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Mean Corpuscular Volume

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41. Association of the Dispersion in Red Blood Cell Volume with Mortality. (PubMed)

Association of the Dispersion in Red Blood Cell Volume with Mortality. The red cell distribution width (RDW) predicts mortality among many populations. RDW is calculated as the standard deviation (SD) of the red blood cell (RBC) volume divided by mean corpuscular volume (MCV). Because higher MCV also predicts mortality, we hypothesized that the RDW numerator (one SD of RBC volume or 1SD-RDW) predicts mortality more strongly than the RDW.Adult subjects hospitalized during a contemporary clinical (...) to RDW as an individual risk predictor. Further, these results indicate that the dispersion of RBC volume and its mean are independent risk markers. Further research is required to understand the clinical value and mechanistic basis of these associations.© 2015 Stichting European Society for Clinical Investigation Journal Foundation.

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2015 European journal of clinical investigation

42. Iron Deficiency – Diagnosis and Management

are highly suggestive of iron deficiency: hypochromia (low mean corpuscular hemoglobin concentration (MCHC)) microcytosis (low mean corpuscular volume (MCV)) Patients with microcytic anemia should not be given iron supplements until iron deficiency is confirmed by testing ferritin. Low MCV in the setting of normal ferritin may indicate hemoglobinopathies such as thalassemia especially in high risk ethnic groups. Long term iron therapy is harmful for these patients. Refer to . Additional tests (...) at First Nations Health Authority Guide to Your Baby’s First Solid Foods: Traditional Foods Fact Sheets: List of Abbreviations ACD CBC Fe GI GU ID IDA IM IV MCHC MCV TSAT anemia of chronic disease complete blood count iron gastrointestinal genitourinary iron deficiency iron deficiency anemia intramuscular intravenous mean corpuscular hemoglobin concentration mean corpuscular volume transferrin saturation This guideline is based on scientific evidence current as of January 2019. The guideline

2019 Clinical Practice Guidelines and Protocols in British Columbia

43. Oral vitamin B<sub>12</sub> versus intramuscular vitamin B<sub>12</sub> for vitamin B<sub>12</sub> deficiency. (PubMed)

by Cochrane. Our primary outcomes were serum vitamin B12 levels, clinical signs and symptoms of vitamin B12 deficiency, and adverse events. Secondary outcomes were health-related quality of life, acceptability to patients, haemoglobin and mean corpuscular volume, total homocysteine and serum methylmalonic acid levels, and socioeconomic effects. We used GRADE to assess the quality of the evidence for important outcomes. We did not perform meta-analyses due to the small number of included trials (...) and substantial clinical heterogeneity.Three RCTs met our inclusion criteria. The trials randomised 153 participants (74 participants to oral vitamin B12 and 79 participants to IM vitamin B12). Treatment duration and follow-up ranged between three and four months. The mean age of participants ranged from 38.6 to 72 years. The treatment frequency and daily dose of vitamin B12 in the oral and IM groups varied among trials. Only one trial had low or unclear risk of bias across all domains and outcome measures

2018 Cochrane

44. Assessment of anaemia

of macrocytic anaemia in which DNA synthesis is normal. Megaloblasts and hypersegmented neutrophils are absent. [Figure caption and citation for the preceding image starts]: Megaloblastic macrocytic anaemia From the collection of Dr Robert Zaiden; used with permission [Citation ends]. [Figure caption and citation for the preceding image starts]: Classification of anaemia: MCV, mean corpuscular volume; fL, femtolitres Created by the BMJ Knowledge Centre [Citation ends]. Differentials Trauma Acute (...) into the circulation. After one further day in the circulation, reticulocytes lose their ribosomal network and become mature RBCs, which circulate for 110-120 days before being removed from the circulation by macrophages. At steady state, the rate of RBC production equals the rate of RBC loss. Anaemia develops when the rate of RBC production decreases and/or the rate of RBC loss increases. Morphological classification of anaemia The most clinically useful classification system is based on the mean corpuscular

2018 BMJ Best Practice

45. Polycythaemia vera

History and exam presence of risk factors features of thrombosis features of haemorrhage asymptomatic headache generalised weakness/fatigue pruritus erythromelalgia redness of fingers, palms, toes, heels facial redness splenomegaly affected family member age >40 years Budd-Chiari syndrome (BCS) Diagnostic investigations haemoglobin haematocrit white blood cell (WBC) count platelet count mean corpuscular volume (MCV) liver function tests (LFTs) JAK2 gene mutation screen oxygen saturation haemoglobin

2018 BMJ Best Practice

46. Assessment of anaemia

of macrocytic anaemia in which DNA synthesis is normal. Megaloblasts and hypersegmented neutrophils are absent. [Figure caption and citation for the preceding image starts]: Megaloblastic macrocytic anaemia From the collection of Dr Robert Zaiden; used with permission [Citation ends]. [Figure caption and citation for the preceding image starts]: Classification of anaemia: MCV, mean corpuscular volume; fL, femtolitres Created by the BMJ Knowledge Centre [Citation ends]. Differentials Trauma Acute (...) into the circulation. After one further day in the circulation, reticulocytes lose their ribosomal network and become mature RBCs, which circulate for 110-120 days before being removed from the circulation by macrophages. At steady state, the rate of RBC production equals the rate of RBC loss. Anaemia develops when the rate of RBC production decreases and/or the rate of RBC loss increases. Morphological classification of anaemia The most clinically useful classification system is based on the mean corpuscular

2018 BMJ Best Practice

47. The Collaborative Assessment, OTCA12, on “C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescribing in primary care settings for acute respiratory tract infections (RTIs)

pharyngitis (Centor Score 1-4: sensitivity: 0.90; specificity 0.45), but only if RADT is not available (Centor Score 1-4: sensitivity: 0.90; specificity 0.97) [6]. The low specificity of this cut-point means that many false positives may be treated unnecessarily with antibiotics. (D1005, D1006) Nine studies reported on the usefulness of CRP in LRTI and, or specifically in pneumonia. Five studies reported on the diagnostic accuracy of CRP at a specified threshold for diagnosing pneu- monia. Four studies (...) of accuracy for CRP POCT are a bias (the difference between the measured value and the true value) that is no greater than 15% (10% for some health bodies). The most common methods of reporting accuracy were agreement from a Passing Bablok regression, correlation from a Pearson or Spearman correlation coefficient or a mean difference from Bland-Altman plots. Precision is a measure of the random error in an assay and can presented as a coefficient of vari- ation (CV); Scandinavian health bodies and other

2019 EUnetHTA

48. Iron-ing Out the Wrinkles in Anemia Management

be supported. Evidence: • Randomized controlled trials. Differences statistically significant unless indicated. o General population adults: ? 80 patients (92% female, mean age 39): 1 iron polysaccharide (Niferex™) versus ferrous fumarate, both ~150mg/day elemental iron. After 12 weeks: • Ferrous fumarate improved hemoglobin (28.4g/L) more than iron polysaccharide (6g/L). o Ferrous fumarate: Better serum ferritin, mean corpuscular volume, and transferrin saturation but more nausea (31% versus 3%). ? 43 (...) patients: 2 iron polysaccharide (Niferex™) versus ferrous fumarate - similar hemoglobin improvements after ~4 weeks. o Children: ? 80 children (mean age 23 months): 3 Iron polysaccharide (NovaFerrum™) versus ferrous sulfate, both 3mg/kg/day elemental iron. • At 12 weeks, ferrous sulphate improved hemoglobin more (10g/L), resolved IDA (29% vs 6%, Number Needed to Treat=5), caused less diarrhea (35% versus 58%). ? 32 premature infants: 4 Iron polysaccharide versus ferrous sulphate (both 7.5mg/day

2019 Tools for Practice

49. Iron Deficiency and Anaemia in Adults

disease IDA iron deficiency MCH mean cell haemoglobin MCHC mean corpuscular haemoglobin concentration MCV mean cell volume PBM patient blood management PPH primary postpartum haemorrhage PRCA pure red-cell aplasia QoL quality of life RBC red blood cells TSAT transferrin saturation Acronyms and abbreviationsROYAL COLLEGE OF NURSING 41IRON DEFICIENCY AND ANAEMIA IN ADULTS: RCN GUIDANCE FOR NURSING PRACTICE 42ROYAL COLLEGE OF NURSING 4344 The RCN represents nurses and nursing, promotes excellence (...) . Iron deficiency results in a failure to synthesise haemoglobin. In cases of hypochromia the MCH (mean cell haemoglobin) is reduced as there is less haemoglobin within the red blood cells. This makes the cells appear pale. The lack of haemoglobin also makes the cells smaller than they should be, leading to a reduced MCV (mean cell volume). Causes of absolute iron deficiency (AID) Inadequate dietary intake Poor nutrition. Chronic alcoholism. Vegetarianism (decreased consumption of animal protein

2018 Royal College of Nursing

50. HTA of C-reactive protein point-of-care testing to guide antibiotic prescribing

. As the included semi-quantitative devices have an upper limit of 80mg/L, they may be of limited use in terms of current guidelines for antibiotic prescribing that use a cut-point of =100 mg/L for antibiotic prescribing. The majority of the evidence suggested acceptable performance for all 11 quantitative devices in the laboratory setting. Most of the devices had a mean difference of 80 mg/L for strips and high of =20 mg/L for single-use disposable device. One device co-tests for the viral biomarker MxA (...) devices sold into the Irish market comply with the relevant legislation. This means that a medical device must achieve the performance criteria specified by the manufacturer and in doing so must not compromise the health and safety of patients, service providers and any other persons. In its role as the Competent Authority, the HPRA operates a vigilance system for medical devices. Vigilance issues include adverse incidents and field safety corrective actions (FSCAs). An adverse incident is an event

2019 Health Information and Quality Authority

51. Oral supplementation of iron: evolving best practices

Oral supplementation of iron: evolving best practices Oral Supplementation of Iron: Evolving Best Practices – Clinical Correlations Search Oral Supplementation of Iron: Evolving Best Practices October 2, 2019 4 min read By Gabrielle Mayer Peer Reviewed The patient’s bloodwork results seemed straight from a hematology textbook: low hemoglobin, low mean corpuscular volume, low ferritin, and high total iron binding capacity. 1 The diagnosis appeared unambiguous: iron deficiency anemia. Equally

2019 Clinical Correlations

52. Ertugliflozin l-pyroglutamic acid (Steglatro) - Diabetes Mellitus, Type 2

in urinary glucose excretion (UGE) and a non-significant decrease in plasma glucose were seen in the pair-fed SHR treated with ertugliflozin concomitant with a 12% loss in body weight from baseline value of 307 ±4 g and 22% reduction in body weight compared to control SHR. Similar to the Sprague Dawley rats, ertugliflozin increased water intake, urine volume, percent of urine volume to water intake, and hematocrit, indicating a diuretic effect. Concurrent with the diuresis, ertugliflozin lowered mean (...) . Absorption Ertugliflozin was well absorbed and demonstrated low to moderate clearance (1.6 – 14 mL/min/kg) with a moderate volume of distribution (0.8 – 1.6 L/kg) in the nonclinical species evaluated. Mean apparent terminal half-life (t½) values for ertugliflozin ranged from approximately 2.7 to 7.6 hours in nonclinical species and oral bioavailability was moderate to high (56% to 97%). Absorption was rapid with a mean time to Cmax occurrence (Tmax) occurring at 0.5 hours postdose in mouse, 0.67 to 2.3

2018 European Medicines Agency - EPARs

53. Sodium zirconium cyclosilicate (Lokelma) - Hyperkalemia

at a dose volume of 10 ml/kg to rats or dogs. Repeat dose toxicity EMA/93250/2018 Page 20/103 Study ID Species/ Sex/ Number/ Group Dose (mg/kg b.w.)/ Route/ Duration NOAEL (mg/kg/ day) Major findings 2009- 001/ GLP - No Rat (Sprague- Dawley)/ M/5 F/5 0, 500, 1000, 2000 1,2 Oral (gavage) 7 days Treatment with ZS-9 did not result in moribundity or mortality. There was a test article-related increase in plasma mean prothrombin time (PT) in M and F from Group 4 when compared to control Group 1. Treatment (...) weight. A decrease in body weight gain across all dose groups including control compared to pre-trial during the 14-day dosing period was attributed to the volume of the dose formulation. Food Consumption: A reduction in mean daily food consumption was observed for both the 0 mg/kg/dose (Control) group as well as all the groups administered ZS-9. This reduction in food consumption is most likely reflective of animals receiving a 10 mL/kg dose volume, three times a day. Hematology: At Day 15/16

2018 European Medicines Agency - EPARs

54. Ertugliflozin l-pyroglutamic acid / metformin hydrochloride (Segluromet) - Diabetes Mellitus, Type 2

treated with ertugliflozin concomitant with a 12% loss in body weight from baseline value of 307 ?4 g and 22% reduction in body weight compared to control SHR. Similar to the Sprague Dawley rats, ertugliflozin increased water intake, urine volume, percent of urine volume to water intake, and hematocrit, indicating a diuretic effect. Concurrent with the diuresis, ertugliflozin lowered mean systolic blood pressure by 11%, mean arterial blood pressure by 13%, and heart rate by 15% when compared (...) –hour UGE and resulted in 5 % reduction in body weight in pair-fed rats compared to control rats (an effect that was not significant compared to baseline values), while furosemide did not have any significant effect on body weight. Both compounds lowered mean systolic blood pressure, diastolic blood pressure and mean blood pressure to the same degree (8-10%) as compared to control rats. Although ertugliflozin increased the urine volume to water intake ratio, indicating a diuretic effect, plasma

2018 European Medicines Agency - EPARs

55. Rucaparib camsylate - Ovarian Neoplasms

resulted in dose-dependent and statistically significant reduction in mean tumour volumes on the last day of dosing (Day 28) in all rucaparib treated groups, with > 100% TGI observed at 50 and 150 mg/kg BID. At study termination (Day 39) there was a dose-dependent and statistically significant TGI in all rucaparib treated groups. Dose, Exposure and Response Relationship of Rucaparib in the MDA-MB-436 (BRCA1 Mutant) Orthotopic Breast Cancer Model The dose, exposure and response relationship of rucaparib (...) in tumour growth, with mean tumour/control (T/C) volumes ranging from 7.0-15.2% and 0.6-14.7% in the HBCx-17 and HBCx-6 models, respectively. In both studies, tumours were monitored for 13-15 days after rucaparib dosing was discontinued. In the HBCx-17 model, 50% of the mice treated with 150 mg/kg BID rucaparib had a PR or CR, whereas in the HBCx-6 model 100% of the mice treated with 150 mg/kg QD or 300 mg/kg BID rucaparib had a PR or CR. Rucaparib Efficacy in 3 BRCA2 Mutant Pancreatic PDX Models

2018 European Medicines Agency - EPARs

56. Ertugliflozin l-pyroglutamic acid / sitagliptin phosphate monohydrate (Steglujan) - Diabetes Mellitus, Type 2

compared to control SHR. Similar to the Sprague Dawley rats, ertugliflozin increased water intake, urine volume, percent of urine volume to water intake, and hematocrit, indicating a diuretic effect. Concurrent with the diuresis, ertugliflozin lowered mean systolic blood pressure by 11%, mean arterial blood pressure by 13%, and heart rate by 15% when compared with vehicle control animals. Ertugliflozin also significantly increased plasma renin activity, serum aldosterone, and plasma and urinary (...) to baseline values), while furosemide did not have any significant effect on body weight. Both compounds lowered mean systolic blood pressure, diastolic blood pressure and mean blood pressure to the same degree (8-10%) as compared to control rats. Although ertugliflozin increased the urine volume to water intake ratio, indicating a diuretic effect, plasma renin activity and urinary and plasma angiotensinogen were not significant altered. Unlike ertugliflozin, furosemide caused a significant increases

2018 European Medicines Agency - EPARs

57. Alpha-thalassaemia

Diagnostic investigations haemoglobin (Hb) mean corpuscular volume (MCV) mean corpuscular haemoglobin (MCH) RBC count peripheral smear reticulocyte percentage serum iron serum ferritin brilliant cresyl blue staining of red blood cells haemoglobin electrophoresis Hb fractionation by high-performance liquid chromatography (HPLC) gap-PCR multiplex ligation-dependent probe amplification (MLPA) direct sequencing MRI (hepatic or cardiac) superconducting quantum interference devices (SQUID) liver biopsy

2017 BMJ Best Practice

59. Alcoholic Liver Disease

inaccurate, the use of alcohol biomarkers can be useful to diagnose alcohol consump- tion. Of the biochemical tests, mean corpuscular volume, ami- notransferases, and ? -glutamyl transferase are sensitive tests, but lack specifi city in patients with cirrhosis ( 34 ). Carbohydrate- defi cient transferrin combined with ? -glutamyl transferase has sensitivity of about 75–90%. However, the levels of carbohydrate- defi cient transferrin may be confounded with increasing dis- ease severity and active smoking (...) damage (Mallory–Denk bodies and/or ballooning), bilirubin sta- sis and liver fi brosis, which is typically described as peri cellular and sinusoidal (“chicken wire” appearance) ( 58 ) ( Figure 4 ). Th ese features are indistinguishable from non-ASH and the alcohol– non-ALD index (including body mass index, gender, AST, ALT, and mean cell volume of the red blood cells or mean corpuscular volume) can be helpful to distinguish the two in cases of unclear alcohol consumption ( 59 ). Th e majority of AH

2018 American College of Gastroenterology

60. Pharmacological Treatment of Patients with Alcohol Use Disorder

corpuscular volume MDD Major depressive disorder MET Motivational enhancement therapy MI Motivational interviewing MM Medical management NIAAA National Institute on Alcohol Abuse and Alcoholism NIMH National Institute of Mental Health NNT Number needed to treat NQF National Quality Forum OPRM1 Genotype Opioid receptor µ 1 genotype OR Odds ratio OTC Over-The-Counter PCM Primary Care Management PEth Phosphatidylethanol Project MATCH Matching Alcoholism Treatments to Client Heterogeneity PTSD Posttraumatic (...) Edition, Text Revision DSM-5 Diagnostic and Statistical Manual of Mental Disorders, 5th Edition eGF Estimated glomerular filtration rate FDA U.S. Food and Drug Administration GGT Gamma-glutamyl transferase GRADE Grading of Recommendations Assess- ment, Development and Evaluation GWG Guideline Writing Group HIV Human immunodeficiency virus ICD-10 International Classification of Diseases, 10th Revision IM Intramuscular IRR Incidence rate ratio MBSCT Modified behavioral self-control therapy MCV Mean

2017 American Psychiatric Association

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