The Global Hemostatic Thrombodynamics Assay in Healthy Children

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Seregina EA ◽  
◽  
Kumskova MA ◽  
Gracheva MA ◽  
Poletaev AV ◽  
...  
Keyword(s):  
Growth Velocity ◽  
Spatial Organization ◽  
Age Groups ◽  
Complete Information ◽  
Specific Reference ◽  
Healthy Children ◽  
Test Results ◽  
Medical Examinations ◽  
Adult Volunteers ◽  
Generation Test

Background: There is evidence that the concentrations of clotting and anticoagulant factors in children depend on age and differ from those found in adults. The results of APPT, TT, PT, fibrinogen are similar in children and adults in some studies, while PT and APTT show differences in others. Recent studies on global hemostatic assays Thromboelastography (TEG) revealed no significant differences in test results between healthy children and adults, while the thrombin generation test (TGT) showed significant differences. The Thrombodynamics (TD) assay is a new global hemostasis assay that considers the spatial organization of coagulation. Methods: APTT, TT, PR, fibrinogen and TD assays were performed in 102 healthy children between the ages of 1 and 17 years who underwent annual medical examinations and in 91 healthy adult volunteers. The following TD assay parameters were determined: lag time (Tlag), initial clot growth velocity (Vi), stationary clot growth velocity (Vs), clot size 30 minutes after the start of clot growth (CS) and clot Density (D). Written consent was obtained from all participants or their parents after they received complete information about the tests. Results: Age-specific reference values for the TD assay in healthy children aged 1-17 years are presented. No significant differences were observed between different age groups of children (15 years, 6-10 years, and 11-17 years) or between all children (1-17 years) and adults. Significant differences were not observed between genders. Conclusions: The TD assay results revealed no age-specific differences in the parameters between children aged 1-17 years and adults.

scholarly journals Age- and sex-specific reference intervals for the serum cystatin C/creatinine ratio in healthy children (0–18 years old)

2019 ◽  
Vol 47 (7) ◽  
pp. 3151-3159 ◽  
Author(s):  
Changjin Liu ◽  
Jing Wen ◽  
Jialin Xiang ◽  
Xuhong Ouyang ◽  
Yan Yang ◽  
...  
Keyword(s):  
Cystatin C ◽  
Pediatric Population ◽  
Age Groups ◽  
Serum Markers ◽  
Reference Intervals ◽  
Specific Reference ◽  
Healthy Children ◽  
Serum Samples ◽  
Serum Cystatin C ◽  
Age And Sex

Objective This study aimed to investigate serum levels of the cystatin C (CysC)/creatinine (Cr) ratio and renal serum markers (CysC, Cr, urea, and uric acid [UA]) for different ages and by sex. We also aimed to establish pediatric reference intervals for the serum CysC/Cr ratio. Methods Serum samples were collected from 4765 healthy children (0–18 years old). Serum markers of renal function were measured, and the CysC/Cr ratio of each participant was calculated and statistically analyzed. Results The renal marker CysC did not substantially change after 1 year old. Cr, urea, and UA levels generally increased with age. However, the serum CysC/Cr ratio steadily decreased with age. The CysC/Cr ratio showed significant differences in age among all age groups and varied with sex, except for in the 1 to 6-year-old groups. The overall serum CysC/Cr ratio in girls was higher than that in boys. Conclusion Reference intervals of the serum CysC/Cr ratio in the pediatric population were established. These intervals need to be partitioned by age and sex.

scholarly journals Pediatric Thromboelastograph 6s and Laboratory Coagulation Reference Values

2021 ◽  
Author(s):  
Katie M. Moynihan ◽  
Kerry Johnson ◽  
Mark Rane ◽  
Andrew Norman ◽  
Susan Humphreys ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Partial Thromboplastin Time ◽  
Venous Blood ◽  
Age Groups ◽  
Activated Partial Thromboplastin Time ◽  
Specific Reference ◽  
Fibrinogen Concentration ◽  
Healthy Children ◽  
Coagulation Parameters ◽  
Model Based

Context.— Specific reference intervals (RIs) facilitate accurate interpretation of results. Coagulation assay results may vary by demographics and also between reagents and analyzers used. Current Thromboelastograph 6s (TEG 6s) Hemostasis Analyzer RIs were generated from adult samples. Objective.— To generate reagent analyzer-specific pediatric RIs for TEG 6s and coagulation parameters. Design.— A prospective, observational, single-center study of healthy children undergoing general anesthesia (January 3, 2017 to January 3, 2019). Venous blood samples were obtained for TEG 6s (Kaolin, Kaolin-Heparinase, Rapid and Functional Fibrinogen assays) and coagulation parameters (activated partial thromboplastin time, prothrombin time, thrombin clotting time, Echis time, antithrombin activity, and fibrinogen concentration using Instrumentation Laboratory ACL-TOP analyzers). Differences between activated partial thromboplastin time and prothrombin time reagents were investigated using mixed-effects regression, comparing maximum coefficients-of-variation with assay-specific allowable variation. RIs (lower/upper limits 2.5th of 97.5th percentiles) were generated using the following 2 methods: within discrete age-groups (neonates [<1 month], infants [1 month–1 year], young children [1–5 years], older children [6–10 years], and adolescents [11–16 years]), and modeled as functions of age and/or sex using quantile regression, including significant fractional polynomial and interaction terms. Results.— Variation between prothrombin time and activated partial thromboplastin time assays using different reagents was clinically significant. Reagent-analyzer specific pediatric RIs were generated using data from 254 children. Discrete and model-based RIs varied by age for all coagulation parameters and TEG 6s variables in all assays. Conclusions.— We report reagent-analyzer specific pediatric RIs for TEG 6s and coagulation parameters. Observed variation reinforces recommendations for laboratory-specific RIs. These findings improve accuracy of interpretation of clinical results, provide a foundation for comparison and validation of tests in pathology and illustrate feasibility and advantages of model-based RI approaches.

Age Dependency Of Coagulation Parameters During Childhood

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2341-2341
Author(s):  
Pierre A. Toulon ◽  
Julien Arcizet ◽  
François Grand ◽  
Neila De Pooter ◽  
Dominique Lasnes ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Age Groups ◽  
Technical Condition ◽  
Specific Reference ◽  
Factor V ◽  
Reference Ranges ◽  
Test Results ◽  
Coagulation Test ◽  
Mean Values ◽  
D Dimer

Abstract Developmental hemostasis, a concept first reported by M.Andrew et al. in the late 80s, is now universally accepted, as it is critical to ensure optimal prevention, diagnosis, and treatment of hemorrhagic and thrombotic diseases in children. As coagulation test results, particularly prothrombin time (PT), and activated partial thromboplastin time (aPTT), are known to vary with the reagents and analyzers used, it is recommended for each laboratory to define the age-dependent reference ranges by using its own technical condition (J Thromb Haemostas 2012; 10: 298). To address that issue, the present multicenter study was carried out in six centers using the same reagents and the same ACL TOP analyzer (all from Instrumentation Laboratory, Bedford, MA, USA). There were 598 samples obtained from pediatric patients (407 M and 191 F), aged between 2 Weeks and 17 Years. Samples were obtained from the routine workload in all participating centers. Indication for coagulation testing was pre-operative screening (non-acute) in most cases. They were divided in 6 age groups: <1 Month (median=3 Weeks, range 2-4 W, n=11), between 1 and 5 Months (median=3 Mo, n=135), between 6 and 12 Mo (median=8.5 Mo, n=73), between 1 and 5 Years (median=2 Y, n=238), between 6 and 10 Y (median=8 Y, n=49) and between 11 and 17 Y (median=13 Y, n=99). As the data obtained in the different centers were not significantly different, test results were pooled and further analyzed. In most cases, data were found to be normally distributed, allowing expression of the test results as the mean values with SDs. Alternatively, in the case of non-normal distribution, test results were expressed as the median values with their ranges. PT (ratio) was found to be positively correlated with age (r=+0.61, p<0.0001), with shorter clotting times in younger children. The same applied to fibrinogen (Clauss) level (r=+0.47, p<0.0001). Conversely, aPTT (ratio) was negatively correlated with age (r=-0.15, p<0.01), with longer clotting times in younger children. Factor V (FV) and FVIII levels (Table) were found roughly unchanged during childhood, and the same applied to FX (not shown). In contrast, FII, FIX, FXI, and FXII levels were significantly decreased in youngest children particularly in those below 1 Mo, and then increased correlatively with age before reaching adult values in children above 10 Y. D-dimer levels (HemosIL D-dimer HS 500) were found higher in the first 6 months of life and remained slightly elevated during childhood before reaching adult values during puberty.< 1 Mo1 - 5 Mo6 - 12 Mo1 - 5 Y6 - 10 Y11 - 16 YPT (ratio)0.96+0.070.96+0.070.98+0.071.01+0.081.06+0.081.07+0.09aPTT (ratio)1.19+0.121.11+0.111.08+0.131.07+0.141.07+0.101.03+0.09Fg (g/L)2.53+0.202.36+0.522.46+0.512.84+0.592.81+0.602.84+0.58F V (%)116+24118+27104+24113+21114+24116+23F VIII (%)98+4188+2587+1886+1799+1793+22FIX (%)47+1360+1873+1785+1485+1795+19FXI (%)59+1069+2685+2094+2184+1389+19D-dimer (ng/mL)495 (85-1200)420 (90-1100)292 (130-950)280 (80-2100)284+124233+157 These data suggest that, at least in the described technical conditions, most coagulation test results are highly dependent on age, mainly during the first year of life, and that age-specific reference ranges must be used to ensure proper evaluation of coagulation in children. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Establishment and Verification of Sex- and Age-Specific Serum Electrolyte Reference Intervals in Healthy Han Children in Changchun, Northeastern China

2019 ◽  
Vol 2019 ◽  
pp. 1-10
Author(s):  
Qi Zhou ◽  
Xin Li ◽  
Yanan Jia ◽  
Wenjia Guo ◽  
Baojie Guan ◽  
...  
Keyword(s):  
Age Groups ◽  
Reference Intervals ◽  
Specific Reference ◽  
Early Age ◽  
Healthy Children ◽  
Population Differences ◽  
Serum Electrolyte ◽  
Specific Serum ◽  
Biochemical Analyzer ◽  
Automatic Biochemical Analyzer

For lack of feasible interval values from population differences and potential analytical discrepancies, it is essential to ascertain potassium (K), sodium (Na), chlorine (Cl), calcium (Ca), and phosphorus (P) ions reference intervals within Chinese children to fill the gap. Healthy children (n = 1391, 2–<15 years old) were recruited from communities and schools to establish sex- and age-specific serum electrolyte reference intervals of Han children in Changchun, China. Levels of serum K, Na, Cl, Ca, and P were measured using a Hitachi 7600-210 automatic biochemical analyzer. Reference intervals were established according to Clinical and Laboratory Standards Institute EP28-A3c guidelines. Data from five representative hospitals located across Changchun were used to verify pediatric serum electrolyte reference intervals. Values were different from adult reference intervals in China. There were sex-specific differences in Na, Cl, Ca, and P reference intervals in 13-<14 children. Serum Na, Cl, and Ca reference intervals showed stable trends within early age groups but fluctuated in teens. Each serum electrolyte had ≤3 age-specific reference intervals. Five laboratories suggested reference intervals were applicable across Changchun.

Age dependency for coagulation parameters in paediatric populations

2016 ◽  
Vol 116 (07) ◽  
pp. 9-16 ◽  
Author(s):  
Pierre Toulon ◽  
Micheline Berruyer ◽  
Marie Brionne-François ◽  
François Grand ◽  
Dominique Lasne ◽  
...  
Keyword(s):  
Age Groups ◽  
Technical Condition ◽  
Specific Reference ◽  
First Year ◽  
Reference Ranges ◽  
Test Results ◽  
Coagulation Test ◽  
Clotting Factors ◽  
First Year Of Life ◽  
Thrombotic Diseases

SummaryUnderstanding of developmental haemostasis is critical to ensure optimal prevention, diagnosis, and treatment of haemorrhagic and thrombotic diseases in children. As coagulation test results are known to be dependent on the reagents/analysers used, it is recommended for each laboratory to define the age-dependent reference ranges by using its own technical condition. That study was carried out in seven centers to establish age-specific reference ranges using the same reagents and analyser. Plasma samples were obtained from 1437 paediatric patients from the following age groups: 15 days-4 weeks (n=36), 1–5 months (n=320), 6–12 months (n=176), 1–5 years (n=507), 6–10 years (n=132) and 11–17 years (n=262). Indication of coagulation testing was pre-operative screening for non-acute diseases in most cases. PT values were similar in the different age groups to those in adults, whereas longer aPTTs were demonstrated in the younger children. Plasma levels of all clotting factors, except for FV, were significantly decreased (p<0.0001) in the youngest children, adult values being usually reached before the end of the first year. The same applied to antithrombin, protein C/S, and plasminogen. In contrast, FVIII and VWF levels were elevated in the youngest children and returned to adult values within six months. The same applied to D-dimer levels, which were found elevated, particularly until six months of life, until puberty. These data suggest that most coagulation test results are highly dependent on age, mainly during the first year of life, and that age-specific reference ranges must be used to ensure proper evaluation of coagulation in children.

Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

2020 ◽  
Author(s):  
Anders Batman Mjelle ◽  
Anesa Mulabecirovic ◽  
Roald Flesland Havre ◽  
Edda Jonina Olafsdottir ◽  
Odd Helge Gilja ◽  
...  
Keyword(s):  
Shear Wave ◽  
Transient Elastography ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Healthy Children ◽  
Significant Difference ◽  
Pediatric Liver Disease ◽  
Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

Age development of cortical rhythmics in the EEG depending on the formation of the child’s personal psychical characteristics

2019 ◽  
Vol 1 (8) ◽  
pp. 42-50
Author(s):  
A. V. Budkevich ◽  
L. B. Ivanov ◽  
G. R. Novikova ◽  
G. M. Dzhanumova
Keyword(s):  
Alpha Rhythm ◽  
Age Groups ◽  
Healthy Children ◽  
Brain Organization ◽  
Age Related ◽  
Mathematical Processing ◽  
Functional Brain Organization ◽  
Child's Brain ◽  
Attention Function ◽  
Apparently Healthy

According to the authors, rationing the age-related EEG parameters in children should be based on personal psychical characteristics. A comparative analysis of personal psychical characteristics and electroencephalographic data was carried out in 300 apparently healthy children aged 3-15 years. According to this principle, two subgroups of conditionally healthy children in each age group were singled out: 1) with an immature attention function and 2) with an increased anxious background that do not reach the pathological level. Registration and analysis of EEG was performed by the Neurokariograf computer complex (MBN, Moscow) using mathematical processing methods.The EEG interpretation was based on the principle of assessing the functional state of a child's brain using a three-component model according to: 1) wakefulness level and its dissociation, 2) severity of signs of the EEG neurotic pattern, 3) directionality of formation of traits of the system-functional brain organization (severity of signs functional hypofrontality).lt was found the presence of EEG signs was indicative of a lower level of wakefulness in children with an immature function of attention in all age groups, compared with the indicators of the average population of group and children with an increased background of anxiety. Children with an increased background of anxiety have a tendency to prevalence and excessive spatial synchronization of the alpha rhythm. ln healthy children, the fact of a decrease in wakefulness and the presence of signs of anxiety in the clinic and in EEG patterns indicates individual personalities and should not be considered as pathology.

scholarly journals Effect of 1 mg/kg oral prednisolone on biochemical analytes in ten dogs: a cross-over study

2021 ◽  
Author(s):  
Helena Pettersson ◽  
Carl Ekstrand ◽  
Anna Hillström ◽  
Inger Lilliehöök
Keyword(s):  
Clinical Relevance ◽  
Control Period ◽  
Iron Concentration ◽  
Oral Prednisolone ◽  
Reference Intervals ◽  
Specific Reference ◽  
Test Results ◽  
Prednisolone Treatment ◽  
Anti Inflammatory ◽  
And Control

AbstractPrednisolone is used for treatment of inflammatory, allergic, neoplastic, and immune-mediated diseases in dogs. As a glucocorticoid, prednisolone has biochemical effects, which may interfere with the interpretation of biochemistry test results. The aim of this study is to investigate the effects of prednisolone treatment in an anti-inflammatory dose on common biochemical analytes in dogs and to evaluate the clinical relevance of the changes. Ten beagle dogs, enrolled in a cross-over study, were treated with oral prednisolone (1 mg/kg 24 h) for 10 days. Blood samples were collected at day 0, 1, 3, 6, 9, 10, 12, 16, and 20. Data was analyzed using a general linear model with time and treatment as fixed factors. Pairwise comparisons were done between prednisolone and control period for each dog and sampling. Significant results were further evaluated for clinical relevance using laboratory-specific reference intervals and reference change values (RCVs), when available. Statistically significant changes were observed for ALP activity and iron concentration, which increased to levels exceeding the RCV, and several results were outside reference intervals. Phosphate and bile acids increased significantly, while amylase, lipase, and cholesterol decreased significantly, but with mean/median results remaining within reference intervals. Anti-inflammatory prednisolone treatment did not induce significant changes in ALT, GLDH, GGT, cPLI, glucose, or calcium. Treatment with an anti-inflammatory dose of prednisolone induced changes in several analytes. Only the increases in ALP and iron were of such magnitude that they are expected to affect the clinical interpretation of test results.

scholarly journals Distances between mandibular posterior teeth and the WALA ridge in Peruvians with normal occlusion

2017 ◽  
Vol 22 (6) ◽  
pp. 56-60 ◽  
Author(s):  
Carla Y. Kong-Zárate ◽  
Marcos J. Carruitero ◽  
Will A. Andrews
Keyword(s):  
Age Groups ◽  
Test Results ◽  
Posterior Teeth ◽  
Normal Occlusion ◽  
Tooth Type ◽  
The Mean ◽  
Student’S T ◽  
Mandibular Posterior Teeth ◽  
Digital Caliper ◽  
Student’S T Test

ABSTRACT Objective: The purposes of this investigation were to determine the horizontal distances between the mandibular posterior teeth and the WALA ridge in a sample of Peruvians with normal occlusion and to compare them by tooth type, sex, arch side, and age groups. Methods: 65 dental casts of subjects with normal occlusion were collected. Posterior teeth, except for third molars, were evaluated. The horizontal distances between the occluso-gingival midpoints of the buccal surfaces (FA points) of each tooth and the WALA ridge were measured using a modified digital caliper. The values between each different tooth type within the sample were compared using the ANOVA and Scheffe tests, while comparisons by sex, arch side and age groups, using the Student’s t-test. Results: The mean distances in the sample was 0.96 mm for first premolars, 1.45 mm for second premolars, 2.12 mm for first molars and 2.55 mm for second molars. Statistically significant differences between each of the four tooth types were found. There were no significant differences found between sex, arch side and age groups. Conclusion: The horizontal distances between the mandibular posterior teeth and the WALA ridge increased progressively from the first premolars to the second molars in Peruvians with normal occlusion. The WALA ridge was a good landmark to evaluate the positions of posterior teeth in Peruvians with normal occlusion.

scholarly journals Reference values of electrographic and cardiac ultrasound parameters in Russian healthy children and adolescents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geraldine Landon ◽  
Isabelle Denjoy ◽  
Enora Clero ◽  
Aleksandr Silenok ◽  
Irina Kurnosova ◽  
...  
Keyword(s):  
Age Groups ◽  
Cross Sectional Study ◽  
Healthy Children ◽  
Cardiac Ultrasound ◽  
Relevant Feature ◽  
Sectional Study ◽  
Cross Sectional ◽  
Echocardiographic Parameters ◽  
Electrocardiographic Parameters ◽  
Ultrasound Parameters

AbstractBetween 2009 and 2013, a large cross-sectional study on the health consequences of the Chernobyl nuclear accident was performed in the contaminated and uncontaminated territories of the Bryansk Oblast (Russian Federation). The objective of this work was to confirm or refute a possible association between childhood cardiac arrhythmia and a chronic exposure to caesium-137. As part of this study, a large number of electrocardiographic and cardiac ultrasound parameters were collected from 18,152 children aged 2–18 years including 12,512 healthy ones not contaminated with caesium-137. It seemed therefore relevant for us to share in a second publication these medical data based on healthy and uncontaminated children with the scientific community because of the large quantities and the limited availability of such kind of data. In the present study, relating to electrocardiographic parameters, the measurements performed fully reflect the expected evolution of the paediatric electrocardiogram between 5 and 18 years of age. Thus, the median values were generally quite close to those available in the literature. In contrast, differences in the 2nd and 98th percentiles were notable and could be explained in particular by the type of equipment used, the number of subjects included in the study and racial disparities. As for echocardiographic parameters, the evolution of the measured values in age groups is consistent with what was expected considering factors such as growth. In comparison with other scientific studies that have investigated these echocardiographic parameters, some differences by age groups have been identified. The ethnic factor truly appears to be a relevant feature to consider. In view of the results, it appeared essential to the authors to approach the methodological conditions of the scientific studies already published on the topic to be truly comparable and thus to provide a reliable answer on a topic for which real expectations in terms of medical care are required.

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