Hygiene INTRODUCTIONEarly detection of malaria in patients not suspected of having the disease is a potential novel application for modern hematology analyzers like the Sysmex XE-2100 (Sysmex Corporation, Kobe, Kansai, Japan). A prompt and accurate diagnosis is critical to reduce adverse outcomes associated with malaria, including death. 1 In endemic regions, malaria is a prime diagnostic concern in febrile patients, and expert thickfilm evaluation is usually available.2 However, the accuracy of microscopic malaria diagnosis in less experienced centers or in non-endemic regions may be lower, and health personnel is less likely to consider the disease, leading to delayed diagnoses.1 Automated full blood counts (FBC) are usually performed in patients with febrile illnesses, providing a unique opportunity to guide a timely parasitological malaria diagnosis.Hematology analyzers evaluated for malaria detection include the Cell-Dyn (Abbott Diagnostics, Santa Clara, CA), 3 the GEN.S and LH-750 (Beckman Coulter, Miami, FL), 4 and the XE-2100 and XS-1000 i (Sysmex Corporation, Kobe, Kansai, Japan). 5,6 The Sysmex XE-2100 is an automated hematology analyzer that uses flow cytometry, direct current (DC) impedanciometry, and radiofrequency conductance (RF) to detect and measure blood corpuscular elements.7 Flow cytometry may detect malaria parasites or parasite debris such as free hemozoin or hemozoin-laden macrophages as reported for Cell-Dyn instruments.8 For the Sysmex XE-2100, two case series reported a gap between the manual and automated eosinophil counts (pseudoeosinophilia) and abnormal granulocyte-coded events in the DIFF scatterplot used for white blood cell (WBC) separation based on fluorescence versus side-scatter signals in samples from Plasmodium vivaxinfected patients.9, 10 Later, Huh and others 5 found that the two previously reported abnormalities, compared with thick film, had a sensitivity of 69.4% and a specificity of 100% for P. vivax diagnosis. These findings suggest the potential clinical utility of malaria detection by the XE-2100. Ideally, to improve the clinical impact of this detection method, it should be an automated process relying on the analyzer's quantitative data and expressed as a "malaria alarm" that could motivate the microscopic search for malaria.The primary aim of this study was to develop, validate, and test the accuracy of one observer-dependent (OD) and two non-observer-dependent (N-OD) diagnostic prediction models for P. vivax and P. falciparum malaria. The approach for developing the OD models was similar to previous studies using the XE-2100 for malaria diagnosis 5 with the inclusion of other clinical and scatterplot variables not previously investigated. The N-OD models were developed to obtain a framework for an automated malaria-detection algorithm for the XE-2100. Secondary aims were to determine the occurrence of pseudoeosinophilia and to explore a possible cause for the XE-2100 FBC malaria-related abnormalities. MATERIALS AND METHODSStudy population. Blood samples were col...

Helicobacter pylori (H. pylori) is the most common infection in humans, with a marked disparity between developed and developing countries. Although H. pylori infections are asymptomatic in most infected individuals, they are intimately related to malignant gastric conditions such as gastric cancer and gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to benign diseases such as gastritis and duodenal and gastric peptic ulcers. Since it was learned that bacteria could colonize the gastric mucosa, there have been reports in the medical literature of over 50 extragastric manifestations involving a variety medical areas of specialization. These areas include cardiology, dermatology, endocrinology, gynecology and obstetrics, hematology, pneumology, odontology, ophthalmology, otorhinolaryngology and pediatrics, and they encompass conditions with a range of clear evidence between the H. pylori infection and development of the disease. This literature review covers extragastric manifestations of H. pylori infection in the hematology field. It focuses on conditions that are included in international consensus and management guides for H. pylori infection, specifically iron deficiency, vitamin B12 (cobalamin) deficiency, immune thrombocytopenia, and MALT lymphoma. In addition, there is discussion of other conditions that are not included in international consensus and management guides on H. pylori, including auto-immune neutropenia, antiphospholipid syndrome, plasma cell dyscrasias, and other hematologic diseases.

According to these results and others from different countries where H. pylori infection rates are high, patients with ITP should be initially tested for H. pylori status, and if present, infection should be eradicated before initiating a drastic conventional ITP treatment. An algorithm for the study and management of patients with ITP in the post-Helicobacter era is presented.

La alopecia areata es una enfermedad de los folículos pilosos con una fuerte evidencia que apoya su origen autoinmune [1,2], aunque la patogénesis exacta no está aún lo suficientemente clara. La alopecia areata tiene una frecuencia que oscila entre el 0,7% y el 3,8% de los pacientes que acuden al dermatólogo, y del 2% en la población general; afecta a ambos sexos [3] y a menudo se informa una mayor concurrencia familiar [4,5]. El patrón de pérdida del cabello puede variar y afectar cualquier parte del cuerpo. En marzo de 2011 se presentó a la comunidad médica mundial el informe de un paciente con alopecia areata en quién las manifestaciones clínicas, en cuero cabelludo y barba, desaparecieron tras la erradicación exitosa de una infección por Helicobacter pylori, bajo el título “Cure of alopecia areata after eradication of Helicobacter pylori: A new association?” [6], en donde se comunicó una posible nueva asociación de esta enfermedad con Helicobacter pylori, hasta ese momento no descrita en la comunidad científica.

La aspirina es la piedra angular del tratamiento en pacientes con enfermedades cardiovasculares y cerebrovasculares; sin embargo, varios estudios sobre la respuesta in vitro de las plaquetas a la administración de aspirina mostraron que esta respuesta es variable, encontrando algunos pacientes con falta de respuesta o resistencia a la aspirina. La resistencia a la aspirina puede ser ”clínica” o "de laboratorio". La resistencia clínica a la aspirina se define como el fracaso para evitar la aparición de los episodios isquémicos aterotrombóticos en pacientes a los que se les administra. La resistencia de laboratorio a la aspirina se define como el fracaso de la aspirina para inhibir la producción de tromboxano A2 por las plaquetas o para inhibir la activación de las plaquetas dependiente de la producción de tromboxano A2. Hasta el momento no hay ningún método general para la evaluación ex vivo de la activación plaquetaria o del grado de activación de las plaquetas después de la administración de aspirina, y los datos relativos al impacto clínico de la resistencia a la aspirina son conflictivos. Por esto, no es posible sugerir directrices específicas para el tratamiento de pacientes que muestran altos niveles de activación plaquetaria o un bajo nivel de inhibición de las plaquetas después del tratamiento con aspirina. El objetivo de esta revisión es presentar los datos de estudios clínicos y de laboratorio que están relacionadas con la resistencia a la aspirina y discutir las posibles causas, importancia clínica y formas de manejo clínico de dicha resistencia.