Blood Values Research Articles

Analysis and identification of mRNAsi‑related expression signatures via RNA sequencing in lung cancer.

High stemness index scores are associated with poor survival in patients with lung cancer. Studies on the mRNA expression-based stemness index (mRNAsi) are typically conducted using tumor tissues; however, mRNAsi-related expression signatures based on cell-free RNA (cfRNA) are yet to be comprehensively investigated. The present study aimed to elucidate the gene expression profiles of tumor stemness in lung cancer tissues and corresponding cfRNAs in blood, and to assess their links with immune infiltration. Tumor tissue, paracancerous tissue, peripheral blood and lymph node samples were collected from patients with stage I-III non-small cell lung cancer and RNA sequencing was performed. The TCGAbiolinks package was used to calculate the mRNAsi for each of these four types of sample. Weighted gene co-expression network analysis and differentially expressed gene analyses were performed to investigate mRNAsi-related genes, and pathway enrichment analysis was performed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) orthology-based annotation system. In addition, the STAR-Fusion tool was used to detect fusion variants, and CIBERSORT was used to analyze the correlations of stemness signatures in tissues and blood with immune cell infiltration. The mRNAsi values in peripheral blood and lymph nodes were found to be higher than those in cancer tissues. 'Hematopoietic cell lineage' was the only KEGG pathway enriched in mRNAsi-related genes in both lung cancer tissues and peripheral blood. In addition, the protein tyrosine phosphatase receptor type C associated protein gene was the only gene commonly associated with the mRNAsi in these two types of sample. The expression of mRNAsi-related genes was increased in the dendritic and Treg cells in tumor tissues, but was elevated in Treg and CD8 cells in the blood. In conclusion, cfRNAs in the blood exhibit unique stemness signatures that have potential for use in the diagnosis of lung cancer.

Two cases of Dent disease type 1 with Bartter-like phenotype and literature review

The clinical presentation, treatment, and follow-up of two boys with type 1 Dent disease who exhibited a Bartter-like phenotype were retropectively analysed. The related literature of pediatric patients with type 1 Dent disease who had hypokalemia and metabolic alkalosis was screened through databases such as PubMed, CNKI, and Wanfang until February 1, 2024, and common features among these patients were summarized through literature review. A total of 7 literatures were included, and 9 children were included in the analysis. All patients were male, presenting with significant low molecular weight proteinuria and hypercalciuria. Other prominent characteristic phenotypes included short stature (7/8), hypophosphatemia (8/9), and rickets (6/8). Seven previously reported patients had missense or nonsense mutations, while 2 patients in this study carried possible pathogenic mutations in the CLCN5 gene, c.315+2T>A (p.?) and c.584dupT (p.I196Yfs*6), respectively. Five patients were able to maintain blood potassium levels around 3 mmol/L with oral potassium chloride solution combined with non-steroidal anti-inflammatory drugs (ibuprofen or indomethacin). The follow-up showed that 2 patients developed chronic kidney disease stage 4 and stage 3 at the age of 13 and 21 years, respectively. The phenotypic overlap between Dent disease and Batter syndrome is considerable,with the distinguishing feature being the presence of significant low molecular weight proteinuria. Patients with type 1 Dent disease presenting with the Bartter-like phenotype have a high prevalence of short stature, hypophosphatemia, and rickets. Non-steroidal anti-inflammatory drugs can be used to correct hypokalemia in patients under periodic renal function assessment.

Association Between Eyelid Twitching and Digital Screen Time, Uncorrected Refractive Error, Intraocular Pressure, and Blood Electrolyte Imbalances.

Previous studies have shown that isolated eyelid myokymia (EM) is usually caused by stress, fatigue, and caffeine consumption. The purpose of this study was to evaluate the association between EM and digital screen time, uncorrected refractive error, intraocular pressure (IOP), and blood electrolyte levels. Between February 2023 and June 2024, 103 eyes of 103 patients who applied to the ophthalmology outpatient clinic with complaints of eyelid twitching lasting for more than two weeksand 103 eyes of 103 healthy individuals as a control group were included in the study. All participants were asked to record their daily time spent with digital screens for two weeks. Cycloplegic refractive error, IOP, optic nerve head cup/disc (C/D) ratio, and blood calcium, sodium, potassium, and magnesium levels were recorded and compared between the two groups. Mean digital screen time was 4.84±1.74 hours in the control group and 6.88±2.01 hours in the EM group. It was found that digital screen time was significantly higher in the EM group compared to the control group (p<0.001). There was a strong positive correlation between the duration of eyelid twitching and the time spent in front of digital screens (p<0.001, r=0.670). There was no significant difference in cycloplegic refractive error, IOP, C/D ratio, and blood electrolyte levels between the two groups (p>0.05). Prolonged digital screen time might play a role in the development of EM. On the other hand, no relationship was found between eyelid twitching and uncorrected refractive error, glaucoma, or blood electrolyte levels.

Abstract P366: Co-Created Intervention Promotes Uptake of Low Sodium Iodized Salt Substitute to Control Hypertension: Results from a Large Community-based Quasi-Experimental Study from India

Introduction: India has a high burden of uncontrolled hypertension (28%) with low control rates (&lt;10%). Mean dietary sodium intake (4000mg/d) is also high, which warrants implementation of population-level sodium reduction interventions, such as using low-sodium iodized salt (LSIS). Given the low awareness about LSIS, we co-created and evaluated an intervention to promote its usage. Objective: To estimate change from baseline to end line in proportion of households reporting LSIS use post implementation of a co-created (involving multiple stakeholders) intervention to provide education (education only arm) on LSIS and education along with subsidy to purchase LSIS (education+subsidy arm). Methods: The study was implemented (8 months intervention) in rural and urban sites of north and south India. In the education only arm, trained health workers provided education on LSIS to community members using pamphlets, a short video and encouraged retailers to sell LSIS to consumers by displaying point of sale posters. In the education+subsidy arm, apart from aforementioned activities, subsidy of $ 0.24/kg (~50% of the price) to purchase LSIS was provided to the distributors, who passed this on to retailers and consumers. Results: A total of 1,602 households and 3,108 participants were interviewed. The mean(SD) age of the participants was 46.9(14.2) years. Fifty two percent were females. At baseline, proportion of households reporting ever use of LSIS was 1.3% (95%CI: 0.9–2.1) and 2.3% (1.8–2.7) respectively, in the education and education+subsidy arms. At end line, this proportion increased to 22.6% (21.1–24.1) and 49.3% (47.5-51.2%) respectively. The odds of LSIS ever use was 2.6 (1.2-5.7) times higher in the education+subsidy arm compared to education only arm. The odds of reporting LSIS use was higher if the household had ≥ one patient with hypertension (1.7[1.3-2.3]), with graduate education (1.6[1.3-2.0]) or belonged to richest quintile (1.6[1.3-2.0]). There was no significant change in mean systolic and diastolic blood pressure, urinary sodium, and potassium between the two arms from baseline to end line. Conclusion: We demonstrated the possibility of increasing LSIS usage through a co-created intervention providing either education only or education+subsidy to buy LSIS with a substantially higher response for the latter. This underscores the need to make LSIS accessible, available, and affordable for regular use to reduce dietary sodium intake and control hypertension.

Interpretable Machine Learning Model for Predicting the Prognosis of Guillain-Barré Syndrome Patients.

Machine learning (ML) is increasingly used in medical predictive modeling, but there are no studies applying ML to predict prognosis in Guillain-Barré syndrome (GBS). The medical records of 223 patients with GBS were analyzed to construct predictive models that affect patient prognosis. Least Absolute Shrinkage and Selection Operator (LASSO) was used to filter the variables. Decision Trees (DT), Random Forest (RF), Extreme Gradient Boosting (XGBoost), k-nearest Neighbour (KNN), Naive Bayes (NB), Neural Network (NN). Light Gradient Boosting Machine (LGBM) and Logistic Regression (LR) were used to construct predictive models. Clinical data from 55 GBS patients were used to validate the model. SHapley additive explanation (SHAP) analysis was used to explain the model. Single sample gene set enrichment analysis (ssGSEA) was used for immune cell infiltration analysis. The AUCs (area under the curves) of the 8 ML algorithms including DT, RF, XGBoost, KNN, NB, NN, LGBM and LR were as follows: 0.75, 0.896 0.874, 0.666, 0.742, 0.765, 0.869 and 0.744. The accuracy of XGBoost (0.852) was the highest, followed by LGBM (0.803) and RF (0.758), with F1 index of 0.832, 0.794, and 0.667, respectively. The results of the validation set data analysis showed AUCs of 0.839, 0.919, and 0.733 for RF, XGBoost, and LGBM, respectively. SHAP analysis showed that the SHAP values of blood neutrophil/lymphocyte ratio (NLR), age, mechanical ventilation, hyporeflexia and abnormal glossopharyngeal vagus nerve were 0.821, 0.645, 0.517, 0.401 and 0.109, respectively. The combination of NLR, age, mechanical ventilation, hyporeflexia and abnormal glossopharyngeal vagus used to predict short-term prognosis in patients with GBS has a good predictive value.

Summary of Research: Cardiovascular and Kidney Outcomes with Finerenone in Patients with Type 2 Diabetes and Chronic Kidney Disease-The FIDELITY Pooled Analysis.

People living with type 2 diabetes (T2D) and chronic kidney disease (CKD) are at risk of CKD progression and kidney failure. This is a summary of the FIDELITY pooled analysis where two clinical trials (FIDELIO-DKD and FIGARO-DKD) were performed to investigate the safety and efficacy of finerenone in people with T2D and CKD. The data from these two studies were combined and analyzed and it was found that those who took finerenone on top of standard-of-care medicine had a 14% reduced risk of having a cardiovascular event and 23% reduced risk of having a kidney event versus those who took placebo. Those who took finerenone were also more likely to have high blood potassium, but this was mostly manageable.A graphical abstract and translations of all content (Chinese, Japanese, German, Spanish, Brazilian-Portuguese, French) are available for this article.

HEMATOLOGY AND BIOCHEMICAL REFERENCE INTERVALS FOR FREE-RANGING PRONGHORN (ANTILOCAPRA AMERICANA) IN WEST TEXAS.

Pronghorn (Antilocapra americana) are considered a keystone species of North American grasslands and an important economic source for many landowners in Texas. Pronghorn restoration projects routinely capture and translocate individuals from surplus populations to restoration areas. The objective of this study was to generate normal hematological and biochemical reference intervals (RI) for free-ranging pronghorn populations in Texas as a health monitoring tool for pronghorn restoration efforts. Blood samples were collected by jugular venipuncture and divided among an EDTA tube, serum separator tube, and a single blood smear on site. Complete blood counts and biochemical profiles were completed at the Texas Veterinary Medical Diagnostic Laboratory. In total, 417 individuals (41 males, 376 females) were included in the analysis. RI were determined by robust methods (R Studio) and mixed models' analysis of variance (SPSS 28) to examine differences in blood parameters due to fever, sex, age (adult versus yearling [<1 yr of age]), cell abnormalities, and pathogen exposure reported by the testing laboratory. Sex, age, and pathogen exposure affected mean blood values, but did not warrant development of separate RI by class. Bluetongue virus was identified in 46.8% (195/417) of pronghorns and epizootic hemorrhagic disease in 89.4% (194/217) of pronghorns; 84.8% (184/217) of the pronghorns tested positive for both diseases. This information provides baseline hematology and biochemical parameters to assess the health of free-ranging pronghorn and guide wildlife managers in decision-making for future translocations and restoration objectives.

Blood-, Tissue- and Urine-Based Prognostic Biomarkers of Upper Tract Urothelial Carcinoma.

Upper tract urothelial carcinoma (UTUC) is a rare but aggressive neoplasm. Currently, there are few reliable and widely used prognostic biomarkers of this disease. The purpose of this study was to assess the prognostic value of blood-, tissue- and urine-based biomarkers in patients with UTUC. A comprehensive literature search was conducted using the PubMed, Cochrane and Embase databases. Case reports, editorials and non-peer-reviewed literature were excluded from the analysis. As a result, 94 articles were included in this review. We evaluated the impact of 22 blood-based, 13 tissue-based and 4 urine-based biomarkers and their influence on survival outcomes. The neutrophil-lymphocyte ratio, albumin, C-reactive protein, De Ritis ratio, renal function and fibrinogen, which are currently mentioned in the European Association of Urology (EAU) guidelines, are well researched and most probably allow for a reliable prognosis estimate. However, our review highlights a number of other promising biomarkers that could potentially predict oncological outcomes in patients with UTUC. Nonetheless, the clinical value of some prognostic factors remains uncertain due to the lack of comprehensive studies.

Investigation of the Effect of Herbal Omega-3-Rich Food Consumption on Hematologic Parameters and Total Cholesterol Levels According to Physical Activity Status in Healthy Individuals

Objective: It is known that walnut consumption has favorable effects on health. Walnuts are known to be a food rich in unsaturated fatty acids and herbal omega-3 fatty acids. This study investigated the effects of walnut (plant omega-3) consumption on hematologic factors in healthy adults with a certain physical activity level. Methods: Healthy participants in this study were offered thirty grams of walnuts per day for three weeks. Walnuts were consumed on an empty stomach or with breakfast every morning for three weeks. The blood values of people were measured at the beginning and the end of the study. Hematological parameters were measured in the routine blood test from blood taken. Results: The effect of a consumption rich in vegetable omega-3 products on hematologic factor levels caused a significant difference in MCH (p=0.001), MCHC (p=0.001) and LENFOSIT (p=0.001) levels. A significant increase in HCT levels was found only in male subjects. No significant changes were observed in other hematologic parameters. In addition, although a decrease in TC levels (p=0.023) and an increase in MONOSITE levels (p=0.027) were observed after consumption of plant omega-3 in active individuals, this difference was not observed in sedentary individuals. On the other hand, sedentary individuals showed an increase in LENFOSITE levels after consumption of plant-based omega-3 (p=0.016), whereas this difference was not observed in active individuals. There was also a statistically significant difference in carbohydrate, PUFA and a-linolenic acid intake compared to TBSA. There were no significant differences in energy, cholesterol, monounsaturated fatty acid and saturated fatty acid intakes. Conclusion: In this study, the addition of plant omega-3 fatty acids to the diet of healthy volunteers affected some hematologic factors and is thought to have a stimulating effect against cells that defend the body. It was also observed that the effect on hematologic factors and cholesterol levels was higher when plant omega-3 supplements were given to individuals who engaged in regular physical activity. We think that the effect of plant omega-3 fatty acids on hematologic factors should be further investigated.

The Effects of Calcium Gluconate Administration on Potassium Levels of Post Packed Red Cell (PRC) Transfusion Patients with More Than Three-Day-Stored Blood at RSUP Haji Adam Malik, Medan

Background: Blood transfusion is an important and routine medical treatment, especially in cases requiring surgeries such as trauma. One of the biochemical changes that occurs in PRC due to erythrocyte storage is an increase in potassium levels. Hyperkalemia is the most common complication of stored blood transfusion. Cardiac arrest has been widely reported in transfusion-associated hyperkalemia. Methods : This study used a pre-experimental study with a pretest-posttest group design to determine the effects of Ca gluconate administration on blood potassium levels in patients receiving packed red cell (PRC) transfusions with blood stored for &gt; 3 days at RSUP Haji Adam Malik Medan. Results : The distribution of sample characteristics in this study showed a mean age of 46 ± 13.63. There were 7 (22.6%) male and 24 (77.4%) female patients, with a mean BMI of 23.28 ± 6.44. Based on the hemodynamic profile, the mean systolic BP was 105.87 ± 20.59, diastolic BP 70.41 ± 11.94, RR 23.06 ± 2.39 and MAP 83.31 ± 14.48. The mean value of potassium levels before an administration of Ca gluconate was 5.84 ± 0.89, while the mean value after the administration was 5.43 ± 0.90. There were no statistically significant changes in the potassium levels after the administration of Ca gluconate in any samples. Conclusions : There are effects of Ca gluconate administration on the potassium levels of post Packed red cell (PRC) transfusion patients with blood stored for &gt; 3 days at RSUP Haji Adam Malik Medan.

Mortality Risk Stratification Utilizing Artificial Intelligence Electrocardiogram for Hyperkalemia in Cardiac Intensive Care Unit Patients

BackgroundHyperkalemia has been associated with increased mortality in cardiac intensive care unit (CICU) patients. An artificial intelligence (AI) enhanced electrocardiogram (ECG) can predict hyperkalemia, and other AI-ECG algorithms have demonstrated mortality risk-stratification in CICU patients. ObjectivesThe authors hypothesized that the AI-ECG hyperkalemia algorithm could stratify mortality risk beyond laboratory serum potassium measurement alone. MethodsWe included 11,234 unique Mayo Clinic CICU patients admitted from 2007 to 2018 with a 12-lead ECG and blood potassium (K) level obtained at admission with K ≥5 mEq/L defining hyperkalemia. ECGs underwent AI evaluation for the probability of hyperkalemia (probability >0.5 defined as positive). Hospital mortality was analyzed using logistic regression, and survival to 1 year was estimated using Kaplan-Meier and Cox analysis. ResultsIn the final cohort (n = 11,234), the mean age was 69.6 ± 10.5 years, 37.8% were females, and 92.4% were White. Chronic kidney disease was present in 20.2%. The mean laboratory potassium value for the cohort was 4.2 ± 0.3 mEq/L. The AI-ECG predicted hyperkalemia in 33.9% (n = 3,810) of CICU patients and 12.9% (n = 1,451) of patients had laboratory-confirmed hyperkalemia (K ≥5 mEq/L). In-hospital mortality increased in false-positive, false-negative, and true-positive patients, respectively (P < 0.001), and each of these patient groups had successively lower survival out to 1 year. ConclusionsAI-ECG-based prediction of hyperkalemia, even with a normal laboratory potassium value, was associated with higher in-hospital mortality and lower 1-year survival in CICU patients. This study demonstrated that AI-ECG probability of hyperkalemia may enable rapid individualized risk stratification in critically ill patients beyond laboratory value alone.

Identification of blood at simulated crime scenes using silver nanoparticles with SERS.

The analysis of substances and samples obtained from a crime scene is very important in solving forensic cases. To determine the variables involved in a crime and to expedite the investigation process, the rapid analysis of body fluids in small quantities and within environments containing diverse components is particularly necessary. For this reason, it is of great importance to analyze biological fluids with rapid, noncontaminating, nondestructive, low-cost, and accurate techniques. In recent years, with advancements in laser technology, spectroscopic methods have been introduced as analytical techniques in forensic medicine and chemical studies. This study focuses on surface-enhanced Raman spectroscopy (SERS) to demonstrate the detection of blood samples in simulated crime scenes. To minimize the background signal from fluorescent biomolecules in blood, dilution was performed with two different components and Raman analysis was performed for four different concentrations of blood. In general, a decrease in noise in the spectra was observed as the blood was diluted. Crime scenes consisting of pure blood, blood diluted with ethanol and distilled water (1:2, 1:4, and 1:8), a blood-mineral water mixture, a blood-cherry juice mixture, and silver nanoparticle-added mixtures were simulated, and their spectra were examined. Chemometric analyses of the data were performed. Despite high noise and low peak intensities, blood-identifying signals were detected when examining different blood concentrations. It was observed that silver nanoparticles provided high enhancement of blood peaks thanks to their strong plasmonic properties.

Incidence of Intra-abdominal Adhesions Following Intraperitoneal Injection of Hemostatic Products in Rabbits.

Definitive management of non-compressible intra-abdominal hemorrhage (NCIAH) currently requires a surgeon and operating room capable of performing damage control surgery. In a wartime scenario or a geographically remote environment, these may not be readily available. In this study, we sought to test the safety of 2 emerging injectable hemostatic agents (CounterFlow and Fast Onset Abdominal Management, or FOAM, poloxamer component) versus normal saline control over a prolonged monitoring duration following administration by a non-surgical provider. The Institutional Animal Care and Use Committee approved all research conducted in this study. We randomized male New Zealand white rabbits into 2 monitoring cohorts of 24 hours and 2 weeks. Each cohort contained 3 treatment groups (n = 4 rabbits/group): CounterFlow, the testable poloxamer component of FOAM, and normal saline control. We injected each treatment intraperitoneally in the left lower abdominal quadrant. Doses were 15 mL/kg for CounterFlow, 6.3 mL/kg for the poloxamer component of FOAM, and 15 mL/kg for normal saline. We conducted all injections under isoflurane anesthesia monitored by trained veterinary staff. Animals were euthanized at each cohort end point, and a veterinary pathologist blinded to treatment type performed necropsy. The primary outcome was incidence of intra-abdominal adhesions at necropsy. Quantitatively, adhesions when present were graded by the veterinary pathologist on a 1 to 4 scale, where "1" represented adhesions involving from 1 to 25% of the examined abdomen, "2" represented from 26 to 50%, "3" represented from 51 to 75%, and "4" represented from 76 to 100%. Qualitatively, adhesions present were graded by degree ("1" = minimal, "2" = mild, "3" = moderate, and "4" = severe) and chronicity ("1" = acute, "2" = subacute, and "3" = chronic). We also drew d-dimer blood values and measured body weights for each animal. Statistical analysis included either repeated measures 2-way ANOVA or a mixed-effects model (in the case of missing data) with Geisser-Greenhouse correction. We adjusted multiple comparisons using Tukey statistical hypothesis tests. In the 2-week cohort, 3 CounterFlow animals showed adhesions judged to be "1" quantitatively. Qualitatively, 2 of these were assessed as "1" for degree of adhesions and the other demonstrated a "2." On the chronicity of adhesions scale, 1 animal demonstrated a "2" and 2 demonstrated a "3." No animals in other groups (FOAM and control) demonstrated adhesions. CounterFlow-treated animals showed a statistically significant rise in d-dimer values in the 24-hour cohort only. In the 2-week cohort, CounterFlow-treated animals showed a decrease in body weight at 24 hours after injection but returned to their baseline (normal) body weights at 7 days. Findings from this study demonstrate that the tested ingredients of FOAM poloxamer component are safe for intraperitoneal injection and hold potential for further study directed toward prehospital non-compressible intra-abdominal hemorrhage management by non-surgical providers. Although CounterFlow produced abdominal adhesions in 3 of 4 rabbits in the 2-week cohort, these were determined to be "minimal" or "mild" in degree.

Protective and therapeutic effects of hesperidin in an experimental colitis model

Ulcerative colitis is a gastrointestinal problem with increasing prevalence. In this study, the effect of hesperidin (commonly found in citrus white peel) on colitis was investigated. For this purpose, 28 Wistar albino female rats, 3–4 months old and weighing between 250–350 g, were used in the study. Rats were randomly divided into four groups: control (n=7), colitis (n=7), protective effect (n=7), and treatment (n=7) groups. Colitis was induced in rats with acetic acid (except control), and hesperidin was then administered at 150 mg/kg for 1 week before and after colitis. At the end of the study, IFN-γ and IL-6 values in blood, TAS, TOS, and OSI in tissue were evaluated. Intestinal tissues were assessed visually by haematoxylin and eosin staining. Our results showed that the levels of IFN-γ and IL-6 were highest in the colitis group and lowest in the treatment group, with statistical significance. The most histopathological damage was seen in the colitis group, while less prevalent in the treatment and control groups. The results of the study show that hesperidin had limited protective and therapeutic effects on experimental colitis mouse models.

Familial Hypokalemic Periodic Paralysis Attack Following SARS‑Cov‑2 Infection: A Case Report

Familial hypokalemic periodic paralysis is a rare disorder that manifests manifests with the sudden onset of flaccid paralysis that is triggered by low levels of blood potassium, which can be caused by various factors such as, rest after intense exercise, or high-carbohydrate foods. This report presents cases of hypokalemic periodic paralysis attack triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A 29-year-old male patient was admitted with quadriparesis, fever, shortness of breath, and sever hypokalemia. The patient had a history of three episodes of Familial hypokalemic periodic paralysis (HPP). Diagnostic tests, such as chest computed tomography scan and polymerase chain reaction test, confirmed SARS-CoV-2 infection. The patient was treated with potassium chloride infusion, spironolactone, and remdesivir, and was eventually discharged from the hospital.in conclusion, SARS-CoV-2 infection can potentially exacerbate HPP and should be considered a risk factor for its occurrence.

Prenatal mercury exposure and the secondary sex ratio: The Japan Environment and Children's Study

Prior research into the association between prenatal mercury (Hg) exposure and the secondary sex ratio has yielded inconclusive and conflicting results. Notably, no study has used cord blood Hg measurement in this context. Also, the differences in Hg species and the potential modifying role of selenium (Se) on this association remain unexplored. Using data from the Japan Environment and Children's Study, we analyzed mother–child pairs with available data for concentrations of total mercury (THg) and Se in maternal blood during late pregnancy, and THg, inorganic mercury (IHg), methylmercury (MeHg), and Se in cord blood. Logistic regression models were employed to examine the association between Hg and Se biomarkers and the secondary sex ratio. Out of the total sample of 3698 children, 1877 (50.8 %) were male, corresponding to an overall secondary sex ratio of 1.03. After adjusting for maternal age and parity, no significant associations were observed between THg concentrations of maternal blood and the secondary sex ratio. Nevertheless, we identified that two-fold increases in THg, IHg, and MeHg concentrations in cord blood were positively associated with increased odds of having a male child, yielding adjusted odds ratios of 1.13 (95 %CI: 1.04, 1.22), 1.12 (1.03, 1.21), and 1.12 (1.03, 1.22), respectively. When stratified by the median Se concentrations, no apparent differences were detected in the associations between Hg concentrations and the secondary sex ratio. In summary, elevated Hg concentrations in cord blood, but not maternal blood, were associated with an increased probability of male births.

Primary aldosteronism with hypokalemic rhabdomyolysis: a case report and review of the literature

BackgroundHypokalemic rhabdomyolysis is a rare clinical manifestation of primary aldosteronism, making its diagnosis challenging, particularly when it becomes the primary presenting symptom. Herein, we present a case of primary aldosteronism with hypokalemic rhabdomyolysis and conduct a related literature review.Case presentationWe report the case of a 54-year-old Chinese male patient who presented with intermittent weakness over the past year and was admitted with sudden limb paralysis for 2 days. The final diagnosis was primary aldosteronism accompanied by hypokalemic rhabdomyolysis syndrome. By reviewing the related Chinese and English literature, we noticed that only a few cases were published since 1978. After excluding irrelevant literatures, we summarized and analyzed 43 patients of with primary aldosteronism accompanied by hypokalemic rhabdomyolysis syndrome. All patients showed good recovery, with normalized blood potassium levels, and a majority achieved normalized blood pressure. Some patients still required medication for blood pressure control.ConclusionsPrimary aldosteronism rarely causes rhabdomyolysis; the occurrence of severe hypokalemia and rhabdomyolysis should prompt consideration of primary aldosteronism in the differential diagnosis. Early detection and treatment are crucial for determining patient prognosis.

Solid-State Electrodes Towards a Real-Time Sensor Array for Health Monitoring

The healthcare industry has been transformed by advances in biotechnology, resulting in improved health outcomes. Central to this has been advances in medical diagnostics that can both monitor patients as well as provide actionable data at the point-of-care. However, further improvements are needed to maximize the utility of diagnostics at times where acute care may be required, such as when individuals are unstable after experiencing physical trauma. When medical resources are limited, the ability to rapidly and effectively triage patients that have experienced trauma is critical to maximizing health outcomes. Notably, individuals that have experienced significant trauma can degrade quickly. Therefore, continuous monitoring approaches are needed that can provide critical biometric and biomarker information that will enable updating of the triage in real-time.At present time, patients are assessed continuously using biometric monitoring. However, biometrics are often a lagging indicator to biochemical markers, and thus while easier to measure, less informative. Currently, the ISTAT-8 is a point-of-care unit to perform an automated, rapid biochemical panel that can assess the patient’s ability to maintain homeostasis by monitoring eight biomarkers. However, the ISTAT-8 captures biochemical data only at a point in time instead of continuously; this is a drawback, as the health of patients who have undergone trauma can improve or deteriorate rapidly. Therefore, a continuous biochemical monitoring solution is needed to allow for triage to happen in real-time.Advances in biotechnology have for the first time made real-time biochemical sensing a reality. Unfortunately, commercial continuous biochemical sensors to-date are limited to subcutaneous continuous glucose monitors (CGMs). CGMs monitor glucose concentrations in the interstitial fluid (ISF), which strongly correlates to blood values. While the CGM is now commonly used, the current devices are not easily multiplexed. Therefore, a scalable, easy to insert system is needed to perform multiplexed measurements; microneedle-based platforms have the promise to enable sensing in the ISF leveraging five or more distinct sensors.Here we present a solid-state platform that can enable multiplexed sensing leveraging hollow, wicking microneedles in fluidic contact with solid-state electrodes. Our approach leverages optimized sensor formulations and electrode materials fabricated onto a printed circuit board (PCB). The putative sensor array can be produced in a modular fashion leveraging scalable technologies and processes. Notably, this talk focuses on methods and approaches to fabricate an array of solid-state sensors that are capable of detecting ions and metabolites over extended periods (> 1 week) and can be readily integrated with microneedles for sensing interstitial fluid.

Urine dipstick blood and acute kidney injury in infants undergoing cardiopulmonary bypass.

Cardiopulmonary bypass (CPB) is associated with hemolysis and acute kidney injury (AKI). The study aim was to determine if urine dipstick blood in infants after CPB was associated with AKI and urine neutrophil gelatinase-associated lipocalin (NGAL). Infants who underwent CPB at a single center were enrolled prospectively between October 2017 and June 2019. Urine samples prior to CPB and 6h after CPB cessation were analyzed in batch for NGAL and dipstick blood. AKI was defined using creatinine-based KDIGO criteria within 72h of CPB. Spearman correlation examined associations between urine dipstick blood and NGAL at each time point. Linear regression estimated the associations between urine dipstick blood and log-transformed NGAL 6h after CPB. Logistic regression estimated associations and compared discrimination between urine dipstick blood and NGAL for predicting AKI. At baseline, 7/63 samples (11%) had > trace blood. Six hours after CPB, 62/98 samples (63%) had > trace blood and 26% had 3 + (large) blood. In total, 18/98 (18%) with a 6-h post-CPB sample had postoperative AKI. Urine dipstick blood values correlated with urine NGAL 6h after CPB (r = 0.52, p < 0.01), but not at baseline (r = 0.06, p = 0.66). Those with 3 + (large) blood on urine dipstick had 6 times higher mean NGAL values compared to those with negative/trace blood (mean ratio 6.6, 95%CI 3.1-14.4, p < 0.01). Those with 3 + (large) blood had 8 times higher odds of AKI (OR 7.99, 95%CI 1.5-41.9, p = 0.01). Urine dipstick blood post CPB may be a simple and inexpensive tool to help predict AKI in infants.

Evaluation of Anti-Thyroperoxidase (A-TPO) and Anti-Thyroglobulin (A-Tg) Antibodies in Women with Previous Hashimoto's Thyroiditis during and after Pregnancy.

Background/Objective: Autoimmune thyroid diseases (AITD) affect 2 to 5% of the general population. This study aimed to determine changes in activity of A-Tg and A-TPO antibodies before, during, and after pregnancy in women with previous AITD. Methods: This was a single-center study with a retrospective review of the medical records of 30 female patients aged 25-41 years who came to our endocrinology service in the city of Santo André, state of São Paulo, Brazil, to investigate thyroid diseases. The following data were reviewed: total triiodothyronine (totalT3), total thyroxine (totalT4), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and anti-TSH receptor antibodies (anti-TSH receptor or anti-thyrotropin receptor antibodies (TRAb), anti-thyroid peroxidase (A-TPO), and anti-thyroglobulin (A-Tg)). These data were reviewed for 30 patients before and during the three trimesters of pregnancy and during the three months after pregnancy. Results: During gestation, we observed a progressive decrease in the blood values of A-TPO and A-Tg, which reached their lowest values in the third trimester of pregnancy, but after birth, they returned to values statistically equivalent to those before pregnancy. Analyzing the three trimesters and the post-pregnancy period, A-TPO increased 192% between the first trimester and postpartum (p = 0.009); it increased 627% between the second trimester and postpartum (p < 0.001); and it increased >1000% between the third trimester and postpartum (p < 0.001). There was no significant difference in the A-TPO values between the pre- and post-gestational periods (p = 1.00), between the first and second trimesters (p = 0.080), or between the second and third trimesters (p = 0.247). Conclusions: According to the results presented here, we observed changes in the activities of A-Tg and A-TPO antibodies during and after pregnancy in women with previous AITD. In women who intend to become pregnant, are pregnant, or have given birth within three months, it is essential to monitor A-TPO, A-Tg, and thyroid function as well as serum thyroid hormones and TSH to identify thyroid dysfunction in a timely manner and adjust the treatment strategy to avoid the deleterious effects of hypothyroidism on both mother and baby during and after pregnancy.