Blood Count Parameters Research Articles

Pre-operative Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios as Predictors of Morbidity and Mortality in Diabetic Foot Infection Amputation Patients

Background: Diabetic foot infection is a complication of uncontrolled diabetes. Some cases require amputation to avoid the spread of infection; however, this can also lead to poor outcomes. Inflammatory markers, such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), have been explored as predictors of outcomes following amputation; however, only a few published studies are available. Objective: The study aimed to determine the diagnostic value of pre-operative neutrophil-lymphocyte and platelet-lymphocyte ratios in predicting in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation in a tertiary government hospital. Methodology: This retrospective cohort study included a total of 535 diabetic foot ulcer patients who underwent amputation at a tertiary government hospital. Data was collected via medical chart review. Complete blood count (CBC) parameters closest to the time of amputation were obtained to calculate the neutrophil-lymphocyte and platelet-lymphocyte ratios. Stata software was used for data processing and analysis. Results: Only 10.28% of patients experienced in-hospital morbidity and/or mortality. Based on Youden’s index, the optimal cutoff points of neutrophil-lymphocyte and platelet-lymphocyte ratios were 7.27 and 32.40, respectively. Both markers showed 98% sensitivity in predicting the outcome. Specificity was 99% for the neutrophil-lymphocyte ratio and 93% for the platelet-lymphocyte ratio. Accuracy parameters remained high when morbidity and mortality were analyzed separately, and subgroup analyses by major and minor amputations were performed. Conclusion: Neutrophil-lymphocyte and platelet-lymphocyte ratios accurately predict in-hospital morbidity and mortality among diabetic foot infection patients who underwent amputation. The low cost and wide availability of a CBC make NLR and PLR valuable options in low-resource settings. Future studies should explore these markers' utility in predicting long-term outcomes after amputation.

Evaluation of Complete Blood Count in Chronic Lymphoid Leukemia Patients

Chronic Lymphoid Leukemia (CLL) is characterized by the uncontrolled proliferation of lymphocytes, usually in the elderly, which can lead to various hematological abnormalities in patients. Analysis of hematological parameters is very important for the diagnosis, prognosis, and monitoring of treatment response in CLL. This study aimed to compare the complete blood count (CBC) parameters of CLL patients with a healthy control group. The study included 50 patients diagnosed with CLL and 50 healthy controls without a history of cancer. CBC parameters (WBC, RBC, HGB, HCT, MCV, MCH, MCHC, RDW, RDW-SD, PDW, PLT, MPV, PCT, NEU%, LYM%, MONO%, EOS%, BASO%, NEU#, LYM#, MONO#, EOS#, BASO#, NRBC#) of CLL patients and control group were statistically compared. According to the analysis results, no significant difference was found between MCV, RDW, RDW-SD, PDW, MPV, BASO%, NEU#, and EOS# values of the patient and control groups (p>0.05). However, WBC, RBC, HGB, HCT, LYM%, MONO%, LYM#, MONO#, BASO#, and NRBC# values of the patient group were significantly higher relative to the control group (p<0.05). MCH, MCHC, PLT, PCT, NEU%, and EOS% parameters were significantly higher in the control group relative to the patient group (p<0.05). As a result, significant differences were observed in some CBC parameters between patients and the control groups. Particularly, the significant difference observed in some parameters emphasizes that the hematological profile of CLL can be used in the diagnosis and monitoring processes. Our findings support

Alterations in Whole Blood Count Parameters and Some Inflammatory Biomarkers of Occupationally Exposed Metal Recyclers: A Case-Control Study

Alterations in Whole Blood Count Parameters and Some Inflammatory Biomarkers of Occupationally Exposed Metal Recyclers: A Case-Control Study

Linear regression analysis for complete blood count parameters during radiotherapy.

This study aimed to evaluate the correlations between complete blood count (CBC) during radiotherapy and patient and treatment factors. Data of cancer patients, including age, sex, concurrent chemotherapy (CCRT), radiotherapy dose (equivalent dose in 2‑Gy fractions with an alpha/beta value of 10 Gy, EQD2Gy10), radiotherapy location, and baseline CBC were collected. Linear regression was used to determine results during radiation. Validation data comprised 20% of the whole cohort. Atotal of 496 radiotherapy courses and 1884 weekly CBC results during treatment were analyzed. Baseline hemoglobin (Hb) was positively associated with subsequent Hb. Each 1 g/dL increase in baseline Hb predicted a0.73 g/dL increase in Hb during treatment (95% confidence interval [CI] 0.7-0.76). Male sex was associated with a0.16 g/dL higher Hb (95% CI 0.04-0.29), while female sex showed the opposite trend. CCRT was associated with a0.18 g/dL reduction in Hb (95% CI -0.33 to -0.03). Radiotherapy to the pelvis, bone, and head and neck regions resulted in Hb reductions of 0.18, 0.34, and 0.94 g/dL, respectively (95% CI -0.33 to -0.03, -0.53 to -0.15, and -1.26 to -0.62, respectively), while brain irradiation increased Hb by 0.22 g/dL (95% CI 0.05-0.38). Age, cumulative dose, and thoracic irradiation did not show asignificant correlation with Hb changes. Adjusted R‑squared for the development and validation data were 0.6 and 0.71 for Hb, 0.42 and 0.11 for white blood cell count, 0.36 and 0.32 for neutrophils, 0.42 and 0.06 for absolute neutrophil count, and 0.43 and 0.36 for platelets, respectively. Hb levels during radiotherapy could be explained using linear regression, although they did not negatively correlate with cumulative dose.

Early hematological indices as a predictor of placenta accreta in women with high suspicion of accreta

There is a lack of early biomarkers to predict the placenta accreta spectrum; thus, searching for available and easily obtained markers such as hematological indices is an attractive option. The current study is a diagnostic accuracy study included 198 women; all women underwent an assessment of their hematological indices during their first trimester as part of their routine antenatal care. All women included in the study had a high suspicion of developing placenta accreta spectrum; the women were followed up until their delivery. White blood cell, neutrophil count, and red cell distribution width (RDW) were significantly higher in the women with accreta than those without accreta. RDW had fair ability (area under the curve, 0.707) as a predictor of accreta. RDW had the highest positive and lowest negative likelihood ratios (indicating better value than the rest of the markers). In multivariate analysis, RDW and the platelet-lymphocyte ratio were independently associated with accreta after adjustment to the effects of age, gestational age, gravida, parity, abortion, and past medical/surgical history. In conclusion, simple, early blood count parameters may be utilized for placenta accreta; RDW appears to be the best predictor of placenta accreta.

INDICES OF SYSTEMIC INFLAMMATION IN VERY LOW BIRTH WEIGHT PRETERM INFANTS WITH SEVERE PERINATAL PATHOLOGY

Hematopoiesis plays a pivotal role in providing compensatory and adaptive mechanisms of the body in response to stressors associated with birth and in facilitating adaptation to new conditions of existence. The evaluation of the complete blood count in newborns is a recommended laboratory test for perinatal pathology, as outlined in standard practice guidelines. The interpretation of results from peripheral blood analysis, with consideration of ratios of indicators and the calculation of systemic inflammation indices, enables not only the assessment of the hematopoietic system but also the determination of specific features of the child's adaptation in the context of preterm birth. Materials and methods. A comprehensive clinical and laboratory examination of the newborns was conducted following standard protocols. Based on the results of the complete blood count, additional ratios were calculated, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). Additionally, the following indices were calculated: systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and platelet, neutrophil, monocyte, and lymphocyte index (PIV). Statistical analysis was performed using STATISTICA software (StatSoft Inc., USA, Version 10). Quantitative indicators with a normal distribution were compared using Student's t-test, and differences were considered statistically significant at p < 0.0001. Results. The severity of the newborns’ condition is accompanied by characteristic changes in complete blood count parameters, including ratios and indices. The results demonstrated specific alterations that suggest the presence of distinct deviations in the indicators when compared to the control group. This indicates a disruption in the activation of erythroid, myeloid, and granulocyte germ cells of hematopoiesis in response to hypoxia during the early neonatal period in extremely preterm infants. The utilization of these indicators provides a degree of insight into the pathophysiological alterations occurring in the children under hypoxic inflammation during preterm birth. Conclusion. Determining the ratio of traditional CBC indicators and systemic inflammation indices is a valuable addition to the traditional assessment of laboratory results in perinatal pathology for preterm infants. Calculating the ratio of complete blood count and systemic inflammation indices in newborns provides an additional criterion for assessing the severity of the condition, helping to predict the progression of perinatal pathology, with consideration of gestational age. An in-depth analysis of complete blood count results facilitates a more objective evaluation of the pathophysiological mechanisms of hypoxic inflammation and their specific characteristics in preterm infants.

Age Dependence of Prognostic Significance of Complete Blood Count Parameters on Mortality from COVID-19

The aim of this study is to determine the age dependence of prognostic significance of complete blood count parameters at the time of admission on mortality from the SARS-CoV-2 infection. This is a single-centre retrospective analytic case-control study covering all 2132 patients with COVID-19 treated in the period 2020–2021 in the hospital. Subject of our study is to compare the diagnostic ability of parameters of the complete blood count (CBC) to predict mortality in different age groups using receiver operating characteristics (ROC) and the corresponding area under the curve (AUC) analyses. Out of the red blood cells related parameters, a sufficient accuracy demonstrates only the red blood cell distribution width (RDW-CV), with a gradual decrease of the area under the curve with ageing – from 0.796 in the age groups under 40 and up to 0.601 in the age group of 80 years and above. From the parameters characterizing platelets, the platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) exhibit a sufficient accuracy only in the age group under 50 years. White blood cells related parameters – white blood count (WBC), granulocytes, granulocytes/lymphocytes ratio (G/L) – demonstrate the best prognostic significance with good accuracy for the age under 50 years – AUC above 0.7, which is retained the same only for granulocytes/lymphocytes ratio in the age group under 70 years. With ageing, we again observe a decline of the accuracy to sufficient in the age groups past 70 years. The results from our study give us grounds to accept that the prognostic value of complete blood count parameters for the prediction of the mortality from COVID-19 is different in various age groups, and decreases with ageing. In patients above 70 years, a limited prognostic value for unfavourable course of the disease have only the RDW-CV and G/L.

The Interplay Between Vitamin D Deficiency, Iron Status, and Anemia Risk in Moroccan Women of Reproductive Age: A Cross-Sectional Analysis.

Background: Vitamin D and iron deficiencies are prevalent among Moroccan women of reproductive age (WRA). Research suggests that Vitamin D deficiency (VDD) may impair iron bioavailability, potentially leading to iron deficiency (ID) and anemia. Objectives: This study investigates associations between vitamin D status, iron levels, and anemia risk in WRA, aged 18-49, from Meknes, Morocco. Methods: A cross-sectional study was conducted among 463 participants, measuring serum 25(OH)D, blood count parameters, iron, ferritin, C-reactive protein, and creatinine. Lifestyle factors, including dietary intake, sun exposure, and physical activity, were assessed through validated questionnaires, and anthropometric data were collected. Linear and logistic regression models analyzed associations, while ROC analysis evaluated VDD's predictive accuracy for ID and anemia. Results: VDD (25(OH)D < 20 ng/mL) was significantly associated with reduced hemoglobin, hematocrit, red blood cells, and ferritin (all p < 0.01), indicating vitamin D's role in erythropoiesis and iron storage. Multivariate logistic regression showed that VDD increased the risk of anemia (OR: 7.17, 95% CI: 3.19-19.28, p < 0.001), ID (OR: 2.20, 95% CI: 1.32-3.77, p = 0.007), and IDA (OR: 4.10, 95% CI: 1.73-12.08, p = 0.004). Dietary iron intake was inadequate, showing minimal protective effects against anemia and ID (β(SE): -0.08(0.03), p = 0.030 and β(SE): -0.05(0.02), p = 0.037). Conclusions: VDD is a significant risk factor for impaired iron status and anemia in Moroccan WRA, highlighting the need for targeted nutritional interventions and further research.

Hematological markers as prognostic indicators in multiple sclerosis progression.

To evaluate routine blood count parameters as diagnostic and prognostic markers in Multiple Sclerosis (MS) progression. 182 patients with Relapsing-Remitting MS (RRMS) and 60 with Secondary Progressive MS (SPMS) were analyzed for blood parameters. In RRMS, the Expanded Disability Status Scale (EDSS) score correlated positively with Red Cell Distribution Width (RDW). In SPMS, the EDSS score correlated positively with White Blood Cell count (WBC) and Mean Platelet Volume (MPV). RDW predicted higher EDSS scores in RRMS, while MPV was a predictor in SPMS. Elevated MPV levels characterized the increased risk of transitioning from RRMS to SPMS. Elevated MPV may serve as a significant indicator of disease progression from RRMS to SPMS, emphasizing its potential clinical relevance.

Screening for Thalassemia Traits in Pregnancy: The Role of Mentzer Index

Thalassemia traits present significant challenges during pregnancy, often leading to complications such as anemia and adverse maternal and fetal outcomes. Early identification of carriers is essential for managing these risks and providing appropriate care. This review article examines the Mentzer Index, a straightforward and cost-effective tool derived from complete blood count (CBC) parameters, which can effectively screen for thalassemia traits in pregnant women. By calculating the ratio of mean corpuscular volume (MCV) to red blood cell (RBC) count, the Mentzer Index serves as a valuable first-line screening measure, facilitating timely referrals for further diagnostic testing. The relevance of early detection is underscored by the need for informed reproductive choices and tailored management strategies. Recognizing thalassemia traits allows healthcare providers to monitor affected women closely and implement appropriate interventions, ultimately improving maternal health outcomes. Furthermore, the Mentzer Index is easily applicable in various clinical settings, particularly in resource-limited environments where access to advanced laboratory testing may be limited. Keywords: Thalassemia, pregnancy, Mentzer Index, anemia, screening, complete blood count, maternal health, carrier detection.

Reference ranges for complete blood count in children and adolescents with Down syndrome.

Down syndrome (DS) is linked to unique hematopoietic characteristics that affect complete blood count (CBC) parameters. Accurate reference ranges are essential for proper CBC interpretation in this population. This retrospective study analyzed 2,627 CBCs from 481 DS patients, aged 31 days to 18 years, at a tertiary care center in Italy. Patients with significant comorbidities were excluded to ensure a homogeneous group. CBC parameters were assessed to establish age- and sex-specific reference ranges. Centile charts were developed for each parameter, and an online tool was created to allow clinicians to compare individual CBC results with the new ranges. Comparisons with the general pediatric population revealed significant differences, particularly in hemoglobin, hematocrit, and mean corpuscular volume, which were higher in DS (p < 0.001). In contrast, a significant percentage of CBCs showed white blood cell counts below the 2.5th centile of healthy controls (p < 0.001), except for the 31 days-1 year age group. A similar trend was observed for lymphocytes (p < 0.001) in the 1-18 years group. These newly established DS-specific reference ranges provide clinicians with a crucial tool for evaluating CBC results, potentially reducing unnecessary tests and emphasizing the need for tailored clinical assessment in managing this unique population.

Effect of Sub- Chronic Administration of Omeprazole on Hematological and Biochemical Parameters in Fischer Male Rats

Long-term use of proton pump inhibitors (PPIs) is believed to have various potential adverse events. Omeprazole is a part of PPIs most commonly prescribed worldwide; it irreversibly binds to the H+-K+ ATPase enzyme system in the gastric parietal cells to reduce the secretion of H+ ions into the lumen of the stomach. The main objective of the current work is to assess the adverse effects of omeprazole medication on certain hematological and biochemical parameters in rats who were on treatment for three months. We conducted a comparative cross-sectional study between March 2024 and July 2024. 20 male Fischer rats (Albino) aged two months, weighting (200-250g) was obtained from the animal house located in the Libyan center for medical research, in the city of Alzawia, and were enrolled in this study. Rats were divided into two groups, the first group was the control (Normal saline group) (n=10), second was administered 40mg/kg omeprazole via IP route (n=10) once daily. Complete blood count and biochemical parameters were measured for both groups. The treatment group had remarkably significant reductions in the number of red blood cells (RBCs) (p&lt;0.001) and the platelets indices. Omeprazole elevated the cholesterol level (p&lt;0.001) and triglyceride (p&lt;0.001) as well as low-density lipoprotein (p&lt;0.01). However, no impact was found with high density lipoprotein (HDL) (p&gt;0.05). Blood urea levels (p&lt;0.001) were significantly increased in the treatment group treated with omeprazole medication. The results also showed that the treatment group had a significant decline in calcium levels (p&lt;0.001) than that of the control group. Prolonged use of omeprazole might result in adverse effects on hematological profile, particularly RBCs and their indices leading to the development of anemia in patients on this medication. Furthermore, it might result in disturbances in biochemical profile, levels of minerals, and vitamins as consequences of affected absorption.

The predictive role of inflammatory biomarkers based on first trimester complete blood count parameters for the risk of HELLP syndrome : A case-control study

Aim; To conclude the predictive role of inflammatory biomarkers based on first trimester complete blood count parameters for the risk of HELLP syndrome. Materials and methods; This case-control study was included 45 of 73 pregnant women with HELLP syndrome. Clinical data and laboratory results were retrieved by medical and hospital records. We compared the inflammatory biomarkers based on first trimester complete blood count parameters for the risk of HELLP syndrome. Results; We recruited 45 cases (pregnant women with HELLP syndrome) and 45 controls (healthy pregnant women), matched for body mass index, gravidity, parity and gestational week. The lymphocyte, platelets - lymphocyte ratio, neutrophil - lymphocyte ratio and systemic inflammation index values were statistically significant (p

The Use of Heated Tobacco and the Health Status of Young Adults in Poland- Preliminary Results

IQOS (I-Quit-Ordinary-Smoking) is the most frequently chosen heated tobacco product among young people in Poland. The study aimed to investigate the effect of IQOS on blood count parameters, biochemical biomarkers, and lipid profile, as well as to make a comparative assessment between people using IQOS, smoking traditional cigarettes, and non-smokers. This case-control study was conducted in 2022-2024 among 85 young people in Poland (Lodz voivodeship) aged 18-30: 29 people using only IQOS, 15 people smoking traditional cigarettes and 41 healthy people not using nicotine products. A 20 ml blood sample was taken and the blood count (WBC, RBC, MONO, PLT, HGB), biochemical biomarkers (CRP, uric acid, fibrinogen, apo A1, apo B, glucose), and lipid profile (total cholesterol, TG, HDL, LDL). There were no statistically significant differences (p&gt;0.05) in the level of blood count, biochemical biomarkers, and lipid profile between the three study groups. Among cigarette smokers, the uric acid level was significantly higher compared to IQOS users and non-smokers: 5.47 vs. 4.77 vs. 4.47 mg/dl (p=0.01). Among IQOS users (n=29), the level of glucose (r=-0.41; p=0.03) and uric acid (r =-0.46; p=0.01) was negatively correlated with the daily number of heated tobacco sticks. Further research is necessary to assess the impact of IQOS use on the health of young people.

Comparison of Hematological Parameters and the Associated Factors Among Women with and without Breast Cancer: A Case-Control Study.

Breast cancer (BC) is the most popular and dangerous cancer, with a high mortality rate. Hematological parameters are often used in routine diagnosis of numerous disorders. Therefore, the study aimed to evaluate hematological parameters amongst women with and without BC. Briefly, 200 blood samples (100 cases and 100 controls) were collected at Life Center of Breast Cancer Control, Ibb City, Yemen. The whole blood samples were tested immediately for complete blood count (CBC) parameters. Socio-demographic and reproductive characteristics were collected by using a standardized questionnaire. Kolmogorov-Smirnov test, Unpaired t-test, Mann-Whitney test, Fisher's exact test and chi-square test for trends were calculated using GraphPad Prism 8.0.1. P-values ≤0.05 were statistically significant. The mean and standard deviation (SD) revealed significant differences between BC group and the healthy control group attributed to the variables of age (P<0.0001), weight (P<0.0001), residence (P=0.0218), employment state (P<0.0001), economic state (P=0.0003), education levels (P<0.0001), regular exercise (P<0.0001) and a strict diet (P<0.0008). Marital state, marital age, number of births, and use of contraceptives demonstrated statistical significance (P<0.0001, P=0.0008, P=0.0009, and P<0.0001, respectively). Additionally, Hb, RBCs, WBCs count, neutrophils, lymphocytes and monocytes displayed significant differences (P=0.0393, P=0.0045, P=0.0327, P=0.0441, P=0.0098 and P<0.0001, respectively). Hb, RBCs, WBCs, neutrophils, lymphocytes, monocytes and other parameters scored high points of evidence for BC surveillance. Further studies are required to evaluate hematological parameter differences and biochemical parameters after or during chemotherapy or mastectomy.

BLOOD DERIVED INFLAMMATORY MARKERS IN COMPLETED SUICIDE: RESULTS FROM A CASE-CONTROL STUDY.

It has been suggested that suicidal behavior may be associated with inflammatory processes. Several studies found altered blood count derived markers in suicide attempters. This study evaluated the potential association of inflammatory factors with completed suicide. Data of in-patient and post-discharge suicide cases and matched controls were obtained from a preexisting data file. Blood count values with a focus on inflammatory parameters were compared. None of the blood count and inflammatory parameters assessed differed significantly between groups. Previous indications of an association of blood count derived inflammatory factors with attempted suicide were not replicated in completed suicides.

Risk Factors and Diagnostic Model Construction of Chronic Pain with Cognitive Impairment.

Cognitive impairment (CI) is frequently observed in patients with chronic pain (CP). CP progression increases the risk of dementia and accelerates Alzheimer's disease pathogenesis. However, risk diagnostic models and biomarkers for CP-related CI remain insufficient. Previous research has highlighted the relationships between several complete blood count parameters for CP or CI-related diseases, such as Alzheimer's disease, while the specific values of complete blood count parameters in CP-related CI patients remain unclear. This study aimed to explore the correlation between complete blood count parameters and CP-related CI to establish a risk diagnostic model for the early detection of CP-related CI. This cross-sectional study was conducted at West China Hospital, Sichuan University. The Montreal Cognitive Assessment (MoCA) was used to classify patients into either the CP with CI group or the CP without CI group. Univariate analysis and multivariate logistic regression analysis were used to screen the related factors of CP-related CI for constructing a risk diagnostic model, and the model was evaluated using receiver operating characteristic (ROC) curve analysis. The study ultimately included 163 eligible patients. Based on analysis, age (OR, 1.037 [95% CI, 1.007-1.070]; P=0.018), duration of pain (OR, 2.546 [95% CI, 1.099-6.129]; P=0.032), VAS score (OR, 1.724 [95% CI, 0.819-3.672]; P=0.153), LMR (OR, 0.091 [95% CI, 0.024-0.275]; P<0.001), absolute neutrophil value (OR, 0.306 [95% CI, 0.115-0.767]; P=0.014), and lymphocyte percentage (OR, 6.551 [95% CI, 2.143-25.039]; P=0.002) were identified as critical factors of CP-related CI. The diagnostic model was evaluated by the ROC curve, demonstrating good diagnostic value with an area under the curve (AUC) of 0.803, a sensitivity of 0.603 and a specificity of 0.871. The risk diagnostic model developed in this study for CP-related CI has significant value and enables clinicians to customize interventions based on each patient's needs.

Predicting abnormal C-reactive protein level for improving utilization by deep neural network model

BackgroundC-reactive protein (CRP) is an inflammatory biomarker frequently used in clinical practice. However, insufficient evidence-based ordering inevitably results in its overuse or underuse. This study aims to predict its normal and abnormal levels using the deep neural network (DNN) models, helping clinicians order this item more appropriately and intelligently. MethodsWe considered complete blood count (CBC) parameters as feature vectors and 10 mg/L as a cutoff value for CRP. Several models, including linear support vector classification, logistic regression, decision trees, random forests, and DNN, were developed based on a dataset of 53834 medical records to predict binary output. We externally validated DNN models on independent 20723 samples through discrimination, calibration curve, and decision curve analysis. ResultsDNN models has the best area under the receiver operating characteristic curves (AUC). Learning curves revealed that models’ AUC, balanced accuracy, and F1 score do not significantly and continuously improve following increasing data volume. In internal validation, the AUC, balanced accuracy, and the F1 score of 10 models were 0.818 (0.95 CI: 0.812-0.824), 0.741 (0.95 CI: 0.736-0.747), and 0.649 (0.95 CI: 0.643-0.656), respectively. These metrics were 0.817 (0.95 CI: 0.816-0.817), 0.741 (0.95 CI: 0.740-0.742), and 0.641 (0.95 CI: 0.640-0.642), respectively, in external validation. AUC and balanced accuracy shown no significant difference (P-values were 0.106 and 0.339). CRP10-C2 model has the lowest Brier score of 0.154, AUC of 0.818, and calibration curve formula of y=1.001x-0.010, which was identified as a target model to deploy in the app. ConclusionsDNN models obtained moderate performance, surpassing baseline indices in distinguishing binary CRP levels. They are good generalizations and well-calibrated. The CRP-C2 model can enhance CRP utilization by informing the orders appropriately and can contribute to inflammatory diagnostics in primary health care where CBC is available, but the CRP test is inaccessible.

Complete blood count parameters and inflammation-related biomarkers in patients with colorectal carcinoma.

The aim of this study was to determine whether there are differences in complete blood count parameters (CBC) and inflammation-related biomarkers, MPV/PC, PLR, NLR, LWR, LMR, NMR, and LCR, among patients with colorectal carcinoma (CRC) and patients with colorectal adenomas. The study included 155 patients who were divided into two groups according to histopathological analysis - 74 adenomas patients and 81 CRC patients. A routine examination of CBC was conducted on Sysmex XN1000 whereas CRP was measured on Alinity ci-series. Statistical analysis was performed by ROC curve analysis using MedCalc Statistical Software. In CRC patients, hemoglobin concentration, hematocrit, MCV, MCH, and MCHC were lower, while RDW was higher (p < 0.001), compared to patients with adenomas. Total leukocyte count (p = 0 .006), absolute neutrophils (p = 0.005), and absolute monocytes (p = 0.007) were lower while relative eosinophils (p = 0.001) and relative basophils (p = 0.001) were higher in CRC patients. Platelet count (p < 0.001) was significantly higher and MPV (p = 0.003) was significantly lower in CRC patients. Furthermore, MPV/PC (p < 0.001) was significantly lower and PLR (p < 0.001) was significantly higher in CRC. Moreover, Receiver Operating Characteristic (ROC) analysis revealed poor diagnostic accuracy, for all tested parameters (AUC was 0.7 or less). PC, MPV, MPV/PC, and PLR were significantly different between study groups, but ROC analysis revealed poor diagnostic accuracy. Lower hemo globin levels in CRC patients are possibly due to more frequent and excessive bleeding. Higher levels of basophils and eosinophils in CRC patients are indicators of inflammatory reaction, which is linked to CRC.

Evaluation of the Tobacco Heating System (THS) During Closed Lower Limb Fracture Healing in Trauma Smokers’ Patients

BACKGROUND: Since 1976, it's been recognized that increased cigarette consumption correlates with decreased bone density, hindering fracture healing and leading to prolonged hospitalization. Although prior research has shown the relatively less harmful effects of electronic nicotine delivery systems (ENDS) on bone cells in lab settings and animal models, clinical evidence regarding their impact on fracture healing remains scarce. This study aims to investigate whether switching to a tobacco heating system (THS) post-orthopedic surgery improves outcomes for smoking patients during tibia or femur fracture healing over a 6-month period. METHODS: The study is a prospective, open-label, non-parallel, single-center trial involving 150 patients from a Level 1 Trauma center, Germany, diagnosed and treated for closed tibia, closed femur shaft, or closed distal femur fractures (according to AO/OTA: 41A2-41C3, 42A-C, 43A-C, 32A-C, 33A2-3, 33B-C). Participants will be categorized into three groups based on smoking behavior: smokers (no intervention), THS (participants switching from cigarettes to THS), and ex-smokers (participants abstaining from cigarettes or ENDS during the study). Clinical, radiological, and laboratory data will be collected during preoperative and postoperative assessments at 6, 12, 18, and 24 weeks. The primary outcome will be the serum concentration of N-terminal propeptide procollagen type 1, a bone formation marker. Secondary outcomes include bone metabolism, healing, immunological, blood count, and clinical parameters. Approval for the study protocol and consent declarations was obtained from the ethics committee of the medical faculty of Eberhard Karls University (724/2022BO1). DISCUSSION: The study results will provide evidence that switching to THS previous orthopedic intervention improves clinical outcomes during closed tibia or femur fracture healing in smokers’ patients due to reduced bone resorption rate consequent to the diminished activity of cigarette smoke-activated osteoclast.