common parkinsonian syndrome in the population, however, despite its frequency, nowadays it's diagnosis is still clinical and therefore late, because when it shows up the motor clinic, there is already a large neuronal destruction. In PD pathogenesis are involved dopamine (DA) and its principal metabolites, DOPAC and DOPAL. These substances are cytotoxic, so it is necessary to be stored inside secretory vesicles (SV) in dopaminergic neurons. It has been shown that one of the possible onsets of this disease may be an increase of DA in the neuronal cytosol due to incorrect accumulation in said SV. The correct catchment and accumulation of biogenic amines inside SV is achieved thanks to the action of vesicle transports, which are common in other secretory granules in peripheral cells, like platelets and its neurotransmitter, the serotonin (5-HT). Taking into account this and the impossibility to use human neurons, it is proposed the use of 5-HT concentration in platelets as a diagnosis method of PD. On the other hand, there are some studies that demonstrate the onset of PD in subjects who presented non-motor symptoms (NMS), years before the onset of the motor symptoms (MS). The goal of this study is to correlate results of the so-called “platelet serotonin test” with the presence or absence of NMS in subjects with PD and healthy ones. So that it could start to show the effectiveness of this test as an early diagnosis method for PD.

Introducción: Las lesiones endoperiodontales son patologías que afectan a la pulpa y al tejido periodontal originadas por trauma y/o iatrogenia, para estas lesiones se muestra que el uso del plasma rico en plaquetas como terapia alternativa, promueve e induce los procesos de cicatrización por su composición celular rico en factores de crecimiento. Objetivo: Determinar el efecto del plasma rico en plaquetas como tratamiento alternativo para los defectos intraóseos en pacientes con lesiones endoperiodontales a partir de una revisión sistemática. Materiales y métodos: Se realizó una revisión sistemática, que incluyo metaanálisis y revisiones sistemáticas, se recopilo información a partir de artículos reportados en diferentes bases de datos. Se incluyeron metaanálisis y revisiones sistemáticas que estuvieran relacionadas con el efecto del plasma rico en plaquetas en lesiones endoperiodontales con defectos intraóseos. Se evaluó la calidad metodológica d ellos artículos utilizando la herramienta AMSTAR. Resultados: En el presente estudio se identificaron 40 documentos, nueve artículos cumplieron con los criterios de inclusión. En cuanto a la calidad metodológica se encontró que tres metaanálisis incluidas son de alta calidad metodológica y bajo nivel de sesgo. Conclusión: De los artículos, se pudo evidenciar que la efectividad del plasma rico en plaquetas en lesiones endoperiodontales con defectos intraóseos tiene resultados favorables, pero se concluye que la información sobre la temática no es suficiente debido a los pocos antecedentes en investigación encontrados. Introduction: Endoperiodontal lesions are pathologies affecting the pulp and periodontal tissue caused by trauma and/or iatrogenesis, for these lesions it is demonstrated that the use of platelet-rich plasma as an alternative therapy promotes and induces healing processes due to its cellular composition rich in growth factors. Objective: the main objective is to determine the effect of platelet-rich plasma as an alternative treatment for intraosseous defects in patients with endoperiodontal lesions on the basis of a systematic review. Materials and methods: First of all, a systematic review was carried out, including meta-analyses and systematic reviews, subsequently, information was collected from articles reported in different databases. In addition, meta-analyses and systematic reviews were included which were related to the effect of platelet-rich plasma on endoperiodontal lesions with intra-osseous defects. Finally, the methodological quality of articles was evaluated using the AMSTAR tool. Results: Forty papers were identified in the present study, nine articles met the inclusion criteria. In terms of methodological quality, three meta-analyses included were found to be of high methodological quality and low bias. Conclusion: From the articles, it could be evidenced that the effectiveness of platelet-rich plasma in endoperiodontal lesions with intra-osseous defects has favourable results, however, it is concluded that the information on the subject is not sufficient due to the few research precedents found. Odontólogo http://www.ustabuca.edu.co/ustabmanga/presentacion Pregrado

Yeast β-D-Glucans are polysaccharides consisting of a central linear skeleton of glucose units linked at the β (1-3) position and side chains joined by β (1-6) linkages. These polymers are important biological response modifiers and have several biological effects beneficial to health. Therefore, there is great interest in its derivatives, especially in the carboxymethylated form, which demonstrates antioxidant, immunostimulant, antiplatelet, and vascular function modulating action. However, its action on cardiovascular function is still poorly understood, mainly in hypertension. Therefore, this study aimed to investigate the effects of Carboxymethyl-glucan (CMG) from Saccharomyces cerevisiae on blood pressure, vascular function, autonomic modulation, platelet aggregation, and oxidative stress in spontaneously hypertensive rats (SHR). All experimental protocols were approved by the UFPB's Ethics Committee on Animal Use (CEUA 087/2017). Male SHR and their normotensive Wistar Kyoto (WKY) controls were assigned to groups (n=8): WKY control (WKY CT); WKY CMG 60 mg/kg; SHR control (SHR CT); SHR CMG 20 mg/kg and SHR CMG 60 mg/kg. The animals were treated for four weeks at doses of 20 and 60 mg/kg orally, and the controls received saline. At the end of treatment, weight gain, biochemical parameters, blood pressure levels, baroreflex sensitivity, and sympathetic tone participation were evaluated. Then, the animals were euthanized for vascular reactivity tests, platelet aggregation evaluation, histological, morphometric, and antioxidant capacity analyses. The results showed that CMG treatment decreased the weight gain in SHR CMG 60 mg/kg, and changed lipid profile and renal function, with a reduction in urea. Only in the SHR CMG 60 mg/kg group was observed a significant reduction in mean arterial pressure. However, the two doses tested promoted a reduction in systolic and diastolic blood pressure, without changing heart rate in the SHR groups, and also decreased cardiac hypertrophy.Modulation in baroreflex gain was observed, promoting improved response in SHR CMG 60 mg/kg animals, and decreased sympathetic tone involvement in this group. As for vascular function, improvement in the endothelium dependent vasorelaxant response assessed by acetylcholine (ACh) was verified in SHR CMG 20 mg/kg and SHR CMG 60 mg/kg groups. In the vasorelaxation induced by sodium nitroprusside (SPN), an improved response was observed in the WKY CMG 60 mg/kg animals. Platelet aggregation studies demonstrated lower platelet aggregation in the SHR CMG 60 mg/kg group compared to the SHR CT, when induced by adenosine diphosphate (ADP). Oxidative stress analyses showed that although SHR CT animals had significantly higher levels of reactive oxygen species (ROS) compared to WKY CT, CMG was not able to promote ROS reduction. These findings suggest that CMG improves vascular function in SHR animals, demonstrating antihypertensive action through baroreflex via negative modulation of sympathetic tone, and has platelet antiaggregant property. Thus, CMG presents itself as a potential strategy for the management of arterial hypertension. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES Fundação de Apoio à Pesquisa do Estado da Paraíba - FAPESQ As β-D-Glucanas de levedura são polissacarídios constituídos por um esqueleto linear central de unidades de glicose ligadas na posição β (1-3) e cadeias laterais unidas por ligações β (1-6). Esses polímeros são importantes modificadores de resposta biológica e possuem diversos efeitos biológicos benéficos a saúde. Por isso, há grande interesse em seus derivados, principalmente na forma carboximetilada, que demonstra ação antioxidante, imunoestimulante, antiplaquetária e moduladora da função vascular. Entretanto, sua ação sobre a função cardiovascular ainda é pouco compreendida, principalmente na hipertensão. Diante disso, o estudo buscou investigar quais os efeitos da Carboximetil-glucana (CMG) da Saccharomyces cerevisiae sobre a pressão arterial, função vascular, modulação autonômica, atividade plaquetária e estresse oxidativo em animais espontaneamente hipertensos (SHR). Todos os protocolos experimentais foram aprovados pelo Comitê de Ética no Uso de Animais da UFPB (CEUA 087/2017) Ratos machos SHR e seus controles normotensos Wistar Kyoto (WKY) foram distribuídos em grupos (n=8): WKY controle (WKY CT); WKY CMG 60 mg/kg; SHR controle (SHR CT); SHR CMG 20 mg/kg e SHR CMG 60 mg/kg. Os animais foram tratados durante quatro semanas nas doses de 20 e 60 mg/kg por via oral, e os controles receberam solução salina. Ao final do tratamento, foram avaliados o ganho de peso, parâmetros bioquímicos, os níveis pressóricos, a sensibilidade do barorreflexo e a participação do tônus simpático. Em seguida, os animais foram eutanasiados para testes de reatividade vascular, avaliação da agregação plaquetária, análises histológica, morfométrica e da capacidade antioxidante. Os resultados mostraram que o tratamento com CMG reduziu o ganho de peso no grupo SHR CMG 60 mg/kg, alterou o perfil lipídico e a função renal, com redução na ureia. Apenas no grupo SHR CMG 60 mg/kg foi observado redução significativa na pressão arterial média. No entanto, as duas doses testadas promoveram redução na pressão arterial sistólica e diastólica, sem alterar a frequência cardíaca nos grupos SHR, e ainda diminuiu a hipertrofia cardíaca. Foi observado modulação no ganho do barorreflexo, promovendo melhora na resposta dos animais SHR CMG 60 mg/kg, e diminuição na participação do tônus simpático nesse grupo. Quanto à função vascular, foi constatada melhora na resposta vasorrelaxante dependente de endotélio avaliada pela acetilcolina (ACh) nos grupos SHR CMG 20 mg/kg e SHR CMG 60 mg/kg. No vasorrelaxamento induzido pelo nitroprussiato de sódio (NPS), observou-se melhora na resposta no grupo WKY CMG 60 mg/kg. Os estudos de agregação plaquetária demonstraram menor agregação plaquetária no grupo SHR CMG 60 mg/Kg em relação ao SHR CT quando induzido por difosfato de adenosina (ADP). As análises de estresse oxidativo mostraram que, apesar de os animais SHR CT apresentarem significativamente maiores níveis de espécies reativas de oxigênio (ROS) comparados aos WKY CT, a CMG não foi capaz de promover a redução de ROS. Esses achados sugerem que a CMG melhora a função vascular de animais SHR, demonstrando ação anti-hipertensiva através do barorreflexo via modulação negativa do tônus simpático, e possui propriedade antiagregante plaquetária. Assim, a CMG se apresenta como potencial estratégia para o manejo da hipertensão arterial.

Introduction:Anabolic-androgenic steroids (AAS) modify the physiological functioning of the cardiovascular system and have possible effects on the origin of cardiovascular thrombosis.Objective:To determine the impact of the testosterone metabolite on platelet quantification in ORX rats with or without DHT replacement.Material and methods:24 male 45-day-old Wistar rats underwent orchidectomy with a simple scrotal incision. At 2.5 months of age, the 24 rats were divided into 4 study groups. Half of the 12 male ORX rats received hormone replacement with dihydrotestosterone propionate (DHT) at a 2 mg/kg dose via subcutaneous injection for 7 days and the other half received a physiological solution (0.9% NaCl). The same occurred in the 12 non-ORX males (SHAM). After 7 days of the administration, blood was collected by orbital puncture, and platelet quantification was performed.Results:A significant difference (ANOVA, p < 0.005) was found between the 4 groups. When performing the Dunn Method, a significant difference (p < 0.05) was found in the endogenous administration of DHT between Sham rats and rats ORX + 0.9% NaCl but not with ORX + DHT.Conclusions:DHT induces an increase in platelet quantification inrats Sham and not in ORX rats with DHT, which may affect the increase in platelet quantification. Introducción:Los esteroides androgénicos anabólicos (EAA) modifican el funcionamiento fisiológico del sistema cardiovascular y tienen posibles efectos en el origen de trombosis cardiovascular.Objetivo:Determinar el efecto del metabolito de la testosterona en la cuantificación de plaquetas en ratas ORX con o sin reemplazo de DHT.Material y métodos:24 ratas macho wistar de 45 días de edad fueron sometidas a orquidectomía con una incisión simple escrotal. A los 2 meses y medio de edad, las 24 ratas fueron divididas en 4 grupos de estudio. De las 12 ratas macho ORX, la mitad recibió reemplazo hormonal con propionato de dihidrotestosterona (DHT) a dosis de 2 mg / kg a través de una inyección subcutánea durante 7 días y la otra mitad recibió solución fisiológica (0.9% NaCl). De la misma manera ocurrió en los 12 machos no ORX (SHAM). Después de 7 días de administración, se extrajo sangre mediante punción orbital y se realizó la cuantificación de plaquetas.Resultados:Se encontró una diferencia significativa (ANOVA, p < 0.005) entre los 4 grupos. Al realizar el Método Dunn, se encontró una diferencia significativa (p < 0.05) en la administración endógena de DHT entre ratas Sham y ratas ORX + NaCl al 0.9% pero no con ORX + DHT.Conclusiones:DHT induce un aumento en la cuantificación de plaquetas en ratas Sham y no en ratas ORX con DHT, lo que puede afectar el aumento en la cuantificación de plaquetas.

Surgicаl procedures аre interventions thаt аim to rehаbilitаte function аnd physiology of some follow-up, using techniques thаt аre, in most cаses, very invаsive аnd thаt generаte а situаtion of discomfort to the pаtient. As а result, а series of studies on surgicаl аdditives thаt аssist in the process of curing procedures, including dentаl procedures, begаn. Fibrin-rich plаsmа (PRF) wаs developed by Choukroun for use in orаl аnd mаxillofаciаl surgery аnd, in the field of dentistry, it hаs severаl domаins of аpplicаtion, such аs mаxillаry sinus lifting, аlveolаr grаft, аesthetic periodontаl surgery, аmong others. The mаin objective of this study is to perform а literаture review аs а tool for аnаlyzing а concentrаte of plаtelets, describing their evolution to а new surgicаl аdditive model bioаctive (L- PRF), which helps in the heаling of surgicаl lesions аnd other dentаl procedures due to its chаrаcteristics of tissue regenerаtion аnd inflаmmаtory regulаtion. As it is аn inexpensive procedure with greаt benefits, its use in orаl аnd mаxillofаciаl surgery should be considered аs а clinicаl option of greаt interest. Los procedimientos quirúrgicos son intervenciones encaminadas a rehabilitar la función y fisiología tras algún seguimiento, utilizando técnicas que son, en la mayoría de los casos, muy invasivas y que generan una situación de malestar para el paciente. Como resultado, se iniciaron una serie de estudios sobre aditivos quirúrgicos que ayudan en el proceso de curación de los procedimientos, incluidos los procedimientos dentales. El plasma rico en fibrina (PRF) fue desarrollado por Choukroun para su uso en cirugía oral y maxilofacial y, en el campo de la odontología, tiene varios dominios de aplicación, como la elevación del seno maxilar, otros procedimientos quirúrgicos, incluido el injerto periodontal. El objetivo principal del presente estudio es realizar una revisión de la literatura como herramienta para el análisis de un concentrado de plaquetas, describiendo su evolución hacia un nuevo modelo de aditivo quirúrgico bioactivo (L-PRF), que ayuda en la cicatrización de otras cirugías. procedimientos y lesiones. por sus características de regeneración tisular y regulación inflamatoria. Al tratarse de un procedimiento económico y con grandes beneficios, su uso en cirugía oral y maxilofacial debe considerarse como una opción clínica de gran interés. Os procedimentos cirúrgicos são intervenções que visаm reаbilitаr função e fisiologiа de аlgum seguimento, lаnçаndo-se mão de técnicаs que são, nа mаioriа dаs vezes, muito invаsivаs e que gerаm umа situаção de desconforto аo pаciente. Em virtude disso, iniciou-se umа série de estudos sobre аditivos cirúrgicos que аuxiliem no processo de curа de procedimentos, inclusive odontológicos. O plаsmа rico em fibrinа (PRF) foi desenvolvido por Choukroun pаrа ser usаdo em cirurgiа orаl e mаxilofаciаl e, no cаmpo dа odontologiа, possui vários domínios de аplicаção, como levаntаmento do seio mаxilаr, enxerto de аlvéolos, cirurgiаs periodontаis estéticаs, entre outros. O objetivo principаl do presente estudo é reаlizаr umа revisão de literаturа como ferrаmentа pаrа аnálise de um concentrаdo de plаquetаs, descrevendo suа evolução аté um novo modelo de аditivo cirúrgico bioаtivo (L-PRF), que аjude nа cicаtrizаção de lesões cirúrgicаs e em outros procedimentos odontológicos por suаs cаrаcterísticаs de regenerаção teciduаl e de regulаção inflаmаtóriа. Por se trаtаr de um procedimento bаrаto e com grаndes benefícios, а suа utilizаção em cirurgiа orаl e mаxilofаciаl, deve ser considerаdа como umа opção clínicа de grаnde interesse.

The COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, which belongs to the new strain of the coronavirus, identified in China in early December 2019. This one presents symptoms and serious conditions, which can lead to Severe Acute Respiratory Syndrome. Thus, the need for a laboratory hematological profile of SARS-CoV-2 infection and its monitoring, becomes of great value to assist in the prognosis and treatment of the disease. This systematic review aims to trace the hematological profile resulting from infection by the SARS-CoV-2 virus, identifying the main changes found in the leukogram, erythrogram and platelet chart. For the elaboration of this study, an electronic search was carried out in several databases. The most frequently found hematological changes were lymphopenia, leukopenia, neutrophilia associated with leukocytosis, eosinopenia, reduced hemoglobin, thrombocytopenia and platelet aggregation, in addition to morphological changes. Anemia was not noticeably observed, but the reduction in hemoglobin was evident in healthy patients. The coagulation factors associated with platelet reduction as well as its hyper activation were altered in critically ill patients. These changes demonstrate the state of hypercoagulability present in critically ill patients with COVID-19, present in microthrombus pictures in various organs, being one of the most serious complications of COVID-19. Therefore, platelet count and changes in parameters associated with platelets are currently a concern. However, with the survey carried out, it is evident that an inflammation associated with high oxidative damage will compromise the hemostasis and leukocyte physiology of patients with COVID-19. COVID-19 es una enfermedad infecciosa causada por el virus SARS-CoV-2, que pertenece a la nueva cepa de coronavirus, identificada en China a principios de diciembre de 2019. Esta infección presenta síntomas leves y severos, que pueden derivar en Síndrome Respiratorio Agudo Grave. Por lo tanto, la necesidad de un perfil hematológico de laboratorio de la infección por SARS-CoV-2 y su seguimiento, se vuelve de gran valor para ayudar en el pronóstico y tratamiento de la enfermedad. Esta revisión sistemática tiene como objetivo rastrear el perfil hematológico resultante de la infección por el virus SARS-CoV-2, identificando los principales cambios encontrados en el leucograma, eritrograma y tabla de plaquetas. Para la elaboración de este estudio se realizó una búsqueda electrónica en varias bases de datos. Los cambios hematológicos más frecuentemente encontrados fueron linfopenia, leucopenia, neutrofilia asociada a leucocitosis, eosinopenia, hemoglobina reducida, trombocitopenia y agregación plaquetaria, además de cambios morfológicos. La anemia no se observó de forma notable, pero la reducción de la hemoglobina fue evidente en los pacientes sanos. Los factores de coagulación asociados con la reducción de plaquetas así como su hiperactivación se alteraron en pacientes críticamente enfermos. Estos cambios demuestran el estado de hipercoagulabilidad presente en pacientes críticamente enfermos con COVID-19, resultando en imágenes de microtrombos en varios órganos, que es una de las complicaciones más graves del COVID-19. Por lo tanto, el recuento de plaquetas y los cambios en los parámetros asociados con las plaquetas son actualmente una preocupación. Sin embargo, con la encuesta realizada, es evidente que la inflamación asociada a un alto daño oxidativo comprometerá la hemostasia y la fisiología leucocitaria de los pacientes con COVID-19. A COVID-19 é uma doença infecciosa causada pelo vírus SARS-CoV-2, o qual pertence à nova cepa do coronavírus, identificado na China no início de dezembro de 2019. Essa infecção apresenta sintomas leves e graves, podendo levar à Síndrome Respiratória Aguda Grave. Dessa forma, a necessidade de um perfil hematológico laboratorial da infecção pelo SARS-CoV-2 e seu monitoramento, torna-se de grande valia para auxiliar no prognóstico e tratamento da doença. Esta revisão sistemática tem como objetivo traçar o perfil hematológico decorrente da infecção pelo vírus SARS-CoV-2, identificando as principais alterações encontradas no leucograma, eritrograma e plaquetograma. Para a elaboração deste estudo foi realizada uma busca eletrônica em diversos bancos de dados. As alterações hematológicas mais frequentemente encontradas foram linfopenia, leucopenia, neutrofilia associada à leucocitose, eosinopenia, redução de hemoglobina, trombocitopenia e agregação plaquetária, além das alterações morfológicas. A anemia não foi observada de forma notável, mas a redução da hemoglobina foi evidente em relação a pacientes saudáveis. Os fatores de coagulação associados à redução de plaquetas assim como a sua hiper ativação foram alterados em pacientes graves. Essas alterações demonstram o estado de hipercoagulabilidade presente em pacientes graves com COVID-19, resultando em quadros de microtrombos em vários órgãos, sendo esta uma das complicações mais graves da COVID-19. Sendo assim, a contagem de plaquetas e as alterações dos parâmetros associados às plaquetas são atualmente uma preocupação. Contudo, com o levantamento realizado, fica evidente que a inflamação associada a um dano oxidativo elevado irá comprometer a hemostasia e fisiologia leucocitária de pacientes com COVID-19.

We thank Pablo Lardelli Claret for his helpful advice in statistical methods. We also acknowledge the staff of Hospital Universitario Virgen de las Nieves who took (and are taking) care of the COVID-19 patients., Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors associated with mortality before and after treatment remain unclear. Cox regression models were used to estimate the predictors of time to death in a cohort of hospitalized patients with COVID-19 receiving TCZ. In addition, the mean differences between discharged and deceased patients in laboratory parameters measured before and 3, 6 and 9 days after TCZ administration were estimated with weighted generalized estimation equations. The variables associated with time to death were immunosuppression (Hazard Ratio-HR 3.15; 95% confidence interval-CI 1.17, 8.51), diabetes mellitus (HR 2.63; 95% CI 1.23–5.64), age (HR 1.05; 95% CI 1.02–1.09), days since diagnosis until TCZ administration (HR 1.05, 95% CI 1.00–1.09), and platelets (HR 0.27; 95% CI: 0.11, 0.69). In the post-TCZ analysis and compared to discharged patients, deceased patients had more lactate dehydrogenase (p 0.013), troponin I (p 0.013), C-reactive protein (p 0.013), neutrophils (p 0.024), and fewer platelets (p 0.013) and lymphocytes (p 0.013) as well as a lower average PaO2/FiO2 ratio. In conclusion, in COVID-19 diagnosed patients receiving TCZ, early treatment decreased the risk of death, while age, some comorbidities and baseline lower platelet counts increased that risk. After TCZ administration, lower platelet levels were again associated with mortality, together with other laboratory parameters.

SUMMARY OBJECTIVE: Patients in intensive care units (ICU) have greater morbidity and mortality. We aimed to study neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the ICU population. METHODS: Medical and laboratory data of patients treated in ICU were retrospectively analyzed. Patients were divided into deceased and survived groups. RESULTS: The NLR of survived and deceased groups were 3.6 (0.2-31) and 9.5 (1-40), respectively (p

BACKGROUND: Platelet concentrates (PCs) treated by the pathogen inactivation technology (PI) using amotosalen and UVA illumination (PI-PCs) can be manufactured in additive solutions (PAS-III and PAS-IIIM) or in 100% Plasma. Quality control (QC) is an integral part of the production. We capitalized on our ongoing QC program to capture 8 years-worth of data on parameters related to the quality of 116,214 PI-PCs produced under different manufacturing methods. MATERIALS AND METHODS: Selected in vitro parameters of metabolism, activation, and storage were analyzed for the different manufacturing periods to compare PI-PCs versus conventional PCs (C-PCs) resuspended in different PAS. RESULTS AND DISCUSSION: All BC-PCs met quality standards for pH and dose and residual leucocytes. As expected, storage time correlated with increased lactate, LDH, Annexin V, CD62, sCD40 L levels and decreased glucose and pH. With PAS-IIIM, higher levels of glucose were observed toward the end of shelf life (p

The high prevalence of exercise-induced pulmonary hemorrhage (EIPH) in athletic horses constitutes to be a challenge to the racing industry and a source of major concern to animal welfare. Both experimental and clinical evidence indicate that the use of autologous platelet-rich plasma (PRP) is a promising effector of repair in a variety of pulmonary conditions. The present study evaluated the effect of intrabronchial instillation of PRP on EIPH endoscopic scores from 37 Thoroughbred racehorses. Inclusion criteria were for animals to be EIPH-positive in, at least, two consecutive post-exercise endoscopic exams and to receive 250mg of furosemide IV four hours before racing. Animals were randomly assigned into 3 groups: placebo, control, and PRP instillation. All 37 Thoroughbred racehorses included had EIPH endoscopic scores pre- and post- treatment compared by statistical analysis. The bleeding score from the group receiving PRP was significantly lower than in the control and placebo groups. No adverse effects were observed in any animal during or after the experiment. It was possible to conclude that the intrabronchial instillation of autologous PRP was effective in reducing EIPH scores in racehorses receiving furosemide and that this bioproduct can be considered as a promising coadjuvant in controlling EIPH in athletic horses. RESUMO A alta prevalência de hemorragia pulmonar induzida por exercício (HPIE) em cavalos atletas é um desafio de longa data para a indústria de corridas, além de figurar como grande preocupação sobre o bem-estar animal. As evidências experimentais e clínicas indicam que o uso do plasma rico em plaquetas (PRP) de fonte autógena é promissor na terapêutica de diversas lesões pulmonares. O presente estudo objetivou avaliar as mudanças após corrida no escore endoscópico de HPIE de 37 cavalos Puro-Sangue Inglês que receberam instilação intrabronquial de PRP autólogo. Os animais selecionados eram HPIE-positivos em, ao menos, dois exames endoscópicos consecutivos e recebiam 250mg de furosemida IV administrado quatro horas antes de cada corrida. Na comparação dos escores endoscópicos pré e pós-tratamento, verificou-se que o escore de HPIE do grupo tratado com PRP foi significantemente menor que o dos grupos controle e placebo. Nenhum efeito adverso foi observado nos animais durante ou após o experimento. Concluiu-se que a instilação intrabronquial de PRP autólogo foi efetiva na redução do escore de HPIE de cavalos de corrida usuários de furosemida e que este bioproduto pode ser considerado uma alternativa promissora no controle de HPIE em cavalos atletas.

Resumen Se realizó una revisión sistemática del uso de plasma rico en plaquetas (PRP) en animales, seleccionando 105 artículos de referencia, publicados en los últimos 8 años (2012 a 2020) de las revistas Veterinary Medicine International, Scientific Reports, BMC Veterinary Research, Platelets, Biomedicine and Pharmacotherapy entre otras y validadas en las siguientes bases de datos: Pubmed, Web of Science, Sciencedirect, Scielo, Medline, Embase y Scopus. Limitando solo las revistas con altos rankings ayudados con las clasificaciones de revistas por scimago journal. Solo 35 artículos cumplieron los criterios de selección; articulándolo con necesidades actuales en la medicina veterinaria, buscando una nueva biotecnología y proyectándose hacia la medicina regenerativa, basándose en reconstrucción de tejidos vivos para contrarrestar daño o remplazo de función de órganos lesionados. Una de estas herramientas es el plasma rico en plaquetas (PRP) con sus factores de crecimiento (FC) Transformante ß (TGF ß), fibroblástico básico (FGFb), derivado de plaquetas (PDGF), del endotelio vascular (VEGF), tejido conectivo (CTGF) y epidérmico (EGF). Actualmente el (PRP) es un bioestimulante tomado como base por estudios en medicina humana y medicina veterinaria, observando su efectividad en el proceso de consolidación ósea en pacientes clínicos. Se recogieron evidencias científicas presentadas en literatura médica con respecto al PRP como una alternativa de tratamiento en el manejo de fracturas y lesiones músculo esqueléticas, con ello se logra determinar la importancia de la estandarización del procedimiento (PRP) en uso, preparación, almacenamiento y administración. Abstract A systematic review of platelet-rich plasma (PRP) use in animals was carried out by taking 105 reference articles published during the last 8 years (2012 to 2020) in Veterinary Medicine International, Scientific Reports, BMC Veterinary Research, Platelets, Biomedicine and Pharmacotherapy; they were validated in the following databases: PubMed, Web of Science, ScienceDirect, SciELO, Medline, Embase and Scopus. The search was limited to just journals having a high impact factor; the SCImago journal rank (SJR) indicator (i.e. a sophisticated citation analysis algorithm) was also used. Only 35 of these articles met the selection criteria: i.e. coordinating content with current needs in veterinary medicine, seeking new biotechnological approaches and promoting regenerative medicine based on reconstructing living tissue to counteract damage or replace injured organs’ function. One such tool is platelet-rich plasma (PRP) with its derivative growth factors (GF): transforming growth factor-ß (TGF-ß), basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), connective tissue growth factor (CTGF) and epidermal growth factor (EGF). PRP is currently used as a biostimulant, acting as the basis for human and veterinary medicine studies; its effectiveness regarding bone/fracture healing/regeneration in clinical patients has been observed. Scientific evidence in the pertinent medical literature regarding PRP as an alternative treatment for managing fractures and musculoskeletal injuries was collected, thereby determining the importance of standardising the PRP procedure regarding its use, preparation, storage and administration. Resumo Foi realizada uma revisão sistemática da utilização de plasma rico em plaquetas (PRP) em animais, com 105 artigos de referência, publicados nos últimos 8 anos (2012 a 2020) das revistas Veterinary Medicine International, Scientific Reports, BMC Veterinary Research, Platelets, Biomedicina e Farmacoterapia entre outros e validados nas seguintes bases de dados: Pubmed, Web of Science, Sciencedirect, Scielo, Medline, Embase e Scopus. Limitar apenas os periódicos com classificações altas ajudou com as classificações de periódicos pelo jornal scimago. Dos quais apenas 35 artigos atenderam aos critérios de seleção; articulando-se com as necessidades atuais da medicina veterinária, buscando uma nova biotecnologia e projetando-se na medicina regenerativa, baseada na reconstrução de tecidos vivos para neutralizar danos ou substituição de função de órgãos lesados. Uma dessas ferramentas é o plasma rico em plaquetas (PRP) com seus fatores de crescimento (FC) ß transformador (TGF ß), fibroblasto básico (FGFb), derivado de plaquetas (PDGF), endotelial vascular (VEGF), tecido conjuntivo (CTGF) e epidérmico (EGF). Atualmente (PRP) é um bioestimulante tomado como base para estudos em medicina humana e veterinária, observando sua eficácia no processo de consolidação óssea em pacientes clínicos. Foram coletadas evidências científicas apresentadas na literatura médica a respeito do PRP como alternativa de tratamento no manejo de fraturas e lesões musculoesqueléticas, determinando a importância da padronização do procedimento (PRP) no uso, preparo, armazenamento e administração.

Submitted by Suzana Kague Schnoor (suzana.schnoor@unesp.br) on 2021-07-22T01:29:53Z No. of bitstreams: 1 SuzanaKSchnoor.Dissertacao.pdf: 1701235 bytes, checksum: 737860579423c975031161b64b15b1eb (MD5) Approved for entry into archive by Tais de Almeida (tais.almeida@unesp.br) on 2021-07-22T14:30:37Z (GMT) No. of bitstreams: 1 schnoor_sk_me_bot.pdf: 1701235 bytes, checksum: 737860579423c975031161b64b15b1eb (MD5) Made available in DSpace on 2021-07-22T14:30:37Z (GMT). No. of bitstreams: 1 schnoor_sk_me_bot.pdf: 1701235 bytes, checksum: 737860579423c975031161b64b15b1eb (MD5) Previous issue date: 2021-05-28 A Aids é consequência da infecção causada pelo vírus da imunodeficiência humana (HIV). Os principais alvos do vírus são linfócitos T CD4+ e os macrófagos, porém já foi demonstrado que as plaquetas interagem com o vírus mesmo não expressando a molécula CD4 em sua superfície celular. Estudos recentes demonstraram que as plaquetas não só interagem com o HIV como são reservatórios de vírus infectantes, capazes de transmiti-lo a outras células suscetíveis. A determinação da carga viral do HIV é considerada padrão-ouro para avaliação da eficácia do tratamento antirretroviral e detecção precoce de problemas de adesão em pessoas vivendo com HIV, sendo realizada utilizando a técnica de transcrição reversa seguida da Reação em Cadeia da Polimerase em tempo real (RT-qPCR) em amostras de plasma pobre em plaquetas, de acordo com o protocolo estabelecido pelo Ministério da Saúde. O objetivo do presente trabalho foi avaliar comparativamente a carga viral do HIV no plasma pobre e rico em plaquetas em amostras de sangue de trinta pacientes, sem tratamento antirretroviral, portadores do vírus e que foram atendidos pelo Laboratório de Biologia Molecular do Hospital das Clínicas da Faculdade de Medicina de Botucatu. Foram utilizados dois protocolos de centrifugação para obtenção do plasma pobre e rico em plaquetas, seguidos de quantificação da carga viral através da metodologia Abbott RealTime HIV-1 (Abbott Molecular, Illinois, USA). Os resultados demonstraram não haver diferença estatística significativa entre os dois grupos avaliados (plasma rico e pobre em plaquetas). Esperava-se que o plasma rico em plaquetas apresentasse uma carga viral maior do que o plasma pobre, uma vez que as mesmas abrigam o vírus, porém essa diferença não foi observada. No entanto, a metodologia pode explicar estes resultados. Os resultados sugerem testar novos protocolos, como utilização de colunas de sílica para extração do RNA viral, uma vez que o protocolo atual utiliza partículas magnéticas que não são especificas para ácidos nucleicos e podem sofrer interferências de outras moléculas presentes na amostra, e outros protocolos de centrifugação para obtenção de plasma rico em plaquetas como descritos em outros estudos. AIDS is a consequence of infection caused by the human immunodeficiency virus (HIV). The main target of the virus is the immune system, especially CD4 + T lymphocytes and macrophages, although platelets have been shown to interact with the virus even though not expressing the CD4 molecule on their cell surface. Recent studies have shown that platelets not only interact with HIV but are also reservoirs of infecting viruses, capable of transmitting it to other susceptible cells. Laboratory monitoring of HIV viral load is considered the gold standard to assess the effectiveness of antiretroviral treatment and early detection of adherence problems in people living with HIV, and the quantification of viral load is performed using the reverse transcription technique followed by Reaction in Polymerase Chain in real time (RT-qPCR) in platelet-poor plasma samples, according to the protocol established by the Ministry of Health. Two centrifuge protocols were used to obtain poor and platelet-rich plasma, followed by quantification of viral load using Abbott RealTime HIV-1 (Abbott Molecular, Illinois, USA) methodology. The objective of the present study was to evaluate comparatively the HIV viral load in the poor and platelet-rich plasma in blood samples from patients, without antiretroviral treatment, carrying the virus and who were attended by the Molecular Biology Laboratory of the Hospital das Clínicas, Botucatu School of Medicine. The results have shown that there is no statistically significant difference between the two groups evaluated. Platelet-rich plasma was expected to have a higher viral load than poor plasma, once they fight the virus, but this difference was not observed. Therefore, we have suggest testing new protocols, such as the use of silica columns to extract viral RNA, once the current protocol uses magnetic particles that are not specific for nucleic acids and may suffer interference from other molecules present in the sample, and other centrifugation protocols to get platelet-rich plasma as described in other studies.

El polipropileno es un material de forma en macrofibra sintética estructural, este material es muy usado en el área de la construccion, siendo limitado su uso en el área de pavimentos y en la mezcla del concreto, ya que estas macrofibras están diseñadas para cumplir un refuerzo secundario en el concreto o morteros, con el fin de reducir los agrietamientos por contracción plástica en estado fresco (Fibraplasconcrete). Teniendo en cuenta el historial de uso de este material, se desarrolló el análisis de las propiedades mecánicas que presentan el material, por medio de ensayos como, módulo de elasticidad, modulo ruptura y ensayo de resistencia a la compresión, donde se crearon plaquetas prefabricadas que contuvieran el material de refuerzo en la mezcla del concreto, para lograr tener una aproximación del comportamiento mecánico. Por consiguiente, los resultados que se obtuvieron fueron comparados con un proyecto similar, con el fin de obtener un análisis del comportamiento mecánico de la mezcla. Polypropylene is a structural synthetic macrofiber shaped material; this material is widely used in the construction area, its use being limited in the pavement area and in the concrete mix, since these macrofibers are designed to fulfill a reinforcement secondary in concrete or mortars, in order to reduce cracking due to plastic shrinkage in the fresh state (Fibraplasconcrete). Taking into account the history of use of this material, the analysis of the mechanical properties presented by the material was developed, through tests such as modulus of elasticity, modulus of rupture and compression resistance test, where prefabricated platelets were created that contain the reinforcing material in the concrete mix, to achieve an approximation of mechanical behavior. Consequently, the results obtained were compared with a similar project, in order to obtain an analysis of the mechanical behavior of the mixture. http://www.ustavillavicencio.edu.co/home/index.php/unidades/extension-y-proyeccion/investigacion Pregrado

Submitted by Neusa Fagundes (neusa.fagundes@unioeste.br) on 2021-07-19T11:49:36Z No. of bitstreams: 2 Letícia_Nadal2021.pdf: 612073 bytes, checksum: c4c8c8071198abd1cd5f8b0f28a10971 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Made available in DSpace on 2021-07-19T11:49:36Z (GMT). No. of bitstreams: 2 Letícia_Nadal2021.pdf: 612073 bytes, checksum: c4c8c8071198abd1cd5f8b0f28a10971 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2021-04-06 Gingival recession is defined as the apical migration of the marginal gingiva with exposure o the root surface, which can lead to aesthetic problems, dentinal hyperesthesia, cervical cavities and non-carious cervical lesions. The Subepithelial Connective Tissue Graft (ETCS) associated with the Coronary Positioned Flap (RPC) is considered the gold standard in the treatment of gingival recessions, however the use of Platelet Rich Fibrin - PRF has been showing good results in gingival plastic surgery. The aim of the present study was to evaluate the efficacy of Advanced Platelet Rich Fibrin (A-PRF) used in combination with RPC and to compare with the ETCS use also associated with RPC in Cairo type 1 gingival recessions. Forty recessions were selected, 20 of which belong to the RPC + A-PRF group (test group) and 20 to the RPC + ETCS group. Height of gingival recession, height and thickness of the inserted gingiva, probing depth, level of clinical insertion and tooth sensitivity were evaluated at the beginning and 6 months after the surgery. There was a gain in gingival height of 1.45 ± 0.96mm in the RPC + ETCS group and 1.04 ± 0.95mm in the RPC + A-PRF group, with a coverage of 54.3% in the test group and 73% in the control group. The total coverage (100%) of the recessions was found at 7 sites (35%) in the group with A-PRF and 10 sites (50%) with the ETCS. In both groups there was a significant improvement in tooth sensitivity (p

An explanatory mechanism for the thrombotic disorders detected after the administration of the COVID AZD1222 vaccine with recombinant adenovirus vectors is postulated: "Platelet activation by adenoviruses, mediated by anti-PEG antibodies generated by the polysorbates themselves included in the vaccine, or generated in a previous administration of polysorbates or PEG to the vaccinated individual". It is an immune interference whose biochemical basis is the chemical similarity between polysorbates and PEG with the repetitive structures on the surface of viruses, which causes cross-reactions between anti-PEG antibodies and viruses. This same mechanism could govern the disseminated intravascular coagulation (DIC) observed in severe cases of COVID-19, due to the spike protein of coronaviruses., This article has been reviewed and updated in: https://doi.org/10.5281/zenodo.4698299

Se postula un mecanismo explicativo de los trastornos trombóticos detectados tras la administración de la vacuna COVID AZD1222 con vectores de adenovirus recombinantes: “La activación plaquetaria por parte de los adenovirus, mediada por anticuerpos anti-PEG generados por los propios polisorbatos incluídos en la vacuna, o bien generados en una administración previa de polisorbatos o PEG al individuo vacunado”. Se trata de una interferencia inmunológica cuya base bioquímica es la similitud química entre los polisorbatos y PEG con las estructuras repetitivas de la superficie de los virus, lo cual provoca reacciones cruzadas entre los anticuerpos anti-PEG y los virus. Este mismo mecanismo podría regir en la coagulación intravascular diseminada (CID) observada en los casos graves de COVID-19, debida a la proteína espiga de los coronavirus.

Resumo Fundamento O volume plaquetário médio (VPM), uma medida simples de ativação plaquetária, tornou-se recentemente um tópico interessante no campo da pesquisa cardiovascular. A reabilitação cardíaca (RC) baseada em exercícios é uma intervenção abrangente que diminui a morbidade-mortalidade em pacientes com doença arterial coronariana (DAC). Estudos sobre os efeitos do exercício físico na ativação plaquetária têm produzido resultados conflitantes. Objetivo O objetivo deste estudo foi determinar o efeito de um programa de RC baseado em exercícios sobre o VPM em pacientes com DAC estável. Métodos A amostra foi composta por 300 pacientes consecutivos com DAC estável. Os pacientes foram divididos em dois grupos: grupo RC (n = 97) e grupo não RC (n = 203). Foi feito um hemograma. As medidas de correlação ponto-bisserial foram tiradas para mostrar a correlação entre a alteração do VPM e a RC. Valor de p

Thrombocytopenia is frequently observed in hemodialysis patients, and its correct investigation and control remain a challenge. It is estimated that during the hemodialysis session there is a drop of up to 15% in the platelet count, with recovery after the end of treatment. This reduction in platelets is due to platelet adhesion and complement activation, regardless of the membrane material. Several studies with platelet surface markers demonstrate increased platelet activation and aggregation secondary to exposure to cardiopulmonary bypass. This case report describes a patient on hemodialysis who developed severe thrombocytopenia during hospitalization. Investigation and exclusion of the most common causes were carried out: heparin-related thrombocytopenia, adverse drug reaction, hypersplenism, and hematological diseases. Afterwards, the possibility of hemodialysis-related thrombocytopenia was raised, since the fall was accentuated during the sessions with partial recovery after the dialyzer change. Attention to the sterilization method and dialyzer reuse must be considered for correction. In the current case, reusing the dialyzer minimized the drop in platelet counts associated with hemodialysis. Resumo Plaquetopenia é frequentemente observada em pacientes em hemodiálise, e sua correta investigação e controle permanecem um desafio. Estima-se que, durante a sessão de hemodiálise, ocorra queda de até 15% da contagem de plaquetas, com recuperação após o término do tratamento. Essa queda de plaquetas é decorrente de adesão plaquetária e ativação do complemento, independentemente do material da membrana. Vários estudos com marcadores de superfície plaquetária demonstram aumento da ativação e agregação plaquetária secundários à exposição à circulação extracorpórea. Este relato de caso mostra um paciente dialítico que evoluiu com plaquetopenia severa durante internação. Realizada investigação e exclusão de causas mais comuns: plaquetopenia relacionada à heparina, reação adversa a medicamentos, hiperesplenismo e doenças hematológicas, foi então aventada a possibilidade de plaquetopenia relacionada à hemodiálise após observação de que a queda se acentuava durante as sessões de hemodiálise com recuperação parcial após. Mudança do dialisador, atenção ao método de esterilização e realização do reuso devem ser consideradas para correção. No presente caso, a utilização do reuso minimizou a plaquetopenia associada a hemodiálise.

INTRODUCCIÓN: El lupus eritematoso sistémico es una enfermedad autoinmune con compromiso multisistémico. En la práctica clínica es de vital importancia diferenciar si un paciente presenta recaída de la enfermedad o infección dado que tienen manifestaciones similares, pero, el enfoque terapéutico es diferente, y el tratamiento de uno puede empeorar el otro. OBJETIVO: Determinar el rendimiento diagnóstico de los índices paraclínicos en la diferenciación de infección y actividad clínica de la enfermedad en pacientes con LES de Medellín, Colombia METODOLOGÍA: Estudio de cohorte retrospectivo que incluyó pacientes con lupus eritematoso sistémico que consultaron a un centro de referencia del noroccidente colombiano entre el 2012-2019. Se realizó estadística descriptiva, comparación de grupos, evaluación de la predicción de los índices y análisis de clúster. Se uso el software R versión 4.0.3 y Stata versión 12.0. RESULTADOS: Se incluyeron 246 sujetos. La edad mediana de los pacientes incluidos fue de 28 años, y de estos el 90.6% correspondió al sexo femenino. La duración mediana de la enfermedad fue de 48 meses. Las manifestaciones más frecuentemente encontradas fueron inmunológicas, hematológicas y mucocutáneas. En cuanto a la variable desenlace el 36.9% tuvieron recaída, el 16.6% tuvieron infección, el 15.4% tuvieron recaída e infección y el 30.8% no tuvieron ni recaída ni infección. Se realizó comparación de los 17 índices en los 4 grupos de pacientes y encontró que los puntajes eran diferentes entre los grupos. El índice de mejor desempeño para la predicción de infección fue linfocito/C4 con una curva ROC de 0.75 para un punto de corte de 66.7 con una sensibilidad de 60.5% y una especificidad de 80.5%, esto con OR de 0.98 que alcanzó la significancia estadística (p

El tratamiento del plasma rico en plaquetas y a su vez derivados de los factores de crecimiento, es un componente autólogo de la sangre. Objetivo: Analizar el conocimiento del uso del plasma rico con factores de crecimiento en la regeneración ósea de los maxilares mediante encuestas a Odontólogos generales y especialista en el área de cirugía, implantología y periodoncia. Materias y Métodos: Se realizó un estudio descriptivo transversal, mediante una encuesta en línea, obtuvimos el tamaño de la muestra siendo 173 Odontólogos generales y especialistas, la encuesta estuvo conformada por 10 preguntas. Resultados: En el presente estudio el 85% corresponde a los 147 encuestados que afirmaron haber escuchado sobre el tratamiento y un bajo porcentaje no lo conoce, de los 173 odontólogos encuestados 121 (69,2%) mencionan haber utilizado el tratamiento, pero el 12.29%, aun así existe un porcentaje mínimo de Odontólogos que han utilizado el tratamiento pero desconocen su preparación y su composición, 6 Odontólogos ( 11.5% ) mencionan que no han escuchado respecto al tratamiento pero aun así consideran eficaz. Recomendamos indagar más a fondo la información sobre el tratamiento antes de ser usado y así obtener resultados positivos a futuro. Trabajo de investigación

Debido a la alta frecuencia de las recesiones periodontales y sus repercusiones, de comparar los efectos de los diferentes derivados plaquetarios utilizados en el tratamiento de lesiones en tejidos blandos y duros orales. Se realizó una búsqueda en Pubmed/ Medline, EMBASE, el Registro de Ensayos del Cochrane Oral Health Group, Lilacs de ensayos clínicos que utilicen concentrados plaquetarios para el tratamiento de defectos periodontales y periimplantarios en comparación con los tratamientos convencionales. Los principales resultados observados no mostraron diferencias significativas en ninguna de las siguientes variables: profundidad de sondaje, nivel de inserción clínico, recubrimiento radicular mediante colgajo de avance coronal y grosor de encía queratinizada. La única variable estudiada en la que se encontraron diferencias significativas fue en la realización de un colgajo de acceso agregando concentrados plaquetarios y sin ellos. Podemos concluir en este estudio que los derivados plaquetarios como el plasma rico en plaquetas (PRP), plasma rico en fibrina (PRF) y el plasma rico en fibrina y leucocitos (L-PRF) pueden ser beneficiosos en el tratamiento y regeneración de tejidos blandos y duros periodontales y periimplantarios. No obstante, se necesita más investigación para analizar detalladamente el comportamiento de estos derivados sanguíneos. This study was put forward as a result of the number and consequences of periodontal recessions, this review aims to compare the effects of different types of platelet concentrates used to treat hard and soft oral tissue defects. In order to do so, clinical trials were researched based on the usage of platelet concentrates, compared with conventional treatments were searched in PubMed/Medline, EMBASE, Cochrane Oral Health Group, and Lilacs. Within the main outcomes, there were not found remarkable differences in any of the following factors: probing depth, clinical attachment level, root coverage, coronal advance fl ap, keratinized gingival width. There was only signifi cant distinction on the studies that compared the usage of an access fl ap variable with and without platelet concentrates. To sum up, seems to be benefi cial the addition of platelet rich plasma (PRP), platelet rich fibrin (PRF) and leucocyte platelet rich fibrin (L-PRF) to the treatment when dealing with periodontal and periimplant defects. Nevertheless, further investigations and studies are needed in order to be able to analyze in detail the behavior of these blood products. Sin financiación No data 2021 UEM

El hemograma completo oConteo Sanguíneo Completo(CSC)es una de las herramientas de monitoreo más utilizadas en la emergencia pediátrica por su versatilidad, disponibilidad y bajo coste. Este permite realizar una aproximación más objetiva del paciente, en especial de aquellos signos y síntomas que este no refiere, por su edad, o desconoce. Objetivo: Caracterizar las anormalidades halladas en el (CSC)en una Urgencia Pediátrica de un Hospital. Metodología: Se realizó un estudio descriptivo prospectivo. Se tuvo en cuenta la edad (grupo etario) motivo de consulta (CIE10). Del CSC, el recuento de glóbulos rojo (GR), Hematocrito (%Hto), recuento de glóbulos blancos o leucocitos (Le) y recuento de plaquetas (PLT). Debido a la variabilidad de los datos, estos fueron ajustados a tres niveles (Elevado, Normal, Disminuido) y fueron mostrados en representación porcentual. Los análisis estadísticos fueron realizados en R-CRAN. Resultados: De los 718 pacientes que llegaron a la PER, 351 cumplieron con criterios de inclusión. Con una edad de 5±5 años, el 52.9 % fueron niñas. El grupo etario de mayor frecuencia fue la primera infancia (0 – 5 años) con 63.3 %. Los diagnósticos de mayor frecuencia fueron aquellos asociados a Síntomas, signos y hallazgos anormales clínicos y de laboratorio, no clasificados en otra parte (R00-R99) con el 43.3 %. Los parámetros que estuvieron más frecuentemente disminuido en el CSC fueron la Hb (64.39 %) y %Hto (57.83 %), el que más frecuentemente aumentado fue Monocitos 77.78 %. Los MON, LEU y NEU, para el grupo de Ciertas enfermedades infecciosas y parasitarias (A00-B99). Conclusión: El CSC es un buen indicador para las sepsis y estado nutricional de los pacientes, por lo que se debe revisar acuciosamente para poder establecer las causas de sus variaciones en la PER.

Tesis-CEINDO, Universidad San Pablo CEU, Programa en Medicina Traslacional, leida 21 de enero de 2021. Durante los últimos años tanto la prevalencia como la gravedad de las enfermedades alérgicas se ha visto aumentada. Además, las características subyacentes al desarrollo de un fenotipo alérgico grave no están bien definidas actualmente y existe una falta de biomarcadores útiles tanto para la clasificación de estos pacientes como de predicción y monitorización de eficacia de tratamientos como la inmunoterapia sublingual. Por otro lado, en los últimos años ha cobrado mucha relevancia el papel de las plaquetas como células clave en la inflamación alérgica, así como la relación entre microbiota y el desarrollo de la alergia, sin embargo, aún no hay estudios suficientes que profundicen en estas cuestiones. Con el fin de indagar en estos aspectos, en este trabajo nos propusimos la evaluación del papel de las plaquetas en el desarrollo y progresión de la alergia en distintos modelos de gravedad respiratoria, con y sin alergia alimentaria asociada mediante un análisis transcriptómico, por otro lado, la caracterización del perfil transcriptómico asociado al tratamiento con inmunoterapia sublingual a Phleum pratense (GRAZAX) y por último, la identificación de cambios en la composición de la microbiota intestinal en un modelo de alergia a la proteína de leche de vaca en lactantes. En cuanto al papel de las plaquetas en la alergia, durante la Fase I del estudio, encontramos una disminución de transcritos asociados a funciones plaquetarias en las CMSP obtenidas de pacientes con alergia respiratoria a gramíneas, sensibilizados a profilina y que llegaban a desarrollar reacciones alimentarias graves en comparación con los sujetos no alérgicos y los pacientes con una alergia respiratoria ligada a alergia alimentaria leve y moderada. Posteriormente, en la Fase II del estudio, nos propusimos validar estos resultados en otro modelo de gravedad alérgica, en este caso de alergia respiratoria a gramíneas en ausencia de alergia alimentaria, centrándonos en la población plaquetaria obtenida mediante un procedimiento de aféresis. Los resultados obtenidos fueron similares a los de la Fase I, los pacientes con una alergia grave mostraban una disminución de transcritos asociados con funciones plaquetarias tales como la agregación y la activación, así como una respuesta inflamatoria disminuida en comparación con los sujetos no alérgicos, sugiriendo un posible agotamiento plaquetario y una alteración en el sistema de reparación. En cuanto al tratamiento con ITSL, se analizó el perfil transcriptómico de los pacientes con alergia a gramíneas incluidos en un estudio aleatorizado doble ciego controlado con placebo a dos años. Los principales resultados obtenidos mostraron que los pacientes tenían un perfil transcriptómico diferente según su sensibilización (monosensibilizados o polisensibilizados) previamente a comenzar al tratamiento. Además, los pacientes monosensibilizados y polisensibilizados que recibían tratamiento activo también mostraban un perfil transcriptómico diferente tras dos años de tratamiento, sugiriendo que su respuesta al tratamiento con ITSL era diferente. Por último, se analizó el perfil transcriptómico de los pacientes monosensibilizados previamente al tratamiento (T0) y tras dos años de ITSL (T2), observándose una desensibilización de las células efectoras a T2, que parece ser clave para la respuesta reguladora que se establece según la mayoría de los estudios a partir del tercer año de tratamiento. Como último objetivo nos propusimos investigar el papel de la microbiota en el desarrollo de la alergia alimentaria, para lo cual utilizamos un modelo de APLV en el que analizamos la composición bacteriana de muestras de heces de lactantes alérgicos, sus madres y sus abuelas y de lactantes control, sus madres y sus abuelas. Por un lado, encontramos que existía una mayor diversidad de la microbiota intestinal en adultos que en lactantes. En cuanto a composición, se encontró una alteración de la familia Prevotellaceae al comparar la microbiota de lactantes alérgicos y lactantes control. Esta diferencia también aparecía al analizar la composición microbiana intestinal de lactantes que se alimentaban con leche de formula (todos lactantes control) con aquellos que tomaban hidrolizado (la mayoría de los lactantes alérgicos), por lo que no podemos saber si es debida a la alergia o a la alimentación ya que existe un sesgo. Por último, quisimos analizar si existía un patrón disbiótico transferido de madres a hijos a lo largo de estas tres generaciones, para lo cual se calculó la distancia de Bray-Curtis en los miembros de la misma familia (madre-lactante, madreabuela, abuela-lactante) y se compararon las familias alérgicas frente a no alérgicas. Las distancias fueron similares por lo que no pudimos concluir que existiese una disbiosis transmitida de madres a hijos en este modelo de APLV.