Changes In Blood Counts Research Articles

Changes in complete blood count parameters influenced by endocrine disorders.

Complete blood count is one of the most common diagnostic methods used in everyday practice. Hormonal status is known to affect blood count parameters. The aim of this study is to summarize changes in blood count that may indicate endocrine disorders, based on a literature review. Red cell parameters deteriorate in thyroid disorders including autoimmune thyroiditis and tend to resolve with appropriate treatment implementation. The most frequent form of anaemia associated with thyroid dysfunction is normocytic anaemia. Macrocytic anaemia is more typical of autoimmune thyroiditis-induced hypothyroidism, while microcytic anaemia is more common in hyperthyroidism. Unexplained anaemia or an increase in red cell distribution width should prompt the investigation of thyroid disorders. Cushing's disease may manifest as an increase in white blood cells and platelets. In the blood smear, neutrophilia is often present, while lymphocytes and eosinophils may be within the lower normal range. Hypercortisolism may induce both hyperaemia and anaemia. In hypopituitarism, a decrease in red blood cell count, haemoglobin, haematocrit, and platelets is observed. Acromegaly may be accompanied by an increase in mean corpuscular volume of erythrocytes. Testosterone deficiency is manifested by a decrease in red cell parameters, whereas hyperandrogenism may lead to polycythaemia. In polycystic ovary syndrome an increase in white blood cell count reflects an underlying inflammatory state. Complete blood count analysis is an easily available and cost-effective additional tool in the diagnosis and treatment monitoring of endocrine disorders.

Hematological and Morphological Changes in the Peripheral Blood Smear of Patients with COVID-19

Background: The novel coronavirus is responsible for a widespread pandemic, causing multiple clinical manifestations. Peripheral blood films have shown changes in white blood cell (WBC) morphology and counts, as well as platelet abnormalities. Atypical and reactive lymphocytes may also be observed in the blood film, which suggests mild leukoerythroblastosis. Objectives: The present study aimed to evaluate the hematological and morphological changes in the peripheral blood smear of patients with COVID-19. Methods: This study was conducted on 175 patients diagnosed with COVID‐19 infection. Blood samples were collected from the patients and examined for the estimation of blood parameters, differential cell count, and presence of atypical lymphocytes. Results: The mean age of the patients was 53.73 years, and males constituted 52.6% of the patients. The majority had normal hemoglobin levels. WBC count was normal in 60.6% of the patients, while 74.3% had normal platelet count, and thrombocytopenia was detected in 23.4%. In addition, differential WBC count indicated that 56.6% of the patients had normal neutrophils, while lymphopenia was detected in 28 and 77.7% had a low eosinophil count. The peripheral blood smears showed atypical lymphocytes with deeply basophilic cytoplasm in 21.14% of the patients. Conclusions: Blood film examination may show multiple abnormal findings in patients with COVID-19 infection. Neutrophilia and lymphopenia with the presence of atypical lymphocytes are frequently observed as well. Low eosinophil count is also highly common. Although platelets showed changes, they were normal or reduced in most cases.

Effect of Whole-Body Cryotherapy on Morphological, Rheological and Biochemical Indices of Blood in People with Multiple Sclerosis.

The aim of this study was to examine and assess the impact of a series of 20 whole-body cryotherapy (WBC) treatments on the biochemical and rheological indices of blood in people with multiple sclerosis. In this prospective controlled study, the experimental group consisted of 15 women aged 34–55 (mean age, 41.53 ± 6.98 years) with diagnosed multiple sclerosis who underwent a series of whole-body cryotherapy treatments. The first control group consisted of 20 women with diagnosed multiple sclerosis. This group had no intervention in the form of whole-body cryotherapy. The second control group consisted of 15 women aged 30–49 years (mean age, 38.47 ± 6.0 years) without neurological diseases and other chronic diseases who also underwent the whole-body cryotherapy treatment. For the analysis of the blood indices, venous blood was taken twice (first, on the day of initiation of whole-body cryotherapy treatments and, second, after a series of 20 cryotherapy treatments). The blood counts were determined using an ABX MICROS 60 hematological analyzer (USA). The LORCA analyzer (Laser–Optical Rotational Cell Analyzer, RR Mechatronics, the Netherlands) was used to study the aggregation and deformability of erythrocytes. The total protein serum measurement was performed using a Cobas 6000 analyzer, Roche and a Proteinogram-Minicap Sebia analyzer. Fibrinogen determinations were made using a Bio-Ksel, Chrom-7 camera. Statistically significant differences and changes after WBC in the levels of red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), elongation index, total extend of aggregation (AMP), and proteins (including fibrinogen) were observed. However, there was no significant effect of a series of 20 WBC treatments on changes in blood counts, rheology, and biochemistry in women with multiple sclerosis. Our results show that the use of WBC has a positive effect on the rheological properties of the blood of healthy women.

Synthetic Lethality Targeting the Aid/RAD51 Axis for Treatment of AICDA-Expressing Lymphoma

Activation Induced Cytidine Deaminase (AICDA or AID) is a DNA directed cytidine deaminase that induces somatic hypermutation and immunoglobulin class switching in stimulated B-lymphocytes. AICDA is a DNA damaging enzyme, producing DNA base pair mismatches that can subsequently be converted into mutations, DNA single strand breaks (SSB), or DNA double strand breaks (DSB). Although AICDA is normally expressed at high levels only in activated B-cells, a wide range of cancer types show constitutive overexpression of AICDA. In malignant cells, as in B-cells, AICDA promotes hypermutation and genomic instability. We previously demonstrated that cells expressing AICDA are critically dependent on the DNA repair factor RAD51 for their survival. We have developed novel small molecule inhibitors of RAD51 that selectively kill AICDA overexpressing cells. One of these, CYT01A, depletes the nucleus of RAD51, thus reducing DNA double strand break repair activity. We have shown CYT01A to be a potent (EC50~150nM) RAD51 inhibitor that reduces the efficiency of RAD51 focus formation, leading to sensitization to excess DNA damage while preserving baseline recombination/repair activity. Here we present the in vitro and in vivo pharmacologic characterization of CYT01A. We first analyzed potential off-target liabilities by carrying out kinome inhibition and safety panel (Panlabs) screens. CYT01A showed negligible inhibitory activity against 429 kinases, receptors, or other pharmacologically important non-RAD51 targets. These data are consistent with high specificity for AICDA and predict in vivo tolerability. We next measured metabolic stability of CYT01A in mouse liver microsome incubation assays, demonstrating CYT01A stability in both the absence and presence of NADPH. Measurement of Caco-2 cell permeability, as a predictor of oral bioavailability, revealed low to moderate efflux of CYT01A. Consistent with these permeability data, CYT01A showed modest oral availability, but relatively long clearance times. Daily oral dosing at 80 mg/kg for 7-14 days resulted in significant reduction in AICDA expressing lymphomas, in a human-to-mouse xenograft model. This demonstrates efficacious iin vivo exposure despite relatively low oral availability. By contrast, AICDA null lymphomas showed no significant tumor response versus vehicle controls, consistent with the synthetic lethal relationship between AICDA and RAD51. Finally, we demonstrated that repeat daily administration of CYT01A up to the maximum dose tested (80mg/kg) was well tolerated and resulted in no observable changes in complete blood counts (CBC), bone marrow function or output, or body weights. Taken together these data represent a definitive proof-of-principle demonstration that in vivo targeting of RAD51 is an effective strategy to treat AICDA expressing cancers. These data form the basis for continued preclinical development of an AICDA/RAD51 synthetic lethal therapeutic paradigm that may be applicable to a wide range of both solid tumors and hematologic malignancies. DisclosuresMills:Cyteir Therapeutics: Employment, Equity Ownership. Cyr:Cyteir Therapeutics: Employment, Equity Ownership. Maclay:Cyteir Therapeutics: Employment, Equity Ownership. Day:Cyteir Therapeutics: Employment, Equity Ownership. Patrick:Cyteir Therapeutics: Consultancy, Equity Ownership. Clas:Cyteir Therapeutics: Consultancy.

ОСОБЕННОСТИ ВЫЯВЛЕНИЯ И ДИАГНОСТИКИ ТУБЕРКУЛЁЗА У ДЕТЕЙ И ПОДРОСТКОВ

Objectives. To assess the peculiarities of diagnosis and clinical course of tuberculosis in children and adolescents. Material and methods. Retrospective analysis of outpatient records of children and adolescents with tuberculosis in Vitebsk region during the period from 2016 to 2020 was made. Results. In the tuberculous disease structure in children and adolescents, pulmonary tuberculosis (infiltrative pulmonary tuberculosis) prevails. In the majority of cases, tuberculosis was diagnosed during adolescence. Almost all of the sick had close family contact with tuberculosis patients. The medical risk group included 25% of patients. In patients with infiltrative pulmonary tuberculosis, symptoms and changes in the total blood count were observed only in the phase of disintegration and seeding. Bacteriological excreters made up 75% of cases. More than half of children and adolescents with tuberculosis had multidrug resistance of mycobacterium tuberculosis. Immunodiagnosing plays an important role in the detection of tuberculosis in children and adolescents. Among the sick children, only extrapulmonary forms of tuberculosis were recorded. Conclusions. Most often, tuberculosis in children and adolescents affects the respiratory organs and is asymptomatic or oligosymptomatic. 75% of patients were bacteria discharging persons, more than half of them having multidrug resistance. Family contact is of great importance in tuberculosis in children and adolescents. Doctors of all specialties need to have phthisiatric alertness in relation to patients with diseases of various localization resistant to nonspecific therapy, especially to persons with chronic diseases and to those who contact with patients suffering from tuberculosis. In case of ineffective antibiotic therapy, it is necessary to take the material for the study and verification of tuberculous infection and to carry out immunodiagnosing of tuberculosis.

COVID-19 related complete blood count changes among asymptomatic pregnant women

Objective: To evaluate complete blood count (CBC) changes that suggest coronavirus disease-2019 (COVID-19) among asymptomatic pregnant women attending routine antenatal care Methods: A cross-sectional study included 187 healthy pregnant women who were attending the antenatal care clinic of a tertiary University hospital between March and June 2020. After a thorough history and examinations, a venous blood sample was taken from each participant for complete and differential blood counts. Those who showed CBC findings suggestive of COVID-19 were further scheduled for a nasopharyngeal swab for detection of SARS-CoV-2 specific antigens through polymerase chain reaction (PCR). Results: We found 5.3% (n=10) of the study population showed CBC changes that are suggestive of COVID-19. When they were scheduled for nasopharyngeal swab for a PCR confirmatory test, 30% (n=3) of them were PCR positive (which represented 1.6% of the entire study population). The most frequently encountered COVID-19-suggestive change in peripheral blood leukocyte differential counts was leucopenia (100%), followed by decreased eosinophil count (50%), then neutropenia and lymphocytopenia (30%). Conclusions: Certain differential leucocyte count changes (leucopenia, neutropenia, lymphocytopenia and decreased eosinophil count) among asymptomatic pregnant women might be related to COVID-19 infection and may indicate a need for further testing.

Resident Perspectives 56–3

Resident Perspectives 56–3

Effect of Arogya Raksha Panchatantra (five lifestyle principles) on hematological parameters and anthropometric measures among healthy volunteers: a pilot study.

A healthy lifestyle is one, where the individual adapts it aiming at prevention from ailments. Unhealthy lifestyle is a behavioral risk factor for non-communicable diseases (NCDs). Arogya Raksha Panchatantra (five principles of healthy living), is a Naturopathy and Yoga lifestyle practice proposed by an eminent Indian Naturopath Dr. B. Venkat Rao, observed to modify the behavioral risk factors. The main objective of this study is to observe the changes in Hematological parameters and Anthropometric measures by practicing this Naturopathic lifestyle. The study adapted one group Pretest- Posttest quasi experimental design, with a total of nine healthy student volunteers between age group 18-20 years. Hematological parameters such as total blood cells count, hemoglobin concentration, MCV, MCH, PCV, and anthropometric measurements such as weight, body circumferences (waist, hip) and changes in blood pressure were measured at baseline and after practice at 25th day. There was a statistically significant difference observed in weight, waist and hip circumference, hematological indices except with MCV and MCH, and blood pressure (p<0.05), with no significant changes in waist-hip ratio and blood counts. The findings of the study indicate that adapting Naturopathy and Yoga lifestyle based on proposed lifestyle practices may be beneficial in reducing the risk factors for non-communicable diseases. The study does not attribute the effects observed to any particular lifestyle practiced in this study; rather it is combination of healthy practices as observed in the study and it needs further longitudinal observations whether the beneficial effect of Naturopathy lifestyle practices is sustained for longer period of time.

Complete blood counts with red blood cell determinants associate with reduced beta-cell function in seroconverted Swedish TEDDY children.

ObjectivesTo investigate whether changes in complete blood count (CBC) in islet autoantibody positive children with increased genetic risk for type 1 diabetes are associated with oral glucose tolerance tests (OGTT) and HbA1c over time.MethodsThe Environmental Determinants of Diabetes in the Young (TEDDY) study follows children with increased risk for type 1 diabetes in the United States, Germany, Sweden and Finland. In the current study, 89 Swedish TEDDY children (median age 8.8 years) positive for one or multiple islet autoantibodies were followed up to 5 (median 2.3) years for CBC, OGTT and HbA1c. A statistical mixed effect model was used to investigate the association between CBC and OGTT or HbA1c.ResultsHbA1c over time increased by the number of autoantibodies (p < .001). Reduction in mean corpuscular haemoglobin (MCH) and mean cell volume (MCV) was both associated with an increase in HbA1c (p < .001). A reduction in red blood cell (RBC) counts (p = .003), haemoglobin (p = .002) and haematocrit (p = .006) levels was associated with increased fasting glucose. Increased red blood cells, haemoglobin, haematocrit and MCH but decreased levels of red blood cell distribution widths (RDW) were all associated with increased fasting insulin.ConclusionsThe decrease in RBC indices with increasing HbA1c and the decrease in RBC and its parameters with increasing fasting glucose in seroconverted children may reflect an insidious deterioration in glucose metabolism associated with islet beta‐cell autoimmunity.

Effects of irradiation doses

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Bone marrow is one of the organs at risk of complications during irradiation due to its radiosensitivity. Hematopoietic toxicity remains one of the main toxicities during irradiation of pelvis. Modern radiotherapy techniques, such as intensity modulation and three-dimensional conformal radiotherapy, allow for better dose compliance in target volumes while optimally sparing organs at risk. There is a lack of prospective studies and comparative trials specifying the dose constraints according to the presence or absence of chemotherapy and correlating with the patient’s bone marrow potential.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This monocentric and prospective study conducted by the Strasbourg Europe Cancerology Institute aims to evaluate the hematological toxicity in patients treated with pelvic irradiation for prostate, rectum, anal canal, endometrium, or cervix cancer. One hundred patients will be included. The primary objective is to quantify the relationship between acute hematological toxicity and delivered doses and irradiated volumes in pelvic bone marrow for pelvic cancers. The prescribed dose to the pelvis depends on the tumor location, from 25 Gy in 5 fractions for rectal cancer to 78 Gy in 39 fractions for low-risk prostate cancer. Hematological toxicity will be measured by weekly blood count during radiotherapy and at one month and three months after the end of radiotherapy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The aim of this study is to improve and optimize radiotherapy if a dose limit or volume constraint is imposed by the results of the study. To our knowledge, this is the first study including several types of pelvic cancers and involving patients treated exclusively with radiotherapy, chemoradiotherapy or radiohormonotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial Registration:&lt;/strong&gt; Trial registration number is NCT04626466.&lt;/p&gt;

Hematological parameters of peripheral blood as prognostic factors in patients with COVID-19 (Literature review)

Annotation. Changes in the complete blood count (CBC) that were recorded in patients against the background of coronavirus infection (COVID-19) attracted the attention of many researchers from the beginning of the pandemic, especially in terms of assessing the prognosis, the severity of the course of the disease in a particular patient. It should be noted that changes in the CBC can be both reactive and systemic response or even reflect the toxic effects of this infection on bone marrow hematopoiesis. The article analyzes the current data in the world literature on changes in CBC against the background of COVID-19 infection to assess their value in the future prognostic sign. To assess the prognosis of the course of the COVID-19 infectious process, a number of peripheral blood indicators were stuck: platelet count, platelet-leukocyte index or systemic inflammation index (ratio of neutrophils × platelets × monocytes to lymphocytes), traditional NLR indices (neutrophil / lymphocyte ratio), PLR (ratio thrombocytopenia / lymphocyte), which with different predictive values indicate the presence of SARS CoV-2 infection, the severity of the course, and the likelihood of a fatal leak or recovery. From the early stages of the disease, COVID-19 is associated with morphological and functional changes in blood cells that are easily detected by conventional haematology analysers, but generalization of the data requires further profiling and multicentre studies. To date, there are no generalized studies on changes in CBC in patients with COVID-19 in the Ukrainian population, which does not allow us to draw conclusions about the features of these changes in this group of patients. It is promising to further study the parameters of peripheral blood in patients with COVID-19 in the Ukrainian population in order to assess reference and prognostic signs and subsequent implementation into practical medical practice.

Blood Counts, Biochemical Parameters, Inflammatory, and Immune Responses in Pigs Infected Experimentally with the African Swine Fever Virus Isolate Pol18_28298_O111.

This study aimed to indicate the influence of infection caused by genotype II African swine fever virus (ASFV)–isolate Pol18_28298_O111, currently circulating in Poland, on blood counts, biochemical parameters, as well as inflammatory and immune responses. Blood and sera collected from 21 domestic pigs infected intranasally with different doses of virulent ASFV were analysed. The infection led to variable changes in blood counts depending on the stage of the disease with a tendency towards leukopenia and thrombocytopenia. The elevated C-reactive protein (CRP) concentrations and microscopic lesions in organs confirmed the development of the inflammation process, which also resulted in an increased level of biochemical markers such as: Aspartate transaminase (AST), creatine kinase (CK), creatinine, and urea. Antibodies could be detected from 9 to 18 days post infection (dpi). Two survivors presented the highest titer of antibodies (>5 log10/mL) with a simultaneous increase in the lymphocyte T (CD3+) percentage–revealed by flow cytometry. Results confirmed a progressive inflammatory process occurring during the ASFV infection, which may lead to multiple organs failure and death of the majority of affected animals.

Evolving Changes in the Full Blood Count in Tuberculosis

Abstract Background: Changes in the full blood count of patients with tuberculosis have been studied previously, but the effect of co-infection with human immunodeficiency virus (HIV) remains to be explored. Objective: To evaluate the changes in full blood count in patients with tuberculosis in an evolving HIV era. Methods: Prospective study of consecutively recruited patients (N = 125) with microbiologically or histologically proven tuberculosis admitted at Chris Hani Baragwanath Academic Hospital between October 2017 and July 2018. Results: Anaemia was found in 60.7% of patients with pulmonary tuberculosis (PTB) and in 61.1% of extra-pulmonary tuberculosis (ETB) patients. ETB patients had lower white cell counts (WCCs) and lower neutrophil counts than PTB patients, (5.59 (3.6–8.1) vs 7.96 (5.27–10.34), p = 0.002) and (4.2 (2.1–7.0) vs 5.5 (3.3–8.4), p = 0.079), respectively. Compared to the HIV-seronegative patients, HIV co-infected PTB patients had lower WCC, lymphocyte counts and neutrophil counts, (6.9 (4.8–9.7) vs 9.4 (8.6–11.4), p = 0.0037), (0.7 (0.46–1.31) vs 1.51 (1.13–2.05), p = 0.0051), and (4.7 (2.8–7.7) vs 8.5 (5.9–10.1), p = 0.0106), respectively. Patients co-infected with HIV on combination antiretroviral therapy and tuberculosis had higher levels of WCC, (7.9 (4.6–10.9) vs 5.8 (4.3–8.3), p = 0.0465). Conclusion: Anaemia is the most common manifestation of tuberculosis. This study highlighted the reactive nature of PTB haematological abnormalities compared to ETB with higher WCCs in both HIV-seropositive and HIV-seronegative patients. Co-infection with HIV was associated with blunting of some of the previously described haematological manifestations among patients with PTB.

Splenic Stromal Sarcoma in a Labrador Dog

Background: Splenic stromal neoplasms are a heterogeneous group of tumors that shares the morphology of spindle cells, and are considered a primary mesenchymal neoplasm of the spleen. Among these neoplasms, some are as yet unclassified. Although stromal neoplasms represent 25 a 50% of dog splenic neoplasms in dogs, subtypes rarely occur alone. As these neoplasms are difficult to diagnose in the routine veterinary medical examination, the objective of this article was to report a case of splenic stromal sarcoma in a dog treated at a private veterinary hospital in Recife, Pernambuco, Brazil. Case: An 8-year-old male labrador dog was treated at a veterinary hospital for an initial clinical suspicion of gastroenteritis. Clinical examinations showed anemic ocular mucosa and a distended abdomen. Considering the animal’s condition, blood count, serum biochemistry, and abdominal ultrasonography (US) were requested. The laboratory tests revealed anemia, thrombocytopenia, leukocytosis with neutrophilia, and changes in the indices of alanine aminotransferase (ALT) and alkaline phosphatase (ALP), among other findings. Abdominal ultrasound showed hepatomegaly, diffuse splenomegaly, a neoformation in the spleen suggestive of splenic neoplasia, and mild cystic prostatic hyperplasia. The dog underwent exploratory laparotomy with splenectomy. During the procedure, a nodule was found attached to the spleen. It was removed, fixed in a 10% neutral buffered formalin solution, and sent for histopathological and immunohistochemical examinations (vimentin, S100, desmin, MyoD1, HHF35, CD31, and alpha smooth muscle actin). The histopathological diagnosis was poorly differentiated spindle cell splenic sarcoma, compatible with splenic stromal sarcoma. Immunohistochemistry showed neoplastic cells immunoreactive for vimentin and S100, and it was not reactive for other markers. Based on the immunohistochemical and morphological profile, the diagnosis of splenic stromal sarcoma was confirmed. Discussion: Dogs affected by splenic neoplasms are generally aged between three and 17 years, and clinically present withanorexia, emesis, lethargy, weight loss, and abdomen distension, which were observed in the present case. However, a purelyclinical diagnosis is disputable, since other diseases can present the same signs. Thus, complementary exams are essential for a correct diagnosis. Laboratory changes in blood count and serum biochemistry are considered nonspecific for splenic neoplasms, with neutrophilic leukocytosis and anemia being consistent with paraneoplastic syndromes frequently diagnosed in small animals. Microscopically, splenic stromal sarcomas are characterized by focal splenic nodules composed of cohesive polygonal to spindle-shaped cell layers. The cells usually exhibit anisokaryosis and often have large oval to round vesicular nuclei and, occasionally, multinucleated cells. They have large areas of necrosis, diffuse or nodular lymphoid aggregates, and foci of extramedullary hematopoiesis, consistent with the histopathological examination reported in the present case. The immunohistochemical analysis included evaluation of seven markers to elucidate the histogenesis of the neoplasm, with the anti-vimentin and anti-S100 markers demonstrating positive cytoplasmic immunoreactivity, revealing the mesenchymal origin of the neoplasm. Thus, the definitive diagnosis was splenic stromal sarcoma, a rare and aggressive neoplasm. Keywords: spleen, histopathology, immunohistochemistry, neoplasm. Descritores: baço, histopatologia, imunohistoquímica, neoplasia

Хронический гепатит С у детей с ВИЧ-инфекцией: особенности течения, успехи противовирусной терапии

Objective. To analyze the course of chronic hepatitis C (CHC) and efficacy of its treatment in children with HIV infection. Patients and methods. This study included 29 children aged 12 to 17 years (mean age 15.1 ± 0.2 years) with perinatal HIV infection and CHC. HIV stages were distributed as follows: stage 4A in 24 individuals (82.8%), stage 4B in 4 individuals (13.8%), and stage 4B in 1 individual (3.4%). All 29 patients received antiretroviral therapy. The distribution of children by HCV genotypes was as follows: 1a in one child (3.4%), 1b in 12 children (41.4%), and 3a in 16 children (55.2%). Antiviral therapy for CHC included glecaprevir/pibrentasvir (3 tablets; 100 mg + 40 mg) once a day for 56 days. Data analysis was performed using the Statistica for Windows software (version 10.0). Results. The mean HCV RNA level was 595,666 ± 34,734 IU/mL (range: 1,100–3,863,025 IU/mL). After 4, 8, or 12 weeks of antiviral therapy for HCV, HCV RNA clearance was achieved in all study participants (p = 0.01). Before treatment initiation, mean CD4+ count was 738 ± 34 cells/μL (above 500 cells/μL), which indicated the absence of immunodeficiency in the group analyzed. Successful antiviral therapy for HCV (sustained virologic response at week 12; SVR 12) also resulted in increase of the CD4+ lymphocytes level, which was considered as a positive effect of glecaprevir/pibrentasvir (p = 0.15). We observed significant differences in the level of liver enzymes (ALT and AST) (p = 0.01) between samples collected before antiviral therapy initiation and those collected during treatment, as well as 12 weeks after its completion (SVR12). All children demonstrated good tolerance of glecaprevir/pibrentasvir; none of them had adverse events, complaints, or clinical/laboratory changes. Conclusion. Thus, all children with HIV infection and CHC achieved SVR12 after the 8-week course of antiviral therapy with glecaprevir/pibrentasvir regardless of HCV genotype. Clinical manifestations (hepatosplenomegaly in 62.1%; asthenovegetative syndrome in 31.0%) were eliminated after 8 weeks of therapy. Laboratory manifestations (hepatic cytolysis (AST/ALT)) were normalized after 4 weeks of therapy. Antiviral treatment for HCV resulted in some increase in the level of CD4+ lymphocytes. We observed no adverse events caused by glecaprevir/pibrentasvir (neither clinical symptoms nor changes in complete blood count or liver function tests), which confirms the safety of this treatment regimen. Key words: antiretroviral therapy, HIV infection, children, direct-acting antivirals, chronic hepatitis C

Changes in the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios before and after percutaneous coronary intervention and their impact on the prognosis of patients with acute coronary syndrome

OBJECTIVES:This study aimed to prospectively observe the changes in the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) before and after percutaneous coronary intervention (PCI) and their impact on the prognosis of patients with acute coronary syndrome (ACS).METHODS:Blood samples from 205 patients with ACS were collected at admission and at 24h and 30 days post-PCI to observe changes in the complete blood count. The Cox multivariate regression model was used to analyze the factors influencing major adverse cardiac events (MACE) after PCI in patients with ACS. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of inflammation indicators for MACE after PCI.RESULTS:Following PCI, NLR and PLR first increased postoperatively and then decreased within 30 days after PCI. Cox multivariate regression analysis showed that NLR and PLR at 24h post-PCI and acute ST-segment elevation myocardial infarction were independent influencing factors for the incidence of MACE after PCI. The ROC curve analysis showed that the NLR at 24h post-PCI was a better predictor of the incidence of MACE. The NLR at 24h post-PCI was significantly correlated with the number and length of implanted stents and operation duration.CONCLUSIONS:After PCI, patients with ACS had an increased neutrophil proportion and NLR. The NLR at 24h post-PCI was a better predictor of the incidence of postoperative MACE.

Impact of various watering regimes on physiological and hematological parameters in intensively kept Marecha (Camelus dromedarius) she-camels in summer season.

Background:Camel is vital to daily life as a source of food and means of transportation, and just as importantly, its milk and urine have been used as medicine for diverse ailments since ancient times for people living in the desert region.Aim:The current study was planned to investigate the effect of different watering regimes on physiological and hematological parameters of lactating Marecha camels during the summer season. Methods:For this purpose, 12 lactating she-camels of almost similar age (8–13 years) and parity (2–5) were selected in a completely randomized design with four animals per treatment at the Camel Breeding and Research Station Rakh Mahni District Bhakkar. The trial was completed in 60 days, while 7 days were given as an acclimatization period for adaptation. The treatments were as follows: Group-1 (G-1) considered as the control had access to water once in a day; Group-2 (G-2) had access to water once in 4 days, and Group-3 (G-3) had access to water once in 6 days. Animals were housed individually for feeding and watering in an intensive management system. The same feed consisting of green fodder (Lucerne) and gram straw (Cicer arientinum) was offered to all animals. The average ambient temperature and relative humidity were 39°C–41°C and 55%–63%, respectively. Result:The mean values (p < 0.001) of water intake were found to be 82.94 ± 1.34 l in G-3, which was higher than G-1 and G-2. Blood analysis showed that packed cell volume, white blood cells, and hemoglobin were affected significantly (p < 0.001, p < 0.01, and p < 0.05, respectively). Conclusion:No serious changes in complete blood count and physiological parameters were reported in this study. So, this shows that the camel is unique in its physiological adaptation in hot and hostile environments.

Large Granular Lymphocytosis With Cytopenias After Allogeneic Blood or Marrow Transplantation: Clinical Characteristics and Response to Immunosuppressive Therapy

Large granular lymphocytosis (LGL)-or LGL leukemia-is a T- or NK-cell lymphoproliferative disorder that often results in cytopenias and autoimmune phenomena. Several studies have described LGL in a subset of patients after allogeneic blood or marrow transplantation (alloBMT), almost exclusively in the setting of asymptomatic lymphocytosis. Some have suggested an association with improved transplant-related outcomes. In contrast, clinically significant LGL after alloBMT is only described in small case reports. This study sought to assess the characteristics, significance, and response to treatment of LGL associated with unexplained anemia, thrombocytopenia, or neutropenia after alloBMT. We performed a retrospective analysis of 150 patients who were evaluated for LGL by peripheral blood flow cytometry (LGL flow) for unexplained cytopenias following initial engraftment after alloBMT from January 1 2012 to July 1, 2019. We identified patients with abnormally increased populations of LGL cells (LGL+) as assessed by Johns Hopkins Hematopathology. We collected demographic, transplantation, and LGL treatment information from electronic medical records. We compared LGL+ patients to patients with unexplained cytopenias with negative flow cytometry for LGL (LGL-) in this cohort. We also assessed change in blood counts after 4 weeks of immunosuppressive therapy in LGL+ patients. Cytopenias occurred at a median of 5.7 months (range 1-81) after alloBMT. The majority of the transplants were nonmyeloablative from haploidentical donors, and all patients received post-transplantation cyclophosphamide for graft-versus-host disease prophylaxis, consistent with the overall alloBMT characteristics at our center. We identified 70 patients with LGL and cytopenias, representing 47% of those evaluated by flow cytometry. There were no significant demographic or transplant-related differences between LGL+ patients and LGL- patients. The median age was 59, and 63% were male. LGL+ patients were more likely to have had cytomegalovirus (CMV) viremia (73% versus 28%, P < .0001), but not acute or chronic graft-versus-host disease. LGL+ patients had higher absolute lymphocyte counts (1500 versus 485/ mm3, P < .0001), a trend toward lower absolute neutrophil count (660 versus 965/mm3, P=.17), and lower neutrophil to lymphocyte ratio (0.39 versus 1.71, P < .001). There were no differences in overall survival or relapse-free survival. Of those with T-cell LGL, 45 were assessed for T-cell receptor clonality. In all, 22% were clonal, 53% oligoclonal, 4% polyclonal, and 20% indeterminate. Thirty (43%) LGL+ patients received immunosuppressive therapy (IST) for cytopenias. First-line treatment was corticosteroids for 25 (83%). Among those treated, there was an increase in median absolute neutrophil count from 720 before treatment to 1990/mm3 after 4 weeks (P=.0017). Thrombocytopenia and anemia showed at most a mild improvement with IST. LGL was a common association with otherwise unexplained cytopenias after alloBMT, almost always after prior CMV infection. LGL in the setting of cytopenias did not predict improved transplantation outcomes compared to those with cytopenias without presence of LGL. IST was effective at improving neutropenia associated with LGL after alloBMT.

Safety and Efficacy Results of BonoFill First-in-Human, Phase I/IIa Clinical Trial for the Maxillofacial Indication of Sinus Augmentation and Mandibular Bone Void Filling

The gold standard for bone regeneration of bone deficiencies is still an autologous bone graft, which has considerable disadvantages; namely, the need for a second major surgery and the limited volume of bone available for harvesting. BonoFill (BF) is a novel, tissue-engineered, bone graft with intrinsic osteoinductive, osteoconductive, and osteogenic properties, consisting of the patient's own adipose tissue-derived mesenchymal stem cells, attached to hydroxyapatite particles. Here, we present the safety and efficacy results of BF first-in-human clinical study for maxillofacial bone tissue regeneration. Eleven eligible male and female subjects, aged 49-65years, were enrolled into the clinical study in 2 clinical indications: Bone augmentation and bone void grafting in the jaws. Clinical follow-up was performed throughout a period of 6 months after BF treatment and included clinical examination, blood tests, CT scans, and biopsies collected from the transplantation site to assess chronic bone infection, changes in complete blood count, and adequate bone augmentation for implant placement. The study results demonstrated that BF promoted adequate bone tissue regeneration without complications. Per our evaluation, there were no incidents of chronic bone infection, or significant changes in complete blood count, and the patients reported overall good health for the duration of the study. At trial end, in the sinus augmentation indication, the BF treated sites residual bone was augmented at an average of 6.36mm (Δ new bone, n=10) and the total bone height at the treated area was on average 11.44mm (n=10). In the indication of filling of bone voids, the patient's average residual bone height of 2.91mm was 15.76mm (n=1) at trial end. BF treatment was shown to be safe and resulted in newly generated bone, which provided adequate bone height for placement of dental implants. Thus, BF is a promising novel autologous bone graft for bone tissue repair.

A novel haemocytometric COVID-19 prognostic score developed and validated in an observational multicentre European hospital-based study.

COVID-19 induces haemocytometric changes. Complete blood count changes, including new cell activation parameters, from 982 confirmed COVID-19 adult patients from 11 European hospitals were retrospectively analysed for distinctive patterns based on age, gender, clinical severity, symptom duration, and hospital days. The observed haemocytometric patterns formed the basis to develop a multi-haemocytometric-parameter prognostic score to predict, during the first three days after presentation, which patients will recover without ventilation or deteriorate within a two-week timeframe, needing intensive care or with fatal outcome. The prognostic score, with ROC curve AUC at baseline of 0.753 (95% CI 0.723-0.781) increasing to 0.875 (95% CI 0.806-0.926) on day 3, was superior to any individual parameter at distinguishing between clinical severity. Findings were confirmed in a validation cohort. Aim is that the score and haemocytometry results are simultaneously provided by analyser software, enabling wide applicability of the score as haemocytometry is commonly requested in COVID-19 patients.