Blood Platelet Count Research Articles

New Onset Pancytopenia in Adults: Clinico-etiological Profile at a Tertiary Care Hospital

Objective: To evaluate and compare common disorders leading to new onset pancytopenia among both genders.
 Methods: It was a cross-sectional study conducted at the Department of Pathology at Watim Medical College and Watim General Hospital, Rawat, from November 2020 to November 2021.A total of 98 adult patients with persistent pancytopenia for one week who gave consent for bone marrow aspiration and a trephine biopsy were selected. A blood-complete picture with peripheral smears along with bone marrow aspiration biopsy were done. Trephine needle biopsy and cytochemical staining were performed when required.
 Results: There were 44 males and 54 female patients. The mean age was 43.49 ±19 years. Common presenting complaints were pallor (82.6%), weakness (63.2%), petechial haemorrhages (45.9%) and fever (23.5%). The hemoglobin value, white blood cell count and platelet count were 6.5± 1.65 g/dl, 3.20 ±1.43 x 109/L and 55.21 ±28.01 x 109/L respectively. Major causes were megaloblastic anemia with female predominance (S.D: 0.003) in 43.8% patients, aplastic anemia with male predominance (S.D:0.001) in 17.3%, portal hypertension induced splenomegaly in 13.2%, infectious diseases in 7%, leukemias in 5.1% and Myelodysplastic syndromes in 3.1%.
 Conclusion: Megaloblastic anaemia is the major cause of pancytopenia in females and aplastic anemia in male pancytopenic patients.

Nomogram for customized recurrence prediction in primary non-muscle-invasive bladder cancer based on routine blood and urine parameters

PurposeA prevalent condition with a high probability of recurrence, non-muscle invasive bladder cancer (NMIBC) necessitates lifetime surveillance. In patients with pathologically confirmed NMIBC, our goal was to create a unique nomogram to predict recurrence after transurethral resection of bladder tumor (TURBT).MethodsOur institution’s 91 NMIBC patients with complete follow-up data between January 2017 and February 2021 were included in the retrospective analysis. The nomogram predicting the 0.5, 1, 2 and 3-year likelihood of recurrence was created using multivariate Cox proportional hazard models to find the significant determinants of recurrence. Using the concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analyses (DCA), we internally validated the nomogram.ResultsThe significant factors related to NMIBC recurrence were age, blood platelet count, especially for the urine leukocyte count and mucus filament. The constructed nomogram performed well in the customized prediction of NMIBC recurrence at 6th, 12th, 24th and 36th month, of which the C-index was 0.724. The calibration curve and the ROC curve both validated the prediction accuracy. On DCA, the nomogram presented good net benefit gains across a wide range of threshold probabilities. Furthermore, the Nomogram-related risk score was used to divide the patient population into two groups with significant recurrence disparities.ConclusionFor the prediction of NMIBC recurrence, our unique nomogram demonstrated a respectable degree of discriminative capacity, sufficient calibration, and considerable net benefit gain. There will be a need for additional internal and external validation.

Abstract 6034: PSMA targeted alpha radiopharmaceutical [211At]PSAt-3 inhibits tumor growth in a preclinical model of prostate cancer

Abstract Introduction: Prostate cancer continues to be a highly prevalent cancer diagnosis among men and a leading cause of cancer related deaths worldwide. With the introduction[177Lu]Lu-PSMA-617, targeted radionuclide therapy has proven successful in increasing survival time for patients with metastasized castration resistant prostate cancer. However, despite encouraging results, such patients tend to develop progressive disease, and thus, enhanced efficacy is warranted. To this end, the use of radiopharmaceuticals harnessing alpha-emitters is a promising venue due to the potent energy deposition and short range of alpha particles in tissue. Here, we employ the PSMA targeting vector, [211At]PSAt-3, for targeted alpha radionuclide therapy in a preclinical prostate cancer model. Methods: [211At]PSAt-3, a structural derivative of PSMA-617, in which the L-2-naphtylalanine was replaced by L-3-[211At]astato-phenylalanine, was obtained by electrophilic [211At]astatodesilylation. Evaluation of [211At]PSAt-3 was conducted in male inbred nude mice of Balb/c background xenografted subcutaneously with human prostate cancer cells (LNCaP). Prior biodistribution studies were carried out with approximately 100 kBq intravenous injections, and subsequent biodistribution 2, 6 and 24h post injection (P.I.). For establishment of therapeutic effect, a single intravenous dose of [211At]PSAt-3 was administered. To asses hematological toxicity, blood cell composition was assessed weekly. Results: Favorable tumor uptake of 15.2±6 %ID/g was observed 2h after injection of [211At]PSAt-3 in LNCaP xenografted nude mice, with subsequent 9±5.1% ID/g and 6.4±2.4% ID/g 6 and 24h P.I., respectively. [211At]PSAt-3 cleared mainly by the kidneys, in which uptake was 72, 38 and 6% ID/g at 2, 6 and 24h P.I., respectively. Thyroid/throat uptake remained low at ~0.1% ID for all timepoints investigated, indicating a low degree of de-astatination. Initial efficacy studies using a single intravenous dose of 0.5 MBq (~20 MBq/kg) demonstrated significant growth delay and tumor volume reduction compared with control mice (saline). Blood platelet count was reduced after administration of [211At]PSAt-3 and subsequently recovered. No signs of severe toxicity, and no significant weight loss between control and treated mice was observed, suggesting that the treatment is well tolerated. Conclusion: 0.5 MBq [211At]PSAt-3 was well tolerated in mice and demonstrated tumor volume reduction and significant delay of tumor growth. These findings suggest [211At]PSAt-3 as a promising candidate for clinical translation. Citation Format: Lars Hvass, Marius Müller, Anne Clausen, Matthias Herth, Andreas Kjaer. PSMA targeted alpha radiopharmaceutical [211At]PSAt-3 inhibits tumor growth in a preclinical model of prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6034.

Effect of Soybean, Groundnut, Crayfish Inclusion and Vitamin C-fortified Formulated Food Blends on Biochemical, Hematological, Protein Quality and Performance Indices in Weanling Albino Rats

In this study, food staples comprising of Zea mays (maize), Sorghum bicolor (guinea corn), Glycine max (soybean), Arachis hypogea (groundnut) and Procambarus clarkii (crayfish) were traditionally processed and formulated into maize-guinea corn based weaning diets at 16% protein level. A replica of each diet was formulated with inclusion of vitamin C (50 mg/100 g diet). Fifty four 3-week old weanling albino rats (Rattus norvegicus) weighing between 36-39 g were placed into 13 groups of 4 rats per group and administered different diet groups ranging from maize- guinea corn base diet alone, through staples-inclusive diet (singly and in combination) and their vitamin c fortified replica diets, and standard commercial infant formula (Cerelac®) diet. Animals were sacrificed on the 28th day from onset of feeding and evaluated for biochemical, hematological and biological parameters; and sensory evaluation also conducted on the diets. Results showed significant increases in serum concentrations of protein, urea, creatinine; in the levels of red blood cell (RBC), hemoglobin (Hb) and packed cell volume (PCV); in total body weight gain and organ weights and insignificant changes in white blood cell (WBC) and platelet counts in the staples-inclusive diets compared to base diet and also in the vitamin C- fortified diets compared to non-fortified diets. Incorporation of food staples enhanced the protein quality of the diets while fortification with vitamin C increased only the biological value. On the acceptability rating, only the base gruel-crayfish mix showed significantly higher taste and overall acceptability. Therefore, the inclusion of the food blends comprising of soybean, groundnut and crayfish improved the nutritive content, hematopoietic potential, protein quality, taste and overall acceptability of the maize-guinea corn based weaning diet. These were further improved by fortification of the diets with vitamin C, while crayfish played a prominent role in taste and overall acceptance of the formulated diets. Fortification also significantly bridges the gap between the formulated weaning diets and Cerelac®, a standard commercial weaning formula in Nigeria.

The effect of hyperbaric oxygen therapy on hematological indices and biochemical parameters in patients with diabetic foot.

Diabetes Mellitus (DM) is a metabolic disease with a high morbidity and mortality and increasing in prevalence all over the world. Due to the hypoxic, ischemic, inflammatory, and infective environment in DM, diabetic foot ulcers have been treated with medico-surgical interventions and adjuvant hyperbaric oxygen Therapy (HBOT). The purpose of this study was to evaluate the effects of HBOT on hematological indices and biochemical parameters in patients with diabetic foot. The study group was formed from the file records of 103 male patients who applied to Yunus Emre State Hospital HBOT Center between September 1, 2016 and December 31, 2020, and were treated HBOT with a multidisciplinary approach. There were negative low correlations between number of HBOT sessions and Mean Corpuscular Hemoglobin (MCH) (P = .037, r = -0.207) and Blood Urea Nitrogen (BUN) (P = .037, r = -0.222). White Blood Cell Count (WBC), Neutrophils (NEU), Monocytes (MON), Platelet Count (PLT), and Plateletcrit (PTC) parameters were found to be decreased, and an increase in lymphocytes (LYM), Eosinophils (EOS), Mean Corpuscular Hemoglobin Concentration (MCHC), and Red Cell Distribution Width (RDW) parameters were detected after the treatments (P < .05). Again, after the treatment, glucose (Glu), C-Reactive Protein (CRP), direct bilirubin, and total protein (TP) levels were decreased, and uric acid (UA) levels increased (P < .05). HBOT improved hematological indices in patients and had a beneficial effect on biochemical parameters, particularly Glu and CRP levels. Adjuvant HBOT alleviates diabetic inflammation and has a beneficial effect on diabetic patient treatment.

Abstract 7121: The novel WEE1i, APR-1051, is a potentially well tolerated and effective treatment for cyclin E-overexpressing cancers

Abstract Previous studies have demonstrated that WEE1 inhibitors (WEE1i) are a promising cancer therapeutic through synthetic lethality with Cyclin E overexpression. One challenge for two of the leading WEE1i, AZD1775 and ZN-c3, has been the observed off-targeting of PLK family members, namely, PLK1, PLK2 and PLK3. In addition, the therapeutic application of these inhibitors in clinical trials has been limited by adverse hematological effects, including anemia. Herein, we describe the testing of a novel WEE1i (APR-1051) that, based on preclinical studies: 1) demonstrates reduced off-targeting of PLK1, PLK2 and PLK3, and 2) has the ability to suppress the growth of CCNE1-overexpressing xenografted tumors while causing little impact on red blood cell and reticulocyte levels. APR-1051 has an IC50 of 2.2 nM for WEE1 in vitro and has shown the ability to limit the proliferation of various cancer cell lines in culture. Interestingly, the genotoxicity of APR-1051 is suppressed by increasing concentrations of PLK1 inhibitors, suggesting that off-targeting of PLK1 by other WEE1i may compromise efficacy of this targeted cancer treatment in addition to the risk of producing PLK1i-associated adverse effects. APR-1051 demonstrated effectiveness in suppressing the growth of Cyclin E-overexpressing breast and ovarian cancer cells lines, thus pinpointing Cyclin E as a potential biomarker for APR-1051 treatment. Importantly, dose and scheduling of APR-1051 that causes significant suppression of CCNE1-amplified high-grade serious ovarian cancer tumors in mice is well tolerated, with red blood cell and platelet counts remaining within non-pathogenic ranges after a 28-day treatment period. In addition, inhibition WEE1 by APR-1051 occurs at an IC50 that is 200-fold lower on average than the IC50 of hERG potassium channel inhibition, implying that APR-1051 will potentially exhibit low cardiotoxicity. APR-1051 is now progressing through IND-enabling studies. Together, these findings underscore the potential of APR-1051 as a novel WEE1i for the treatment of Cyclin E-overexpressing cancers. Citation Format: Molly M. Hansbarger, Stephen J. Rocca, Sonia Ritzmann, Joseph Vacca, Bridget Tokiwa, Jonathan Weinstein, Henry Zabierek, Justin Frye, Michael Carleton, Eric J. Brown, Oren Gilad. The novel WEE1i, APR-1051, is a potentially well tolerated and effective treatment for cyclin E-overexpressing cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7121.

Development and validation of a nomogram for predicting in-hospital mortality in ICU patients with infective endocarditis

BackgroundInfective endocarditis (IE) is a disease with high in-hospital mortality. The objective of the present investigation was to develop and validate a nomogram that precisely anticipates in-hospital mortality in ICU individuals diagnosed with infective endocarditis.MethodsRetrospectively collected clinical data of patients with IE admitted to the ICU in the MIMIC IV database were analyzed using the Least Absolute Shrinkage and Selection Operator (LASSO) regression to identify potential hazards. A logistic regression model incorporating multiple factors was established, and a dynamic nomogram was generated to facilitate predictions. To assess the classification performance of the model, an ROC curve was generated, and the AUC value was computed as an indicator of its diagnostic accuracy. The model was subjected to calibration curve analysis and the Hosmer–Lemeshow (HL) test to assess its goodness of fit. To evaluate the clinical relevance of the model, decision-curve analysis (DCA) was conducted.ResultsThe research involved a total of 676 patients, who were divided into two cohorts: a training cohort comprising 473 patients and a validation cohort comprising 203 patients. The allocation ratio between the two cohorts was 7:3. Based on the independent predictors identified through LASSO regression, the final selection for constructing the prediction model included five variables: lactate, bicarbonate, white blood cell count (WBC), platelet count, and prothrombin time (PT). The nomogram model demonstrated a robust diagnostic ability in both the cohorts used for training and validation. This is supported by the respective area under the curve (AUC) values of 0.843 and 0.891. The results of the calibration curves and HL tests exhibited acceptable conformity between observed and predicted outcomes. According to the DCA analysis, the nomogram model demonstrated a notable overall clinical advantage compared to the APSIII and SAPSII scoring systems.ConclusionsThe nomogram developed during the study proved to be highly accurate in forecasting the mortality of patients with IE during hospitalization in the ICU. As a result, it may be useful for clinicians in decision-making and treatment.

Association Between Changes in Haematological Parameters and Mortality in Patients Hospitalized Due to Severe COVID-19 in a Peruvian Reference Hospital

Objective: To determine the association between changes in haematological parameters and mortality in patients hospitalized due to severe COVID-19 at a Peruvian reference hospital from April to December 2020. Materials and Methods: Observational, analytical, historical cohort study based on the review of clinical records of patients hospitalized due to severe COVID-19 from April to December 2020. We evaluated changes in common haematological parameters, including white blood cells (WBCs), lymphocytes, neutrophils, and platelet counts, as well as the neutrophil-to-lymphocyte ratio (NLR) on the third and seventh days of hospitalization compared with admission values in the deceased and nondeceased groups. Changes in haematological parameters were expressed as median and interquartile ranges (IQR). Multivariate Poisson regression analysis was further done to evaluate the effect of haematological changes in mortality, adjusting for gender, age, and comorbidities. Results: We included 1033 cases, of which 68.05% were male. Deceased patients had a significant increase in total WBC on the third day (1.0 *103/μL; IQR -1.7 to 5.4) and the seventh day (1.6*103/μL; IQR -1.9 to 4.9) compared to their admission values. The neutrophil count in the deceased patients also increased on the third day (1.2; IQR -1.7 to 4.9) and seventh day (1.9; IQR-1.5 to 5.8), as did the NLR ratio on the third day (0.2; IQR -0.4 to 1.6) and seventh day (0.7; IQR -0.2 to 2.2). Surviving patients showed an opposite trend in these parameters. In contrast, platelet counts increased on the third day (49*105/μL; IQR -0.3 to 1.3) and the seventh day (90*105; IQR 0.0 to 2.0) in surviving patients, whereas deceased patients did not show significant changes. All these differences remained statistically significant in the adjusted analysis. Conclusion: An increase in total WBC, neutrophils, and NLR at the third and seventh days compared to admission values was associated with higher mortality in patients hospitalized due to COVID-19, while an increase in platelet count was associated with decreased mortality. Monitoring these changes can help in identifying those patients with higher mortality risk.

Risk Factors for Early HALT after Transfemoral TAVI

Objective: To investigate the risk factors of hypoattenuated leaflet thickening (HALT) in the early stage after transfemoral transcatheter aortic valve implantation (TAVI). Methods: Patients who underwent transfemoral TAVI in the Affiliated Hospital of Qingdao University from January 2021 to June 2023 were selected. According to the results of four-dimensional computed tomography (4DCT), patients were divided into HALT group and non-HALT group. The perioperative data of the two groups were collected to find the risk factors of HALT in the early postoperative period. Results: A total of 100 patients underwent TAVI operation via femoral artery, 2 died after operation, 1 discharged due to cerebral complication, and 2 patients had incomplete 4DCT data. The data of 95 patients were completely collected, including 56 males and 39 females, with an average age of (72.0 ± 6.7) years and a body mass index of (24.0 ± 3.7) kg/m2. 10 patients had HALT, the incidence was 10.5%. 85 patients were in the non-HALT group, including 52 males (61.2%). 10 patients were in the HALT group, 4 cases were male (40%). There were no significant differences in age, sex, body mass index (BMI), hypertension, diabetes, chronic obstructive pulmonary disease (COPD), brain complications, coronary heart disease, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and operation time between the two groups. And the differences between the two groups in perioperative white blood cell, neutrophil, lymphocyte and platelet counts, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and creatinine were not significant. Compared with the non-HALT group, patients in the HALT group had a higher proportion of isolated aortic insufficiency, a lower proportion of post dilatation after valve release, and a higher proportion of valves with skirts. Conclusion: Isolated aortic insufficiency, without post dilatation after valve release, and use of valves with skirt are associated with early HALT after transfemoral TAVI.

Effect of dengue infection on liver profile and hematological parameters

Dengue fever is endemic in Sri Lanka. Liver damage is common in dengue fever. Understanding the pattern change of the liver profile and haematological parameters is crucial for managing dengue patients and minimising liver damage. The purpose of this study was to determine the pattern change in liver profile and the haematological parameters of dengue patients. Sixty apparently healthy volunteers and 169 acute dengue patients aged 20 or older had their blood samples examined. Liver enzymes, albumin, protein, bilirubin, white blood cell count, platelet count, haematocrit, and haemoglobin were measured. There was an increase in aspartate aminotransferase (105.6 IU/L), alanine aminotransferase (82.6 IU/L), and gamma-glutamyl transferase (68.9 IU/L), which were 3.4, 3.9, and 3.2-fold higher, respectively, than those of the control group, suggesting liver injury. Eighty-four percent of patients had raised levels of aspartate aminotransferase, and 74% of patients had elevated levels of alanine aminotransferase, indicating the prominence of aspartate aminotransferase over alanine aminotransferase. The presence of a positive correlation between the levels of aspartate aminotransferase and alanine aminotransferase indicates that the elevation of enzymes is primarily due to a single cause, liver injury. White blood cells and platelet counts were significantly lower. Platelet count demonstrated a negative correlation with both haematocrit and haemoglobin in dengue patients. In conclusion, aspartate aminotransferase was identified as the most significant marker of dengue-associated liver injury, followed by alanine aminotransferase. Low platelet and white blood cell counts were the major unfavourable changes in dengue patients' haematological characteristics.

Primary Thromboprophylaxis for the Prevention of Venous Thromboembolism in Cancer Patients with Central Venous Catheters: A Literature Review.

Cancer is a known risk factor for venous thromboembolism (VTE). The wider adoption of immunotherapy and anti-angiogenic drugs in recent years have increased this risk further. Central venous catheters (CVCs) are widely used access devices utilized to deliver infusion therapy, mostly in ambulatory settings. The endothelial injury associated with the use of these catheters adds to the risk of VTE to already high-risk patients. The introduction of direct oral anticoagulants (DOACs), with its proven efficacy and safety in multiple clinical indications, have renewed the attention to VTE prophylaxis in cancer patients with CVC. Several clinical trials and meta-analyses had shown that both apixaban and rivaroxaban are effective in lowering the risk of VTE, without increasing the risk of bleeding. Several risk assessment models (RAM) have utilized patient-related, tumor-related, and treatment-related factors, in addition to widely available biomarkers, like Hemoglobin (Hb) level, white blood cell (WBC) and platelets counts to stratify patients into two or three VTE risk levels. In this manuscript, we review the published clinical trials and meta-analyses that attempted to study the efficacy and safety of anticoagulants, mostly the DOACs, in cancer patients with CVCs. We will also propose a practical risk-directed approach to enhance VTE prophylaxis rate.

Pre-existing Immunocompromising Conditions and Outcomes of Acute COVID-19 Patients Admitted for Pediatric Intensive Care.

We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care. Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted 12 March 2020-30 December 2021 to the pediatric intensive care unit (PICU) or high-acuity unit for acute COVID-19 were included. Of 1274 patients, 105 (8.2%) had an ICC, including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid-organ transplantation, 16 (15.2%) solid tumors, and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs 4.6%, P = .005) and hospitalization was longer (P = .01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, P = .40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19. In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities.

Comparative Analysis of Pediatric Brucellosis Cases With and Without Bacteremia.

Introduction: Brucellosis, which is among the endemic regions of Turkey, is a common zoonotic disease. The gold standard in diagnosing brucellosis is culture. We aimed to compare demographic characteristics, risk factors, and clinical and laboratory variables between cases with culture positivity and undetected in culture. Materials and Methods: This single-center study was conducted between January 2007 and April 2022. Clinical and laboratory data of patients with brucella growth in blood culture and patients without growth were compared. Results: A total of 150 patients were included in the study. The median age was 10 (1-18 years). Of the patients, 66 (44%) were female and 84 (56%) were male. Forty (26.7%) of the patients were bacteremic and 110 (73.3%) were nonbacteremic. In the bacteremic group, white blood cell count, platelet, and hemoglobin counts were lower, and aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values were higher. In clinical evaluation, fever, hepatomegaly, splenomegaly, and abdominal pain were more common in the bacteremic group. Conclusion: The distinction between bacteremic and nonbacteremic brucellosis can be predicted using laboratory values such as white blood cells, hemoglobin counts, platelet, ALT, and AST, and clinical findings such as fever, abdominal pain, hepatomegaly, and splenomegaly.

ASSESSMENT OF COMPLETE BLOOD COUNT AND LIVER ENZYMES IN CHRONIC KIDNEY DISEASE PATIENT

Chronic renal failure (CRF) poses a significant global health challenge, with chronic kidney disease (CKD) characterised by kidney damage or a glomerular filtration rate (GFR) persistently below 60 ml/min for over three months. This observational study, conducted in Faisalabad from January to July 2023, aimed to evaluate haematological variables and liver enzymes across different stages of CKD. Using non-probability purposive sampling, 144 CKD patient files and 48 healthy control files were collected, excluding specific conditions. CKD staging was determined using the Modification of Diet in Renal Disease (MDRD) algorithm, categorizing patients into mild (Group A), moderate (Group B), severe (Group C) CKD, and controls (Group D). Data analysis was performed using SPSS v23. Mean ± SD values were presented for each parameter across the four groups. Haemoglobin levels (Hb g/dl) exhibited a decreasing trend in CKD patients compared to the control group, with values of 13.7 ± 1.50 in controls, 11.7 ± 0.64 in Group 1, 9.7 ± 0.57 in Group 2, and 6.7 ± 1.5 in Group 3. Red blood cell count (RBCs per million/mm3) also decreased progressively in CKD patients compared to controls, with values of 5.48 ± 0.59, 4.62 ± 0.15, 3.57 ± 0.28, and 2.81 ± 0.23 in the respective groups. Conversely, white blood cell counts (WBC thousand/mm3) increased with CKD progression, showing values of 8406 ± 1383 in controls, 10674 ± 1006 in Group 1, 12028 ± 643.5 in Group 2, and 13564 ± 741.29 in Group 3. Similarly, platelet counts (lakh/ul) exhibited a decreasing trend in CKD patients compared to controls, with values of 324708 ± 112970, 235458 ± 63853, 144979 ± 6935.8, and 126333 ± 4768.3, respectively. Analysis of liver enzymes revealed a progressive decrease in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels as CKD advanced. AST levels (U/L) decreased from 29.104 ± 3.130 in controls to 7.5825 ± 1.543 in Group 3, while ALT levels (U/L) decreased from 48.145 ± 4.9679 in controls to 12.270 ± 3.3500 in Group 3. Our findings demonstrate that haemoglobin, red blood cell count, platelet count, and liver enzyme levels (AST and ALT) decrease as CKD progresses while white blood cell count increases. These insights into haematological and hepatic biomarkers underscore the dynamic nature of CKD pathology and may inform clinical management strategies.

Rujifang inhibits triple-negative breast cancer growth via the PI3K/AKT pathway

Ethnopharmacological relevanceRujifang (RJF) constitutes a traditional Chinese medicinal compound extensively employed in the management of triple-negative breast cancer (TNBC). However, information regarding its potential active ingredients, antitumor effects, safety, and mechanism of action remains unreported. Aim of the studyTo investigate the efficacy and safety of RJF in the context of TNBC. Materials and methodsWe employed the ultra high-performance liquid chromatography-electrospray four-pole time-of-flight mass spectrometry technique (UPLC/Q-TOF-MS/MS) to scrutinize the chemical constituents of RJF. Subcutaneously transplanted tumor models were utilized to assess the impact of RJF on TNBC in vivo. Thirty female BLAB/c mice were randomly divided into five groups: the model group, cyclophosphamide group, and RJF high-dose, medium-dose, and low-dose groups. A total of 1 × 106 4T1 cells were subcutaneously injected into the right shoulder of mice, and they were administered treatments for a span of 28 days. We conducted evaluations on blood parameters, encompassing white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB), platelet count (PLT), neutrophils, lymphocytes, and monocytes, as well as hepatorenal indicators including alkaline phosphatase (ALP), glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), albumin, and creatinine (CRE) to gauge the safety of RJF. Ki67 and TUNEL were detected via immunohistochemistry and immunofluorescence, respectively. We prepared RJF drug-containing serum for TNBC cell lines and assessed the in vitro inhibitory effect of RJF on tumor cell growth through the CCK8 assay and cell cycle analysis. RT-PCR was employed to detect the mRNA expression of cyclin-dependent kinase and cyclin-dependent kinase inhibitors in tumor tissues, and Western blot was carried out to ascertain the expression of cyclin and pathway-related proteins. Results100 compounds were identified in RJF, which consisted of 3 flavonoids, 24 glycosides, 18 alkaloids, 3 amino acids, 8 phenylpropanoids, 6 terpenes, 20 organic acids, and 18 other compounds. In animal experiments, both CTX and RJF exhibited substantial antitumor effects. RJF led to an increase in the number of neutrophils in peripheral blood, with no significant impact on other hematological indices. In contrast, CTX reduced red blood cell count, hemoglobin levels, and white blood cell count, while increasing platelet count. RJF exhibited no discernible influence on hepatorenal function, whereas Cyclophosphamide (CTX) decreased ALP, GOT, and GPT levels. Both CTX and RJF reduced the expression of Ki67 and heightened the occurrence of apoptosis in tumor tissue. RJF drug-containing serum hindered the viability of 4T1 and MD-MBA-231 cells in a time and concentration-dependent manner. In cell cycle experiments, RJF diminished the proportion of G2 phase cells and arrested the cell cycle at the S phase. RT-PCR analysis indicated that RJF down-regulated the mRNA expression of CDK2 and CDK4, while up-regulating that of P21 and P27 in tumor tissue. The trends in CDKs and CDKIs protein expression mirrored those of mRNA expression. Moreover, the PI3K/AKT pathway displayed downregulation in the tumor tissue of mice treated with RJF. ConclusionRJF demonstrates effectiveness and safety in the context of TNBC. It exerts anti-tumor effects by arresting the cell cycle at the S phase through the PI3K-AKT pathway.

Association between systemic immune-inflammation index and psoriasis: a population-based study.

The systemic immune-inflammation index (SII),as measured by lymphocyte, neutrophil and platelet counts in peripheral blood, is regarded as a favorable indicator of both inflammatory state and immune response. Psoriasis is an immune-mediated disease notable for its chronic inflammation of the entire system. Our research sought to explore the latent link between psoriasis and SII. We performed a cross-sectional investigation utilizing data extracted from the National Health and Nutrition Examination Survey (NHANES, 2009-2014). Employing multivariate linear regression models and subgroup analysis, we sought to uncover the association between SII and psoriasis. This study enrolled a total of 17,913 participants as part of its research cohort. Our multivariate linear regression analysis revealed a notable and positive correlation between SII and psoriasis [1.013 (1.000, 1.026)]. As SII tertiles increased, the risk of psoriasis demonstrated an upward trend. The significant dependence on this positive association were maintained in women, BMI(≥ 30 kg/m2),non-stroke and non-cancer subjects in subgroup analysis and interaction tests. Furthermore, we identified a significant association between SII and psoriasis, characterized by two consecutive inverted U-shaped patterns. Notably, the analysis revealed the most prominent inflection point at a specific value of 797.067. The results indicate a significant correlation between elevated SII levels and the presence of psoriasis. However, to corroborate and strengthen these results, additional large-scale prospective studies are required.

Protective and therapeutic effects of apigenin on thioacetamide-induced hepatotoxicity in male rats: physiological and morphological study

BackgroundLiver fibrosis is an irreversible liver destruction. Apigenin (API) has different pharmacological properties as anticancer, anti-inflammatory, and antioxidant; however, API hepatoprotective and therapeutic effects are not often studied. This study assesses protective and therapeutic API effects on hepatic injuries produced by thioacetamide (TAA) in rats.MethodsForty-nine rats were sorted into seven groups (7 in each): negative control (G1), positive control (G2, TAA), API group (G3), TAA+API group (G4), TAA+SL group (G5), API+TAA group (G6), and SL+TAA group (G7). API and SL effects on TAA-induced hepatotoxicity were examined by determined body weights, liver weights, complete blood count picture (white blood cells, red blood cells, hemoglobin, hematocrit, and platelets counts), liver function tests (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, gamma glutamyl transferase, alkaline phosphatase, total proteins, albumin, and globulin), and oxidative stress markers (malonaldehyde, catalase, superoxide dismutase, and reduced glutathione) in serum and liver histological was assessed.ResultsTAA decreased red blood cells, platelets, hemoglobin content, and hematocrit (p <0.001) and increased white blood cells count (p <0.001) versus control. Serum values of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, gamma glutamyl transferase, alkaline phosphatase, and malondialdehyde significantly elevated (p <0.001); meanwhile, total protein, albumin, globulin, catalase, superoxide dismutase, and glutathione S transferase decline (p <0.001) versus negative control. Hepatic structure of TAA group revealed fibrosis and hepatocyte destruction. Therapeutic or protective treating TAA-rats with API or SL ameliorate hematological values, liver functions, oxidative stress, and histological alterations especially therapeutic effects on hematological changes, liver function tests, and oxidative stress markers.ConclusionsApigenin had therapeutic and protective effects on liver fibrosis due to its antioxidant activity with therapeutic better than protective effects.

Rapid, Simple and Low-Cost Analytical Method Development for Quantification of Eltrombopag Olamine in Tablet Dosage by UV Spectroscopy Method.

Eltrombopag Olamine is a drug used to treat thrombocytopenia, a disorder where blood platelet counts get lower and severe aplastic anemia. It serves as a thrombopoietin receptor agonist, which give rise to platelet production in the bone marrow. The objective of this study is to develop a simple, specific, accurate, precise and economical Ultraviolet spectroscopy method to estimate the amount of Eltrombopag Olamine in bulk and tablet dosage form. The developed method was performed using methanol for identification and physicochemical characterization of the drug. The validation parameters like linearity, precision, accuracy, robustness limits of detection and quantitation, and specificity were assessed as per ICH Q2 (R2). The maximum absorbance wavelength (λmax) of the drug was found at 247 nm in methanol. The linearity was found in the concentration range of 2-14 μg/ml with regression equation y = 0.0619x - 0.0123 and r² = 0.999. The standard addition method was used to determine the accuracy of the developed method. The result was found in the % recovery range of 98-99%. The precision was done on λmax with respect to the parameters such as repeatability, intraday, and interday. The method was found to be precise as the % RSD value was found to be <2%. The detection limit value (LOD) and quantitation limit value (LOQ) were 0.0524 μg/ml and 0.1588 μg/ml, respectively. The developed method is simple, economical, accurate and selective. The developed method was adaptable for the estimation of Eltrombopag Olamine analysis in pharmaceutical dosage form and routine quality control laboratory.

Seroprevalence of melioidosis and its association with blood profiles and pathogens in sheltered dogs in southern Thailand.

Melioidosis is a notable zoonotic disease in Thailand that can affect both humans and animals. Although dogs are one of the most popular pets worldwide, there is a remarkable lack of information on the prevalence and knowledge of canine melioidosis. This study aimed to estimate the seroprevalence of melioidosis in sheltered dogs and its relationship with the blood profile and blood pathogens. Melioidosis in 156 dogs was analyzed using an indirect hemagglutination assay. Hematology and serum biochemistry tests were performed using an automated system. Blood pathogens (e.g., Ehrlichia, Anaplasma, Hepatozoon, and Babesia) were diagnosed using conventional polymerase chain reaction. The seroprevalence rates of canine melioidosis and blood pathogen infection were 5.77% (9/156) and 50.64% (79/156), respectively. Seropositive dogs generally have higher lymphocyte counts and aspartate aminotransferase levels but lower total white blood cell, neutrophil, and platelet (PLT) counts than seronegative dogs. No statistically significant difference (p > 0.05) was observed between the seropositive and seronegative dogs' hematology and serum biochemistry findings. Neither the correlation between melioidosis and blood pathogen infection nor the association between melioidosis and thrombocytopenia was statistically significant (p > 0.05). Remarkably, dogs that had coinfections with both melioidosis and blood pathogens demonstrated a significantly reduced PLTcount (49,167 ± 7,167) compared with dogs that tested positive for melioidosis but negative for blood pathogens (139,333 ± 29,913) (p < 0.01). In southern Thailand, the prevalence of canine melioidosis was low but the prevalence of blood pathogens was high. Coinfection with blood pathogens can significantly reduce PLT counts, which may have a potentially serious impact. Future research should focus on conducting seroprevalence studies in the general dog population.

INFLA-score: A new diagnostic paradigm to identify pericarditis

BackgroundDiagnosis of pericarditis may be challenging because not all patients meet the conventional criteria. An overlooked diagnosis implies a longer course of symptoms and an increased risk of recurrences. C-reactive protein (CRP), widely used as an inflammation marker, has some limitations. This study aimed to assess the usefulness and prognostic value of INFLA-score, a validated index assessing low-grade inflammation, in the definite diagnosis of pericarditis. MethodsPatients with suspected pericarditis were included. The INFLA-score was computed based on white blood cells and platelet count, neutrophil-to-lymphocyte ratio, and CRP, ranging from −16 to +16. An INFLA-score > 0 was considered positive for the presence of pericardial inflammation. The primary end point was the association of INFLA-score with diagnosis of pericarditis according to conventional criteria. The recurrence of pericarditis at 6 months was the secondary end point. ResultsA total of 202 patients were included, aged 47 ± 17 years, and 57% were females. Among 72 (36%) patients with a diagnosis of pericarditis, an INFLA-score > 0 was observed in 86% (vs. 36%, p < 0.001), abnormal CRP in 42% (vs. 10%, p < 0.001), pericardial effusion in 44% (vs. 19%, p < 0.001), abnormal electrocardiogram in 56% (vs. 24%, p < 0.001), and rubs in 5% (vs. 0.1%, p = 0.072). INFLA-score > 0 had the strongest predictive value for the diagnosis of pericarditis (hazard ratio 8.48, 95% confidence interval [CI] 3.39–21.21), with 86% sensitivity and 64% specificity, as opposed to CRP (hazard ratio 1.72, non-significant 95% CI 3.39–21.20). Recurrent pericarditis at 6 months was more frequent in patients with a positive INFLA-score (37% vs. 8%, p < 0.001, rate ratio 4.15, 95% CI 2.81–6.12). In patients with normal CRP, INFLA-score–confirmed ongoing inflammation in 78% of the cases. Compared with the conventional criteria, the INFLA-score had the highest accuracy (area under the curve = 0.82). Different cutoffs were valuable to rule out (INFLA-score > 0, sensitivity 86%, and negative LR 0.22) or rule in (INFLA-score ≥ 10, specificity 97%, and positive LR 13) the diagnosis. ConclusionsThe INFLA-score is a useful diagnostic tool to assess the probability of pericarditis, with a strong prognostic value for further recurrences, outperforming CRP.