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Nephrology; CKD-EPI equation Nefrologia; Equació CKD-EPI Nefrología; Ecuación CKD-EPI

Full blood count; Schistosomiasis; Travel Hemograma completo; Esquistosomiasis; Viajar Hemograma complet; Esquistosomiasi; Viatjar Background Earlier studies found characteristic haematological changes in African patients with active schistosomiasis. If consistently present, full blood counts (FBC) may be helpful to diagnose schistosomiasis also in migrants and returning travellers. Methods A retrospective patient record review was conducted on data from seven European travel clinics, comparing FBC of Schistosoma egg-positive travellers and migrants to reference values. Sub-analyses were performed for children, returned travellers, migrants and different Schistosoma species. Results Data analysis included 382 subjects (median age 21.0 years [range 2–73]). In returned travellers, decreases in means of haemoglobin particularly in females (β = −0.82 g/dL, p = 0.005), MCV (β = −1.6 fL, p = 0.009), basophils, neutrophils, lymphocytes and monocytes (β = −0.07, p < 0.001; −0.57, p = 0.012; −0.57, p < 0.001 and −0.13 103/μL, p < 0.001, respectively) were observed. As expected, eosinophils were increased (β = +0.45 103/μL, p < 0.001). In migrants, a similar FBC profile was observed, yet thrombocytes and leukocytes were significantly lower in migrants (β = −48 103/μL p < 0.001 and β = −2.35 103/μL, p < 0.001, respectively). Conclusions Active egg-producing Schistosoma infections are associated with haematological alterations in returned travellers and migrants. However, these differences are discrete and seem to vary among disease stage and Schistosoma species. Therefore, the FBC is unsuitable as a surrogate diagnostic parameter to detect schistosomiasis.

Chronic liver disease; Fibrosis 4 score Malaltia hepàtica crònica; Puntuació de fibrosi 4 Enfermedad crónica del hígado; Puntuación de fibrosis 4 Liver disease is frequently asymptomatic, challenging early identification in the primary care setting. The fibrosis 4 (FIB4) index is a liver fibrosis biomarker that is a potential alternative to liver biopsy for diagnosing and managing liver disease. This study aimed to calculate the FIB4 index for screening individuals at high risk of liver disease at the community level. This was a retrospective real-world study analyzing blood and serum test results from a central laboratory. The primary outcome was the number of individuals within each risk category for hepatic fibrosis: high risk (FIB4 ≥ 3.25) and low risk (FIB4 < 1.3). The analysis included samples from 31,753 patients, of which 18,102 were aged 40 to 75 years. In these patients, the FIB4 index had been explicitly requested in 1852 (10.2%) cases and estimated ad hoc in the rest. Of the 263 (1.5%) cases with FIB4 ≥ 3.25, the FIB4 index was requested in 46 (17.5%), and 52 (19.8%) showed evidence of liver fibrosis in their medical records, while the rest did not report any data regarding liver fibrosis. FIB4 is a simple score that can play a role as a “red flag” for early identification of patients at high risk of advanced liver fibrosis and their referral to specialized care.

Grup sanguini; COVID-19; SARS-CoV-2 Grupo sanguíneo; COVID-19; SARS-CoV-2 Blood group; COVID-19; SARS-CoV-2 La infección SARS-CoV-2 ha representado la mayor pandemia del siglo XXI afectando a millones de personas en el mundo. Su alto grado de contagiosidad y morbi-mortalidad en algunos grupos de la población ha supuesto un reto para el mundo científico en la búsqueda de marcadores que permitieran identificar las razones de la diferente susceptibilidad y gravedad a la COVID-19 entre la población. Algunos grupos sanguíneos se han descrito como factor de protección para diferentes patologías como infecciones, enfermedades cardiovasculares..., siendo este el motivo por el que numerosos estudios han desarrollado su investigación buscando la relación de estos con la COVID-19.

Trypanosoma cruzi; Mancha de sangre seca (DBS); Cribado serológico Trypanosoma cruzi; Taca de sang seca (DBS); Cribratge serològic Trypanosoma cruzi; Dried blood spot (DBS); Serological screening Background: Chagas disease is a public health problem not only in Latin America, but also in other regions, including Spain, due to migration movements. Conventional serological diagnosis requires an invasive sample (plasma or serum) and a well-equipped laboratory. To circumvent those limitations, blood samples dried on filter paper (DBS) or Rapid Diagnostic Test (RDT) could be a practical alternative to reference protocol for serological screening in epidemiological studies. We evaluated the usefulness of dried blood sampling and a rapid diagnostic test (Trypanosoma Detect™) for the detection of antibodies against T. cruzi for their use in community-based screening. Methodology/Principal Findings: A total of 162 stored paired whole-blood and serum samples from Latin American migrants and 25 negative-control blood samples were included. Diagnosis of chronic Chagas disease was performed in serum according to WHO algorithms. Blood samples were retrospectively collected as dried spots and then analyzed using two different serological techniques, enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay (E-CLIA). Whole-blood samples were also used to evaluate a rapid diagnostic test based on immunochromatography. A better correlation with conventional serum was observed in dried blood elutes using E-CLIA than ELISA (97% vs. 77% sensitivity, respectively). Both assays reported 100% specificity. The median cut-off index values of E-CLIA for dried blood were significantly lower than those for serum (138.1 vs. 243.3, P

Background Chagas disease is a protozoan infection caused by Trypanosoma cruzi. The disease has a chronic course in which 20–30% of the patients would develop progressive damage to the cardiovascular system and the gastrointestinal tube. We are still unable to predict who will develop end-organ damage but there are some acquired and genetic risk factors already known. Results We reviewed data from 833 patients with serologically confirmed Chagas disease in this retrospective study. Patients were classified as siblings or non-siblings (controls) and the results of pre-treatment blood PCR assay, end-organ damage (cardiac and/or gastrointestinal), and the presence of delayed type hypersensitivity (DTH) skin involvement in patients treated with benznidazole were analyzed. Siblings were grouped by family and we randomly generated groups of 2 or 3 persons with the remaining controls. We classified the results of each variable as concordant or discordant and compared the concordance in these results among the sibling groups with that among control groups. We identified 71 groups of siblings and randomly generated 299 groups of non-related patients. Pre-treatment blood PCR concordance was significantly higher (19%) among siblings compared to controls (P = 0.02), probably due to a higher frequency in pre-treatment positive results. No other statistically significant differences were found. Conclusions A significant difference was found in the concordance of pre-treatment blood PCR for T. cruzi among siblings compared to non-related controls. Electronic supplementary material The online version of this article (10.1186/s13071-019-3518-4) contains supplementary material, which is available to authorized users.

Introduction We evaluated the diagnostic reliability of serum polymerase chain reaction (PCR) versus blood culture, abdominal fluid or both (composite measure) in patients receiving empirical antifungal treatment for suspected invasive candidiasis. Methods This observational, prospective, non-interventional, multicentre study in Spain enrolled 176 critically ill patients admitted to the intensive care unit. Separate blood samples for culture and serum PCR were taken before the start of antifungal therapy. Patient assessment was performed according to each site’s usual clinical practice. The primary end point was concordance between serum PCR and blood culture. Secondary end points were concordance between serum PCR and a positive abdominal fluid sample or the composite measure. Quality indices included sensitivity, specificity, positive/negative predictive values (PPV/NPV) and kappa indices. Results Among 175 evaluable patients, rates of Candida detection were similar for serum PCR (n = 16/175, 9.1%) versus blood culture (n = 14/175, 8.0%). Quality indices for serum PCR relative to blood culture were: sensitivity 21.4%; specificity 91.9%; PPV 18.8%; NPV 93.1%; kappa index 0.125. Thirty-two abdominal fluid samples were positive. Quality indices for serum PCR versus abdominal fluid were: sensitivity 31.3%; specificity 83.0%; PPV 15.6%; NPV 92.3%; kappa index 0.100. Quality indices for serum PCR versus the composite measure were: sensitivity 15.8%; specificity 92.7%; PPV 37.5%; NPV 79.9%; kappa index 0.107. Conclusion The sensitivity of serum PCR for Candida detection was low and the rate of concordance was low between serum PCR and the other diagnostic techniques used to identify Candida infections. Hospital-based diagnostic tests need optimising to improve outcomes in patients with suspected invasive candidiasis. Funding Astellas Pharma Inc. Electronic supplementary material The online version of this article (10.1007/s40121-019-0248-z) contains supplementary material, which is available to authorized users.

Creatina quinasa; Encefalomielitis miàlgica/síndrome de fatiga crònica; Anàlisis de sang de rutina Creatina quinasa; Encefalomielitis miálgica/síndrome de fatiga crónica; Análisis de sangre de rutina Creatine kinase; Myalgic encephalomyelitis/chronic fatigue syndrome; Routine blood tests There is a lack of research regarding blood tests within individuals with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and between patients and healthy controls. We aimed to compare results of routine blood tests between patients and healthy controls. Data from 149 patients diagnosed with ME/CFS based on clinical and psychiatric evaluation as well as on the DePaul Symptom Questionnaire, and data from 264 healthy controls recruited from blood donors were compared. One-way ANCOVA was conducted to examine differences between ME/CFS patients and healthy controls, adjusting for age and gender. Patients had higher sedimentation rate (mean difference: 1.38, 95% CI: 0.045 to 2.714), leukocytes (mean difference: 0.59, 95% CI: 0.248 to 0.932), lymphocytes (mean difference: 0.27, 95% CI: 0.145 to 0.395), neutrophils (mean difference: 0.34, 95% CI: 0.0 89 to 0.591), monocytes (mean difference: 0.34, 95% CI: 0.309 to 0.371), ferritin (mean difference: 28.13, 95% CI: −1.41 to 57.672), vitamin B12 (mean difference: 83.43, 95% CI: 62.89 to 124.211), calcium (mean difference: 0.02, 95% CI: −0.02 to 0.06), alanine transaminase (mean difference: 3.30, 95% CI: −1.37 to -7.971), low-density lipoproteins (mean difference: 0.45, 95% CI: 0.104 to 0.796), and total proteins (mean difference: 1.53, 95% CI: −0.945 to 4.005) than control subjects. The patients had lower potassium levels (mean difference: 0.11, 95% CI: 0.056 to 0.164), creatinine (mean difference: 2.60, 95% CI: 0.126 to 5.074) and creatine kinase (CK) (mean difference: 37.57, 95% CI: −0.282 to 75.422) compared to the healthy controls. Lower CK and creatinine levels may suggest muscle damage and metabolic abnormalities in ME/CFS patients. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Taca de plasma sec; Hepatitis C; Targeta de separació de plasma Mancha de plasma seca; Hepatitis C; Tarjeta de separación de plasma Dried plasma spot; Hepatitis C; Plasma separation card Diagnosis and clinical management of people infected with hepatitis C virus (HCV) relies on results from a combination of serological and virological tests. The aim of this study was to compare the performance of dried plasma spots (DPS), prepared using the cobas® Plasma Separation Card (PSC), to plasma and serum from venipuncture, for HCV diagnosis. We carried out a prospective study using DPS and paired plasma or serum samples. Serum and DPS samples were analyzed by immunoassay using Elecsys® Anti-HCV II (Roche). Plasma and DPS samples were analyzed using the cobas® HCV viral load and cobas® HCV genotyping tests (Roche). All DPS samples that had high anti-HCV antibody titers in serum were also antibody-positive, as were five of eight samples with moderate titers. Eight samples with low titers in serum were negative with DPS. Among 80 samples with plasma HCV viral loads between 61.5 and 2.2 × 108 IU/mL, 74 were RNA-positive in DPS. The mean viral load difference between plasma and DPS was 2.65 log10 IU/mL. The performance of DPS for detection of serological and virological markers of hepatitis C virus infection was comparable to that of the conventional specimen types. However, the limits of detection were higher for DPS. This work was supported by Roche and a microelimiation grant of Gilead Science (GLD19-0104).

Anàlisis de sang; Periodicitat; Recomanacions Análisis de sangre; Periodicidad; Recomendaciones Blood test; Periodicity; Recommendations Esencial es una iniciativa que identifica practicas clínicas de poco valor y promueve recomendaciones para poder evitar su realización. En este informe se encuentran recomendaciones sobre la necesidad o no de la realización de análisis de sangre periódicos anuales en la población adulta sana. Essencial és una iniciativa que identifica pràctiques clíniques de poc valor i promou recomanacions per tal d'evitar-ne la realització. En aquest informe trobem recomanacions sobre la necessitat o no de la realització d'anàlisis de sang periòdiques anuals en la població adulta sana.

Anàlisis de sang; Periodicitat; Recomanacions Análisis de sangre; Periodicidad; Recomendaciones Blood test; Periodicity; Recommendations Esencial es una iniciativa que identifica practicas clínicas de poco valor y promueve recomendaciones para poder evitar su realización. En este informe se encuentran recomendaciones sobre la necesidad o no de la realización de análisis de sangre periódicos anuales en la población adulta sana. Essencial és una iniciativa que identifica pràctiques clíniques de poc valor i promou recomanacions per tal d'evitar-ne la realització. En aquest informe trobem recomanacions sobre la necessitat o no de la realització d'anàlisis de sang periòdiques anuals en la població adulta sana.

Anàlisis de sang; Periodicitat; Recomanacions Análisis de sangre; Periodicidad; Recomendaciones Blood test; Periodicity; Recommendations Esencial es una iniciativa que identifica practicas clínicas de poco valor y promueve recomendaciones para poder evitar su realización. En este informe se encuentran recomendaciones sobre la necesidad o no de la realización de análisis de sangre periódicos anuales en la población adulta sana. Essencial és una iniciativa que identifica pràctiques clíniques de poc valor i promou recomanacions per tal d'evitar-ne la realització. En aquest informe trobem recomanacions sobre la necessitat o no de la realització d'anàlisis de sang periòdiques anuals en la població adulta sana.

Mycobacterium tuberculosis; T-cells; Immune response Tuberculosis micobacteriana; Células T; Respuesta inmune Tuberculosi micobacteriana; Cèl·lules T; Resposta immune Background: Current blood-based diagnostic tools for TB are insufficient to properly characterize the distinct stages of TB, from the latent infection (LTBI) to its active form (aTB); nor can they assess treatment efficacy. Several immune cell biomarkers have been proposed as potential candidates for the development of improved diagnostic tools. Objective: To compare the capacity of CD27, HLA-DR, CD38 and Ki-67 markers to characterize LTBI, active TB and patients who ended treatment and resolved TB. Methods: Blood was collected from 45 patients defined according to clinical and microbiological criteria as: LTBI, aTB with less than 1 month of treatment and aTB after completing treatment. Peripheral blood mononuclear cells were stimulated with ESAT-6/CFP-10 or PPD antigens and acquired for flow cytometry after labelling with conjugated antibodies against CD3, CD4, CD8, CD27, IFN-γ, TNF-α, CD38, HLA-DR, and Ki-67. Conventional and multiparametric analyses were done with FlowJo and OMIQ, respectively. Results: The expression of CD27, CD38, HLA-DR and Ki-67 markers was analyzed in CD4+ T-cells producing IFN-γ and/or TNF-α cytokines after ESAT-6/CFP-10 or PPD stimulation. Within antigen-responsive CD4+ T-cells, CD27− and CD38+ (ESAT-6/CFP-10-specific), and HLA-DR+ and Ki-67+ (PPD- and ESAT-6/CFP-10-specific) populations were significantly increased in aTB compared to LTBI. Ki-67 demonstrated the best discriminative performance as evaluated by ROC analyses (AUC > 0.9 after PPD stimulation). Data also points to a significant change in the expression of CD38 (ESAT-6/CFP-10-specific) and Ki-67 (PPD- and ESAT-6/CFP-10-specific) after ending the anti-TB treatment regimen. Furthermore, ratio based on the CD27 median fluorescence intensity in CD4+ T-cells over Mtb-specific CD4+ T-cells showed a positive association with aTB over LTBI (ESAT-6/CFP-10-specific). Additionally, multiparametric FlowSOM analyses revealed an increase in CD27 cell clusters and a decrease in HLA-DR cell clusters within Mtb-specific populations after the end of treatment. Conclusion: Our study independently confirms that CD27−, CD38+, HLA-DR+ and Ki-67+ populations on Mtb-specific CD4+ T-cells are increased during active TB disease. Multiparametric analyses unbiasedly identify clusters based on CD27 or HLA-DR whose abundance can be related to treatment efficacy. Further studies are necessary to pinpoint the convergence between conventional and multiparametric approaches. This research was supported by a grant from the Instituto de Salud Carlos III (PI18/00411, PI19/01408 and CP20/00070), integrated in the Plan Nacional de I + D + I and cofunded by the ISCIII Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); a grant from the Sociedad Española de Neumología y Cirugía Torácica (project 25/2016; SEPAR; Barcelona, Spain); and from the European Union’s Horizon 2020 Research and Innovation Programme under the Marie Skłodowska-Curie grant agreement no. 823854 (INNOVA4TB). JD and IL are researchers from the Miguel Servet programme. AS-M is supported by a Juan Rodés (JR18/00022) postdoctoral fellowship from ISCIII.

Anàlisis de sang; Periodicitat; Recomanacions Análisis de sangre; Periodicidad; Recomendaciones Blood test; Periodicity; Recommendations Esencial es una iniciativa que identifica practicas clínicas de poco valor y promueve recomendaciones para poder evitar su realización. En este informe se encuentran recomendaciones sobre la necesidad o no de la realización de análisis de sangre periódicos anuales en la población adulta sana. Essencial és una iniciativa que identifica pràctiques clíniques de poc valor i promou recomanacions per tal d'evitar-ne la realització. En aquest informe trobem recomanacions sobre la necessitat o no de la realització d'anàlisis de sang periòdiques anuals en la població adulta sana.