Evaluation of the Toxic Health Hazards in Female Nurses Chronically Exposed to Anaesthetic Gases

Acute-on-chronic liver failure (ACLF) is a life-threatening disease that requires urgent liver transplantation (LT). Accurate identification of high-risk patients is essential for predicting post-LT survival. The chronic liver failure consortium ACLF score is a widely accepted risk-stratification score that includes total white blood cell (WBC) counts as a component. This study aimed to evaluate the predictive value of total and differential WBC counts for short-term mortality following LT in patients with ACLF. A total of 685 patients with ACLF who underwent LT between January 2008 and February 2019 were analyzed. Total and differential WBC counts were examined as a function of the model for end-stage liver disease for sodium (MELD-Na) score. The association between total and differential WBC counts and 90-day post-LT mortality was assessed using multivariable Cox proportional hazards regression analysis. The total WBC counts and neutrophil ratio were higher in patients with ACLF than in those without ACLF. The neutrophil ratio was significantly associated with 90-day post-LT mortality after adjustment (hazard ratio [HR], 1.04; P = 0.001), whereas total WBC counts were not significantly associated with 90-day post-LT mortality in either univariate or multivariate Cox analyses. The neutrophil ratio demonstrated a relatively linear trend with an increasing MELD-Na score and HR for 90-day post-LT mortality, whereas the total WBC counts exhibited a plateaued pattern. Neutrophilia, rather than total WBC counts, is a better prognostic indicator for short-term post-LT mortality in patients with ACLF.

Increment of absolute neutrophil count in the third trimester and increased risk of small-for-gestational-age birth: Hirakata Risk Associated with Pregnancy Assessment Research (HIRAPAR)

Sulphamethoxazole/trimethoprim (SMX/T) is an antimicrobial agent that has been used for decades against both Gram-positive and Gram-negative bacteria as well as protozoa. It is particularly used as prophylaxis against Pneumocystis carinii pneumonia (PCP) in patients with acquired immune-deficiency syndrome (AIDS). Its use in dogs with associated adverse reactions has necessitated an experimental study that may enhance clinical management of the toxicities. The study aimed to determine the effects of prolonged treatment with high doses of sulphamethoxazole/trimethoprim on the haematological profile of dogs. Dogs were given SMX/T at 30, 60 and 120 mg/kg body weight at 12-h intervals for 21 days. The packed cell volume (PCV), haemoglobin concentration (HbC), red blood cell (RBC) count and total and differential white blood cell (WBC) counts were performed using standard techniques. Data generated was analysed by one-way analysis of variance (ANOVA). Alopecia, epistaxis and skin eruptions were seen at the dose of 120 mg/kg. There were also dose-dependent decreases in the PCV and RBC count. HbC was significantly (p < 0.05) lower than the control only at the dose of 120 mg/kg. Total WBC count was significantly (p < 0.05) lower than the control only on day 7 of treatment at 30, 60 and 120 mg/kg. Beyond day 7, the white cell response, total and differential WBC counts, were fluctuating with significant depression at the dose of 120 mg/kg. Increase in dose and prolonged use of SMX/T in the dogs decreased the haematological parameters and increased the occurrence of toxic reactions and may outweigh the benefits of treatment with the drug in recommended cases.

The aim of this study was to explore the relationship between hyperuricemia and hematological indicators.Five hundred twenty-two male and 255 female subjects (18–90 years old) were recruited in the study. The level of serum uric acid (SUA), total white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin, hematocrit, and platelet count was measured, computed, and analyzed. Pearson correlation coefficients, Student t-tests, multivariate linear regression models, and multivariate logistic regression models were performed to analyze the results.For men, WBC count (r = 0.13, P < 0.01), RBC count (r = 0.15, P < 0.001), and hemoglobin (r = 0.11, P < 0.05) were significantly correlated with SUA. For women, WBC count (r = 0.24, P < 0.001), RBC count (r = 0.31, P < 0.001), hemoglobin (r = 0.31, P < 0.001), and hematocrit (r = 0.29, P < 0.001) were significantly correlated with SUA. For men, WBC (P < 0.01) and RBC (P < 0.05) counts were significantly higher in patients with hyperuricemia than in normal subjects. For men, after adjustment for confounding factors, those in the fourth quartiles of WBC counts had 1.66-fold increased odds of hyperuricemia as compared with those in the reference group. For women, after adjustment, those in the second to fourth quartiles of WBC count, RBC count, hemoglobin, and hematocrit had increased the odds of hyperuricemia as compared with those in the reference groups.Our study showed significant relations between the level of SUA and WBC count, RBC count, hemoglobin, and hematocrit, which could be important biological markers of hyperuricemia.

Purposes: To evaluate changes of the immune system in athletes during and after 7- day marathon and to correlate these changes with mechanism of clinical sepsis. METHODS: The subjects were nine healthy athletes (5 males and 4 females, age 52.4±2.5 yr; means±SEM) in 7-day race of the 2008 Athens ultra-marathon festival. Blood samples were collected before, during and after the competition. The concentrations of plasma cortisol, neutrophil degranulation (total elastase release), and total white blood cell (WBC) and differential WBC counts including lymphocytes, neutrophils and monoocytes were measured. RESULTS: (1) Comparing to pre-race, total WBC counts, lymphocyte counts and monocyte counts of subjects significantly decreased (-6.7%∼-33.6%, -61.7%∼-72.7%, -3.1%∼-63% respectively, P<.05) during the race. Contrarily, neutrophil counts, total elastase release and the concentration of plasma cortisol significantly increased (-3.1%∼43.5%, 21.7%∼119.8%, 288.3%∼387.3% respectively, P<.05) (2) Total WBC counts, neutrophil counts and total elastase release during the race were less than post-race (P<.05) while lymphocyte counts slightly recovered after the race. (3) Total WBC counts, neutrophil counts, lymphocyte counts and monocyte counts during post-race were less than pre-race (P<.05) while the concentration of plasma cortisol was still higher than pre-race concentration (P<.05). CONCLUSIONS: The main findings of this study were (1) acute inflammatory response in runners occurred in the first day of 7-day race, including increased neutrophil counts and total elastase release, which may be due to heavy stress of ultra-marathon; (2) immunosuppression induced by prolong exercise and presented as the decrement of total and differential white blood cell counts, may not fully recover during 2 days post-race; (3) the inflammatory responses pattern of the immune system in the 7-day marathon runners is similar to the developing of sepsis.

BackgroundElevated total white blood cell (WBC) count is associated with an increased risk of coronary heart disease and death. Aerobic exercise is associated with lower total WBC, neutrophil, and monocyte counts. However, no studies have evaluated the effect of the amount of aerobic exercise (dose) on total WBC and WBC subfraction counts.PurposeTo examine the effects of 3 different doses of aerobic exercise on changes in total WBC and WBC subfraction counts and independent effects of changes in fitness, adiposity, markers of inflammation (IL-6, TNF-α, C-reactive protein), fasting glucose metabolism, and adiponectin.MethodsData from 390 sedentary, overweight/obese postmenopausal women from the DREW study were used in these analyses. Women were randomized to a non-exercise control group or one of 3 exercise groups: energy expenditure of 4, 8, or 12 kcal kg−1⋅week−1 (KKW) for 6 months at an intensity of 50% VO2peak.ResultsA dose-dependent decrease in total WBC counts (trend P = 0.002) was observed with a significant decrease in the 12KKW group (−163.1±140.0 cells/µL; mean±95%CI) compared with the control (138.6±144.7 cells/µL). A similar response was seen in the neutrophil subfraction (trend P = 0.001) with a significant decrease in the 12KKW group (−152.6±115.1 cells/µL) compared with both the control and 4KKW groups (96.4±119.0 and 21.9±95.3 cells/µL, respectively) and in the 8KKW group (−102.4±125.0 cells/µL) compared with the control. When divided into high/low baseline WBC categories (median split), a dose-dependent decrease in both total WBCs (P = 0.003) and neutrophils (P<0.001) was observed in women with high baseline WBC counts. The effects of exercise dose on total WBC and neutrophil counts persisted after accounting for significant independent effects of change in waist circumference and IL-6.ConclusionAerobic exercise training reduces total WBC and neutrophil counts, in a dose-dependent manner, in overweight/obese postmenopausal women and is especially beneficial for those with systemic low grade inflammation.Clinical Trials Identifier: NCT00011193

Total and differential white blood cell counts, high-sensitivity C-reactive protein, and the metabolic syndrome in non-affective psychoses

Study of the association of total and differential white blood cell counts with geriatric conditions, cardio-vascular diseases, seric IL-6 levels and telomere length

To study the haematology of the German Shepherd breed of dog in a humid, tropical environment, an experiment was conducted to elucidate the effects of sex, age, and breed on the erythrocyte and leukocyte values of this species. There were no significant (p > 0.05) gender-related differences in the values of red blood cell counts (RBC), packed cell volume (PCV), haemoglobin (Hb) concentration, mean corpuscular haemoglobin concentration (MCHC), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), total and differential white blood cell counts (WBC) of the German Shepherd dog. The study also revealed that the adult German Shepherd dog (between 3 and 5 years old) had significantly higher RBC, total WBC, PCV and Hb, MCV, MCH, MCHC and lymphocyte values than a younger animal (between 8 and 15 weeks old). However, neutrophil, monocyte and eosinophil counts were similar (p > 0.05) in the two age groups. Although there were no breed differences in the erythrocyte values between the Nigerian local dog and the German Shepherd dog, the WBC and neutrophil counts were however significantly higher in the Nigerian dog. This study revealed that although there were no gender or breed differences in the erythrocyte values of the German Shepherd dog, there were some age-related differences.

Total and differential white blood cell counts, high-sensitivity C-reactive protein, and cardiovascular risk in non-affective psychoses.

Tuberculosis is one of the first most common causes of death in the world alongside HIV/AIDS, causing considerable mortality globally. Tuberculosis is also accompanied by hematological alterations although the alteration related to the disease is not well determined yet and showed variation in different studies. This study aimed at evaluating hematological profiles in pulmonary tuberculosis patients in Metema hospital and Gondar referral Hospital, North West Ethiopia. A case-control study design was conducted from January to July 2018. A total of 88 blood samples (44 from cases and 44 from control groups) were collected. The collected blood samples were tested using a Hematology analyzer (Sysmex) for hematological profiles. The mean+standard deviation of hemoglobin, hematocrit, and red blood cell count of the cases were significantly lower than the control groups (P&lt; 0.05). However, platelet and total white blood cell counts; and erythrocyte sedimentation rate were significantly increased as compared with control groups (p&lt;0.05). Body mass index had significant positive associations with red blood cell count, hemoglobin, and hematocrit (P &lt; 0.05). Pulmonary Tuberculosis patients in this study showed hematological profile abnormalities; where the red blood cell count, hematocrit and hemoglobin were significantly reduced. However, the total white blood cell count, thrombocyte, and erythrocyte sedimentation rate of tuberculosis patients were significantly elevated than control groups. The factors associated with hematological profile alterations require a due attention to prevent further complications and further studies should be conducted.

Although many studies have reported an association between total white blood cell count and metabolic syndrome, relatively few reports are available on the association between differential white blood cell counts and metabolic syndrome. The medical records of 15,654 subjects (age, median 46, range 14-90 yr; 8,380 men and 7,274 women) who visited the Center for Health Promotion were investigated. It was found that as total white blood cell (WBC) and differential WBC counts increased the frequencies of diabetes, hypertension, obesity, dyslipidemia, and metabolic syndrome also increased. Moreover, these significant relationships persisted after adjusting for age, gender, smoking, alcohol intake, educational background, and household income. The odds ratios (95% CI) for metabolic syndrome was 2.64 (2.30-3.04) in the highest quartile of total WBC count, with corresponding figures of 2.14 (1.88-2.44) for neutrophils, 2.32 (2.03-2.64) for lymphocytes, 1.56 (1.37-1.78) for monocytes, 1.36 (1.20-1.54) for basophils, and 1.82 (1.59-2.08) for eosinophils versus the lowest quartiles of the appropriate total and differential counts, respectively, after adjusting for the variables mentioned above. These independent associations were also observed by subgroup analyses according to the smoking status. Our data suggest that even within normal ranges, total WBC count and the differential WBC counts are associated with the presence of metabolic syndrome.

In their recently published article, Ates et al. [1] have evaluated the relationship between total white blood cell (WBC) count and the presence, severity and extent of coronary atherosclerosis detected in 817 subjects undergoing multislice computed tomographic coronary angiography for suspected coronary artery disease (CAD). Although plaque morphology was not associated with total WBC counts, the extent of coronary atherosclerosis was increased with higher total WBC quartiles. Patients with critical luminal stenosis had higher levels of total WBC counts compared to patients with non-critical luminal narrowing. Although the current study is a well-designed and presented one, there is an important point needing to be further discussed. It was reported that the neutrophil to lymphocyte ratio was a more important parameter than total WBC count with regards to the presence, severity and extent of coronary atherosclerosis. Papa et al. [2] analyzed the predictive ability for cardiac events of differential WBC against established risk factors in angiographically proven CAD patients in a relatively large-scale prospective study. They prospectively evaluated complete blood count, biomarkers of inflammation (C-reactive protein [CRP] and serum iron [SI]), glucose/lipid metabolism (fasting glucose [FG], total, high-density lipoprotein [HDL] and low-density lipoprotein cholesterol) and established risk factors in 422 consecutive ischemic patients with angiographically documented stable CAD. On a three-year follow-up, cardiac death and non-fatal myocardial infarction (MI) were considered as end-points. In multivariate analysis, neutrophil to lymphocyte ratio emerged as an independent predictor of cardiac death (HR 8.13) together with CRP, left ventricular ejection fraction (LVEF), FG, HDL and SI. CRP, LVEF, and HDL showed an independent prognostic value for cardiac death and non-fatal MI. Event-free survival according to neutrophil to lymphocyte ratio tertiles was 99% for the first tertile (1.23 ± 0.26), 96.5% for the second (2.05 ± 0.29), and 88.8% for the third one (5.19 ± 3.81). In another very large-scale prospective study, Horne et al. [3] analyzed the predictive ability of total WBC count and its subtypes for risk of death or MI in 3,227 patients. The predictive ability for death/MI of quartile (Q) 4 vs Q1 total WBC, neutrophil (N), lymphocyte (L), and monocyte (M) counts and neutrophil to lymphocyte ratio were assessed using Cox regressions. Total WBC count is confirmed to be an independent predictor of death/MI in patients with or at high risk for CAD, but greater predictive ability is provided by high N (Q4 > 6.6 × 10 3 /µL) or low L counts. The greatest risk prediction is given by the N/L ratio, with Q4 vs Q1 (> 4.71 vs > 1.96) increasing the hazard by 2.2-fold. In conclusion, high N to L ratio was associated with increased cardiac mortality in clinically stable patients with CAD compared to total WBC count. Further large-scale prospective studies are needed to clearly understand the exact role of total WBC and subtypes in the pathophysiology of CAD.

Smoking status and differential white cell count in men and women in the EPIC-Norfolk population

Accuracy and Precision Study: Body Fluid White Blood Cell (WBC) Analysis (Peritoneal, Pleural and Peritoneal Dialysate) Using a Light Scatter Technology (ADVIA®2120/2120i) Versus Hemocytometer Manual Counts