Blood Cell Count Levels Research Articles

Modern differential diagnosis of various types of anemia in patients with HIV-associated disease

This article substantiates the development of a diagnostic algorithm to differentiate between anemia of chronic disease (ACD) and iron deficiency anemia (IDA) in patients with HIV-associated disease. A cross-sectional descriptive study included 125 patients with HIV-associated disease, 101 of whom had anemia syndrome and 24 were without it (control group). Patients with anemia were divided into three groups: Group 1 with ACD only, Group 2 with ACD and IDA, and Group 3 with IDA only. Upon admission, all patients underwent assessments for red blood cell count, hemoglobin, IL-6, IL-10, and IL-1β, IFN-γ, TNF-α, ferritin, C-reactive protein, transferrin, hepcidin, and soluble transferrin receptor levels. Discriminant analysis followed by obtaining a canonical linear discriminant function was used to calculate a mathematical model for the differential diagnosis of ACD and IDA. Canonical analysis was also used to obtain centroids for ACD (2.86 arbitrary units) and IDA (2.54 arbitrary units). A patient with a calculated canonical linear discriminant function was to be assigned to the group of ACD or IDA based on the minimal distance to the corresponding centroid. The resulting mathematical model has 88.8% sensitivity and 100% specificity. The use of IL-6 and ferritin concentrations is also proposed as independent laboratory markers for the differential diagnosis of ACD and IDA. The canonical linear discriminant function obtained from the calculations, along with the levels of IL-6 and ferritin in the blood, have high diagnostic value for verifying ACD and IDA in patients with HIV-related disease. Their use enables the determination of the type of anemia during the initial contact between the physician and the patient.

Procalcitonin, C-reactive protein, and white blood cell count levels in end-stage cancer patients: A retrospective study on inflammatory markers and their prognostic value.

Procalcitonin (PCT), C-reactive protein (CRP), and white blood cell count (WBC) are commonly recognized as inflammatory markers. Some studies showed that these markers were also related to some cancers. This study aimed to investigate whether these markers were exhibited aberrations in end-stage cancer patients and to assess their correlation with infection and prognosis. The study underscores the potential of inflammatory markers as prognostic indicators in end-stage cancer, proposing that routine monitoring of these markers could substantially enhance patient management and improve outcomes. The medical records of 116 cancer patients were retrospectively reviewed. Data from end-stage cancer patients were collected during the week preceding their death. The control group consisted of cancer patients with a performance status score of 3 to 4 and clinical stage of III to IV. Normally distributed continuous data (mean ± SD) were analyzed using t-test. Non-normally distributed data (median [M] with interquartile range [P25, P75]) were analyzed using Wilcoxon rank-sum test. Numerical data were subjected to Chi-square test. Logistic regression analysis was employed to assess the correlation between inflammatory markers and patient prognosis. There were significant differences between the 2 groups for PCT, WBC, CRP, platelet count, and body mass index. However, subgroup analysis indicated that there were no significant differences in PCT, CRP, and WBC levels between infected and noninfected patients within the deceased group. It is worth noting that elevated levels of PCT (OR = 7.13, 95% confidence interval [CI] = 1.68-30.36, P = .008) and WBC (OR = 2.47, 95% CI = 1.13-1.13, P = .024) were ultimately identified as independent risk factors associated with poor prognosis in cancer patients, as demonstrated by further logistic regression analysis. In the subgroup analysis of noninfected patients, the univariate analysis revealed that both PCT (OR = 11.612, 95% CI = 1.217-110.776, P = .033) and WBC (OR = 3.077, 95% CI = 1.004-9.427, P = .049) had a statistically significant difference in outcomes between the alive group and the deceased group. The PCT, WBC, and CRP levels of end-stage cancer patients were significantly elevated, regardless of infection. An increase in PCT and WBC was associated with an increased risk of death. These findings suggest that monitoring PCT and WBC levels in end-stage cancer patients may provide valuable prognostic information, aiding in clinical decision-making.

Predictive value of mNUTRIC score for chronic critical illness in patients of sepsis complicated with ARDS

Background To explore the predictive value of the modified NUTrition Risk in the Critically ill (mNUTRIC) for patients with sepsis and acute respiratory distress syndrome (ARDS) developing into chronic critical illness (CCI). Methods A retrospective observational study was conducted on 118 patients admitted to the Intensive Care Unit (ICU) of Yiwu Central Hospital from January 2020 to May 2022. Patients were categorized into two groups: CCI and rapid recovery (RAP), based on the occurrence of CCI. Age, gender, white blood cell count, C-reactive protein, albumin, serum creatinine, sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation II (APACHE II), mNUTRIC score, ICU length of stay, mechanical ventilation duration, and continuous renal replacement therapy (CRRT) were compared between the two groups. The association between mNUTRIC and CCI in patients with sepsis complicated by ARDS was further examined using three models and multivariate logistic regression.The receiver operating characteristic (ROC) curve was utilized to analyze the predictive values of mNUTRIC score, SOFA score, and APACHE II score for predicting the occurrence of CCI in patients with sepsis complicated by ARDS. Results The age, mNUTRIC score, SOFA score, APACHE II score, ICU length of stay, mechanical ventilation duration, and CRRT ratio were significantly higher in the CCI group compared to the RAP group (all P < 0.05). Conversely, there were no statistically significant differences in white blood cell count, C-reactive protein, and albumin levels between the two groups (all P > 0.05). Multivariate logistic regression analysis identified the mNUTRIC score as an independent risk factor for CCI in patients with sepsis complicated by ARDS. The constructed models showed that the mNUTRIC score remained significant, while the SOFA score and APACHE II score did not.The area under the ROC curve analysis demonstrated that the mNUTRIC score had the highest AUC of 0.880, 95% Confidence Interval (CI): 0.808–0.933. The AUC for the SOFA score was 0.864, and for the APACHE II score was 0.825, all of which were statistically significant. Conclusions The mNUTRIC score is valuable in predicting the progression of sepsis combined with ARDS to CCI, and may even be superior to the SOFA score and APACHE II score.

Dietary Effect of Withania somnifera (Ashwagandha) Root Powder on Growth and Blood Parameters of Cyprinus carpio (Common Carp)

Aims: The present study evaluated the effect of different levels of Withania somnifera root powder in fish formulated diets on the growth performance of economically important freshwater fish species in Asia Cyprinus carpio and compare the hematological changes occurred in fishes fed with control feed and herbal formulated diet. Study Design: The experiment was planned with the size group of 30.0±1.0g. Fish of the respective size group of Cyprinus carpio were subjected to different herbal formulated diets at a concentration 0%, 0.5%, 1.0%, 1.5%, 2.0% of Withania somnifera root powder extract through their diet, while the control group received a standard diet without any supplementation. Duration of Study: The study was conducted over a period of 4 weeks. Methodology: During which growth parameters such as Average Daily Growth, Specific Growth Rate and Absolute Growth Rate were monitored at regular (10 days) intervals. The blood samples were collected at 4th week from each group to assess hematological parameters including Red Blood Cell count, White Blood Cell count, Hemoglobin, Total Cholesterol and Total serum protein levels. The overall results revealed that the inclusion of Withania somnifera extract in the diet of Cyprinus carpio significantly influenced both growth and blood parameters. Results: Fish exposed to Withania somnifera extract exhibited enhanced growth performance compared to the control group, with increased Average Daily Growth, Specific Growth Rate and Absolute Growth Rate. Moreover, hematological analysis revealed positive effects on the blood parameters of treated fish, including improvements in Red Blood Cell count, White Blood Cell count, Hemoglobin, Total Cholesterol and Total serum protein levels. Conclusion: The overall results revealed that the inclusion of Withania somnifera extract in the diet of Cyprinus carpio significantly influenced both growth and blood parameters.

Relationship of inflammatory factors with migraine in patients with patent foramen ovale undergoing percutaneous closure

Abstract Background Observational studies have reported the incidental reduction of the frequency and severity of migraine attacks following transcatheter patent foramn ovale (PFO) for established indications. Possible physiologic mechanisms for a relationship between PFO and migraine, if such a link does exist, have been the subject of much speculation, with some researchers suggesting the possible role of PFO as a conduit for the passage of various migraine-inducing inflammatory, vasoactive triggers in cerebral circulation. Purpose The aim of this study was to compare the levels of inflammatory mediators between migraineurs and non –migraineurs and to investigate the impact of PFO closure on the inflammatory state of individuals with migraine and alleviation of migraine symptoms. Methods Forty-five patients (mean age 48.2 ± 10.8 years, 48% male) undergoing percutaneous PFO closure were enrolled in the study. Among them, 15 patients reported recurrent migraine episodes (mean age 46.4 ± 8.90 years, 86% female) while 30 individuals (mean age 49 ± 12.32 years, 70% male) were non-migraineurs. White blood cell count, C-reactive protein (CRP), ferritin and d-dimers levels, as well as the erythrocyte sedimentation rate (ESR) were compared between migraineurs and non-migraineurs. We additionally analyzed the inflammatory levels before and after the percutaneous PFO closure in migraineurs, correlating these changes with migraine relief assessed using the Migraine Disability Assessment Questionnaire (MIDAS) over a 6-month follow-up period. Results White blood cell count, d-dimers levels and ESR were similar in migraineurs and non-migraineurs (6,583 ± 2,251 Χ1 0.e3/uL vs 6,115 ± 1,958 Χ10.e3/uL; p-value = 0.48; 0.54 ± 0.49 μg/L vs 0.45 ± 0.29 μg/L; p- value= 0.49; 23.08 ± 16.68 mm vs 18.51 ± 14.98 mm; p- value 0.402; respectively). However, CRP and ferritin levels were significantly greater in patients with migraine compared to non- migraineurs (3.82 ± 1.87 mg/L vs 1.34 ± 1.52 mg/L; p- value =0.037 and 111.21 ± 82.70 ng/ml vs 50.12 ± 47.9 ng/ml; p- value = 0.023, respectively). Moreover, there was no significant difference between pre- and post-procedural inflammatory levels in migraineurs undergoing percutaneous PFO closure. Of note, following the procedure a reduction in CRP levels was observed without, however, reaching statistical significance. Finally, all patients observed a cessation in the occurrence of migraine attacks after closure. Conclusions Our study revealed significantly higher baseline levels of CRP and ferritin in migraineurs compared to non-migrainers with PFO. Although no alteration in inflammatory factors was observed following the procedure in migraineurs with PFO, all individuals experienced relief from migraine symptoms. Given the limitation of our study due to the small sample size, future studies may provide more insights into the potential benefits of PFO closure in specific migraine patient phenotypes.

Non-Surgical Management of Methicillin-Sensitive Staphylococcus Aureus Bacteremia-Related Mediastinitis.

Acute mediastinitis is rarely caused by haematogenous spread of a remote infection. In this respect, since the only medical therapy is usually unsuccessful, treating acute mediastinitis with no source of infection detected is very challenging and management not standardized. In this case report, we describe non-surgical management experience of acute mediastinitis caused by methicillin-sensitive Staphylococcus aureus. In a 79-year-old man judged not eligible for cardiac surgery, we attempted the infection source control through vacuum-assisted closure therapy, together with antimicrobial therapy. We observed gradual clinical, laboratory and radiologic improvements: reduced swelling and normalization of the white blood cell count and C-reactive protein level were associated with reduction in size of a periaortic abscess. We managed a clinical condition with high mortality risk with chronic antimicrobial therapy alone, a strategy that is rarely considered. With this medical strategy we achieved an optimal response to a clinical picture that does not allow any other approach. Mediastinitis is a rare but severe infection with a high mortality rate.Chronic antimicrobial therapy can be an effective strategy in high surgical risk patients.The present case demonstrates good tolerability of lifelong antibiotic therapy.

Togetherness Reminded by the Earthquake: Relationship Between Stress and Peptic Ulcer Perforation

Background: Severe stress is one of the leading causes of peptic ulcer perforations. Peptic ulcer perfora-tion is a clinical condition that can be fatal if not treated urgently. This study aimed to investigate the effects of social stress caused by the earthquakes in Kahramanmaraş on peptic ulcer perforation. Materials and Methods: A retrospective evaluation was conducted on 66 peptic ulcer perforation cases operated on in three major centers in Şanlıurfa, considering two large earthquakes that occurred on February 6, 2023, and by comparing the 6-month periods before and after the earthquakes. Patients were assessed in terms of age, gender, diagnostic method, perforation site, surgical technique, operation time, length of hospital stay, and mortality. Our study also evaluated laboratory parameters such as white blood cell (WBC) count, hemoglobin, urea, creatinine, and albumin levels. Results: In the 6 months prior to the earthquakes, 21 patients underwent surgery for peptic ulcer perfo-ration, whereas 45 patients were operated on for the same reason in the 6 months following the earthquakes; there were two deaths in each group. The number of patients operated on after the earthquakes was significantly higher than the number of patients operated on before the earthquakes. Furthermore, the two groups were also compared in terms of demographic data and laboratory findings; no significant differences between the two groups were observed regarding these parameters. Conclusions: Stress plays a remarkable role in the development of peptic ulcer perforation. In stressful situations that affect the general population, such as earthquakes, it is essential to assess stress tenden-cies and dyspeptic complaints in patients presenting to the hospital. Patients with positive findings should undergo endoscopy if necessary, followed by appropriate gastric treatment.

Investigating the protective effects of epigallocatechin-gallate against polystyrene microplastics-induced biochemical and hematological alterations in rats

BackgroundPolystyrene microplastics (PS-MPs) are widely used and found in drinking water and food, concerns have been raised about their potential health effects, especially in causing oxidative stress and inflammation in living organisms. ObjectivesThe aim of this study was to investigate the protective effects of epigallocatechin-gallate (EGCG), a natural antioxidant and anti-inflammatory compound, against PS-MPs-induced biochemical and hematological alterations in rats. MethodsMale Wistar rats were divided into four groups: control, EGCG-treated (80 mg∙ kg-1/d), PS-MPs-exposed (0.01 mg∙kg-1/d), and PS-MPs+EGCG-treated groups. PS-MPs were orally administered for 56 days, while EGCG was given concomitantly by gavage. At the end of the treatment period, blood samples were collected for hematological and biochemical analyses. Oxido-nitrergic stress markers, including malondialdehyde (MDA), nitric oxide (NO), reactive nitrogen species (RONS) and reduced glutathione (GSH), Superoxide dismutase (SOD), catalase (CAT), as well as inflammatory markers, such as tumor necrosis factor alpha (TNF-α), interferon gamma (IFY-γ) and interleukin-10 (IL-10), were also measured in serum. ResultsTreatment with PS-MPs caused a significant increase in MDA, RONS, NO levels and a decrease in SOD, CAT and GSH levels, indicating the induction of oxido-nitrergic stress. PS-MPs also caused an increase in the levels of TNF-α, IFY-γ, MPO and decreased IL-10, indicating the induction of inflammation. Additionally, PS-MPs caused alterations in hematological and serum transaminase parameters, including a decrease in red blood cell count, hemoglobin, and hematocrit levels, neutrophil and eaosinophil and an increase in white blood cell count, lymphocyte count, AST, ALT, ALP, LDH and GGT. PS-MPs also caused disturbances in electrolyte balance and renal function markers. However, treatment with EGCG significantly attenuated these alterations induced by PS-MPs, indicating its protective effects. ConclusionThe results of this study demonstrate that EGCG can protect against PS-MPs-induced biochemical and hematological alterations in rats, possibly through its antioxidant and anti-inflammatory properties.

Clinical features of Guillain-Barré syndrome and chronic inflammatory demyelinating polyradiculoneuritis associated with SLE

ObjectiveWe report on the clinical characteristics, treatments and outcomes of Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuritis (CIDP) associated with SLE.MethodsPatients treated at Peking Union Medical College Hospital between...

Maternal serum ischemia-modified albumin as an oxidative stress biomarker in preterm pre-labor rupture of membranes.

To evaluate the maternal serum ischemia-modified albumin (IMA) concentration as an oxidative stress biomarker in pregnancies complicated by preterm pre-labor rupture of membranes (PPROM) without maternal clinical infection and compare these results with healthy pregnancies. The present cohort study included 40 pregnancies complicated by PPROM and 49 similar gestational age healthy pregnancies in the third trimester of gestation. Maternal venous blood specimens were obtained at the day of first diagnosis. Maternal serum IMA level was assayed with an Albumin Cobalt Binding test. The subjects were followed up until delivery and perinatal outcomes were recorded. The maternal serum IMA concentrations were significantly higher in the study group (0.56 ± 0.05 absorbance units) as compared to controls (0.54 ± 0.03 absorbance units) (p = 0.020). The maternal serum IMA concentrations were not significantly correlated with the initial maternal white blood cell count (r: 0.118, p = 0.269) and C-reactive protein levels (r: 0.066, p = 0.541). The maternal serum IMA concentrations were negatively correlated with gestational age at delivery (r: -0.248, p = 0.019), birthweight (r: -0.247, p = 0.020) and Apgar scores (r: -0.200, p = 0.049; r: -0.245, p = 0.020). The threshold value of maternal serum IMA concentration above 0.55 absorbance units indicated the pregnancy complicated by PPROM by 57.5% sensitivity and 57.1% specificity (Area under curve 0.613, confidence interval 0.50-0.73). The current study supported for the first time that there is an association between increased maternal serum IMA levels and the development of PPROM in the third trimester of gestation without maternal clinical infection. Elevated maternal serum IMA levels may alert the obstetrician about poor ongoing perinatal outcomes in the early phase of PPROM before increased maternal C-reactive protein and white blood cell count.

Assessing the predictive value of pre- and post-operative inflammatory markers in patients undergoing total knee arthroplasty

Background and objectiveTotal Knee Arthroplasty (TKA) has proven highly effective in improving quality of life for patients with severe knee conditions. Despite advancements, surgical complications such as periprosthetic joint infections (PJIs) pose risks. The potential predictive value of pre- and post-operative inflammatory markers like neutrophil-to-lymphocyte ratio (NLR), D-dimer, and albumin levels on surgical outcomes is garnering attention. There is a growing interest in leveraging these markers to enhance patient selection and outcome prediction in the context of TKA.Focusing on the natural course of these markers, and the incidence of PJIs and to refine perioperative care strategies, improve patient outcomes, and identify high-risk patients for targeted intervention.MethodsThe study included 94 patients who underwent total knee arthroplasty (TKA) between 2019 and 2023. Blood tests were conducted before surgery and at 1, 3, 7, and 15 days after surgery to assess various parameters including white blood cell count, neutrophils, lymphocytes, platelets, hemoglobin, C-reactive protein, D-dimers, total protein, albumin, and total cholesterol values and ratios.ResultsFollowing total knee arthroplasty (TKA), key observations in blood markers included a sharp rise in white blood cell (WBC) counts from 5.81 to 10.22 (*10^9/L) on the first day post-surgery, with levels returning close to preoperative values by day-15. Neutrophil counts similarly increased from 3.46 to 8.50 (*10^9/L) on day-1, decreasing to 4.01 by day-15. Hemoglobin levels significantly decreased from 115.70 g/L to 90.62 by day-3 before improving to 100.30 by day-15. C-reactive protein (CRP) levels also saw a significant rise from 6.15 mg/L to a peak of 47.07 on day-3, then reducing to 10.55 by day-15, indicating a response to inflammation.ConclusionFollowing total knee arthroplasty (TKA), a significant initial postoperative increase in white blood cell count, neutrophils, and C-reactive protein levels, indicative of an acute inflammatory response, before returning towards baseline values by day 15. Hemoglobin levels displayed a notable dip post-surgery, gradually improving by the study’s end. These patterns emphasize the dynamic nature of inflammatory and hematological responses after TKA, highlighting their potential role in predicting surgical outcomes and guiding postoperative care.

A Comparison of Kawasaki Disease during the SARS-CoV-2 Pandemic with Multisystem Inflammatory Syndrome in Children.

The purpose of this study was to compare and contrast Kawasaki disease (KD) with multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic. A retrospective analysis of the medical records of patients diagnosed with KD and MIS-C at a single institution from July 2020 to November 2021 was performed. The study included 39 MIS-C patients (84.6% male) with a median age of 138 months and 17 KD patients (58.8% male) with a median age of 36 months. The MIS-C patients were older (p < 0.001) and had prolonged hospitalizations (p = 0.023), elevated neutrophil counts (p < 0.001), C-reactive protein (p < 0.001), procalcitonin (p < 0.001), interleukin-6 (p < 0.014), ferritin (p < 0.001), fibrinogen (p < 0.001), troponin I (p = 0.001), NT-proBNP (p < 0.001), and D-dimer levels (p < 0.001). There were more cases of hypotension (p = 0.024), decreased left ventricular function (p = 0.023), and a greater need for corticosteroids (p < 0.001), enoxaparin (p = 0.045), and therapeutic plasma exchange (p < 0.001). Kawasaki disease patients had a greater incidence of rash (p < 0.001), changes in oral mucosa (p < 0.001), conjunctival injection (p < 0.001), extremity changes (p < 0.001), and cervical lymphadenopathy (p < 0.001). They had a longer duration of fever (p < 0.001), elevated white blood cell count (p < 0.001), platelet count (p < 0.001), and alanine aminotransferase level (p < 0.001). The two groups were similar regarding the hemoglobin levels, erythrocyte sedimentation rates, albumin levels, and the frequency of coronary aneurysm, myocarditis, pericarditis, invasive mechanical ventilatory support, and intravenous immunoglobulin treatment. Advanced patient age, a greater presence of gastrointestinal and cardiac findings associated with hypotension, increased NT-proBNP levels, decreased left ventricular function, the use of various treatment modalities, and longer hospital stays suggest MIS-C, whereas prolonged fever and classical clinical features of KD favor KD.

Abdominal imaging and endoscopic characteristics of adult abdominal IgA vasculitis: a multicenter retrospective study

Background IgA vasculitis (IgAV), previously known as Henoch-Schönlein purpura, is an IgA-mediated systemic small vessel vasculitis that tends to be more severe in adults than in children. Early diagnosis of IgAV involving the gastrointestinal tract remains difficult, especially in patients who present with gastrointestinal symptoms before purpura. This study aims to systematically analyze the abdominal imaging and endoscopic features of adult patients with abdominal IgAV, providing assistance to clinicians in the early recognition of this condition. Patients and Methods This multicenter retrospective study was conducted in three large tertiary hospitals in China from January 2017 to January 2024. A total of 108 adult patients with abdominal IgAV, who had complete abdominal imaging and/or endoscopy results, were enrolled. The clinical manifestations, abdominal imaging findings, endoscopic characteristics, and serological indicators of the patients were analyzed. Results The median age of the patients was 40 years (IQR: 26–55), with a male-to-female ratio of 2:1. Acute abdominal pain was the most common presenting symptom (100 patients, 92.59%). Bowel wall thickening was the most frequent finding on abdominal imaging (50/86 patients, 58.14%). Gastrointestinal endoscopy showed findings of congestion and erosion (32/67 patients, 47.76%), and erosion with ulcers (21/67 patients, 31.34%). Among patients with both imaging and endoscopic results, the duodenum (28/51 patients, 54.90%) and ileum (28/51 patients, 54.90%) were the most commonly affected sites. Laboratory findings revealed elevated white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), D-dimer and fibrinogen levels, along with decreased albumin level. Comparing patients with gastrointestinal symptoms versus purpura as the initial symptom, those with gastrointestinal symptoms had higher levels of WBC (p < 0.05) and NLR (p < 0.01). Conclusions The most common symptom in adult abdominal IgAV patients is acute abdominal pain. In the early stage of the disease, most patients exhibit elevated levels of WBC, NLR, CRP, D-dimer, and fibrinogen, along with decreased albumin level. The duodenum and ileum are the most commonly affected sites. By integrating these findings, clinicians can identify abdominal IgAV patients earlier and more accurately.

Appendicitis in Children: Does Age Really Matter?

Acute appendicitis (AA) is a frequent and emergent surgical abdominal condition that presents some particularities and challenges in young children. Data of 402 children aged <16 years with a confirmed diagnosis of AA were retrospectively reviewed. Included patients were divided into two groups: Group A (preschool children aged ≤5 years, n = 44) and Group B (school children aged >5 years, n = 358). Clinical presentation, biological findings, calculated diagnosis scores (paediatric appendicitis score [PAS] and Alvarado score), intraoperative findings and outcomes were comparatively analysed between the two groups. Children of Group A had more likely fever, bowel disorders, diffuse abdominal pain and diffuse tenderness than those of Group B (P = 0.001, P = 0.005, P = 0.006 and P = 0.001, respectively). Regarding biomarkers, the mean of white blood cell count and C-reactive protein levels was higher in Group A than in Group B (18,849 cell/mm3 and 162.8 mg/L in Group A versus 15,938 cell/mm3 and 86.7 mg/L in Group B, P = 0.003 and < 0.001, respectively). The mean of calculated PAS and Alvarado scores was higher in Group A than in Group B (8.2 ± 1.1 and 8.2 ± 1 vs. 7.5 ± 1.4 and 7.4 ± 1.5, P = 0.003 and P = 0.001, respectively). Most children with a calculated PAS and Alvarado score equal to or higher than 8 belonged to Group A (PAS: 84.1% vs. 58.4%, P = 0.001, Alvarado score: 84.1% vs. 55.6%, P < 0.001). The perforation of the appendix was seen in 77.3% of Group A patients and only in 41.5% of children in Group B (P < 0.0001). The mean length of stay was 5.1 ± 1.9 days in Group A and 4.3 ± 2.8 days in Group B but without any statistical difference between the two groups (P = 0.094). AA in preschool children is associated with atypical presentation and rapid progression of the disease making the early diagnosis mostly challenging in our settings.

Effects of Maltodextrin-Fructose Supplementation on Inflammatory Biomarkers and Lipidomic Profile Following Endurance Running: A Randomized Placebo-Controlled Cross-Over Trial.

Managing metabolism for optimal training, performance, and recovery in medium-to-high-level endurance runners involves enhancing energy systems through strategic nutrient intake. Optimal carbohydrate intake before, during, and after endurance running can enhance glycogen stores and maintain optimal blood glucose levels, influencing various physiological responses and adaptations, including transitory post-endurance inflammation. This randomized trial investigates the impact of a high-dose 2:1 maltodextrin-fructose supplementation to medium-to-high-level endurance runners immediately before, during, and after a 15 km run at 90% VO2max intensity on post-exercise inflammatory stress. We evaluated inflammatory biomarkers and lipidomic profiles before the endurance tests and up to 24 h after. We focused on the effects of high-dose 2:1 maltodextrin-fructose supplementation on white blood cell count, neutrophil number, IL-6, cortisol, and CRP levels, as well as polyunsaturated fatty acids, ω-3 index, and AA/EPA ratio. This supplementation significantly reduced inflammatory markers and metabolic stress. Additionally, it may enhance the post-activity increase in blood ω-3 fatty acid levels and reduce the increase in ω-6 levels, resulting in a lower trend of AA/EPA ratio at 24 h in the treated arm. Adequate carbohydrate supplementation may acutely mitigate inflammation during a one-hour endurance activity of moderate-to-high intensity. These effects could be beneficial for athletes engaging in frequent, high-intensity activities.

Small Bowel Obstruction Masking a Perforated Dermoid Ovarian Cyst.

A 58-year-old female presented with abdominal pain, vomiting and constipation. Laboratory tests indicated elevated white blood cell count and C-reactive protein levels. Imaging via CT scan revealed a large cystic mass in the right ovary, abscesses and generalized small bowel distension, which initially raised suspicion of the existence of ovarian cancer with peritoneal carcinomatosis. Despite conservative management, the patient's condition did not improve, prompting a laparotomy. Intraoperative findings included generalized peritonitis, significant small bowel dilation due to inflammatory adhesions and a perforated dermoid ovarian cyst. The cyst was resected and a prophylactic ileostomy was installed. Histopathological examination confirmed the diagnosis of a benign dermoid ovarian cyst. This case illustrates the rare presentation of a perforated dermoid cyst mimicking peritoneal carcinomatosis and emphasizes the importance of considering such complications in the differential diagnosis of bowel obstruction and peritoneal disease. Early recognition and appropriate surgical intervention are crucial for optimal outcomes.

Exploring the influence of anemia and inflammation indices on colorectal cancer: analysis of the national health and nutrition examination survey From 2011 to 2018.

Patients with colorectal cancer (CRC) frequently present with anemia and signs of infection. However, the relationships between these factors remain unclear. This study investigated the potential association between anemia, inflammatory indices, and CRC. We analyzed data from the 2011-2018 National Health and Nutrition Examination Survey to investigate links between anemia, inflammation, and CRC. Inflammatory indices, including the neutrophil-percentage-to-albumin ratio, neutrophil-to-lymphocyte ratio, and eosinophil-to-lymphocyte ratio, were analyzed. Following rigorous inclusion criteria, 14,114 participants were included. Statistical methods such as logistic regression and subgroup analyses were employed. Moreover, survival analysis was performed. Among the 14,114 participants, 0.6% had CRC and 11.0% were diagnosed with anemia. Anemia and inflammatory indices were associated with CRC, suggesting an increased risk (OR range: 2.03-2.50, P<0.05). Patients with CRC had lower red blood cell counts, reduced hemoglobin levels, and higher inflammatory indices. This is accompanied by an increase in the inflammatory indices, which is also a risk factor for CRC (OR range: 1.12-7.00, P<0.05). Survival analyses indicated that anemia was associated with lower survival rates, impacting all-cause, cancer, and CRC mortality. Our results indicate that anemia and inflammatory indices are correlated with CRC. Patients with CRC tend to exhibit increased inflammatory indices and decreased red blood cell count and albumin levels, potentially impacting survival.

Trends in Clinico-Epidemiological Profile and Outcomes of Patients with HIV-Associated Cryptococcal Meningitis in Shanghai, China, 2013-2023.

The study aimed to analyze changes in the clinical and epidemiological aspects of HIV-associated cryptococcal meningitis (CM) patients and to identify factors influencing their prognosis. Clinical data of patients with HIV-associated CM treated in Shanghai, China between 2013 and 2023 were collected. This study included 279 cases, 2.89% of AIDS patients, showing a yearly decrease in CM prevalence among AIDS patients (p < 0.001). Overall mortality was 10.39% with rates declining from a 2013 peak of 15.38% to 0% in 2023 despite no significant temporal pattern (p = 0.265). Diagnosis took an average of 18 ± 1 days post-symptoms, and admission CD4 counts averaged 29.2 ± 2.5 cells/μL, hinting at a non-significant decline. Frequent symptoms included fever (62.4%), headache (61.6%), fatigue (44.1%), and appetite loss (39.8%), with younger patients more likely to initially show signs of meningeal irritation. Logistic regression analysis underscored the prognostic importance of cerebrospinal fluid (CSF) white blood cell (WBC) count and procalcitonin levels. Over the decade spanning from 2013 to 2023, the incidence and mortality rates of CM among AIDS patients exhibited a downward trend. The average duration from the onset of CM to confirmation of diagnosis remained prolonged. CSF WBC count and procalcitonin levels were associated with unfavorable outcomes.

Benzalkonium chloride induced acute toxicity and its multifaceted implications on growth, hematological metrics, biochemical profiles, and stress-responsive biomarkers in tilapia (Oreochromis mossambicus).

This study aimed to investigate the toxic effects of benzalkonium chloride (BAC) on Oreochromis mossambicus, a freshwater fish species. Probit analysis was used to determine the lethal concentration (LC50) of BAC for different exposure periods (24, 48, 72, and 96h). The viability of fish exposed to BAC was assessed using the general threshold survival models (GUTS) and confirmed with relevant datasets to evaluate model accuracy. Experimental groups of fish were exposed to BAC concentrations equivalent to 10% and 20% of the 96-h LC50 for 45days. The study revealed significant alterations in various parameters during sublethal BAC exposure. These effects included decreased specific growth rate (SGR), red blood cell count (RBC), hemoglobin (Hb) concentration, hematocrit (Ht) value, plasma protein, and albumin levels, as well as acetylcholinesterase (AChE) activities in both gills and liver. Additionally, an increase in gastrosomatic index (GSI), feed conversion ratio (FCR), plasma glucose and creatinine concentrations, alanine aminotransferase (ALT), aspartate aminotransferase (AST) enzymatic activities, catalase (CAT), superoxide dismutase (SOD), and malondialdehyde (MDA) levels were observed in the exposed fish's gills and liver. Furthermore, the study found that glutathione S-transferase (GST) and glutathione peroxidase (GPx) levels initially increased and then decreased in both gills and liver after exposure to BAC. Correlation matrix analysis, multivariate multiple regression (MMR), canonical correspondence analysis (CCA), integrated biomarker response (IBR), and biomarker response index (BRI) were utilized to assess the impact of BAC on fish, highlighting significant effects on multiple biomarkers in O. mossambicus following surfactant exposure. Thus, the study provides valuable insights into the toxic effects of BAC on this fish species, emphasizing the importance of monitoring such pollutants in aquatic environments.

Foley catheter after ureteroscopy and JJ stent placement: a randomised prospective European Association of Urology Section of Urolithiasis-Young Academic Urologists (EULIS-YAU) endourology study.

To evaluate the effects of inserting a Foley catheter after ureteroscopy (URS) and JJ stent placement on pain scores, voiding patterns, biochemical parameters and postoperative complications. A randomised clinical trial (1:1) with adult patients following unilateral URS + JJ stent placement was planned. In Group A, no Foley catheter was placed, in Group B, a Foley catheter was placed following URS + JJ stent placement. The primary objective was to evaluate effect of placing a Foley catheter on International Prostate Symptom Score (IPSS), Ureteric Stent Symptom Questionnaire (USSQ) score and postoperative biochemical parameters. The secondary objective was to evaluate postoperative complications. A total of 112 patients were included (56/group). A ureteric access sheath was used in each patient. Patients had similar demographic and surgical parameters. The pre- and postoperative biochemical analyses including white blood cell count, C-reactive protein, procalcitonin and creatinine levels were similar between the two groups. The IPSS were similar between the two groups. All the subdomains of the USSQ were similar between two groups except Total Body Pain score, which was lower in Group B. The visual analogue scale scores were similar. Complications were all Clavien-Dindo Grade I and II, and the complication rate was 5.4% and 8.9% in Group A and B, respectively. Placing a Foley catheter following URS + JJ stent placement did not show significant effects on postoperative biochemical parameters and voiding symptoms. However, a Foley catheter lowered the Total Body Pain score on the USSQ without having significant effects on VAS scores. The practice of placing a Foley catheter following URS and JJ stent placement should be based on surgeon's preference keeping in mind the potential positive effect on pain scores.