Blood Lymphocyte Counts Research Articles

INFLUENCE OF PHYTOBIOTIC AND SYNBIOTIC-ACIDIFIER BLEND SUPPLEMENTS ON HEMATO-BIOCHEMICAL INDICES, ANTIOXIDANT ENZYMES AND GUT MICROFLORA OF BROILER CHICKEN

This study examined the effect of phytobiotic (Superliv powder®, SP) and symbiotic-acidifier blend (Bacflora-F®, BF) feed additives on hemato-biochemical indices, antioxidant enzymes, and gut microflora of broiler chicken. A total of 120-day-old Arbor Acres broiler chicks were randomly allotted to four dietary treatments, with three replicates of ten birds per treatment as follows, Diet 1 (basal/control diet), Diet 2 (basal + 0.05 g/kg SP), Diet 3 (basal + 1g/kg BF) and Diet 4 (basal + 0.05g/kg SP and 1g/kg BF). The result revealed significant differences (P <0.05) in values of all haematological parameters except monocyte counts. Broiler chickens fed a diet supplemented with SP and BF had higher packed cell volume, red blood cell, and haemoglobin concentration but lower white blood cells and lymphocyte count compared to the control group. The dietary supplementation of SP and BF did not influence the concentration of alanine aminotransferase, creatinine, total protein, and globulin contents (P > 0.05) but significantly reduced cholesterol levels of the broiler chicken compared to the control group. The result further showed that broiler chickens fed the diet supplemented with of SP and BF had higher (P <0.05) concentration of total glutathione peroxidase (GPx), catalase (CAT) and superoxide dismutase (SOD) compared to the control group. There was no significant difference in aerobic bacteria, lactic acid-producing bacteria and coliform bacteria (p > 0.05) count across the experimental treatments. In conclusion, the dietary supplementation of SP and BF can be used to enhance the antioxidative status, reduce cholesterol levels and maintain the gut health of broiler chickens during production.

Lentinan and β-glucan extract from shiitake mushroom, Lentinula edodes, alleviate acute LPS-induced hematological changes in mice.

Immunomodulatory activity of β-glucans of shiitake mushroom (Lentinula edodes) has been known. We investigated whether β-glucans from L. edodes would attenuate the acute effects of lipopolysaccharides (LPS) on peripheral hematological parameters in mice. An in-house β-glucans extract (BG) prepared from fruiting bodies of shiitake mushroom L. edodes was chemically measured and characterized using spectrophotometry and HPLC. Male BALB/c mice directly inhaled aerosolized LPS of 3 mg/ml and were treated with BG or commercial β-glucan (known as lentinan; LNT) (10 mg/kg bw) at 1 hr before or 6 hr after LPS inhalation. The blood samples were collected by cardiac puncture from euthanized mice at 16 hr post-treatment. The results showed a significant reduction in levels of blood parameters, including red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), and platelets (PLT); and a significant increase in blood lymphocyte counts in LPS-treated mice as compared with the control mice (P≤0.05). Total white blood cells, neutrophils, and monocyte counts did not show any significant difference among the groups. Treatment of LPS-challenged mice with LNT or BG significantly increased the levels of RBC, HGB, HCT, and PLT; and reduced blood lymphocyte counts as compared with LPS-treated mice (P≤0.05). These findings suggest that β-glucans from L. edodes might be effective in attenuating the effects of inhaled LPS on peripheral blood parameters. Thus, these findings might be useful in acute inflammatory diseases particularly pulmonary infectious diseases in which the hematological parameters would be affected.

Soluble ITGaM and ITGb2 Integrin Subunits Are Involved in Long-Term Pulmonary Complications after COVID-19 Infection

(1) Introduction: The role of soluble integrins in post-COVID-19 complications is unclear, especially in long-term pulmonary lesions. The purpose of this study was to investigate the association between soluble ITGa2, ITGaM and ITGb2 integrin subunits and long COVID-19 pulmonary complications. (2) Methodology: Post-COVID-19 patients were enrolled. According to the evidence of persistent interstitial lung lesions on CT, patients were divided into a long-term pulmonary complications group (P(+)) and a control group without long-term pulmonary complications (P(-)). We randomly selected 80 patients for further investigation (40 subjects for each group). Levels of ITGa2, ITGaM and ITGb2 integrin subunits were determined by ELISA assay. (3) Results: The serum concentration of sITGaM and sITGb2 were significantly higher in the P(+) group (sITGaM 18.63 ng/mL [IQR 14.17-28.83] vs. 14.75 ng/mL [IQR 10.91-20] p = 0.01 and sITGb2 10.55 ng/mL [IQR 6.53-15.83] vs. 6.34 ng/mL [IQR 4.98-9.68] p = 0.002). We observed a statistically significant correlation between sITGaM and sITGb2 elevation in the P(+) group (R = 0.42; p = 0.01). Patients from the P(+) group had a lower (1.82 +/-0.84 G/L) lymphocyte level than the P(-)group (2.28 +/-0.79 G/L), p = 0.03. Furthermore, we observed an inverse correlation in the P(-) group between blood lymphocyte count and sITGb2 integrin subunit levels (R = -0.49 p = 0.01). (4) Conclusions: Elevated concentrations of sITGaM and sITGb2 were associated with long-term pulmonary complications in post-COVID-19 patients. Both sITGaM and sITGb2 may be promising biomarkers for predicting pulmonary complications and could be a potential target for therapeutic intervention in post-COVID-19 patients.

Neutrophil and lymphocyte count as predictors of the location of calcific coronary lesions in patients treated with rotational atherectomy.

The role of immune system activation in development and progression of atherosclerotic plaques has been postulated. Previous studies on inflammation have focused on the severity of coronary disease, the risk of acute coronary syndrome, and the prediction of outcomes based on hematological indices obtained from whole blood count analysis. To analyze simple data of the whole blood count in relation to the location of calcified atherosclerotic lesions in patients treated with coronary rotational atherectomy (RA). Eighty-one patients (57 (70%) males, mean (SD) age of 70.4 ±8 years) who underwent RA were enrolled in the study. The study group was divided into two subgroups depending on the proximal (group 1) and non-proximal (group 2) location of the culprit lesions in coronary arteries. The angiographic results were compared with demographic and clinical data and whole blood count analysis. The multivariable analysis revealed the predictive value of low neutrophil (OR = 0.75, 95% CI: 0.58-0.97, p = 0.030) and lymphocyte counts (OR = 0.27, 95% CI: 0.11-0.68, p = 0.005) for the proximal location of the culprit lesions. In the ROC analysis, combined neutrophil and lymphocyte counts showed the best prediction of proximal location, with the area under the curve of 0.747 (p < 0.001), yielding a sensitivity of 79.07% and specificity of 73.68%. The lower neutrophil and lymphocyte counts in peripheral blood count analysis may be more representative of proximal calcified coronary lesions. The relationship between neutrophil and lymphocyte blood count and calcific atherosclerotic plaque location can indicate the inflammatory background of epicardial atheroma formation and distribution.

An elevated systemic inflammation index is related to an inferior response to pomalidomide and dexamethasone treatment in patients with relapsed and refractory multiple myeloma.

The systemic inflammation index (SII) might serve as an indicator of the equilibrium between the inflammatory and immune responses. The aim of the study was to determine the clinical value and prognostic significance of SII in the cohort of multiple myeloma (MM) patients treated with a regimen of pomalidomide and dexamethasone (Pd). This retrospective, real-life study included patients who received a Pd regimen in our centre between November 2018 and July 2022. The systemic inflammation index was calculated from peripheral blood counts of platelets, neutrophils, and lymphocytes collected shortly before commencement of Pd treatment using the equation: SII = N × P/L, where N, P, and L are the respective counts per litre of peripheral blood for neutrophils, platelets, and lymphocytes. The study group consisted of 54 patients. Most patients received Pd as the third (38.9%) or fourth (37.0%) line of treatment. The median number of completed treatment cycles was 5 (IQR: 1-12). The median progression-free survival (PFS) was 6.8 months and overall survival (OS) 14.8 months. High SII (> 374) was an independent prognostic factor for PFS (HR = 3.0, 95% CI: 1.4-6.3, p < 0.01) and OS (HR = 2.2, 95% CI: 1.0-4.6, p = 0.04). In the low SII group, the respective median PFS and OS values were 9.6 and 21.7 months, compared to 2.6 (p = 0.018) and 5.5 months (p = 0.035) in the high SII group. The systemic inflammation index has prognostic significance in MM patients treated with Pd. A high SII predicts a poorer outcome in pretreated MM patients undergoing Pd treatment evaluation. As such, it may well be a key factor for guiding subsequent treatment decisions.

The modified systemic inflammation score is a predictor of ICU admission of COVID-19 patients

Objective: To evaluate the effect of the modified systemic inflammation score (mSIS) on prognosis in patients diagnosed with COVID-19. Methods: In this retrospective cross-sectional study, 181 patients were selected and divided into two groups: patients with and without admission to the intensive care unit (ICU). An albumin level of ≥4.0 g/dL and lymphocyte-to-monocyte ratio (LMR) of ≥3.4 was scored 0, an albumin level of &lt;4.0 g/dL or LMR of &lt;3.4 was scored 1, and an albumin level of &lt;4.0 g/dL and LMR of &lt;3.4 was scored 2. Results: A total of 242 COVID-19 positive patients were initially included in this study. Of these patients, 61 were excluded and 181 patients remained. Among the 181 participants, 94 (51.9%) were female, and the median age was 61 (51, 75) years. The mSIS scale ranged from 0 to 2. After analysis, the median score was 0 (0, 0) in the non-ICU group and 2 (0, 2) in the ICU group (P&lt;0.001). The median white blood cell, lymphocyte counts, and albumin levels were lower in the ICU group (P&lt;0.001, P&lt;0.001, and P&lt;0.001, respectively). In logistic regression analysis lymphocytopenia (OR=5.158, 95% CI=1.249-21.304, P=0.023), hypoalbuminemia (OR=49.921, 95% CI=1.843-1 352.114, P=0.020), AST elevation (OR=3.939, 95% CI=1.017-15.261, P=0.047), and mSIS=2 (OR=5.853, 95% CI=1.338-25.604, P=0.019) were identified as independent predictors of ICU admission. Conclusion: The mSIS can be used as an independent parameter for establishing the intensive care needs of patients with COVID-19.

Incidence of neurological complications following pediatric heart surgery and its association with neutrophil-to-lymphocyte ratio.

Due to increased rate of open-heart surgeries in children, postsurgical mortality and morbidities have increasingly gained attention. Neurological complications are some of the most important postsurgical events. However, the number of studies regarding postsurgical neurological complications seems to be inadequate. We aimed to study the incidence of neurological complications following cardiac surgery in the pediatric cardiac intensive care unit (ICU) of the children's medical center. This cross-sectional study was conducted from March to September 2019. We included all of the children who underwent cardiac surgery and were admitted to ICU at CMC. We collected their demographic data, lab test results (white blood cell count, absolute neutrophile and lymphocyte counts) and calculated their Risk Adjustment for Congenital Heart Surgery (RACHS) score. We then documented neurological adverse events and investigated the associations between those events and the patients' data. Of the 267 studied patients, 14 developed neurological complications (5.2%); seven developed chorea (2.6%), four developed seizures (1.5%), and two developed both seizure and chorea (0.7%). One case developed subarachnoid hemorrhage (SAH). We observed that age (p = 0.000), weight (p = 0.000), and RACHS score (p = 0.006) were associated with the development of neurological complications. Additionally, we observed that "neutrophil to lymphocyte ratio" was not associated with the risk of postsurgical neurological complications. Younger age, lower weight, and higher RACHS score were associated with neurological complications after operations. Given the importance of postsurgical neurological complications, further investigations should be carried out to cover this issue and discover preventive strategies for such morbidities.

Supplements Administration during Infectious Bursal Disease Virus Infection in Poultry Evaluation of the Effects of Prebiotic Probiotic and Synbiotic on the Haematological Alterations in Commercial Pullets

The administration of supplements during viral infections in poultry is gaining more attention. This study evaluated the effects of supplements (prebiotic, probiotic and synbiotic) administration on haematological parameters of ISA Brown chicks inoculated with a very virulent infectious bursal disease (vvIBDV). Two hundred and fifty one-day-old chicks were assigned into five groups (A, B, C, D and E) of 50 chicks each. Groups A, B and C were administered molasses, Antox® and EN-FLORAX®, respectively daily via drinking water from 1 to 49 days of age (doa) while D and E were not administered any supplement. Groups A, B, C and D were inoculated with a vvIBDV at 28 doa while E was not inoculated. Blood was collected from all groups at 1, 28, 35, 42 and 49 doa, and processed for haematology using standard laboratory procedures. Results revealed significantly (P&lt;0.05) higher packed cell volume (PCV), haemoglobin concentration, total red blood cells and thrombocyte count in groups A, B and C compared to group D at 35, 42 and 49 doa. Total white blood cells, heterophils and lymphocyte counts were significantly (P&lt;0.05) higher in groups A, B and C than in group D at 35, 42 and 49 doa. The PCV between groups A, B, C and D differed significantly (P&lt;0.05). The haematological changes induced by vvIBDV were mitigated by the supplements in this study. Therefore, molasses, Antox® and EN-FLORAX® could be administered to ameliorate haematological alterations due to vvIBDV infection in poultry.

Phytochemical evaluation and acute oral toxicity of crude methanol extract of Pleurotus tuber-regium (Fr.) Singer in laboratory mice (Mus musculus)

This research aimed to evaluate the phytochemical components of the crude methanol extract (CME) of Pleurotus tuber-regium and its acute toxicity in mice, Mus musculus. Before being filtered and evaporated, the crushed mushroom was macerated in 70% methanol for 72 hours. The phytochemical screening and acute oral toxicity were carried out using standard procedures. The CME consists of alkaloids, cardiac glycosides, saponins, phenolic compounds, tannins, steroids, carbohydrates, flavonoids, and terpenoids. When given orally, the LD50 was shown to be greater than 5000 mg/kg with no outward symptoms of toxicity. Haematology showed a significant (p &lt; 0.05) decrease in packed cell volume, hemoglobin concentration, total red blood cell, and neutrophil counts in the treatment group as compared to the control group, while total white blood cell and lymphocyte counts significantly (p &lt; 0.05) increased. On serum biochemistry, a significant (p &lt; 0.05) increase in aspartate aminotransferase, alanine transferase, alanine phosphatase, blood urea nitrogen, and creatinine was observed in the treated group. There was however no significant (p &gt; 0.05) difference in serum albumin and total protein. In conclusion, 5000 mg/kg of extract had a significant influence on the hematological and biochemical profiles of mice but didn’t cause irreparable liver and kidney damage.

Modified naples prognostic score as a potential predictor for coronary slow flow: a retrospective observational study

The Naples prognostic score (NPS) predicts patient survival in gastroesophageal cancer using parameters related to nutritional and inflammatory status. These parameters include risk factors for coronary endothelial dysfunction except for low total cholesterol. Therefore, we modified the score (mNPS) to include high cholesterol, a risk factor for coronary endothelial dysfunction. We aimed to evaluate the relationship between mNPS and the angiographic epicardial coronary slow flow phenomenon (CSFP). This retrospective study included 301 patients with coronary slow flow who underwent coronary angiography between 2018 and 2022. The mNPS parameters were calculated and the population was divided into three groups based on the calculated parameters. Angiographic findings were classified in the left anterior descending (LAD), circumflex (Cx), right coronary (RCA) arteries, and three coronary arteries together. Statistical analyses were performed to identify mNPS as predictors of a slow flow phenomenon. Participants were divided into mNPS Group 1 (n=63), mNPS Group 2 (n=201), and mNPS Group 3 (n=37). No significant differences were observed in age, gender, or medications among the mNPS groups. The RCA had a statistically significant association with mNPS groups for slow flow phenomenon (p=0.006). Considering all three coronary arteries, the association with mNPS groups was also significant (p=0.005). White blood cell and lymphocyte counts showed significant differences. Compared with group 1, group 3 had 4.11 times more coronary artery slow flow. Our study suggests that the mNPS, integrating nutritional and inflammatory parameters along with high cholesterol, holds promise as a potential predictor for the coronary slow flow phenomenon. This could impact risk stratification and clinical management in this patient group.

SARS-CoV-2 severity prediction in young adults using artificial intelligence

Aim: to build a predictive model for severe COVID-19 prediction in young adults using deep learning methods. Materials and methods: data from 906 medical records of patients aged 18 to 44 years with laboratory-confirmed SARS-CoV-2 infection during 2020–2021 period was analyzed. Evaluation of laboratory and instrumental data was carried out using the Mann-Whitney U-test. The level of statistical significance was p≤0,05. The neural network was trained using the Pytorch framework. Results: in patients with mild to moderate SARS-CoV-2 infection, peripheral oxygen saturation, erythrocytes, hemoglobin, total protein, albumin, hematocrit, serum iron, transferrin, and absolute peripheral blood eosinophil and lymphocyte counts were significantly higher than in patients with severe СOVID-19 (p&lt; 0,001). The values of the absolute number of neutrophils, ESR, glucose, ALT, AST, CPK, urea, LDH, ferritin, CRP, fibrinogen, D-dimer, respiration rate, heart rate, blood pressure in the group of patients with mild and moderate severity were statistically significantly lower than in the group of severe patients (p &lt; 0.001). Eleven indicators were identified as predictors of severe COVID-19 (peripheral oxygen level, peripheral blood erythrocyte count, hemoglobin level, absolute eosinophil count, absolute lymphocyte count, absolute neutrophil count, LDH, ferritin, C-reactive protein, D-dimer levels) and their threshold values. A model intended to predict COVID-19 severity in young adults was built. Conclusion. The values of laboratory and instrumental indicators obtained in patients with SARS-CoV-2 infection upon admission significantly differ. Among them eleven indicators were significantly associated with the development of a severe COVID-19. A predictive model based on artificial intelligence method with high accuracy predicts the likelihood of severe SARS-CoV-2 course development in young adults.

Relation between Cytokine Levels and Pulmonary Dysfunction in COVID-19 Patients: A Case-Control Study.

Aim: The study aimed to assess the relationships between serum cytokine levels and pulmonary dysfunctions in individuals with COVID-19. These correlations may help to suggest strategies for prevention and therapies of coronavirus disease. Patients and methods: Fifty healthy participants and one hundred COVID-19 patients participated in this study. COVID-19 participants were subdivided into moderate and severe groups based on the severity of their symptoms. In both patients and healthy controls, white blood cells (WBCs) and lymphocytes counts and serum C-reactive protein (CRP), interleukin (IL)-1, IL-4, IL-6, IL-18, and IL-35 levels were estimated. All the patients were examined by chest computed tomography (CT) and the COVID-19 Reporting and Data System (CO-RADS) score was assessed. Results: All COVID-19 patients had increased WBCs count and CRP, IL-1β, IL-4, IL-6, IL-18, and IL-35 serum levels than healthy controls. Whereas WBCs, CRP, and cytokines like IL-6 showed significantly higher levels in the severe group as compared to moderate patients, IL-4, IL-35, and IL-18 showed comparable levels in both disease groups. Lymphocytes count in all patient groups exhibited a significant decrease as compared to the heathy controls and it was significantly lower in severe COVID-19 than moderate. Furthermore, CO-RADS score was positively connected with WBCs count as well as CRP and cytokine (IL-35, IL-18, IL-6, IL-4 and IL-1β) levels in both groups. CO-RADS score, also demonstrated a positive correlation with lymphocytes count in the moderate COVID-19 patients, whereas it demonstrated a negative correlation in the severe patients. The receiver operator characteristic (ROC) curve analysis indicated that IL-1β, IL-4, IL-18, and IL-35 were fair (acceptable) predictors for COVID-19 in moderate cases. Whereas IL-6 was good predictor of COVID-19 in severe cases (AUC > 0.800), IL-18 and IL-35 were fair. Conclusion: Severe COVID-19 patients, compared to individuals with moderate illness and healthy controls, had lower lymphocyte counts and increased CRP with greater WBCs counts. In contrast to moderate COVID-19 patients, severe COVID-19 patients had higher levels of IL-6, but IL-4, IL-18, and IL-35 between both illness categories were at close levels. IL-6 level was the most potent predictor of COVID-19 progress and severity. CO-RADS 5 was the most frequent category in both moderate and severe cases. Patients with a typical CO-RADS involvement had a higher CRP and cytokine (IL-1β, IL-6, IL-4, IL-18, and IL-35) levels and WBCs count with a lower lymphocyte number than the others. Cytokine and CRP levels as well as WBCs and lymphocyte counts were considered surrogate markers of severe lung affection and pneumonia in COVID 19 patients.

Relapsing pericarditis: Peripheral blood neutrophilia, lymphopenia and high neutrophil-to-lymphocyte ratio herald acute attacks, high-grade inflammation, multiserosal involvement, and predict multiple recurrences.

To identify peripheral blood cellular correlates of active pericarditis and to verify whether peripheral blood neutrophils, lymphocytes and the neutrophil to-lymphocyte ratio (NLR) are associated with disease phenotype or prognosis. Observational prospective study on a cohort of 63 patients with idiopathic pericarditis followed for 12 months after each pericarditis recurrence. Two distinct analyses were performed: the "index attack" analysis focused on the first pericarditis episode in each patient, while the "all attacks" analysis included all episodes occurring during the study. Absolute and relative neutrophilia and lymphopenia, together with high NLR, were observed during active pericarditis, as compared with disease remission, at both analyses. Neutrophils showed a positive correlation with plasma C-reactive protein levels, while lymphocyte count showed a negative correlation. Relative neutrophil count was higher, and lymphocyte count lower in patients with pleural effusion; a higher NLR and lower absolute lymphocyte count were observed in those with peritoneal involvement. No correlations were found between peripheral blood neutrophil or lymphocyte counts and size of pericardial effusion, or with the presence of myocardial involvement. Peripheral neutrophilia, lymphopenia and NLR during acute attacks predicted the number of recurrences in the following 12 months. Peripheral blood neutrophilia and lymphopenia are typical of acute idiopathic pericarditis. Acute attacks of pericarditis are associated with neutrophilia and lymphopenia, as compared with disease remission. During acute attacks, neutrophilia and lymphopenia reflect the extent of serosal inflammation and could help to customize therapeutic management after remission has been achieved.

Jaundice in relation to immune activation during Epstein-Barr virus-induced infectious mononucleosis

BackgroundLiver involvement during infectious mononucleosis is common, but jaundice is considered rare. This study aimed to investigate serum bilirubin concentrations in patients with infectious mononucleosis and immune abnormalities associated with jaundice. MethodsWe report on an adult patient with monoclonal B lymphocytosis and IgM-lambda gammopathy who developed a severe icteric hepatitis during infectious mononucleosis. We then reviewed the clinical records of 389 patients admitted to the hospital with infectious mononucleosis between 1995 and 2018 (51.7% male patients; median age, 19 years; range, 15-87 years) with focus on liver abnormalities and associated factors. ResultsFifty-nine patients (15.1%) had serum bilirubin concentrations between 1.5 and 3 mg/dL, and 47 patients (12.0%) had serum bilirubin >3 mg/dL. Patients with increased bilirubin concentrations had a distinct clinical presentation, with more frequent abdominal pain, nausea and vomiting, and less frequent sore throat than patients with normal bilirubin. Age and sex were not significantly different for the patients with increased and normal serum bilirubin concentrations. The patients with increased serum bilirubin concentrations showed higher levels of immune activation markers than the patients with normal bilirubin, including blood lymphocyte counts, serum IgM, and β2-microglobulin concentrations. Heterophile antibody-positive patients (88.6%) showed similar bilirubin concentrations but higher aspartate aminotransferase and alkaline phosphatase levels than their heterophile-negative counterparts. Serum bilirubin elevations normalized quickly during follow-up. ConclusionsTransient hyperbilirubinemia is common during severe (in-hospital) infectious mononucleosis in adult patients. Patients with hyperbilirubinemia have less frequent pharyngitis symptoms and more frequent abdominal symptoms. Hyperbilirubinemia during infectious mononucleosis is associated with immune activation markers.

Single-balloon Enteroscopy for Evaluation of Small Bowel Crohn Disease Strictures: Peripheral Blood Lymphocytes As a Risk Factor for Strictures.

Few reports have focused on single-balloon enteroscopy (SBE) for evaluation of small bowel Crohn disease (CD) strictures. The aim of this study was to analyze the relationships between peripheral blood inflammatory markers and small bowel CD strictures observed by SBE. CD patients who underwent SBE between January 2016 and December 2020 were enrolled. The clinical characteristics and peripheral blood inflammatory markers were collected and analyzed to screen for predictive factors significantly associated with small bowel CD strictures. A total of 221 CD patients underwent SBE. The lymphocyte (LC) counts in peripheral blood were significantly lower in the active group (n=178) than in the inactive group (n=43) according to the simple endoscopic score for CD (SES-CD), P =0.011, and was correlated with the SES-CD ( r =-0.134, P =0.047). The LC levels were significantly lower in the stricture group (n=116) than in the nonstricture group (n=105) based on whether small bowel strictures developed, P =0.000, and LC was a risk factor for strictures in the multivariate analysis [hazard ratio (HR), 2.332; 95% CI, 1.102-4.937; P =0.027]. In the subgroup analysis, LC levels notably decreased after stricture aggravation ( P =0.000). Forty-seven patients who underwent small bowel resection underwent SBE at 6 to 12 months after surgery. The LC level was significantly lower in the postoperative patients with strictures ( P =0.025), and LC (HR, 4.444; 95% CI, 1.265-15.617; P =0.020) was a risk of postoperative strictures by univariate analysis, but the age at diagnosis (HR, 6.462; 95% CI, 1.272-22.560; P =0.022) was an independent risk factor by multivariate analysis. Peripheral blood LC levels were correlated with SES-CD and gradually decreased as the intestinal stricture increased in small bowel CD patients. The LC level was also significantly lower in the postoperative CD patients with strictures. The level of LC was a risk factor for small bowel strictures. These results suggest that peripheral blood LC could be a novel marker of small bowel CD strictures to guide CD diagnosis and therapy.

Roles of CRP and Neutrophil-to-Lymphocyte Ratio in the Prediction of Readmission of COVID-19 Patients Discharged From the ED.

Patient admissions beyond the capacity of emergency departments (EDs) have been reported since the coronavirus disease (COVID-19) pandemic. Thus, laboratory parameters to predict the readmission of patients discharged from the ED are needed. For this purpose, we investigated whether C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) could predict the readmission of patients with COVID-19. Patients aged >18 years who visited the ED in October 2020 and had positive polymerase chain reaction test results were evaluated. Among these patients, those who were not hospitalized and were discharged from the ED on the same day were included in the study. The patients' readmission status within 14 days after discharge, age, sex, complaint on admission, comorbidity, systolic blood pressure, diastolic blood pressure, fever, pulse, oxygen saturation level, CRP level, blood urea nitrogen level, creatinine level, neutrophil count, lymphocyte count, and NLR were recorded. Data were compared between the groups. Of the 779 patients who were included in the study, 359 (46.1%) were male. The median age was 41 years (range, 31-53 years). Among these patients, those who were not hospitalized and were discharged from the ED on logistic regression analysis, age, CRP level, NLR, loss of smell and taste, and hypertension had odds ratios of 2.494, 2.207, 1.803, 0.341, and 1.879, respectively. The strongest independent predictor of readmission within 14 days after same-day ED discharge was age > 50 years. In addition, CRP level and NLR were the laboratory parameters identified as independent predictors of ED readmission.

Biochemical, Hematological, and Immunological Biomarkers as Predictors for Intensive Care Unit Admission in Patients with COVID-19.

To identify the biochemical, hematological, and immune biomarkers in COVID-19 patients on admission that are predictive of eventual admission to the intensive care unit (ICU). This retrospective cohort study was conducted on all confirmed COVID-19 cases hospitalized at Royal Hospital, Oman from 24 February to 30 July 2020. The demographic, clinical, and laboratory data were collected from the hospital information system. Patients were divided into two groups: non-ICU admitted group and ICU admitted group. Out of 445 patients, 276 (62.0%) were male and 169 (38.0%) were female; 259 (58.2%) patients were admitted to COVID-19 general wards whereas 186 (41.8%) were admitted to ICU. Admission to ICU was more likely when patient had the following comorbidities: diabetes (OR = 1.8; 95% CI: 1.3-2.7), liver diseases (OR = 2.1; 95% CI: 1.1-4.3), and respiratory diseases (OR = 2.0; 95% CI: 1.1-3.7). Between ICU and non-ICU patients, there were significant differences in on-admission laboratory blood/serum parameters: total white blood cells (WBCs) count, lymphocytes count, C-reactive protein (CRP), ferritin, corrected calcium, interleukin 6 (IL-6), D-dimer, alanine transaminase (ALT), lactate dehydrogenase (LDH), albumin, and troponin. The current study identified the presence of the comorbidities (i.e., diabetes, liver diseases, and respiratory diseases) and on-admission laboratory blood and serum test results (i.e., WBC, lymphocytes, CRP, ferritin, corrected calcium, IL-6, D-dimer, ALT, LDH, albumin, and troponin) that are associated with ICU admission.

Pretreatment Pan-Immune-Inflammation Value Efficiently Predicts Survival Outcomes in Glioblastoma Multiforme Patients Receiving Radiotherapy and Temozolomide.

The purpose of this study was to determine the predictive significance of pretreatment pan-immune-inflammation value (PIV) in patients with newly diagnosed glioblastoma multiforme (GBM) who received postsurgical radiation (RT) and concurrent plus adjuvant temozolomide (TMZ). The outcomes of 204 newly diagnosed GBM patients were analyzed retrospectively. Each eligible patient's PIV was calculated using the findings of peripheral blood platelet (P), monocyte (M), neutrophil (N), and lymphocyte (L) counts obtained on the first day of therapy: PIV = P × M × N ÷ L. We used receiver operating characteristic (ROC) curve analysis to discover the ideal cutoff values for PIV concerning progression-free (PFS) and overall survival (OS) outcomes. The primary and secondary end-points were the OS and PFS divergences across the PIV groups. In ROC curve analysis, the optimal PIV cutoff was 385, which substantially interacted with PFS and OS results and categorized patients into low PIV (L-PIV; N = 75) and high PIV (H-PIV; N = 129) groups. Comparative survival analyses showed that the patients in the H-PIV group had significantly shorter median PFS (6.0 vs. 16.6 months; P < 0.001) and OS (11.1 vs. 22.9 months; P < 0.001) durations than those in the L-PIV group. The results of multivariate Cox regression analysis indicated an independent and significant connection between an H-PIV measure and shorter PFS and OS outcomes. The novel PIV was able to independently stratify newly diagnosed GBM patients into two groups with fundamentally different PFS and OS outcomes following RT and concurrent plus adjuvant TMZ.

Housefly maggot meal complement soybean meal in a fish-free diet for hybrid catfish (Clarias gariepinus ♀ x Heterobranchus longifilis ♂): Effect on growth, body composition, blood biochemistry and antioxidant enzyme activity

A 45-day experiment was designed to study the complementary effect of maggot (Musca domestica) meal (MG) in a fishmeal-free soybean meal (SBM)-based diet on the production performance of African catfish hybrids. Four isoproteic (398.78 g/kg ± 3.23) and iso-energetic (20.23 kJ/g ± 0.15) diets were formulated as positive control (FM-based diet), soybean-based diets (FM-free) and soybean-based diets supplemented with 14 % MG and 21 % MG as complementary ingredients, denoted as FM, SBM, MG14 and MG21, respectively. A total of 180 healthy hybrid catfish (average initial body weight: 4.31 ± 0.04 g) were distinctly stocked into 12 trial tanks (60-L capacity) and fed to apparent satiation twice daily with their respective diets. At the end of the feeding trial, fish fed MG21 outperformed those fed other diets in final body weight (FBW), weight gain (WG), specific growth rate (SGR), and daily growth index (DGI) (p < 0.05). However, MG had no influence on feed intake (FI), feed conversion ratio (FCR), or nutrient utilization indices among the groups (p > 0.05). The MG21 supplementation improved the immuno-physiological indices such as white blood cell, lymphocyte count, total protein, and globulin values compared to other groups, while haemoglobin, haematocrit, and red blood cell counts were not affected. Supplementation with MG at 21 % enhanced the antioxidant capacity of hybrid catfish with no detrimental effect on the serum alanine aminotransferase and alkaline phosphatase enzymes activities. However, the aspartate aminotransferase was found higher in MG14 and MG21 fed fish compared to other dietary groups. Based on the results obtained in this study, it can be concluded that maggot meal could be used as a complementary ingredient in place of fishmeal in soybean meal diets for the culture of hybrid African catfish. Data AvailabilityThe data in this article is available upon request from the corresponding author.

Developing a new sepsis screening tool based on lymphocyte count, international normalized ratio and procalcitonin (LIP score)

Exploring an effective sepsis screening tool that can be widely implemented is important for improving the prognosis of sepsis worldwide. This study aimed to develop a new simple screening tool for sepsis (LIP scoring system) that includes the peripheral blood lymphocyte count, international normalized ratio, and procalcitonin level. In a single-center, prospective, observational study, 444 acute sepsis inpatients and 444 nonsepsis inpatients were ultimately included based on the Sepsis-3 and exclusion criteria. The differences in the Lym, INR, PCT level and other clinical biomarkers were compared between the two groups. Univariable and multivariable logistic regression analyses and receiver operating characteristic analysis were used to establish a LIP screening tool for sepsis with a combination of biomarkers. The Kappa and McNemar tests were used to evaluate the differences between the LIP screening results (LIP score ≥ 3) and Sepsis-3 criteria (SOFA score ≥ 2). Logistic regression analysis showed that the lymphocyte count, INR, PCT level, platelets, neutrophil/lymphocyte ratio (NLR) and prothrombin time (PT) were independent risk factors for the development of sepsis. The ROC analysis showed that the lymphocyte count, INR, and PCT level had high area under the ROC curve values (AUROC (95% CI): Lym 0.84 (0.810–0.860), INR 0.921 (0.902–0.938), PCT level 0.928 (0.909–0.944)). The LIP tool had satisfactory screening efficacy for sepsis (sensitivity, 92.8%; specificity, 94.1%), and a LIP score equal to or greater than 3 points had good agreement with Sepsis-3 criteria in the diagnosis of sepsis (Kappa = 0862 in the Kappa test and P = 0.512 in the McNemar test). The LIP tool has satisfactory sensitivity and specificity for sepsis screening, and it can be used for rapid screening of patients with sepsis in outpatient and emergency departments or in economically underdeveloped areas with limited resources.