Blood Laboratory Parameters Research Articles

Long-term life history predicts current gut microbiome in a population-based cohort study

Extensive scientific and clinical microbiome studies have explored contemporary variation and dynamics of the gut microbiome in human health and disease1–3, yet the role of long-term life history effects has been underinvestigated. Here, we analyzed the current, quantitative microbiome composition in the older adult Bruneck Study cohort (Italians, Bruneck, n = 304 (male, 154; female, 150); age 65–98 years) with extensive clinical, demographic, lifestyle and nutritional data collected over the past 26 years4. Multivariate analysis of historical variables indicated that medication history, historical physical activity, past dietary habits and specific past laboratory blood parameters explain a significant fraction of current quantitative microbiome variation in older adults, enlarging the explanatory power of contemporary covariates by 33.4%. Prediction of current enterotype by a combination of past and contemporary host variables revealed good levels of predictability (area under the curve (AUC), 0.78–0.83), with Prevotella and dysbiotic Bacteroides 2 being the best predicted enterotypes. These findings demonstrate long-term life history effects on the microbiota and provide insights into lifestyle variables and their role in maintaining a healthy gut microbiota in later life.

Surgical corrections of long ureteral defects (initial experience)

Introduction: Restoration of patency of ureters with long defects is one of the major problems in urology. There are cases when it is impossible to perform plastic surgery of ureter with own tissues or bladder; in these situations, appendicoureteroplasty or kidney autotransplantation can be promising solutions. Material and methods: 4 patients underwent surgical corrections or ureter strictures: two underwent appendicoureteroplasty and two – kidney autotransplantation. To verify the diagnosis of long ureteral defects, standard research methods were used: ante- and retrograde pyeloureterography. Results and discussion: In the early postoperative period, all patients underwent dynamic ultrasonography of the abdominal cavity and retroperitoneal space; in addition, hemodynamics parameters as well as clinical and biochemical laboratory blood parameters were monitored. The early postoperative period in three patients proceeded with no incidents and did not require serious additional studies. In one patient after appendicoureteroplasty dynamic intestinal obstruction developed on the third day post-op, which was resolved conservatively. In the late postoperative period the condition of the patients was satisfactory. There are few articles describing surgical interventions that can treat long ureteral defects, with appendiculoplasty and kidney autotransplantation being the most effective. However, each procedure has own advantages and disadvantages, as well as risks. Conclusion: In our study, we performed these two methods with two patients for each method. Results are promising, but for a better statistical analysis and more thorough follow-up we need more patients for both appendiculoplasty and kidney autotransplantation.

Systemic Immune-Inflammation Index: A Novel Predictor for Non-dipper Hypertension.

IntroductionThe non-dipper hypertension (HT) pattern is associated with more end-organ damage and cardiovascular events than is dipper HT. Inflammation is widely established to play a role in the pathophysiology of HT. Recently, a new inflammatory and prognostic marker called the systemic immune-inflammation index (SII) has emerged. Our goal is to determine whether there is a relationship between non-dipper HT and SII.MethodsOur study is a single-center retrospective and ninety-one patients with HT were included. All patients were analyzed with simultaneous 24-hour ambulatory blood pressure monitoring and laboratory parameters. Thirty-five patients had dipper HT while 56 patients had non-dipper HT. SII was calculated according to neutrophil, platelet, and lymphocyte counts.ResultsThe median age was 48 (45-61 interquartile range (IQR)) in the non-dipper HT group, whereas it was 54 (44-64 IQR) in the dipper HT group. Although the neutrophil level, neutrophil-lymphocyte ratio, platelet lymphocyte ratio, SII, sleeping systolic blood pressure (BP), and sleeping diastolic BP were higher (p=0.020, p=0.041, p=0.046, p=0.019, p<0.001, and p=0.001, respectively) in the non-dipper HT group, the lymphocyte level was lower (p=0.040). A multivariate logistic regression model shows that SII (odds ratio (OR)=1.023, 95% confidence interval (CI)=1.002-1.112, p=0.012) may be an independent predictor of non-dipper HT.ConclusionOur study showed that the SII level was higher in the non-dipper HT patient group than in the dipper HT group. Furthermore, SII was an independent predictor of non-dipper HT. The high SII value in hypertension patients can be used as an early warning parameter to identify non-dipper HT patients.

The effect of multistrain probiotics on functional constipation in the elderly: a randomized controlled trial

Background and objectivesConstipation is one of the most common gastrointestinal conditions, particularly among older individuals. This study aimed to evaluate the efficacy and safety of selected multistrain probiotics on functional constipation and laboratory blood parameters in the elderly living in a nursing home.Subjects and methodsSixty participants (42 females and 18 males) aged 77.9 ± 8.84 years with functional constipation, who met the eligibility criteria, completed the study. In a double-blind, placebo-controlled, parallel design, each participant was randomized to receive either the selected probiotic mixture (N = 28) or placebo (N = 32) for 12 weeks as an adjunct to their usual diet and medications. The liquid probiotic formulation containing Bifidobacterium animalis subsp. lactis BLC1, Lactobacillus acidophilus LA3 and Lactobacillus casei BGP93 was tested for the first time.ResultsSupplementation of selected probiotics resulted in a slight but nonsignificant increase in cumulative stool frequency compared with placebo. However, after the 71st day of the treatment, the cumulative number of stools was significantly higher in the probiotic group (P < 0.05) when the influence of laxative was excluded. The trend towards an increase in the difference between the two groups, which began 1 week after the probiotic intervention, pointed out to their prolonged effect. There were no significant dependent or independent effects of treatment and time on most of the 27 laboratory blood parameters tested.ConclusionsMultistrain probiotic supplementation was found to be efficacious, safe and well tolerated in the elderly with functional constipation.

Optimising CT-guided biopsies of sclerotic bone lesions in cancer patients

ObjectivesInvestigate the laboratory, imaging and procedural factors that are associated with a tumour-positive and/or NGS-feasible CT-guided sclerotic bone lesion biopsy result in cancer patients.MethodsIn total, 113 CT-guided bone biopsies performed in cancer patients by an interventional radiologist in one institution were retrospectively reviewed. Sixty-five sclerotic bone biopsies were eventually included and routine blood parameters and tumour marker levels were recorded. Non-contrast (NC) biopsy CTs (65), contrast-enhanced CTs (24), and PET/CTs (22) performed within four weeks of biopsy were reviewed; lesion location, diameter, lesion-to-cortex distance, and NC-CT appearance (dense-sclerosis versus mild-sclerosis) were noted. Mean NC-CT, CE-CT HU, and PET SUVmax were derived from biopsy tract and lesion segmentations. Needle diameter, tract length, and number of samples were noted. Comparisons between tumour-positive/negative and next-generation sequencing (NGS)-feasible/non-feasible biopsies determined significant (p < 0.05) laboratory, imaging, and procedural parameter differences.ResultsSeventy-four percent of biopsies were tumour-positive. NGS was feasible in 22/30 prostate cancer patients (73%). Neither laboratory blood parameters, PET/CT availability, size, nor lesion-to-cortex distance affected diagnostic yield or NGS feasibility (p > 0.298). Eighty-seven percent of mildly sclerotic bone (mean 244 HU) biopsies were positive compared with 56% in dense sclerosis (622 HU, p = 0.005) and NC-CT lesion HU was significantly lower in positive biopsies (p = 0.003). A 610 HU threshold yielded 89% PPV for tumour-positive biopsies and a 370 HU threshold 94% PPV for NGS-feasible biopsies. FDG-PET and procedural parameters were non-significant factors (each p > 0.055).ConclusionIn cancer patients with sclerotic bone disease, targeting areas of predominantly mild sclerosis in lower CT-attenuation lesions can improve tumour tissue yield and NGS feasibility.Key Points• Areas of predominantly mild sclerosis should be preferred to areas of predominantly dense sclerosis for CT-guided bone biopsies in cancer patients.• Among sclerotic bone lesions in prostate cancer patients, lesions with a mean HU below 370 should be preferred as biopsy targets to improve NGS feasibility.• Laboratory parameters and procedure related factors may have little implications for CT-guided sclerotic bone biopsy success.

Correlation between ST-elevation myocardial infarction, non-ST-elevation myocardial infarction and the local Earth’s magnetic field changes

Stronger oscillations in the local Earth magnetic field may have an impact on the course of ischemic heart disease. This effect is individual for every person and depends on the sex, age, living territory, season, capability to adjust to magnetic field fluctuations and health status. Individuals who already have cardiovascular disease are more sensitive to magnetic field fluctuations, therefore further research is needed to make conclusions. Aim: To identify correlations between changes in local Earth magnetic field frequencies and patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) cases per week, cases by sex per week and patients’ blood laboratory parameters (low-density lipoprotein cholesterol and Troponin I level). Methods: A retrospective study of 1667 patients, who were admitted to the Hospital of Lithuanian University of Health Sciences Kaunas Clinics between 1st January and 31st December 2019 due to acute coronary syndrome (STEMI and NSTEMI), were included in the study. Local Earth's time varying magnetic field (TVMF) was measured by a magnetometer located in Baisogala, Lithuania. Data from the magnetometer was collected daily, and weekly averaged. We assessed the correlations between average weekly geomagnetic field strength in six different frequency ranges (Hz) and average number of STEMI and NSTEMI cases per week, cases by sex per week and patients’ blood laboratory parameters (low-density lipoprotein cholesterol and Troponin I level). Results: The presence of a stronger magnetic field in the frequency range of 32-65 Hz was significantly related to the number of cases in the STEMI group during the winter season (r= 0.583, p= 0.036). Tendency towards a positive correlation was found during the winter in the men's group with STEMI in the high frequency range of 32-65 Hz. Low-density lipoprotein cholesterol level correlated positively in the winter STEMI group with the magnetic field in the 32-65 Hz range, and in the autumn STEMI group with the magnetic field in the frequency range of 0-7 Hz. Conclusion: Increased geomagnetic field strength in the high frequency range of 32-65 Hz is associated with a higher number of cases in the STEMI group.

Chronic hepatitis B virus infection: clinical characteristics and antiviral therapy

Objective. Based on the study of clinical and laboratory parameters, to identify groups of patients with chronic hepatitis B virus (HBV) infection who need antiviral therapy, and to evaluate the effectiveness of tenofovir treatment.Materials and methods. The study group included 234 patients with various forms of chronic HBV infection. Сlinical data, blood laboratory parameters (biochemical blood test, complete blood count, coagulogram, serum HBV DNA level), liver fibrosis stage were studied.Results. Currently, chronic HBV infection is more common in the age group of 30-39 years (35.5%), and is more prevalent in males (73.1%). Advanced liver fibrosis (stage F2 and higher) was found in 38.4% of patients, and liver cirrhosis – in 19.8%. Patients were predominantly HBeAg-negative (86.8%), they had lower serum aminotransferase levels (p=0.03) and DNA HBV viral load (p&lt;0.001) as compared with HBeAg-positive ones. HBsAg-negative (occult) chronic HBV infection is detected in 1.3% patients and may occur with progressing liver disease.Conclusion. The clinical and laboratory characteristics of the patients with chronic HBV infection have been presented, indications for antiviral therapy in 48.7% of the patients have been determined. Antiviral tenofovir therapy allows to achieve a biochemical and virological response in most patients, but due to its indefinite duration and high cost, the question of adherence to the therapy is crucial.

Diahnostychna y peredbachuvana tsinnist i vidnoshennia pravdopodibnosty zminy pokaznykiv deiakykh laboratornykh syndromiv ta yikh konsteliatsii u khvorykh na tsyroz pechinky z porushenniam mineralnoi shchilnosty kistkovoi tkanyny

Diahnostychna y peredbachuvana tsinnist i vidnoshennia pravdopodibnosty zminy pokaznykiv deiakykh laboratornykh syndromiv ta yikh konsteliatsii u khvorykh na tsyroz pechinky z porushenniam mineralnoi shchilnosty kistkovoi tkanyny

Comparison of laboratory and immune characteristics of the initial and second phase of tick-borne encephalitis

ABSTRACT Tick-borne encephalitis (TBE) usually has a biphasic course which begins with unspecific febrile illness, followed by central nervous system involvement. Because TBE is not yet suspected during the initial phase, knowledge of early TBE pathogenesis is incomplete. Herein we evaluated laboratory and immune findings in the initial and second (meningoencephalitic) phase of TBE in 88 well-defined adult patients. Comparison of nine laboratory blood parameters in both phases of TBE revealed that laboratory abnormalities, consisting of low leukocyte and platelet counts and increased liver enzymes levels, were predominately associated with the initial phase of TBE and resolved thereafter. Assessment of 29 immune mediators in serum during the initial phase, and in serum and cerebrospinal fluid (CSF) during the second phase of TBE revealed highly distinct clustering patterns among the three groups. In the initial phase of TBE, the primary finding in serum was a rather heterogeneous immune response involving innate (CXCL11), B cell (CXCL13, BAFF), and T cell mediators (IL-27 and IL-4). During the second phase of TBE, growth factors associated with angiogenesis (GRO-α and VEGF-A) were the predominant characteristic in serum, whereas innate and Th1 mediators were the defining feature of immune responses in CSF. These findings imply that distinct immune processes play a role in the pathophysiology of different phases of TBE and in different compartments.

The first experience of cord blood stem cells application in kidney transplantation: A descriptive study

Abstract. Kidney transplantation is recognized as the optimal method of end-stage kidney disease treatment, but chronic renal allograft rejection remains an unresolved issue and leads to transplanted organ function loss. Recent studies show positive effects of stem cell injections in a variety of diseases, including kidney transplantation.&#x0D; The present study aimed to analyze the first experience of umbilical cord blood stem cells application in living-related kidney transplantation in Shalimov’s National Institute of Surgery and Transplantation, give a preliminary assessment of their effectiveness and safety, evaluate the clinical course and especially the dynamics of laboratory parameters in the recipient’s postoperative period.&#x0D; Methods. The study group included 6 male, adult recipients of kidney transplants, who performed the first kidney allotransplantation from a living family donor in the Shalimov’s National Institute of Surgery and Transplantology in 2020 – 2021. Before surgery, all patients received intravenous administration of a fraction of nuclear cells from human umbilical cord blood at a dose of 2-3 x 106/kg body weight in combination with standard three-component immunosuppressive therapy. Immune system studies were performed before kidney transplantation, on the first and third days of the postoperative period, at the end of the first and second week, as well as on the first, third, sixth, and twelfth months, following kidney transplantation. Renal graft function was assessed by serum creatinine and glomerular filtration rate. Monitoring of clinical and laboratory parameters of blood and urine, the concentration of calcineurin inhibitors (C0) was carried out regularly three times a week for the first month, twice a month for 2-3 months, and once a month until the end of the year.&#x0D; Puncture biopsy of the transplanted kidney was performed three months after surgery to diagnose the pathology of the graft, namely the manifestations of acute and chronic rejection, the nature and degree of which were determined according to the Banff classification.&#x0D; The state of the immune system of the recipients was characterized by indicators of cellular and humoral immunity.&#x0D; Statistical processing of research results was performed using the statistical package StatSoft (2010) STATISTICA 9.1 for Windows StatSoft Inc, Tusla.&#x0D; Results. All patients received cord blood stem cells without complications. On the first day after surgery, an average diuresis was 9415 ± 928.1 ml. Normalization of graft function was observed on the second or third day (GFR more than 90 ml/ min/1.73 m2). There were no rejections of grafts and signs of opportunistic infections in the patients during 1 year follow-up period. Morphological studies did not reveal signs of significant pathological changes in transplanted kidneys in patients who received stem cells as induction therapy.&#x0D; The study of the state of the immune system of recipients in the dynamics, given the insufficient number of patients, requires further research.&#x0D; Conclusions. The administration of cord blood stem cells to recipients prior to kidney transplantation is safe and promotes rapid recovery of renal allograft function. There were no signs of morphological proven chronic graft rejection, which allows us to predict its long-term functioning in the future. To assess the response of the recipient's immune system to the application of cord blood stem cells requires the accumulation of additional data.

URINARY ALBUMIN EXCRETION CHANGES AFTER ADRENALECTOMY IN PATIENTS WITH PRIMARY ALDOSTERONISM

Objective: We aimed to evaluate changes in urinary albumin excretion (UAE) in patients with primary aldosteronism (PA) after adrenalectomy compared with those who remained with non-surgical treatment. Design and method: We evaluated 28 patients with PA diagnosed by adrenal venous sampling (AVS), attended by hypertension specialists or endocrinologists in Hospital del Mar, Barcelona. Office blood pressure (BP), body weight and laboratory parameters (estimated glomerular filtration rate by CKD-EPI equation (eGFR), plasma potassium (K) and UAE) were analyzed before and at 6 months after adrenalectomy (Adx group) or before and 6 months after AVS (non-Adx group). Results: Most patients (66.7%) were male and the mean age was 55.8 ± 9.6 years. Twelve patients (42.8%) underwent adrenalectomy and 16 (57.1%) remained on pharmacological treatment alone. Spironolactone was the principal antihypertensive treatment in the non-Adx group (84.6% of patients). The proportion of diabetes mellitus was similar in both groups (12.5% in Adx group vs 16.2% in non-Adx group, p = 0.6). The decrease in BP was statistically significant in both groups (table 1). Adx group patients showed a statistically significant reduction in the UAE (-7.7 [-33.2 to -4.0] mg/g, p = 0.002) compared to patients in non-Adx group (+0.1 [-6.5 to + 24.9], p = 0.8). After six months, the mean reduction in UAE (log-transformed) was significantly superior in the Adx group than in the non-Adx group. After adjusting by variation of systolic-BP and variation of body weight, a mean difference between the two groups of -0.966 mmHg (95% CI -1.746 to -1.182); p = 0.018 was observed. Conclusions: Patients with PA who underwent adrenalectomy presented a higher reduction in UAE than patients who remained on pharmacological treatment alone.

Efficacy of cytoflavin in optimizing the pharmacotherapy of traumatic brain injury

Objective. To study the efficacy of Cytoflavinum optimizing the pharmacotherapy of traumatic brain injury.Material and methods. We examined 45 patients with mild to moderate traumatic brain injury aged 25 to 54 years. The patients were divided into two groups depending on the prescribed treatment. The first index group included 25 patients with traumatic brain injury who received complex therapy: Cytoflavinum against the background of standard therapy in accordance with clinical guidelines for the treatment of traumatic brain injury. Cytoflavinum was injected intravenously, once a day, 10 ml in 200 ml of 0.9% sodium chloride solution at a rate of 60–80 drops/min (3–4 ml/min) daily for 7 days. The second control group included 20 patients with traumatic brain injury who received only standard therapy. In accordance with the purpose of the study, laboratory blood parameters and their correlation with the parameters of the antioxidant status were determined, and the dynamics of the clinical condition of patients was assessed.Results and conclusion. The administration of Cytoflavinum to patients contributed to a more pronounced positive dynamics of laboratory blood parameters in comparison with the control. Optimization of the pharmacotherapy of traumatic brain injury by the administration of Cytoflavinum made it possible to achieve a more pronounced regression of clinical symptoms and reduce the duration of hospitalization in comparison with the control group of patients.

Особливості перебігу коронавірусної хвороби у вагітних та частота виникнення перинатальних ускладнень залежно від ступеня тяжкості захворювання

Purpose - to analyze clinical and laboratory changes in women with mild to moderate coronavirus disease, the frequency of gestational complications depending on the course of the disease. Materials and methods. 120 pregnant women of the main group with coronavirus disease were involved in the clinical and laboratory examination. The control group consisted of 40 women with gestational age from 22 to 41 weeks, whose pregnancy was not complicated by coronavirus disease. The course of the disease and the impact of coronavirus infection on the course of pregnancy were evaluated by the results of general - clinical, laboratory and instrumental examinations. Results. The surveyed women underwent treatment in the period from 2021 to 2022 at the Communal Non-profit Enterprise «Kyiv City Center for Reproductive and Perinatal Medicine». The mild course of disease had 48 (40%) pregnant women, the course of coronavirus disease of moderate severity had 72 (60%) pregnant women. Symptoms of coronavirus disease observed in pregnant women: hyperthermia - body t≥37.0oC (85 (70.8%) women), general weakness (103 (85.8%) women), loss of smell and taste (27 (22.5%) women), catarhal phenomena (69 (57.5%) women). Decrease in saturation to 92-94% was noted at 18 (15%) pregnant women. The following complications of pregnancy were observed: the threat of premature birth, oligohydramnios, polyhydramnios, fetal growth retardation, structural changes in the placenta according to ultrasound examination of the fetus, violation of fetal-placental blood flow I-II centuries. Conclusions. Given the data of the analysis, it is possible to identify certain features of clinical and laboratory manifestations of coronavirus disease. The most common clinical manifestations are hyperthermia and general weakness. Features of changes in laboratory blood parameters are as follows: leukopenia, lymphocytopenia, increased C-reactive protein and D-dimer, decreased activated partial thromboplastin time, increased prothrombin time, increased total fibrinogen. The most common complications in pregnant women with mild to moderate coronavirus disease: the risk of premature birth, structural changes of the placenta and oligohydramnios. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author. Keywords: coronavirus disease, pregnant women, extragenital pathology, complications of pregnancy.

Hypercortisolism on the background of recovery of COVID-19 (сase report)

Damage to the lung tissue is a predominant complication of the viral disease COVID-19. Recently, there have been complications from other organs, including highly vascularized endocrine glands. Regarding the adrenal glands, there are reports of their damage with a decrease in their function. Сhanging the function of the adrenal glands (AG) in patients with or after COVID-19 is important. A few adrenal autopsy studies in patients have revealed vascular thrombosis, cortical lipid degeneration, ischemic necrosis, parenchymal infarcts, and other lesions leading to a decrease in AG function. The central mechanism of adrenal dysfunction through hemorrhage and necrosis of the pituitary gland is also possible. This paper presents a rare case of the development of hypercortisolism in a young woman after recovering from COVID-19. Based on high ACTH levels (157 and 122pg/ml), a negative nocturnal dexamethasone test, and high 24-hour urinary free (daily) cortisol excretion rates, we tentatively suspected Cushing’s disease. Chromogranin A was within the normal range of 21.35 (reference value &lt;100). Other tests showed an elevated dihydrotestosterone level of 780.6 pg/ml (reference values 24–368 pg/ml). The levels of other anterior pituitary hormones tested were within the normal range. According to clinical guidelines, the drug of choice for the short-term treatment of this disease is steroidogenesis inhibitors— ketoconazole. The effectiveness of such a treatment regimen was previously brought to light by others. In our case, ketoconazole was prescribed at a dose of 400 mg 2 times a day and cabergoline (dostinex) at an initial dose of 1 mg per day. Given the low levels of vitamin D in the blood serum, it was recommended to continue taking vitamin D at a dose of 4000 IU per day. It was recommended to control blood laboratory parameters— serum cortisol, ACTH, AST, ALT, electrolytes, 25(OH)D, blood glucose level after 2 months and decide on further tactics for managing the patient.

The relationships between FLAIS, a novel insulin sensitivity index, and cardiovascular risk factors in a population-based study

BackgroundInsulin resistance is a risk factor for cardiovascular disease. Recently, we have developed a novel index, FLAIS (Fasting Laboratory Assessment of Insulin Sensitivity), which accurately reflects insulin sensitivity, measured with hyperinsulinemic-euglycemic clamp, in different groups of subjects. The aim of the present study was to assess the relationship of FLAIS with cardiovascular risk factors in a population-based study.MethodsThe study group comprised 339 individuals from the ongoing Białystok Plus study, without previously known diabetes. Clinical examination, oral glucose tolerance test and the measurement of blood laboratory parameters were performed.ResultsPrediabetes (impaired fasting glucose and/or impaired glucose tolerance) was diagnosed in 165 individuals whereas type 2 diabetes was diagnosed in 19 subjects. FLAIS was lower in individuals with prediabetes and diabetes in comparison with individuals with normal glucose tolerance. FLAIS was significantly related to waist circumference, systolic and diastolic blood pressure, triglycerides, HDL-cholesterol and LDL-cholesterol in the entire study group and in the subgroups with normal glucose tolerance and with prediabetes/diabetes. HOMA-IR, QUICKI and Matsuda index were not related to blood pressure and LDL-cholesterol in individuals with normal glucose tolerance. Majority of the adjusted models with FLAIS were characterized by better fit with the data in comparison with other indices for all cardiovascular risk factors except waist circumference.ConclusionsFLAIS represents useful index to assess the cluster of insulin resistance-associated cardiovascular risk factors in general population.

Prospective analysis of laboratory blood parameters in patients with cardiovascular diseases who underwent COVID-19-associated pneumonia.

The study of the characteristics and dynamics of laboratory biomarkers in patients with cardiovascular diseases (CVD) undergoing COVID-19-associated pneumonia may be of great clinical importance. The study included 116 patients who underwent COVID-19-associated pneumonia. The patients were divided into 2 groups. The first group included 49 patients without CVD, the second group - 67 patients with CVD. A blood sample was performed in all patients at the time of hospitalization and 3 months after discharge from the hospital. The parameters of general blood count, biochemistry, hemostasis, and biomarkers of inflammation were assessed - concentration of C-reactive protein (CRP), highly sensitive CRP (hs-CRP), homocysteine and IL-6. All patients initially underwent computed tomography of the chest organs. We found that ESR, WBC (leukocytes), NLR (neutrophils/lymphocytes ratio), fibrinogen, LDH (lactate dehydrogenase), LYM/CRP ratio (lymphocytes/CRP) were parameters that significantly distinguished patients in the 1st and 2nd groups. Three months after discharge from the hospital in patients of both groups the increased indicators approached the reference values, however, some parameters such as CRP, ESR, WBC, fibrinogen remained at a higher level in group 2 compared to group 1. Correlation analysis revealed the relationship between parameters of inflammation and hemostasis in the 2nd group of patients, which confirms the presence of latent vascular inflammatory potential in this group. It was revealed that such indicators as lymphocytes, neutrophils, APTT and LDH were associated with the initial volume of lung lesion more than 50%. Increase of these parameters by 1 unit contributes to increase in the volume of lung tissue damage by 6.5%, 6.4%, 11%, and 0.6%, respectively. Thus, dynamic control of laboratory parameters has prognostic value in assessing the nature of the course of COVID-19 associated pneumonia in patients with CVD and developing an algorithm for personalized monitoring of patients in the post-COVID period with the aim of timely correction of therapy to prevent unwanted vascular complications.

IL-6 Promoter Hypomethylation Acts As a Diagnostic Biomarker in Hepatitis B Virus-Associated Hepatocellular Carcinoma.

BackgroundNew biomarkers are needed to detect hepatocellular carcinoma at an earlier stage and to individualize treatment strategies. IL-6 has been proven to be associated with liver cancer in numerous studies.AimTo evaluate the value of the IL-6 promoter methylation level as a noninvasive biomarker for the diagnosis of liver cancer.MethodsA retrospective analysis of 165 patients with HBV-associated hepatocellular carcinoma (HCC), 198 patients with chronic hepatitis B (CHB) and 31 healthy controls were involved. The methylight was detected the methylation level of the IL-6 promoter in peripheral blood mononuclear cells (PBMCs), clinical and laboratory parameters were obtained.ResultsIL-6 promoter methylation levels were significantly lower in patients with HCC (median 53.59%, interquartile range 52.01–54.75%) than in those with CHB (median 56.05%, interquartile range 54.65–57.67%; P<0.001). The level of IL-6 mRNA in patients with HCC (median 0.371, interquartile range 0.173-0.671) was significantly higher than that in patients with CHB (median 0.203, interquartile range 0.108-0.354; P<0.001) and HCs (median 0.189, interquartile range 0.140-0.262; P=0.001). Meanwhile, the PMR value of IL-6 was notably negatively correlated with the mRNA expression level (Spearman’s R=-0.201, P<0.001). The IL-6 PMR value of HCC patients in age (Spearman’s R=0.193, P=0.026) and TBIL (Spearman’s R=0.186, P=0.032) were very weak correlated. At the same time, the level of IL-6 promoter methylation was also an independent factor in the development of liver cancer. When the IL-6 promoter methylation level was used to diagnose HCC, its detective value was superior to AFP [area under the receiver operating characteristic curve (AUC) 0.773 vs. 0.686, P=0.027], And the combined use of AFP and IL-6 methylation level can improve the area under the receiver operating characteristic curve (p=0.011).ConclusionIL-6 promoter hypomethylation is present in hepatocellular carcinoma, and it may be used as a noninvasive biomarker to detect early liver cancer.

Development and internal validation of laboratory prognostic score to predict 14-day mortality in terminally ill patients with gastrointestinal malignancy.

Few studies have developed an easy scoring system for the short-term survival of patients with gastrointestinal (GI) malignancy. A total of 816 terminally ill patients with GI malignancy were admitted to our palliative care unit. They were randomly divided into the investigation (n = 490) and validation (n = 326) groups. A total of 19 laboratory blood parameters were analyzed. Receiver-operating characteristic analysis was performed for each blood factor, and the area under the curve was calculated to determine the predictive value for 14-day survival after the blood test. Multivariable logistic regression analysis was performed to identify significant independent prognostic factors for 14-day mortality. To develop a scoring system for 14-day mortality, the laboratory prognostic score for gastrointestinal malignancy (GI-LPS) was calculated using the sum of indices of the independent prognostic factors. Multivariable analysis showed that 5 of 19 indices, namely total bilirubin ≥ 2.1mg/dL, blood urea nitrogen ≥ 28mg/dL, eosinophil percentage ≤ 0.5%, neutrophil-to-lymphocyte ratio ≥ 9.2, and platelet count ≤ 194 × 103/μL, were significant independent factors of 14-day survival. GI-LPS showed acceptable accuracy for 14-day mortality in the investigation and validation groups. GI-LPS 3 (including any three factors) predicted death within 14days, with a sensitivity of 56-58%, a specificity of 82-87%, a positive predictive value of 48-50%, and a negative predictive value of 87-90%. GI-LPS showed an acceptable ability to predict 14-day survival and can provide additional information to conventional prognostic scores.

Characteristics and Outcomes of Psoas Abscess: Experience From a Tertiary Care Center in North India.

BackgroundPsoas abscess (PA) is an uncommon disease involving infection of the psoas muscle with abscess formation. The evidence concerning clinical and diagnostic characteristics of PA and its outcomes is limited. The literature is heterogenous, with varying presentations and outcomes in different regions worldwide. We present a retrospective analysis of the clinical, radiological, and laboratory characteristics of PA, its management, and outcomes from a tertiary care center in North India.MethodologyWe reviewed the clinical records of confirmed cases of PA treated in our institute from January 2016 to December 2020 with a minimum follow-up of one year. Further, we performed a descriptive analysis of demographic characteristics, clinical features, laboratory parameters, radiological investigations, the basis of diagnosis confirmation, causative microorganisms, definitive management, treatment outcomes, and complications.ResultsWe reviewed 33 cases with a mean age of 29.9 ± 16.8 years. Overall, 48.4% of PAs were right-sided, and 24.2% were bilateral. Abdominal discomfort was the most common presenting symptom. Blood laboratory parameters were mostly within the near-normal range except for the elevated erythrocyte sedimentation rate, C-reactive protein, and neutrophil-to-lymphocyte ratio. Ultrasonography was the most commonly performed radiological investigation and was the basis of diagnosis confirmation. Mycobacterium tuberculosis was the most common causative microorganism. Most patients required percutaneous drainage, and around one-fourth required open drainage. All patients had symptomatic as well as radiological improvement and no major complications.ConclusionsTuberculosis is the most prevalent cause of PA in the North Indian population. Most patients respond well to the less invasive treatment with percutaneous therapeutic drainage and antitubercular drugs, with few patients requiring open drainage. However, tissue diagnosis may remain inconclusive in a few patients, and antitubercular treatment may need to be initiated based on the clinicoradiological evaluation. Nevertheless, the rate of complications is low, with nil mortality probably related to the mild-to-moderate disease course of tuberculosis.

Is combined physical therapy more effective than topical hyperbaric oxygen therapy in the treatment of venous leg ulcers? Preliminary study

Abstract Introduction Recently, increased frequency of chronic leg ulcers has been observed. The aim of the study was to compare therapeutic efficacy of combined physical therapy to topical hyperbaric oxygen therapy in the treatment of venous leg ulcers. Materials and Methods Participants included 36 patients (14 females and 22 males) between 18 and 80 years of age with chronic venous leg ulcers. They were randomly divided into two study groups. Group I underwent topical hyperbaric oxygen therapy; group II underwent combined physical therapy. Before and after the therapeutic cycle (15 procedures) measurement of ulceration size by planimetry and analysis of laboratory parameters of blood was performed. Results In both groups, a statistically significant reduction of ulcer surface area was obtained (25.11±17.8cm2 to 16.93±13.89cm2, p=0.000196) vs. (34.17±14.82cm2 to 23.99±15.15cm2, p=0.004337). Blood morphology revealed a statistically significant reduction in patients from group II who underwent combined physical therapy (p=0.01). In both groups, statistically significant reduction of fibrinogen level (p=0.01 and p&lt;0.001), and total protein level (p=0.01) was achieved. In group II reduction of the inflammation marker C-reactive protein (CRP) was noted. Conclusions Topical hyperbaric oxygen therapy and combined physical therapy had statistically significant effects on the reduction of surface area of treated venous leg ulcers. The changes in morphological and biochemical parameters may indicate the anti-inflammatory and anti-clotting action effects of combined physical therapy.