Blood Neutrophil Counts Research Articles

The significance of initial lactate levels in emergency department presentations of abdominal wall hernia.

Abdominal wall hernias are a frequent cause of abdominal pain-related emergency department visits. Our study aimed to establish the connection between lactate levels and patient outcomes in those with abdominal pain due to abdominal wall hernias. Our research followed a retrospective, observational, and descriptive approach and two center. We included patients who visited the emergency department for abdominal pain and were confirmed to have abdominal wall hernias through ultrasound. We enrolled 493 patients meeting the criteria. Median age was 65years, with 54% (n=266) being male. Regarding outcomes, 40.5% (n=200) were hospitalized, 27.7% (n=137) underwent surgery, and 7.9% (n=39) underwent bowel resection. Mortality rate during hernia-related hospital admission was 0.6% (n=3). For hospitalized patients, there were significant differences in white blood cell count, neutrophil count and percentage, platelet count, lymphocyte count, and percentage (p<0.05). Patients undergoing resection showed significant differences in neutrophil count, neutrophil percentage, lymphocyte count, and lymphocyte percentage (p<0.05). Lactate levels were statistically significant in all patient groups requiring hospitalization, surgery, and resection (p<0.05). Sensitivity and specificity of lactate test results indicated in patients undergoing bowel resection, lactate values ≥1.96mmol/L had a specificity of 64%, sensitivity of 71%, and a negative predictive value of 96% (p<0.05). Low lactate levels in patients presenting to the emergency department with abdominal pain caused by abdominal wall hernias have a high negative predictive value for excluding strangulation and the need for bowel resection. Therefore, we recommend the use of lactate as an additional diagnostic tool in emergency department presentations related to abdominal wall hernias.

A study of clinical and serological correlation of early myocardial injury in elderly patients infected with the Omicron variant.

Myocardial injury in elderly Omicron variant patients is a leading cause of severe disease and death. This study focuses on elucidating the clinical characteristics and potential risk factors associated with myocardial injury in elderly patients infected with the Omicron variant. Myocardial injury was defined based on elevated cardiac troponin concentrations exceeding the 99th percentile upper reference limit. Among 772 elderly Omicron-infected patients, categorized into myocardial injury (n = 263) and non-myocardial injury (n = 509) groups. The stratified log-rank statistic was used to compare the probability of patients developing intensive care. Receiver operating characteristic curves were used to determine the best cut-off values of clinical and laboratory data for predicting myocardial injury. Univariate and multivariate logistic regression was adopted to analyze the risk factors for myocardial injury. The occurrence of myocardial injury in Omicron variant-infected geriatric patients was up to 34.07% and these patients may have a higher rate of requiring intensive care (P < 0.05). By comparing myocardial injury patients with non-myocardial injury patients, notable differences were observed in age, pre-existing medical conditions (e.g., hypertension, coronary heart disease, cerebrovascular disease, arrhythmia, chronic kidney disease, and heart failure), and various laboratory biomarkers, including cycle threshold-ORF1ab gene (Ct-ORF1ab), cycle threshold-N gene (Ct-N), white blood cell count, neutrophil (NEUT) count, NEUT%, lymphocyte (LYM) count, LYM%, and D-dimer, interleukin-6, procalcitonin, C-reactive protein, serum amyloid A, total protein, lactate dehydrogenase, aspartate aminotransferase, glomerular filtration rate, blood urea nitrogen, and serum creatinine (sCr) levels (P < 0.05). Furthermore, in the multivariable logistic regression, we identified potential risk factors for myocardial injury in Omicron variant-infected elderly patients, including advanced age, pre-existing coronary artery disease, interleukin-6 > 22.69 pg/ml, procalcitonin > 0.0435 ng/ml, D-dimer > 0.615 mg/L, and sCr > 81.30 μmol/L. This study revealed the clinical characteristics and potential risk factors associated with myocardial injury that enable early diagnosis of myocardial injury in Omicron variant-infected elderly patients, providing important reference indicators for early diagnosis and timely clinical intervention.

Serum vitamin D3 (25-OH vit D3) concentrations and hemogram changes in calves with enzootic pneumonia.

Enzootic pneumonia is an important disease complex associated with insufficient colostrum intake after birth, adverse environmental conditions, and stress. Vitamin D deficiency may be an important predisposing factor for this disease. This study aimed to investigate in calves with enzootic pneumonia. A total of 30 calves, aged 3-5 months, under the same care and feeding conditions were used. Groups were formed according to Clinical Respiratory Scoring as the group with mild/moderate enzootic pneumonia (n = 10), the group with severe enzootic pneumonia (n = 10), and the healthy control group (n = 10) without any disease. Blood samples were collected from the jugular vein of animals in all groups on Day 0; a complete blood count was performed, and serum vitamin D levels were measured using the Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) method. Although no statistical differences were observed in total leukocyte, lymphocyte, eosinophil, basophil, hemoglobin, and hematocrit levels between groups, statistically significant differences in blood neutrophil, monocyte, and erythrocyte counts were found between the groups. Monocyte counts were statistically decreased in the mild/moderate group compared with the control group. Neutrophil counts were significantly higher in the mild/moderate and severe groups than in the control group. Erythrocyte counts were increased in the mild/moderate and severe groups compared with the control group. Vitamin D concentrations were statistically lower in the mild/moderate and severe groups than in the control group. However, no statistical differences in Vitamin D concentrations were observed between the mild/moderate and severe groups. There was a negative and significant correlation between erythrocyte counts and vitamin D concentrations (r = -0.64, P < .0001). While erythrocyte counts increased in the severe group compared with the mild/moderate group, vitamin D concentrations decreased. Also, a negative and significant correlation was observed between platelet counts and vitamin D concentrations (r = -0.74, P < .0001). The results of this study determined that serum vitamin D concentrations in calves with pneumonia were lower than those in healthy calves. Detailed studies on the etiologic and prognostic importance of low vitamin D levels in calves with enzootic pneumonia may provide valuable data for prevention and treatment.

SYSTEMIC INFLAMMATORY INDICES IN PATIENTS WITH MALIGNANT GLIOMAS AND EFFECTS OF PLATELET SECRETOME IN VITRO.

To date, no significant clinical progress has been achieved in the treatment of brain malignant gliomas (MG), and the active search for non-invasive circulating biomarkers continues. The prognostic significance of the ratio of the main peripheral blood cell populations of patients with MG is evaluated. Considerable attention is paid to the secretome of platelets (Pt) of peripheral blood. To evaluate the indicators of the peripheral blood cell population ratios in patients with brain MG and to study the influence of the secretome of Pt (SPt) of the peripheral blood of patients with brain MG in cell cultures in vitro. We studied samples of peripheral blood from patients with glioma CNS WHO grade G2 (n = 5), G3 (n = 12), and G4 (n = 20). The peripheral blood cell counts were analyzed in the preoperative period on an automatic hematology analyzer. The in vitro study of SPt was performed on the U251 human glioblastoma cell line cultured with SPt from MG patients or SPt pre-incubated with anti-TGF-β1 antibody. Cell cultures were observed for 72 h, and mitotic index (MI) was calculated. In MG patients, the count of peripheral blood leukocytes and neutrophils increased (p < 0.05). The neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) increased by 2-3 times compared to control. Nevertheless, correlation analysis did not reveal significant relationships between quantitative indicators of peripheral blood cells and the tumor malignancy degree in MG patients. The MI in U251 cells increased under the influence of SPt from patients with MG (p < 0.021), correlated with the tumor degree of malignancy (r = 0.246, p = 0.014). Pre-incubation of SPt with anti-TGF-β1 antibody tends to neutralize this promitotic effect. In MG patients, the integral indicators of NLR and SII increased but no significant relationship with the degree of tumor malignancy was found. In U251 cells, promitotic effects of SPt of MG patients partially decreased by anti-TGF-β1 antibody.

The Relationship between Endotypes and Exacerbation Events in COPD Patients

Introduction: Acute exacerbations of COPD are responsible for 60% of health costs, reduce patients' quality of life, and accelerate disease progression. COPD endotypes are expected to provide new insights about clinical phenotypic variability and therapeutic response between individuals through certain biomarker approaches. Objective: Our study aims to identify the relationship between COPD endotypes and exacerbation events. Methods: In this cross-sectional study design, participants with stable COPD (n=40) were recruited from the outpatient clinic at Airlangga University Hospital in March-August 2022. Blood was obtained for endotype's biomarker examination, such as α1-antitrypsin (AAT), IL-17A, neutrophil, and eosinophil count. The relationship between COPD endotypes and exacerbation events was analyzed using a non-parametric statistical test Result: The lower limit normal of AAT levels obtained was 12.85ng/ml; 47.5% of subjects have low AAT levels. The average IL-17A levels and blood neutrophil counts were 0.478 ± 0.426 pg/ml and 5,916.95 ± 3,581.08 cells/µl, respectively. The average blood eosinophil count was 298.35 ± 280.44 cells/µl, 16 of 40 (40%) subjects with blood eosinophil count &gt; 300 cells/µl. No significant association was observed between AAT levels (p = 1.000), IL-17A levels (p = 0.944), and blood eosinophil count (p = 0.739) with exacerbation events-only blood neutrophil count (p = 0.033) found to have a significant association with exacerbation events in COPD. Conclusion: AAT levels, IL-17A levels, and blood eosinophil count were not significantly related to exacerbation events in COPD patients. In comparison, blood neutrophil count was the only one associated considerably with exacerbation events. Further research about COPD endotypes is needed to identify exacerbation susceptibility as a precision treatment strategy.

Evaluation of the hematological inflammatory parameters in the patients with immune thrombocytopenic purpura: A case-control study.

Inflammation is one of the immune thrombocytopenic purpura (ITP)'s aggravating elements due to inflammatory cells' function. This study aims to identify and evaluate hematological inflammatory parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and hemoglobin-to-platelet ratio (HPR), in patients with ITP compared to the control group. We retrospectively analyzed the profile of 190 ITP patients from August 2019 to January 2021 at Imam Reza Hospital of Mashhad, Iran, along with 100 healthy individuals who had no ITP-related clinical or laboratory symptoms. Immune cell counts, NLR, PLR, and HPR were calculated using the complete blood count at the time of diagnosis and after the treatment. The results were analyzed through MedCalc, SPSS software, and the receiver operating characteristiccurve. The result showed that white blood cell (WBC) and neutrophil counts were higher in ITP patients (WBC: p: 0.001, neutrophil: p: 0.001), and conversely, platelet and lymphocyte counts were higher in the control group compared to ITP patients (platelets: p: 0.001, lymphocytes: p: 0.001). The indices analysis between the two groups revealed that NLR was significantly increased in ITP patients (p: 0.001), but PLR was significantly reduced in ITP patients (with the mean platelet count of 23.44 ± 35.26 × 109/L) compared to the control group (with the mean platelet count of 234.04 ± 55.88 × 109/L). The HPR index also significantly increased in ITP patients (p: 0.001). An increase in NLR, PLR, and a decrease in HPR can be considered a valuable diagnostic algorithm in patients with ITP.

Isolation and Characterization of Yunnan Variants of the Pseudorabies Virus and Their Pathogenicity in Rats.

Porcine pseudorabies has long existed in China and is a serious threat to the Chinese farming industry. To understand the prevalence and genetic variation of the porcine pseudorabies virus (PRV) and its pathogenicity in Yunnan Province, China, we collected 560 serum samples across seven Yunnan Province regions from 2020 to 2021 and detected anti-gE antibodies in these samples. Sixty-one clinical tissue samples were also collected from pigs with suspected PRV that were vaccinated with Bartha-K61. PRV-gE antibodies were found in 29.6% (166/560) of the serum samples. The PRV positivity rate in clinical tissue samples was 13.1% (8/61). Two isolates, PRV-KM and PRV-QJ, were obtained. The identity of the gB, gD, and gE genes between these isolates and the Chinese mutants exceeded 99.5%. These isolates and the classical Fa strain were used to infect 4-week-old rats intranasally to assess their pathogenicity. All infected rats showed the typical clinical and pathological features of PRV two days post-infection. The viral loads in the organs differed significantly among the infected groups. Viruses were detected in the saliva and feces at 12 h. Significant dynamic changes in total white blood cell counts (WBC), lymphocyte counts (Lym), and neutrophil counts (Gran) occurred in the blood of the infected groups at 24 and 48 h. These results show that mutant PRV strains are prevalent in Bartha-K61-vaccinated pigs in Yunnan Province, China. Moreover, rats shed PRV in their saliva and feces during early infection, indicating the need for rodent control in combatting PRV infections in Yunnan Province, China.

Association of ratios of monocyte/high-density lipoprotein cholesterol and neutrophil/high-density lipoprotein cholesterol with atherosclerotic plaque type on coronary computed tomography.

The monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR) and neutrophil/HDL-C ratio (NHR) are markers for inflammation and dyslipidaemia, which are important factors in atherosclerosis. Studies have linked MHR and NHR to the prediction, severity and prognosis of coronary artery disease. However, no study has explored their connection to plaque stability, specifically its calcific or soft/mixed content. Monocyte, neutrophil and HDL-C levels were examined in 99 patients who had coronary computed tomographic angiography (CTA) between January and August 2023. They were divided into three groups: a group of 42 healthy individuals (group 0) with no coronary artery plaque and an Agatson score of 0, an unstable plaque group (group 1) with 31 patients displaying mixed and/or soft plaque on CTA, and a stable plaque group (group 2) with 26 patients showing only calcific plaque. White blood cell (WBC), monocyte and neutrophil counts were significantly higher in group 1 patients compared to group 0 patients (group 0: WBC = 6.31 ± 0.97 × 103 cells/µl, monocytes = 0.40 ± 0.09 × 10³ cells/µl, neutrophils = 3.32 ± 0.81 × 10³ cells/µl; and group 1: WBC = 7.61 ± 1.95 × 10³ cells/µl, monocytes = 0.50 ± 0.11 × 10³ cells/µl, neutrophils = 4.19 ± 1.36 10³ cells/µl; p < 0.05). MHR and NHR were significantly higher in group 1 patients compared to group 0 patients (group 0: MHR = 0.0079 ± 0.0029, NHR = 0.063 ± 0.023 and group 1: MHR = 0.0102 ± 0.003, NHR = 0.085 ± 0.036, p < 0.05). The significant differences in MHR and NHR between the three groups were due to the differences between groups 0 and 1. MHR and NHR were significantly higher in group 1 patients, although there was no statistically significant difference between groups 1 and 2.

Relationship between systemic immune inflammation index and development of complete atrioventricular block in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

BackgroundThe systemic immune-inflammation index (SII), based on white blood cell, neutrophil, and platelet counts, is a proposed marker of systemic inflammation and immune activation. This study aimed to explore the relationship between SII and complete atrioventricular block (CAVB) development in STEMI patients undergoing primary PCI.MethodsWe retrospectively analyzed data from 883 patients who underwent primary PCI for STEMI between January 2009 and December 2017. Patients were categorized into two groups based on CAVB development. SII levels were calculated from blood samples taken on admission.ResultsOf the included patients, 48 (5.03%) developed CAVB. SII was higher in patients with CAVB compared to those without CAVB (1370 [1050–1779]x109/L vs. 771 [427–1462] x109/L, p < 0.001). Multivariate analysis showed a significant positive correlation between SII and the risk of CAVB development (OR:1.0003, 95%CI:1.0001–1.0005, P = 0.044). The cut-off value for the SII in the estimation of CAVB was 1117.7 × 109/L (area under the ROC curve [AUC]: 0.714, 95% CI = 0.657–0.770 with a sensitivity of 70.8% and specificity of 65.6%, p < 0.001).ConclusionThis study showed a significant link between high SII levels and CAVB development in STEMI patients undergoing PCI. Our findings suggest that SII may be a valuable, routinely available, and inexpensive marker for identifying patients at increased risk of CAVB.

COVID-19 enfeksiyonu doğurganlık çağındaki kadınlar için risk oluşturur mu?

Objectives: This study aims to investigate the potential differential impact of COVID-19 infection on pregnant women compared to non-pregnant individuals of childbearing age by evaluating laboratory findings from both inpatient and outpatient cases. Material and Methods: From the onset of COVID-19 in Turkey in March 2020 until the commencement of vaccination, a total of 94 COVID-19 patients were included in three separate groups: pregnant women and non-pregnant individuals with COVID-19 (with and without pneumonia). Sociodemographic data and examination findings were retrospectively retrieved from the hospital information system. Results: The study revealed that pregnant women, with a mean age of 28.87±1.38, experienced a significantly shorter mean length of hospital stay of 5.03±0.49 days compared to the other groups (p&amp;lt;0.001). Notably, pregnant women exhibited significant variations in urea, creatinine, white blood cell count, neutrophil count, hemoglobin, and hematocrit values in comparison to the other groups (p&amp;lt;0.001). Moreover, there were significant differences among the three groups concerning neutrophil and lymphocyte percentage values (p&amp;lt;0.001). Conclusion: The study suggests that COVID-19 infection in pregnant women is associated with more favorable clinical outcomes, shorter length of hospital stay, and relatively moderate alterations in laboratory findings when accounting for pregnancy-induced changes. It is implied that pregnancy might not pose as substantial a risk factor for severe COVID-19 infection as advanced age or underlying chronic conditions such as diabetes, asthma, COPD, and malignancy.

Systemic immune inflammation index and its implication on in-stent restenosis among patients with acute coronary syndrome.

This study aims to assess the predictive value of the Systemic Immune Inflammation Index (SII) in determining in-stent restenosis (ISR) likelihood in patients with acute coronary syndrome (ACS) who have undergone percutaneous coronary intervention (PCI). The study enrolled 903 ACS patients undergoing PCI, categorized into ISR (+) and ISR (-) groups based on control coronary angiography results. Demographic, clinical, laboratory, and angiographic-procedural characteristics were systematically compared. The ISR (+) group encompassed 264 individuals (29.2%), while the ISR (-) group comprised 639 individuals (70.8%). Patients had a mean age of 55.8 ± 10.2 years, with 69% being male. The ISR (+) group had higher diabetes and smoking prevalence and notably larger stent dimensions. Lab parameters showed significantly elevated creatinine, total cholesterol, red cell distribution width, white blood cell and neutrophil counts, SII index and C-reactive protein (CRP) in the ISR (+) group, while lymphocyte levels were lower. Binary logistic regression identified stent diameter (odds ratio [OR]: 0.598, 95% confidence interval [CI]: 0.383-0.935; P = 0.024), stent length (OR: 1.166, 95% CI: 1.132-1.200; P < 0.001), creatinine (OR: 0.366, 95% CI: 0.166-0.771; P = 0.003), CRP (OR: 1.075, 95% CI: 1.042-1.110; P = 0.031), and SII index (OR: 1.014, 95% CI: 1.001-1.023; P < 0.001) as independent ISR predictors. The SII index exhibits potential as a predictive marker for ISR in ACS patients post-PCI, indicating systemic inflammation and heightened restenosis risk. Integrating the SII index into risk models could identify high-risk patients for targeted interventions.

A Bayesian joint model for multivariate longitudinal and time-to-event data with application to ALL maintenance studies

ABSTRACT Retraction: A Bayesian joint model for multivariate longitudinal and time-to-event data with application to ALL maintenance studies (DOI: 10.1080/10543406.2023.2171430) We, the Publisher of the Journal of Biopharmaceutical Statistics, have retracted the following article: Damitri Kundu, Partha Sarkar & Kiranmoy Das. A Bayesian joint model for multivariate longitudinal and time-to-event data with application to ALL maintenance studies. Journal of Biopharmaceutical Statistics, Latest Articles. 2023. 10.1080/10543406.2023.2171430. This is an outdated version of a duplicate article published in March 2023 (DOI: 10.1080/10543406.2023.2187413). Although published online, this article was never compiled into an issue. We are now correcting the scholarly record. We have been informed in our decision-making by our policy on publishing ethics and integrity and the COPE guidelines on retractions. The retracted article will remain online to maintain the scholarly record, but it will be digitally watermarked on each page as “Retracted.”

Study of clinical traits and systemic immune inflammation index assessments in patients with endogenous endophthalmitis over the last ten years

PurposeThe clinical aspects and prognosis of eyes with endogenous endophthalmitis were compared over the last ten years. The occurrence and progression of endophthalmitis are linked to the systemic immune inflammation index (SII) and clinical features.MethodsThe study comprised patients with endogenous endophthalmitis and 64 patients without endophthalmitis who were treated at Hebei Province Eye Hospital in the last ten years. According to the prognostic visual acuity, patients with endophthalmitis were split into two groups: Group A and Group B. Underlying disease (hypertension, diabetes, tuberculosis), infection risk (liver abscess, urinary tract infection, and recent abdominal surgery), signs and symptoms, and complete blood count were among the evaluation parameters (neutrophil count, lymphocyte count, monocyte count, platelet count, red blood cell distribution width). The NLR, PLR, MLR, and SII values were calculated. A nonparametric test was used to examine the clinical features and complete blood count results of patients in each group. To determine the parameters linked to endophthalmitis progression, researchers used principal component and ordinal logistic regression analyses.ResultsThe study comprised a total of 25 eyes and 22 individuals with endogenous endophthalmitis. Infectious bacteria included Staphylococcus aureus, Micrococcus luteus, Staphylococcus hemolyticus, and so on. The visual acuity of the affected eye ranged from 2.7 (1.55, 2.7) LogMAR to 1.22 (0.6, 2.7) LogMAR during the 6-month to 8-year follow-up period. The neutrophil, monocyte, and PLT counts, NLR, PLR, and SII values and other markers were considerably higher in Groups A and B than in the control group. The likelihood model of the SII and sex, age, onset time, diabetes, hypertension, monocyte count, and red blood cell distribution was the best, and its increase was strongly connected with the occurrence and progression of endophthalmitis, according to ordinal regression analysis.ConclusionPatients with endophthalmitis had significantly higher blood neutrophil, monocyte, and PLT counts and SII, NLR, PLR, and MLR values. The SII can be employed as a biomarker for predicting endophthalmitis severity and prognosis.

Monaspin B, a Novel Cyclohexyl-furan from Cocultivation of Monascus purpureus and Aspergillus oryzae, Exhibits Potent Antileukemic Activity.

Natural products are a rich resource for the discovery of innovative drugs. Microbial cocultivation enables discovery of novel natural products through tandem enzymatic catalysis between different fungi. In this study, Monascus purpureus, as a food fermentation strain capable of producing abundant natural products, was chosen as an example of a cocultivation pair strain. Cocultivation screening revealed that M. purpureus and Aspergillus oryzae led to the production of two novel cyclohexyl-furans, Monaspins A and B. Optimization of the cocultivation mode and media enhanced the production of Monaspins A and B to 1.2 and 0.8 mg/L, respectively. Monaspins A and B were structurally elucidated by HR-ESI-MS and NMR. Furthermore, Monaspin B displayed potent antiproliferative activity against the leukemic HL-60 cell line by inducing apoptosis, with a half-maximal inhibitory concentration (IC50) of 160 nM. Moreover, in a mouse leukemia model, Monaspin B exhibited a promising in vivo antileukemic effect by reducing white blood cell, lymphocyte, and neutrophil counts. Collectively, these results indicate that Monaspin B is a promising candidate agent for leukemia therapy.

Neutrophilic leukocytosis and erythema nodosum leprosum in leprosy: insights from a retrospective observational study.

Leprosy reactions represent immunologically mediated episodes of acute inflammation that, if not diagnosed and treated promptly, can cause irreversible impairment of nerve function and permanent disabilities. A frequent type of reaction experienced by patients with lepromatous leprosy (LL) and borderline lepromatous leprosy (BL) is erythema nodosum leprosum (ENL), an inflammatory complication that may become chronic or recur in multiple episodes. Although ENL is commonly described as a neutrophil-mediated immune disease, the role of neutrophils is not fully understood. In this study, we assess neutrophilic leukocytosis in a retrospective cohort of patients affected by BL or LL leprosy. A retrospective observational study was performed using data from 146 patients with BL and LL leprosy diagnosed and treated at the Souza Araújo Outpatient Clinic, Fiocruz, Rio de Janeiro, Brazil. Clinical, demographic, and hematological data were extracted from medical records. Skin biopsy samples obtained from patients for ENL diagnosis were used for histopathological evaluations. Most patients were male (75%) and had a reactional episode (85%), of which 65% were ENL. Multiple episodes were common, 55% of the 80 patients with ENL presented more than 2 episodes (average of 2.6 episodes). In treatment-naive BL/LL patients, the median blood neutrophil counts of patients who developed ENL at some points of their disease course were higher than those who did not experience any reaction (median= 4,567 cells/mm3 vs 3,731 cells/mm3 respectively, p=0.0286). A correlation between the increase in median neutrophil counts and ENL severity was confirmed (6,066 cells/mm3 for mild ENL vs 10,243 cells/mm3 for moderate/severe ENL, p=0.0009). A longitudinal assessment was also performed in 34 patients, confirming the neutrophilic leukocytosis (BL/LL: 4896 cells/mm3 vs ENL: 8408 cells/mm3, p<0.0001). Moreover, increased NLR was associated with a greater neutrophilic infiltration in ENL lesions. We demonstrate that ENL episodes in patients affected by leprosy are associated with elevated blood leukocyte and neutrophil counts and an increased NLR. These findings highlight the significant involvement of neutrophils in the ENL immunological/inflammatory process.

Investigação de neutropenia em pacientes pediátricos

Neutropenia is common in both adults and children. Defined as a count of peripheral blood neutrophils &lt;1,500 cells/µl. The causes are variable, it is important to consider the different age groups and associated clinical conditions. Its consequences can be serious and may lead even to death. In the literature, mortality from neutropenia, when associated with fever, can reach up to 10%. In Oncohematological patients this percentage reaches 16%. In view of the above and the importance of theme for pediatricians and hematologists, we chose to formulate this work. The study will be presented in the form of a narrative review. It intends to review the main causes of neutropenia in childhood, propaedeutics and identification of severity indicators with the proposal application of a neutropenia initial investigation flowchart in pediatrics, in addition to guiding when refer these patients to specialized services.

Cytokines and Other Laboratory Parameters of Hospitalized COVID-19 Patients that Predict Intensive Care Unit Admission.

This study aimed to investigate the roles of cytokines and other laboratory parameters in determining the need for intensive care in COVID-19 patients. This is a retrospective observational study. Demographic, clinical, and laboratory parameters of the patients were evaluated. Thirteen cytokines were measured along with baseline laboratory tests at admission and at 48-hour intervals: IL-1β, IFN-α, IFN-β, TNF-α, MCP-1, IL-6, IL -8, IL-10, IL-2p70, IL-17A, IL-18, IL-23, and IL-33. COVID-19 was confirmed by PCR in 116 hospitalized patients. The mean age was 55.3 ± 16.4 years. Seventy-four (63.8%) of the patients were male and 42 (36.2%) were female. Twenty-two (18.9%) patients (16 male, 6 female) were transferred to the intensive care unit. A significant increase in white blood cell (WBC), neutrophil (Neu) and lymphocyte (Lym) counts, Neu/Lym ratio (NLR), lactate dehydrogenase (LDH), INR (international normalized ratio), activated prothrombin time (aPTT), D-dimer (D-D), troponin (Trop), Pro-BNP (BNP), procalcitonin (PCT), ferritin (Fer), and alanine aminotransferase (ALT) values were observed in those requiring intensive care. A significant decrease was found in albumin (Alb) levels and Lym counts. Alb levels appeared to be protective against admission to intensive care. Except for IFN- α, IL-23, and IL-33, the baseline values of other cytokines were above the threshold values. MCP-1 and IL-6 were higher in patients requiring intensive care. High NLR and LDH and low Alb levels, especially with an increase in MCP-1 and IL-6, were found to be the best predictors of a serious COVID-19 infection.

Pericardial effusion in patients with chronic kidney disease: A two-center study.

Pericardial effusion (PE) is a prevalent form of pericardial involvement in chronic kidney disease (CKD). This study aims to investigate the clinical and laboratory features associated with PE severity in patients with CKD. In this cross-sectional study, we examined the medical records of patients admitted to tertiary hospitals with International Classification of Diseases 10th Revision (ICD-10) codes associated with CKD and PE. We included 112 CKD patients in stage 4 and 5 non-dialysis (ND) with PE for assessing the clinical and laboratory features of severity. Patients were divided into two categories based on the severity of PE. Seventy-two patients had mild and 40 had moderate and severe PE. Univariate analysis of demographic and laboratory features on the date of admission demonstrated that chest pain, dyspnea, serum albumin, and neutrophil-to-lymphocyte ratio (NLR) are associated with the severity of PE. The univariate analysis on the date of echocardiography showed significantly higher white blood cell count (WBC), neutrophil count (percentage and absolute count), and NLR, along with significantly lower lymphocyte percentage and serum albumin among patients with moderate and severe PE. In the multivariable analysis of laboratory features, on admission hypoalbuminemia (p-value = 0.014, OR = 4.03, CI: 1.32-12.25) and NLR greater than 5.5 (p-value = 0.015, OR = 4.22, CI: 1.32-13.50) were significantly associated with moderate and severe PE. In a parallel matter, at the time of echocardiography hypoalbuminemia (p-value = 0.004, OR = 5.38, CI: 1.74-16.65) and neutrophilia (p-value = 0.005, OR = 7.94, CI: 1.89-33.44) were significantly associated with moderate and severe PE. Despite advancements in the diagnosis and treatment of CKD, PE is still a concerning issue in these patients. This study revealed that hypoalbuminemia, neutrophilia, and NLR greater than 5.5 could be predictive factors of moderate and severe PE in CKD patients with PE. Further prospective study with larger sample size is needed to confirm these results.

Effect of Common Cold on Serum Clozapine Concentrations in Hospitalized Patients with Schizophrenia.

The present study aims to investigate the effect of common cold on the serum clozapine concentrations in hospitalized patients with schizophrenia. A total of 65 schizophrenic patients with common cold receiving clozapine treatment were retrospectively enrolled. The demographic data, medication situation, clozapine concentration, and parameters of routine haematological and biochemical laboratory tests were obtained from the medical record system. The serum clozapine concentration and clozapine concentration/dose (C/D)ratios between the baseline period and cold period were compared by paired-sample t tests. Association between the changes in serum concentration and C/Dratios of clozapine and changes in white blood cell (WBC) and neutrophil (NE) counts was evaluated using Pearson correlation analysis. The serum clozapine concentration (t = -9.856, P < 0.001) and clozapine C/Dratios (t = -10.071, P < 0.001) were found to be significantly elevated in the cold period compared to the baseline period. Moreover, the changes in the serum clozapine concentration were found to be significantly elevated in female patients compared to male patients (t = -2.483, P = 0.017). Furthermore, changes in the serum clozapine concentration were positively correlated to the changes in WBC (r = 0.303, P = 0.014) and NE (r = 0.315, P = 0.011) counts. Similarly, changes in clozapine C/Dratios were positively correlated to the changes in WBC (r = 0.275, P = 0.027) and NE (r = 0.328, P = 0.008) counts. The serum clozapine concentrations in patients with schizophrenia during the common cold period were increased, which might by related to the elevated WBC and NE counts.

Survival prediction for heart failure complicated by sepsis: based on machine learning methods.

Heart failure is a cardiovascular disorder, while sepsis is a common non-cardiac cause of mortality. Patients with combined heart failure and sepsis have a significantly higher mortality rate and poor prognosis, making early identification of high-risk patients and appropriate allocation of medical resources critically important. We constructed a survival prediction model for patients with heart failure and sepsis using the eICU-CRD database and externally validated it using the MIMIC-IV database. Our primary outcome is the 28-day all-cause mortality rate. The Boruta method is used for initial feature selection, followed by feature ranking using the XGBoost algorithm. Four machine learning models were compared, including Logistic Regression (LR), eXtreme Gradient Boosting (XGBoost), Adaptive Boosting (AdaBoost), and Gaussian Naive Bayes (GNB). Model performance was assessed using metrics such as area under the curve (AUC), accuracy, sensitivity, and specificity, and the SHAP method was utilized to visualize feature importance and interpret model results. Additionally, we conducted external validation using the MIMIC-IV database. We developed a survival prediction model for heart failure complicated by sepsis using data from 3891 patients in the eICU-CRD and validated it externally with 2928 patients from the MIMIC-IV database. The LR model outperformed all other machine learning algorithms with a validation set AUC of 0.746 (XGBoost: 0.726, AdaBoost: 0.744, GNB: 0.722), alongside accuracy (0.685), sensitivity (0.666), and specificity (0.712). The final model incorporates 10 features: age, ventilation, norepinephrine, white blood cell count, total bilirubin, temperature, phenylephrine, respiratory rate, neutrophil count, and systolic blood pressure. We employed the SHAP method to enhance the interpretability of the model based on the LR algorithm. Additionally, external validation was conducted using the MIMIC-IV database, with an external validation AUC of 0.699. Based on the LR algorithm, a model was constructed to effectively predict the 28-day all-cause mortality rate in patients with heart failure complicated by sepsis. Utilizing our model predictions, clinicians can promptly identify high-risk patients and receive guidance for clinical practice.