The complete blood count (CBC) is one of the most requested tests by physicians. CBC tests, most realized in conventional hematological analyzers, are restricted to centralized laboratories due to frequent maintenance, large devices, and expensive costs required. On the other hand, most handheld CBC devices commercially available show high prices and are not liable to calibration or control procedures, which results in poor quality compared to standard hematology instruments. The Hilab system is a small-handed hematological platform that uses microscopy and chromatography techniques for blood cells and hematimetric parameters analysis through artificial intelligence, machine learning, and deep learning techniques. For clinical evaluation of the handheld CBC device, 450 blood samples were analyzed. The samples encompassed normal (82%) and pathological conditions (18%), such as thalassemias (2.2%), anemias (6.6%), and infections (9.2%). For all analytes, accuracy, precision, method comparison, and flagging capabilities of the Hilab System, were compared with the Sysmex XE-2100 (Sysmex, Japan) results. The sample source (venous and capillary) influences were also evaluated. Pearson correlation, Student t test, bias, and the Bland–Altman plot of each blood count analyte were calculated and shown. The significance level was set at p ≤ 0.05. For clinical evaluation, Hilab System and the Sysmex XE-2100 showed a strong correlation (r ≥ 0.9) for most evaluated parameters. In the precision study, analytes showed CV inside the limits established according to European Federation of Clinical Chemistry and Laboratory Medicine guidelines. The flagging capabilities of the Hilab system, compared to the manual microscopy technique, presented high sensibility, specificity, and accuracy. Venous and capillary samples (p > 0.05) do not differ statistically. Considering the need for point-of-care CBCs, the study indicated that the Hilab system provides fast, accurate, low cost, and robust analysis for reliable clinical use.
Objetivo: Realizar uma revisão integrativa da literatura a fim de levantar dados que esclareçam a patogênese da coagulação intravascular disseminada (CIVD) e o papel das micropartículas e do fator tecidual (FT) na leucemia promielocítica aguda (LPA). Método: O presente estudo é uma revisão integrativa da literatura que se respalda na busca de artigos em bases de dados, Pub Med, Science Direct, Scielo, periódicos e sites, com os seguintes descritores em “Leucemia Promielocítica Aguda”, “Coagulação Intravascular Disseminada”, “Leucemia Promielocítica Hipogranular”, “Leucemia Promielocítica Hipergranular”, “Micropartículas”, “Fator Tecidual”, utilizando artigos de pesquisas originais entre anos de 2002 a 2022. Esse levantamento bibliográfico foi realizado no período de 01/02/2022 a 23/12/2022. Resultados: De um total de 137 artigos identificados, foram excluídos: 57 por não se enquadrar nos critérios de inclusão, 32 pela análise do título e 14 pela análise do resumo. Restaram 34 artigos que foram analisados de forma completa, dos quais 29 foram excluídos, sendo assim, apenas 5 foram incluídos no estudo. Discussão: A análise dos estudos selecionados na revisão evidencia que a relação entre a fisiopatologia da coagulopatia associada à LPA é complexa, e o principal mecanismo é mediado por propriedades específicas da própria célula leucêmica que libera vários mediadores capazes de ativar a CIVD. Conclusão: Conclui-se que a CIVD que ocorre nos pacientes com LPA é decorrente da ativação da hemostasia pelas micropartículas que transportam fator tecidual e estão presentes nos promielócitos. Esse entendimento é fundamental para o estabelecimento de protocolos de tratamento eficazes.
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