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Introduction: Development of additional parameters for complete blood count has emerged in recent hematology analyzers, leading to many publications. However, few studies have been conducted on advanced RBC parameters and hemolytic anemias. We investigated the interest of Sysmex unique parameters, MicroR and HypoHe, as well as the immature fraction of reticulocytes (IRF) in combination with complete blood and reticulocyte count, for screening hereditary spherocytosis (HS) and pyruvate kinase deficiency. Methods: We analyzed 182 samples using Sysmex XE‐5000 analyzers from a cohort of red cell disorder patients from the Rouen University Hospital. These included 47 HS, 17 pyruvate kinase deficiencies, sickle cell diseases and trait, β‐thalassemia minor, iron deficiencies, and 489 samples from a routine group. Results: Combining five parameters (hemoglobin level, reticulocyte count, IRF, MicroR, and %HypoHe), we developed a specific screening tool for HS allowing a sensitivity of 100% and a specificity of 92.1% and a specific screening tool for pyruvate kinase deficiencies allowing a sensitivity of 100% and a specificity of 96.5%. These parameters were also found accurate in infants and in HS without anemia. Conclusion: We propose a costless, easy‐to‐use, and efficient approach to detect HS and pyruvate kinase deficiencies using Sysmex analyzers. These screening tools may help diagnosis of these disorders, help prevent complications, and result in a better management of these patients. [ABSTRACT FROM AUTHOR]

Background: Patients with Alzheimer's disease (AD) who deteriorate rapidly are likely to have a poorer prognosis. There is a clear need for a clinical assessment fool to defect, such a decline in newly diagnosed patients. Objective: To identify die predictive factors of rapid cognitive decline (RCD) in a cohort of patients with mild to moderate AD; and to validate a self-questionnaire for caregivers as a diagnostic tool for rapid decline. Design and analysis: An open-label, observational, 12-month, multicenter, French study. Physicians were asked to record data of three eligible rivastigmine naïve (or on rivastigmine for < 1 year) AD patients. Risk factors of RCD and the detection power of the Détérioration Cognitive Observée scale (Deco), a 19 item self-questionnaire for caregivers, were assessed at endpoint using regression analyses. Results: Out of the 361 patients enrolled in the study, 91 (25.2%) were excluded due to loss of follow-up. Among subjects using cholinesterase inhibitors or memantine, 161 (59.6%) experienced a stabilization (29.2%) or an improvement (30.4%) in global functioning as measured by the CGI-C. Sixty of the remaining 204 patients retained for analysis (29.6%, CI 95% [23.4; 35.8]) lost three or more points on the MMSH score between the inclusion and one of the follow-up visit. In the multivariate logistic regression analysis, institutionalization, higher level of education and the loss of 3 points or more on the MMSE were found to be significant predictors of a rapid cognitive loss in this population. The threshold which maximizes the predictive values of the Deco score as a diagnostic tool of rapid cognitive decline was significantly different according to the age of the patient (below or over 75 years old). A score below 16 for patients < 75 years old and below 14 for patients ≥ 75 years old consistently predicted a RCD within die next year. Conclusion: The Deco test appears to be a simple tool to alert the physician to the possibility of an aggressive course of the disease which warrants particular management. [ABSTRACT FROM AUTHOR]

The article discusses diagnostic tools for general practitioners (GPs) and specialists to diagnose dementia. The diagnosis of dementia is a complex and evolving issue. In France, guidelines on dementia have been set up by Agence Nationale d'Accréditation et d'Evolution en Santé. These guidelines specify diagnostic criteria for dementia based on structured interviews of patients and their families, clinical examinations, recommended laboratory tests and brain imaging. For specialists, the common goal is the diagnosis of a disease as early and accurately as possible, but they may have different conceptual backgrounds. GPs hold a key position on the primary care level, but they do not diagnose dementia in routine practice.