Cell Count Analysis Research Articles

Comparative Analysis of Clinical Parameters and Sputum Biomarkers in Establishing the Relevance of Filamentous Fungi in Cystic Fibrosis.

BackgroundThe relationship between fungal culture (FC) positivity and airway inflammation in CF is largely unknown. Identifying the clinical significance of filamentous fungi in CF using both clinical parameters and biomarkers may change our antimicrobial therapeutic strategies.ObjectivesTo investigate the clinical characteristics and airway biomarker profile in relation to the detection of filamentous fungi in respiratory samples obtained from CF patients.MethodsA prospective cohort study over 24 months, including children and adults with CF. Participants provided sputum and/or bronchoalveolar lavage samples, which underwent processing for bacterial and fungal culture, leukocyte differential cell count and biomarker analysis for neutrophil elastase (NE), interleukin-8 (IL-8), galactomannan and tumor necrosis factor receptor type 2 (TNF-R2). We performed FC using neat sputum plugs, an approach shown to be more sensitive compared to routine laboratory testing.ResultsSixty-one patients provided 76 respiratory samples (72 sputum and 4 BAL). Median age was 17 years (range 6 months–59 years). FC positivity was noted in 49% of the cohort. FC positivity was greater during pulmonary exacerbation compared to the stable state (67 versus 50%). Participants aged 5–30 years had a lower FEV1 within the FC positive group. A significant association between FC positivity and non-tuberculosis mycobacterial (NTM) culture was observed on non-parametric testing (p = 0.022) and regression analysis (p = 0.007). Exposure to indoor mold was a predictor for FC positivity (p = 0.047). There was a trend towards increased lung clearance index (LCI), bronchiectasis and intravenous antibiotic use in the FC positive group. There was no significant difference in biomarkers between FC positive and negative patients.Conclusion Aspergillus. fumigatus is the commonest filamentous fungi cultured from CF airways. We found no difference in the airway biomarker profile between FC positive and negative patients. The role of galactomannan and TNFR2 as fungal specific biomarkers in CF remains uncertain. FC positivity is associated with a lower FEV1 in younger patients, a lower LCI, NTM positivity, bronchiectasis, and intravenous antibiotic exposure. Larger trials are needed to determine the role of galactomannan and TNF-R2 as potential fungal biomarkers in CF.

Quality profile of milk from high producing dairy cows vaccinated against mastitis

One of the raw milk quality criteria is the count of somatic cells, produced by the cow’s immune system to fight infectious diseases of the mammary gland. The paper presents the analysis of somatic cell count and total bacteria count of milk from cows, vaccinated against mastitis using Startvac vaccine. Tests were performed as a comparison between a dairy unit and a farm under different management conditions and using different milking techniques. Six months after the start of the vaccine application the somatic cell count at the dairy unit decreased by 60 thousand/ml, at the farm by 182 thousand/ml. The agent profile was represented by the following bacteria: Entеrococcus faecium, Staphylococcus aureus, Streptococcus spp., Pseudomonas aeruginosa. Staphylococcus saprophyticus, Staphylococcus epidermidis, Entеrococcus faecalis, Escherichia coli, Bacillus, Lactobacillus were also isolated from udder secretion. After a year of immunization somatic cell count both at the unit and on the farm decreased by 245 and 216 thousand/ml respectively; it is noteworthy that 43.75% of microflora isolated from mammary gland secretion was represented by Streptococcus spp. After two years of the vaccine use the somatic cell count was equal to 371 and 725 thousand/ml at the unit and on the farm respectively. Tests of mammary gland secretions revealed Streptococcus spp. in 27.27% of cases, Staphylococcus aureus and Entеrococcus faecium were isolated in 18.18% of tested samples. It was established that after three years of the vaccine use the major cause of mastitis in cows was Streptococcus spp. (55.00%). During four years of tests, a downward trend in somatic cell count of bulk milk from high producing dairy cows as well as in the number of agents responsible for inflammation in a mammary gland was detected. Somatic cell count of milk from vaccinated animals decreased by 286 and 432 thousand/ml at the unit and on the farm respectively. During the test period Staphylococcus aureus isolation rate declined by 19.41%.

Factors Associated with Sample Rejection for CD4+/CD8+ T Cell Count Analyses at the Kenyatta National Hospital Comprehensive Care Center Laboratory, Kenya

Factors Associated with Sample Rejection for CD4+/CD8+ T Cell Count Analyses at the Kenyatta National Hospital Comprehensive Care Center Laboratory, Kenya

Real-time red blood cell counting and osmolarity analysis using a photoacoustic-based microfluidic system.

Counting the number of red blood cells (RBCs) in blood samples is a common clinical diagnostic procedure, but conventional methods are unable to provide the size and other physical properties of RBCs at the same time. In this work, we explore photoacoustic (PA) detection as a rapid label-free and noninvasive analysis technique that can potentially be used for single RBC characterization based on their photoabsorption properties. We have demonstrated an on-chip PA flow cytometry system using a simple microfluidic chip combined with a PA imaging system to count and characterize up to ∼60 RBCs per second. Compared with existing microfluidic-based RBC analysis methods, which typically use camera-captured image sequences to characterize cell morphology and deformation, the PA method discussed here requires only the processing of one-dimensional time-series data instead of two- or three-dimensional time-series data acquired by computer vision methods. Therefore, the PA method will have significantly lower computational requirements when large numbers of RBCs are to be analyzed. Moreover, we have demonstrated that the PA signals of RBCs flowing in a microfluidic device could be directly used to acquire the osmolarity conditions (in the range of 124 to 497 mOsm L-1) of the medium surrounding the RBCs. This finding suggests a potential extension of applicability to blood tests via PA-based biomedical detection.

Joint Modelling of the Relationship between CD4 Cell Count and Survival Analysis of HIV Infected Patients Receiving Antiretroviral Therapy, Gweru, Zimbabwe

Introduction: The main objective of this research is to apply joint modelling technique to assess the relationship between cd4 cell count and survival of ART patients in Gweru, Zimbabwe. The Cox proportional hazards model is mainly used in modelling survival data when the true values of the time-varying covariates are observed. However, most of these measurements are observed with error and to circumvent this problem, measurements are taken longitudinally to reduce the bias caused using such observed measurements in the Cox proportional hazards models. Methods: We conducted secondary data analysis on the Gweru district ART cohort data for the period 2006 to 2010. The association between CD4 cell count and survival time of the patient was determined using a joint longitudinal-survival model. The factors that affected cd4 cell changes were determined using mixed linear regression model and factors associated with survival of ART patients was determined using a Cox proportional hazard model. Shared parameters were used to determine the association between cd4 cell count and survival of the ART patient. Results: A statistically significant direct effect of gender on survival was observed -0.003 (95% CI: -001, -0.002). Also, a highly negative significant association was observed -9.48 (95% CI: -11.7, -7.23), indicating that female patients with high levels of lncd4 had reduced hazard of death compared to male patients. Place of residents of the ART patient had a significant direct effect on survival -0.66 (95% CI: -0.01, 0.003). There is also a highly negative significant association -10.0 (95% CI: -12.4, -7.67), indicating that patients in urban areas and with high lncd4 cell counts had a reduced hazard of death compared to patients in rural areas. Age had a direct effect on survival as the hazard of death increases as we move from one age group to another. A highly negative significant association was observed -9.4 (95% CI: -11.6, -7.17) indicating that the hazard of death for patients with high lncd4 decreases as we move down the age groups.

Evaluation of the effectiveness and safety of N-Chromosome Royal Jelly on the number of peripheral white blood cells in patients with acute lymphoblastic leukemia

Objectives: This study to investigate the immune response blood cells following N-Chromosome RJ administration in patients with childhood ALL.
 Methods: This single center before and after 12-weeks clinical trial was done in Ali-Asghar Children Hospital on twenty-six patients diagnosed with ALL during maintenance phase of chemotherapy. After collecting their demographics, patients received a starter dose of 2-gram processed new natural N-chromosome RJ before breakfast and were followed up each 2 weeks, counting their peripheral WBC, ANC and ALC by a blood cell count and differential analysis.
 Results: A total of Twenty-six patients were enrolled in this study (16 males and 10 females). Mean Peripheral WBC count of total patients were raised significantly after administering N-RJ Being 2510 ±1192 cells per cubic millimeter at the beginning and then raised to 4549±1500 cells per cubic millimeter at the end of trial. (P<0.005) None of patients suffered from any adverse reaction during the trial.
 There was a positive statistical relationship between total peripheral WBC, ANC and ALC count and N-Chromosome Royal jelly increased dosage, Being more prominent at the beginning of trial (p<0.001) and the last two weeks of follow-ups. (p<0.0005)
 Conclusion: This study has successfully demonstrated that N-chromosome RJ can be a promising immune- enhancing supplement in patients diagnosed with acute lymphoblastic leukemia in their complete remission and maintenance therapy time. In addition, it is a natural alternative for drugs like G-CSF, but without those long-term adverse effects, we can see in G-CSF drugs.

The prognostic value of general laboratory testing in patients with COVID-19.

BackgroundLymphocyte count (LYM) of peripheral blood and some indices of general biochemical analysis had diagnostic and prognostic value for coronavirus disease 2019 (COVID‐19), and the value of other remaining indices is rare.MethodsA total of 94 patients with COVID‐19 were enrolled at Renmin Hospital of Wuhan University. According to the severity of COVID‐19, the patients were divided into three groups (moderate 49, severe 35, and critical 10), and 40 healthy cases were enrolled in the same period as healthy controls. The diagnostic and prognostic value of indices in peripheral blood cell count and general biochemical analysis was analyzed.ResultsCompared with healthy cases, the value differences in peripheral blood analysis in patients with COVID‐19 were statistically significant (p < 0.01), the differences in LYM, neutrophil count (Neu), platelet count (PLT), and white blood cell count (WBC) were statistically significant among different severity of COVID‐19 (p < 0.05). Compared with healthy cases, the differences in general biochemical results in patients with COVID‐19 were statistically significant (p < 0.01), the value differences in direct bilirubin (DBIL), low‐density lipoprotein cholesterol (LDL‐Ch), and nitrogen (urea) were statistically significant among different severity of COVID‐19 (p < 0.05). Neutrophil/lymphocyte ratio (NLR) had higher sensitivity and specificity for COVID‐19 diagnosis.ConclusionsSome indices of peripheral blood cell count and general biochemical analysis were valuable in discriminating COVID‐19 and predicting severity and adverse outcome of patients with COVID‐19. For clinician, it is better to use more economical and easy‐to‐get indices to diagnose and predict the prognosis of COVID‐19.

Dynamic Leukocyte Populations Are Associated With Early- and Late-stage Lesions in Hidradenitis Suppurativa.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition typically targeting the axillary and anogenital regions of the body. The massive inflammatory cell infiltrate produced in this cryptogenic condition has led investigators in the attempt to link particular inflammatory cell fractions and cytokines to disease development, and ultimately to disease treatment. This study qualitatively and quantitatively analyzes the white blood cell fractions of macrophages, B-lymphocytes, T-lymphocytes, plasma cells, and granulocytes in 104 HS lesions on formalin-fixed paraffin-embedded tissues using immunohistochemistry (IHC). Four dermis-associated epithelial categories were investigated from persons with HS: 15 unaffected HS skin (US), 19 distended but unruptured follicle epithelium (UF), 62 migrating stratified squamous epithelium (MSSE) from ruptured follicles, and 35 degraded migrating epithelial sheets (DMES). In addition, 27 control skin (CS) from persons without HS were evaluated. Analysis of cell counts indicated that non-migratory dermal epithelium (CS, US, and UF) stimulated very little inflammatory response. However, contrary to previous studies which indicated macrophages to be the chief inflammatory cell in HS, this study showed that plasma cells were the primary cell type present in early-stage HS lesions (MSSE), whereas granulocytes were the major cell population seen in late-stage HS lesions (DMES).

Evaluation for septic arthritis of the native adult knee is aided by multivariable assessment.

Evaluation of suspected septic arthritis of the native adult knee is a common diagnostic dilemma. Pre-aspirate criteria predictive of septic arthritis do not exist for the adult knee and investigations of aspiration results (cell count, differential, gram stain and crystal analysis) have been limited to univariate analyses. Given numerous clinical variables inform the risk of septic arthritis, multivariable analysis that incorporates all clinically available information is critical to allowing accurate decision-making. We retrospectively identified 455 cases of potential septic arthritis of a native adult knee at a tertiary health system from 2012 to 2017, of which 281 underwent aspiration. We recorded demographics, comorbidities, history, exam, laboratory, and radiographic data. Among aspirated cases, we performed univariate analyses of all variables for association with septic arthritis followed by multivariable logistic regression analysis. Septic arthritis was confirmed in 61 of 281 patients who underwent aspiration. Independent associations of risk for septic arthritis included synovial fluid WBC≥30,000 (Odds Ratio 90.8, 95% Confidence Interval 26.6-310.1, p<0.001), bacteria reported on synovial fluid gram stain (OR 21.5, 95% CI 3.9-119.2, p<0.001), duration of pain >2days (OR 6.9, 95% CI. 2.3-20.9, p<0.001), history of septic arthritis at any joint (OR 5.0, 95% CI 1.1-23.4, p=0.039), clinical effusion (OR 4.8, 95% CI 1.2-20.0, p=0.030). Independent associations protective against septic arthritis included presence of synovial fluid crystals (OR 0.1, 95% CI 0.1-0.4, p<0.001). The multivariable model was highly accurate in discriminating between septic and aseptic cases (AUC=0.942). A web-based tool was created to aid clinical decision-making. When evaluating for septic arthritis of a native adult knee, several independent associations were identified for variables related and unrelated to joint aspiration. The associated multivariable model discriminated very well between patients with and without septic arthritis, outperforming previous univariate assessments. A web-based tool was created that estimates the probability of septic arthritis based on this model. This may aid decision-making in complex clinical scenarios.

A história e o processo da produção da cerveja: uma revisão

A cerveja é considerada uma das bebidas mais populares entre as que são consumidas mundialmente, perdendo somente para água e café. Ela é produzida por meio da fermentação do mosto cervejeiro proveniente do malte da cevada, e água potável por incremento da levedura e adição do lúpulo. Para fabricar uma boa cerveja, é necessária uma excelente técnica de criação – o sabor e o aroma da cerveja estão diretamente ligados às leveduras escolhidas. Atualmente, cepas de Saccharomyces cerevisiae são utilizadas nos processos de produção. Essas culturas selecionadas tendem a aperfeiçoar o processo e a intensificar a qualidade da matéria-prima. São imprescindíveis as análises da fabricação durante o processo. É importante a realização do teste de iodo de modo a verificar se todo o açúcar foi convertido. Após a maturação, é fundamental analisar o teor alcoólico, pois esse indica a porcentagem de álcool presente na amostra. As análises de densidade, pH, cor, turbidez e contagem de células também são essenciais, já que auxiliam na verificação da qualidade da cerveja. O presente artigo tem como objetivo realizar uma revisão de literatura com ênfase na fabricação da cerveja e nas principais análises necessárias para garantir a qualidade do produto durante o processo, bem como a qualidade final.

MiR-379 inhibits proliferation and induces apoptosis in multiple myeloma by targeting Y-box binding protein 1

Purpose: To determine the effect of miR-379 in multiple myeloma.Methods: Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to evaluate the expression of miR-379 in multiple myeloma cells. The effect of miR-379 on multiple myeloma progression was investigated by cell counting, bromodeoxyuridine staining, flow cytometry and Western blot analysis. A potential target for miR-379 was determined using a luciferase reporter assay.Results: MiR-379 expression was reduced in multiple myeloma cells, while over-expression of miR-379 increased both cell viability and proliferation of these cells (p &lt; 0.05). Moreover, miR-379 blocked cell cycle multiple myeloma cells and promoted apoptosis by decreasing Bcl-2 expression, and increasing the expression of cleaved caspase-3 and Bax. MiR-379 bound to Y-box binding protein 1 (YBX1) and reduced YBX1 mRNA and protein expression in multiple myeloma cells (p &lt; 0.05).Conclusion: A YBX1-mediated tumor-suppressive role for miR-379 in multiple myeloma cells has been identified, suggesting a potential strategy for the treatment of multiple myeloma.&#x0D; Keywords: MiR-379, Y-box binding protein 1, Multiple myeloma, Proliferation, Apoptosis

Establishing a Nucleated Count Reflex Trigger for Performing Cell Differential on Cerebrospinal Fluid in Pediatric Patients

Abstract Introduction Analysis of cerebrospinal fluid (CSF) assists in the diagnosis of several disease processes affecting the central nervous system (CNS). Nucleated cell (NC) count and cell differential are two important components of laboratory testing performed to analyze CSF samples. These tests can help diagnose conditions such as infection, inflammation, and malignancy involving the CNS; however, the cell differential, performed manually on a cytospin, is labor-intensive and may divert laboratory resources. Currently, the laboratory at our tertiary care pediatric hospital performs both NC count and cell differential on all specimens submitted for CSF cell count analysis. We hypothesized that when the NC count is low (&amp;lt;10/mcl), performing manual cell differential does not provide clinically meaningful information and leads to unnecessary testing, increasing the turnaround time and decreasing precision. In this study, we investigated the utility of performing a manual differential on CSF when the NC count is ≤10/mcl and the need to establish reflex criteria for performing a cell differential. Methods Data were extracted from our electronic medical record database. We searched for all CSF samples that were submitted to our pediatric hospital’s laboratory for cell count analysis from September 2019 to January 2020. NC count, red blood cell (RBC) count, and number of cells available for differential (€œcells diffed) on cytospin, to a maximum of 100 cells per specimen, were obtained for each sample. Results A total of 577 CSF samples from 332 patients were submitted and analyzed for cell counts, of which 471 (82%) had NC count ≤10/mcl. There was a significant moderate positive correlation between NC count and cells diffed (Pearson correlation coefficient, 0.45, P-value &amp;lt;0.001). Of these 471 samples, 24 (5%) showed evidence of peripheral blood contamination (&amp;gt;500/mcl RBCs in samples with NC = 0/mcl, &amp;gt;500 x (NC count)/mcl RBCs in samples with NC &amp;gt; 0/mcl). A total of 4 cases from two patients with NC ≤10/mcl (0.8%) showed blasts on manual differential. Both patients had B-lymphoblastic leukemia/lymphoma and were being evaluated for CNS involvement with concurrent cytology. One patient was diagnosed as negative for CNS involvement by cytology. The sample for manual differential was contaminated by peripheral blood, hence the presence of blasts did not represent CNS disease. The second patient had the remaining 3 positive samples and was diagnosed with CNS involvement by cytology on multiple follow-ups. Conclusion Performing CSF manual differential when NC &amp;lt; 10/mcl does not provide additional clinically actionable information and is associated with a lower cell yield on the cytospin. Establishing a NC count cutoff for performing manual differential will prevent unnecessary testing, decrease turnaround time, and increase precision. Exceptions may be necessary for oncology patients at high risk for CNS involvement.

Animal-Free Human Whole Blood Sepsis Model to Study Changes in Innate Immunity.

Studying innate immunity in humans is crucial for understanding its role in the pathophysiology of systemic inflammation, particularly in the complex setting of sepsis. Therefore, we standardized a step-by-step process from the venipuncture to the transfer in a human model system, while closely monitoring the inflammatory response for up to three hours. We designed an animal-free, human whole blood sepsis model using a commercially available, simple to use, tubing system. First, we analyzed routine clinical parameters, including cell count and blood gas analysis. Second, we demonstrated that extracellular activation markers (e.g., CD11b and CD62l) as well as intracellular metabolic (intracellular pH) and functional (generation of radical oxygen species) features remained stable after incubation in the whole blood model. Third, we mimicked systemic inflammation during early sepsis by exposure of whole blood to pathogen-associated molecular patterns. Stimulation with lipopolysaccharide revealed the capability of the model system to evoke a sepsis-like inflammatory phenotype of innate immunity. In summary, the presented model serves as a convenient, economic, and reliable platform to study innate immunity in human whole blood, which may yield clinically important insights.

Does cystoscopy method affect the investigation of bladder pain syndrome/interstitial cystitis?

Introduction and hypothesisCystoscopic investigation to identify associated histological findings of increased mast cells in the detrusor muscle has been recommended by the European Society for the Study of Bladder Pain Syndrome (ESSIC) in the investigation of bladder pain syndrome/interstitial cystitis (BPS/IC). The aim of this study was to identify if the cystoscopy approach impacts the biopsy results when investigating women presenting with symptoms of BPS/IC.MethodsWe performed a single-centre retrospective analysis of 300 bladder biopsy reports from 2015 to 2018 from women undergoing cystoscopy for BPS/IC. Biopsies obtained using closed cup forceps through a flexible (FC) or rigid cystoscope (RC) were compared.ResultsFifty-eight FC biopsies were compared with 242 RC biopsies. FC biopsies had a smaller mean diameter (1.6 mm vs 2.9 mm p < 0.01) and volume (4.1 mm3 vs 9.6 mm3p < 0.001) compared with RC biopsies. There was no significant difference in the histological depth of sampling to the muscularis propria. A total of 292 samples had CD117 immunohistochemical staining for mast cell count (MCC) analysis. The MCC/mm2 was significantly lower in FC biopsies (p < 0.01). Sixteen percent of FC samples compared with 60% of RC samples had a high MCC >28/mm2 (p < 0.01). There was no significant difference in positive microbiology culture between FC (21%) and RC (28%) sampling.ConclusionRigid and flexible cystoscopy can be used to investigate BPS/IC as recommended by international societies. However, the biopsy method impacts the mast cell count analysis, which can influence diagnosis and management. Therefore, RC would be the optimal investigation.

A significant decrease in hemoglobin concentrations may predict occurrence of necrotizing enterocolitis in preterm infants with late-onset sepsis.

ObjectiveThis study aimed to examine the clinical value of a decrease in hemoglobin concentration (HC) after the onset of sepsis for predicting occurrence of necrotizing enterocolitis (NEC) in preterm infants with late-onset sepsis.MethodsWe performed a retrospective cohort study between January 2015 and January 2020. Premature neonates (gestational age <37 weeks) with late-onset sepsis (age >3 days) were enrolled. According to the degree of reduction in HC, neonates were divided into the non-decrease group, mild decrease group, and severe decrease group. Demographic data, perinatal conditions, blood cell count analysis, blood culture, and treatment measures were compared.ResultsEighty premature infants with sepsis were studied. The mortality rate and incidence of NEC were significantly higher in the severe decrease group than in the non-decrease and mild decrease groups. Significant differences were observed in the decrease in HC, red blood cell transfusion, and ventilator application between the NEC and non-NEC groups. A significant decrease in HC was an independent risk factor for NEC in preterm infants with sepsis.ConclusionA significant decrease in HC is an independent risk factor for NEC and may predict the occurrence of NEC in preterm infants with sepsis.

Clinical leishmaniosis in a captive Eurasian otter (Lutra lutra) in Spain: a case report

BackgroundCaptive and free-ranging wild mammals have been recognized as potential reservoirs of Leishmania infantum infection. The aim of this study was to describe the first clinical case of leishmaniosis in the Eurasian otter.Case presentationA case of clinical leishmaniosis is reported in a 4-year-old male Eurasian otter housed at a wildlife park (Murcia, South Eastern Spain). The Eurasian otter showed bilateral epistaxis, anorexia, apathy, and weight loss. A complete blood cell count and biochemical analyses revealed hyperproteinemia, hyperglobulinemia, decreases of paraoxonase-1, increases of haptoglobin and ferritin, and proteinuria. Bilateral nephropathy with hydronephrosis, mesenteric lymphadenomegaly, and ascites were also observed. L. infantum infection was confirmed by microscopy (amastigotes were detected in macrophages from spleen aspirate), molecular diagnosis (L. infantum DNA was detected by real-time polymerase chain reaction), and serology (anti-Leishmania IgG2 antibodies were detected by time-resolved immunofluorometry). The animal was treated with allopurinol for 3 months and gained weight, the epistaxis disappeared, and the ferritin concentration decreased.ConclusionsThis is the first report of clinical leishmaniosis in the Eurasian otter. Our results suggest that Eurasian otters are susceptible to infection with L. infantum and can develop clinical leishmaniosis in endemic areas.

Assessment of clinical and hematological profile in dengue fever

Background: Dengue is one of the most important viral diseases especially in the tropical regions. According to the WHO almost 50 million people get dengue infection annually and WHO estimates almost half of the world’s population lives in countries having endemicity for dengue infection. This study is an attempt to elucidate the positive laboratory profile of serologically diagnosed dengue patients so as to facilitate early diagnosis, treatment, management and vector control measures, to reduce the morbidity and mortality because of this disease.Methods: This study was conducted on 80 indoor patients. Patients presenting to the emergency department, outpatient department (OPD) or pediatric OPD with complaints of fever and clinical features of dengue with positive NS1 antigen test or dengue antibody serology IgM or IgG or both were included in the study. Hemogram was done on automated cell counter analyzer (Sysmex XP 100) which included hemoglobin, hematocrit, total leucocyte count (TLC), differential leucocyte count (DLC) and platelets count.Results: Raised hematocrit (&gt;47%) was noted in 10 (16.6%) of patients at presentation and the hematocrit ranged from 20- 51%. The total leukocyte count ranged from 1500 cells/cumm to &gt;11000 cells/cumm. Leucopenia with less than 4000 cells/cumm was present in 25 % cases. In the present study out of 80 cases of dengue fever, 85% cases had thrombocytopenia and 15% cases had severe thrombocytopenia (&lt; 20,000/cumm) with bleeding manifestations.Conclusions: Hemoconcentration, leucopenia, thrombocytopenia, and raised liver enzymes SGOT and SGPT along with reactive/ plasmacytoid lymphocytes on peripheral smear gives enough clues to test for dengue serology so that dengue cases can be diagnosed in their initial stages.

An In Vitro Hemodynamic Loop Model to Investigate the Hemocytocompatibility and Host Cell Activation of Vascular Medical Devices

In this study, the hemocompatibility of tubes with an inner diameter of 5 mm made of polyvinyl chloride (PVC) and coated with different bioactive conjugates was compared to uncoated PVC tubes, latex tubes, and a stent for intravascular application that was placed inside the PVC tubes. Evaluation of hemocompatibility was done using an in vitro hemodynamic loop model that is recommended by the ISO standard 10993-4. The tubes were cut into segments of identical length and closed to form loops avoiding any gap at the splice, then filled with human blood and rotated in a water bath at 37 °C for 3 hours. Thereafter, the blood inside the tubes was collected for the analysis of whole blood cell count, hemolysis (free plasma hemoglobin), complement system (sC5b-9), coagulation system (fibrinopeptide A), and leukocyte activation (polymorphonuclear elastase, tumor necrosis factor and interleukin-6). Host cell activation was determined for platelet activation, leukocyte integrin status and monocyte platelet aggregates using flow cytometry. The effect of inaccurate loop closure was examined with x-ray microtomography and scanning electron microscopy, that showed thrombus formation at the splice. Latex tubes showed the strongest activation of both plasma and cellular components of the blood, indicating a poor hemocompatibility, followed by the stent group and uncoated PVC tubes. The coated PVC tubes did not show a significant decrease in platelet activation status, but showed an increased in complement and coagulation cascade compared to uncoated PVC tubes. The loop model itself did not lead to the activation of cells or soluble factors, and the hemolysis level was low. Therefore, the presented in vitro hemodynamic loop model avoids excessive activation of blood components by mechanical forces and serves as a method to investigate in vitro interactions between donor blood and vascular medical devices.

Eosinophil/Neutrophil/Platelet-to-Lymphocyte Ratios in Various Types of Immediate Hypersensitivity to NSAIDs: A Preliminary Study

Background: The eosinophil/neutrophil/platelet-to-lymphocyte ratios (ELR, NLR, and PLR) have been used as clinical markers of systemic inflammation. However, they have not yet been tested in various subtypes of immediate hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs). Objectives: To assess the ELR, NLR, and PLR in various types of hypersensitivity to NSAIDs. Materials and Methods: A retrospective analysis of complete blood cell count and the ELR, NLR, and PLR was performed. Appropriate types of hypersensitivity to NSAIDs were diagnosed based on the anamnesis and drug provocation tests. The analysis covered 97 patients. Twenty were diagnosed with NERD (NSAID-exacerbated respiratory disease), 20 with NECD (NSAID-exacerbated cutaneous disease), 38 with NIUA (NSAID-inducted urticaria/angioedema), and 19 with SNIUAA (single-NSAID-induced urticaria/angioedema or anaphylaxis). Two controls groups were included: the first covered 15 patients with bronchial asthma and the second 28 patients with chronic spontaneous urticaria without NSAID hypersensitivity. Results: The NLR did not differ significantly between the NSAID hypersensitivity types. The ELR was significantly higher in NERD patients, and the PLR was significantly lower in NECD patients than in patients with other types of NSAID hypersensitivity and in controls. Conclusions: The ELR and PLR may be useful in differentiating various types of immediate hypersensitivity to NSAIDs. Moreover, the ELR may be helpful in differentiating patients with bronchial asthma with and without NSAID hypersensitivity and PLR in differentiating patients with chronic spontaneous urticaria from NECD.

Evaluation of mtr cluster expression in Shewanella RCRI7 during uranium removal.

In recent years, bioremediation is considered as an efficient method to remove the pollutants from the industrial wastewater. In this study, quantitative gene expressions (Real-time RT-PCR) of mtr gene cluster (mtrA, mtrB, mtrC, mtrD, mtrE, mtrF and omcA) in five different uranium concentrations (0.1, 0.25, 0.5, 1 and 2mM) were performed with ICP and microscopic live cell counting analysis under anaerobic condition, by Shewanella RCRI7 as a native bacterium. The results indicated that the amount of uranium removal and live-cell counting were decreased in the higher uranium concentrations (1 and 2mM), due to the uranium toxicity, suggesting 0.5mM as the optimum uranium concentration for Shewanella RCRI7 resistance. The expression of mtrCED and omcA genes presented increasing trend in the lower uranium concentrations (0.1, 0.25 and 0.5mM) and a decreasing trend in 1 and 2mM, while mtrABF, presented an inverse pattern, proving the alternative role of mtrF for mtrC and omcA, as the substantial multiheme cytochromes in Extracellular Electron Transfer (EET) pathway. These data are a proof of these gene vital roles in the EET pathway, proposing them for genetic engineering toward EET optimization, as the certain pathway in heavy metal bioremediation process.