Changes In Leukocyte Counts Research Articles

Leukocyte Count in Solid Organ Transplant Recipients After SARS-CoV-2 mRNA Vaccination and Infection

Background: Solid organ transplant (SOT) recipients are at risk of severe COVID-19. Vaccination is an important preventive measure but may have side effects, including decreased leukocyte counts. We aimed to describe the prevalence and relative incidence of decreased leukocyte counts and changes in leukocyte counts before and after SARS-CoV-2 mRNA vaccination and SARS-CoV-2 infection in SOT recipients. Methods: Changes in leukocyte counts from before to after each vaccine dose were investigated using linear mixed models. We determined the prevalence of decreased leukocyte counts before and after each vaccine dose and before and after SARS-CoV-2 infection. Self-controlled case series analysis was used to investigate whether the period after either vaccination or infection was associated with risk of decreased leukocyte count. Results: We included 228 adult kidney, lung, and liver transplant recipients. Prior to the first vaccine dose, the mean leukocyte count was 7.3 × 109 cells/L (95% CI 6.9–7.6). Both the leukocyte counts, and the prevalence of decreased leukocyte counts remained unchanged from before to after vaccination regardless of the number of vaccine doses provided. There was no association between vaccination and decreased leukocyte counts (incidence rate ratio (IRR): 0.6; 95% CI: 0.2–2.1; p = 0.461). In contrast, SARS-CoV-2 infection was associated with increased risk of a decreased leukocyte count (IRR: 7.1; 95% CI: 2.8–18.1; p < 0.001). Conclusions: SARS-CoV-2 mRNA vaccination was not associated with risk of decreased leukocyte count and did not affect the prevalence of decreased leukocyte counts in SOT recipients. In contrast, SARS-CoV-2 infection was associated with a higher risk of a decreased leukocyte count.

Haematological and Biochemical Profiles, Including Vitamin A and Zinc Status, in Clinical and Subclinical Oriental Theileriosis in Cattle

Aim: The present study investigated the clinical, haematological and biochemical profiles in cattle infected with Theileria orientalis, correlating disease severity with various parameters. Study Design: A total of 32 clinically ill, 10 subclinically infected, and 10 healthy control animals were included. Place and Duration of Study: Department of Veterinary Epidemiology and Preventive Medicine, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Pookode, Wayanad, Kerala, between November 2023 to September 2024. Methodology: Theileria piroplasms, observed via Giemsa staining, appeared as thick and thin rods with trailing cytoplasm and annular, pyriform, garland, and signet-ring shapes. PCR amplification of the T. orientalis major piroplasm surface protein (MPSP) yielded a specific 776 bp product in clinically and subclinically infected animals. Results: Haematological analysis revealed significant anaemia and thrombocytopenia in infected groups, without notable changes in leukocyte counts. Serum protein analysis indicated hypoproteinemia and hypoalbuminemia, while liver enzymes, particularly AST, were elevated in clinically infected cattle, suggesting hepatic involvement. Additionally, serum vitamin A and zinc concentrations were significantly lower in infected cattle, underscoring a possible role for oxidative stress in disease pathogenesis. Conclusion: These findings suggest that T. orientalis infection is associated with multi-systemic impacts, including haematological abnormalities, liver damage, and nutrient deficiencies, which are crucial for accurate diagnosis and effective management strategies.

Clinical, functional and neuropsychological status of joint replacement patients

Introduction The number of hip and knee replacement surgeries is increasing annually in Russia and worldwide. The majority of patients receiving joint arthroplasties are elderly women.The objective was to assess the clinical, functional and neuropsychological status of patients undergoing total knee or hip replacement.Material and methods The study included 448 patients admitted for elective surgery of total knee or hip replacement at the Department of Traumatology and Orthopedics of the Federal Center for High Medical Technologies (CHMT, Kaliningrad Region). Anthropometric parameters of the patients were measured, the medical history and concomitant diseases recorded. Common blood count and biochemistry test were evaluated preoperatively. Neuropsychological examination included assessment of cognitive and executive functions, levels of distress, depression, anxiety and somatization.Results Almost all patients studied were found to have varying degrees of obesity. A typical combination of concomitant pathology in volunteers was stage 2 hypertension, risk degree 2–3, and chronic gastritis in remission. Half of the volunteers showed moderate and high levels of distress, depression, anxiety and somatization. A significant number of volunteers showed moderate to high levels of cognitive decline. Age- and sex-related blood counts were slightly different from the normal ranges for a CBC and biochemistry. Changes in leukocyte count were detected.Discussion Leukocyte counts indicated the osteoarthritis induced inflammatory process in most patients. Mitochondrial dysfunction and aging of the immune system contributed to the “proinflammatory status.” The high rate of cognitive impairment in volunteers was associated with age and comorbidity, cardiovascular conditions, in particular. Distress and anxiety were associated with emotional reactions to surgery.Conclusion The factors reported can affect the duration and course of rehabilitation. The “pro-inflammatory status” of patients can complicate the healing of a postoperative wound. Neuropsychological disorders noted during postoperative rehabilitation can have a significant impact on physical recovery, social and professional adaptation.

IMMUNOENHANCEMENT EFFECTS OF THE HERBAL FORMULA ANTI-U200 ON CYCLOPHOSPHAMIDE-INDUCED IMMUNOSUPPRESSION IN MICE

Anti-U200 is an herbal blend comprising Ganoderma lucidum, Hedyotis diffusa, and Scutellaria barbata is known to have immunomodulatory effects. Objectives: We examined the immuno-enhancing effect of this herbal blend on cyclophosphamide (CYP)-induced immunosuppression. Methods: Swiss mice were assigned to one of five groups: the intact control and four CYP treatment groups (one control, one reference (levamisole), and two with the application of Anti-U200 at different dosages; 1.92 or 5.76 capsules/kg). Mice received one of the experimental treatments after being injected with CYP to induce myelosuppression and immunosuppression. Results: Anti-U200 therapy improved lymphoid organ atrophy in histological assessments and ameliorated the CYP-induced decreases in spleen and thymus weights in immunosuppressed animals. It also led to beneficial changes in leucocyte counts and boosted TNF-α and IgM serum levels. Conclusions: We have proven that Anti-U200, a combination of three immunomodulatory herbs, is an efficient immunomodulatory agent that can strengthen the immune system.

Unnecessary repetitions of C-reactive protein and leukocyte count at the emergency department observation unit contribute to higher hospital admission rates.

The aim of the present study was to assess the effect of repeated laboratory measurement of C-reactive protein (CRP) and leukocyte count on the decision whether to admit or dicharge the patient with localized infections who received antibiotics at the Emergency Department (ED) observation unit. Adult patients with respiratory, urinary tract and abdominal infections, observed at the ED after antibiotic administration, in whom repeated measurements of CRP and leukocyte count were performed within 24 h, were included. They were initially grouped as planned discharge, planned admission and unclear attitude towards admission. Initial and repeated CRP and leukocyte count results, clinical dynamics (improvement, worsening, unchanged) and clinical decision about discharge or admission, were recorded. A total of 1,038 patients were eligible for inclusion. No significant differences in initial CRP and leukocyte count values were observed, nor any association of CRP and leukocyte count changes with clinical dynamics. Among 504 patients eligible for discharge at second laboratory sampling according to clinical dynamics, 54.4 % were further observed or admitted. Discharged patients had an average negative absolute (p<0.001) and relative CRP change (p=0.002). Clinical dynamics, first and second CRP results and absolute CRP change were independently associated with the decision to discharge or further observe/admit. Schematic repetitions of CRP and leukocyte count at the ED observation unit are common, regardless of patients' clinical condition. Clinical judgment remains the main guiding factor to admit or discharge the patient, but repeated CRP testing influences the final decision, contributing to higher admission rates.

Clinical response to nonsurgical periodontal therapy is associated with decreased serum leukocyte count and uric acid levels in kidney transplant recipients.

This study sought to investigate the relationship between clinical response to nonsurgical periodontal therapy (NSPT) and serum changes in leukocyte count, fasting blood glucose, hemoglobin, hematocrit, creatinine, and uric acid in kidney transplant recipients (KTR). A prospective study was performed on 20 KTRs. Periodontal and serum data were collected before and 90 days after NSPT, and delta values (Δ = after NSPT - before) were calculated. Periodontal assessment included periodontal probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP). Patients were classified based on the presence of periodontitis and then categorized into stages. Patients showed a reduction in the percentage of sites with PPD≥3mm, PPD≥4 mm and BOP, after NSPT. There was a direct correlation between the deltas of leukocyte count and CAL ≥3 mm (r=0.645, P=0.002) and BOP (r=0.663, P=0.001), and the deltas of uric acid and CAL ≥3 mm (r=0.562, P=0.010). A good clinical response to NSPT may affect the reduction of serum levels of leukocyte count and uric acid, suggesting a beneficial effect on systemic health in KTR.

ГЕМАТОЛОГИЧЕСКИЕ ПОКАЗАТЕЛИ КРОВИ ПРИ БОЛЕЗНИ МОРТЕЛЛАРО КРУПНОГО РОГАТОГО СКОТА В ЧЕЧЕНСКОЙ РЕСПУБЛИКЕ

This article presents information reflecting changes in hematological blood parameters in cattle with Mortellaro disease. Experimental studies of hematological blood parameters of cattle affected by Mortellaro disease were conducted in 2024 at LLC Chechmol-Salman, Chervennaya station, Shelkovsky district of the Chechen Republic. Hematological examination of animal blood is an integral part of preclinical studies at the initial stage of diagnosis of various animal diseases, including Mortellaro disease. It is also necessary in cases requiring differential diagnosis of diseases, as well as as a definition for more detailed studies. The real laboratory tests of cattle blood were planned based on the understanding that the results obtained complement the pathogenetic changes in Mortellaro disease. Of great diagnostic importance in clinical practice is the study of the morphological composition of blood, including the counting of shaped elements - erythrocytes, leukocytes, platelets and the removal of a leukogram. As a result of the analysis of hematological studies of the blood of cattle affected by Mortellaro disease, changes in leukocyte counts in the studied samples were not found. Analyzing the indicators of the number of red blood cells, cases of a relative increase in the red blood cell count were noted. The study of monocyte levels showed their decrease (monocytopenia), also marked by eosinopenia, moderate lymphocytosis and an increase in granulocyte levels, which will undoubtedly be useful for the early primary diagnosis of interdigital dermatitis in cattle.

Leucocyte volume, conductivity, and scatter at presentation in COVID-19 patients.

In COVID-19 patients, besides changes in leucocyte count, morphological abnormalities of circulating blood cells have been reported. This study aims to investigate the relationship between the morphological and functional properties of leucocytes and the severity of the disease in COVID-19 patients. Blood samples were collected from COVID-19 patients (n = 130) at the time of admission. The patients were stratified according to the comorbidity, age, LDH, lymhocyte count score as mild, moderate, and severe. Complete blood count and the cell population data were analyzed by the Volume, conductivity, scatter (VCS) technology on Beckman Coulter LH-780 hematology analyzer. Kruskal-Wal'lis test was used to assess the differences between the groups with subsequent Bonferroni correction. Neutrophil count was increased, and lymphocyte count was decreased in severe patients compared to mild patients. The increase in the percent of neutrophils and the neutrophil/lymphocyte ratio in the severe patient group was significant in comparison to both the moderate and the mild group. The dispersion of the neutrophil volume and conductivity showed significant changes depending on the severity of the disease. The lymphocyte volume, lymphocyte-volume-SD and lymphocyte-conductivity as well as the monocyte-volume and monocyte-volume-SD were significantly increased in severe patients in comparison to mild patients. The increase of lymphocyte and monocyte volume in severe patients was also significant in comparison to moderate patients. COVID-19 infection leads to important changes in cell population data of leucocytes. The volumetric changes in lymphocytes and monocytes are related to the severity of the disease.

Agreement Study between Total Leukocyte Count Methodologies in South American Sea Lions (Otaria byronia) and Peruvian Fur Seals (Arctocephalus australis).

South American sea lions (Otaria byronia) and Peruvian fur seals (Arctocephalus australis) are sympatric species inhabiting the coastal Peruvian marine ecosystem. Declining abundance has prompted population health monitoring programs, including temporal monitoring of blood parameters. Several methods exist to determine total leukocyte count, yet no studies have evaluated agreement between methods in pinnipeds. We assessed agreement between total leukocyte counts determined by blood film estimate, Leuko-TIC, HemoCue, and UNOPETTE methods by using archival results from pinnipeds at Punta San Juan, Peru. Blood film estimates were prospectively performed, and resulting data were compared with retrospective leukocyte counts obtained from both species between 2009 and 2019 by using the other methodologies. Agreement in hematologic counts between methods was evaluated using Passing-Bablok regression and Bland-Altman plots (α=0.05). In total, 295 individuals (201 A. australis and 94 O. byronia) were included in the analysis. The blood film estimate method resulted in the highest leukocyte values (P<0.0001). Leuko-TIC counts were significantly higher than HemoCue counts (P<0.0001). Constant and proportional error was present in the agreement between the blood film estimate method and the other methods. Given the variation demonstrated between the different methodologies, additional research is needed to further evaluate agreement between these methodologies. The results underscore the importance of maintaining consistency in leukocyte count methodology for monitoring trends in population health over time. Method consistency may be the more important clinical consideration for assessing changes in leucocyte count over time and avoiding apparent changes depending on the methodology used.

Differentiation syndrome and coagulation disorder — comparison between treatment with oral and intravenous arsenics in pediatric acute promyelocytic leukemia

Realgar-Indigo naturalis formula (RIF), with A4S4 as a major ingredient, is an oral arsenic used in China to treat pediatric acute promyelocytic leukemia (APL). The efficacy of RIF is similar to that of arsenic trioxide (ATO). However, the effects of these two arsenicals on differentiation syndrome (DS) and coagulation disorders, the two main life-threatening events in children with APL, remain unclear. We retrospectively analyzed 68 consecutive children with APL from South China Children Leukemia Group-APL (SCCLG-APL) study. Patients received all-trans retinoic acid (ATRA) on day 1 of induction therapy. ATO 0.16 mg/kg day or RIF 135 mg/kg·day was administrated on day 5, while mitoxantrone was administered on day 3 (non-high-risk) or days 2–4 (high-risk). The incidences of DS were 3.0% and 5.7% in ATO (n = 33) and RIF (n = 35) arms (p = 0.590), and 10.3% and 0% in patients with and without differentiation-related hyperleukocytosis (p = 0.04), respectively. Moreover, in patients with differentiation-related hyperleukocytosis, the incidence of DS was not significantly different between ATO and RIF arms. The dynamic changes of leukocyte count between arms were not statistically different. However, patients with leukocyte count > 2.61 × 109/L or percentage of promyelocytes in peripheral blood > 26.5% tended to develop hyperleukocytosis. The improvement of coagulation indexes in ATO and RIF arms was similar, with fibrinogen and prothrombin time having the quickest recovery rate. This study showed that the incidence of DS and recovery of coagulopathy are similar when treating pediatric APL with RIF or ATO.

An exploratory study of hypnosis-induced blood count changes in chronically stressed individuals

Hypnosis is a clinically accepted relaxation technique known for stress reduction. Results from hematological research provide evidence of changes in blood components through hypnosis. However, these hematological effects have been rarely examined. Hence, we exploratively investigated the effect of a single relaxation hypnosis on the hemogram in stressed individuals, assuming a reduction of leukocytes, thrombocytes, and erythrocytes (primary outcomes). Additionally, a reduction in the erythrocyte-related parameters (hemoglobin, hematocrit), and an increase in plasma volume was hypothesized (secondary outcomes). Forty-four either individuals (89 % women) with chronic stress and moderate to high hypnotic suggestibility were randomized to a hypnosis condition (20 min relaxation hypnosis; n = 20) or a control condition (20 min documentary; n = 24). Venous blood was drawn before and after the intervention and used to generate a differential hemogram and determine the plasma volume. The relaxation hypnosis led to a significant reduction in erythrocytes (Cohen's d=0.23) and consequently to a decrease in erythrocyte-related parameters (hemoglobin, d=0.27; hematocrit, d=0.37) as well as to a reduction in thrombocytes (d=0.15) in the hypnosis compared to the control condition. Putatively, this could be the consequence of an increased plasma volume (d=0.10), estimated by the hematocrit concentration and body weight. A hypnosis-induced change in leukocyte count could not be confirmed. Thus, a single session of relaxation hypnosis already alters specific blood count parameters. While relaxation-induced vasodilatation might explain these changes, it is still not completely clear how these changes affect our stress response system.

Study of Acute Toxicity of an Herbal Extract of &lt;i&gt;Astragalus vulpinus&lt;/i&gt;

This paper studies the acute toxicity of an herbal extract of Astragalus vulpinus Willd. growing in the Astrakhan Oblast. Experiments were carried out on white nonlinear rats. The animals were divided into several groups (n = 6): the control group receiving intragastric distilled water and the experimental groups receiving intragastric extract of the Astragalus vulpinus extract once at doses of 100, 500, 1000, 2000, and 4000 mg/kg. On the first day after extract administration, the animals were under continuous observation. During the entire observation period for 14 days, the animals were monitored in terms of their general condition, body weight, food refusal, and coat appearance, as well as their response to sound, light, and tactile stimuli. The response to sound was evaluated by a sudden sharp knock on the cage and identification of the animal’s flinching. The response to light was assessed by shining light into the eye with a penlight to control eye lid closure. Tactile stimuli were evaluated by compressing the basal part of the tail. After removing the animals from the experiment, macroscopic examination of internal organs (brain, liver, spleen, heart, stomach) and hematological analysis of blood smears were performed. During the research, the LD50 of the Astragalus vulpinus herbal extract under study was established. When the extract was administered at a dose of 4000 mg/kg, animal mortality was recorded (3 individuals died by the third day). In the remaining animals, a decrease in weight and leukocyte count was observed along with changes in the gastric mucosa. In terms of acute toxicity, the extract under study was found to belong to low-toxic substances with an LD50 of 4000 mg/kg. However, its administration at a dose of 4000 mg/kg led to changes in leukocyte count and gastric mucosa. Therefore, the chronic toxicity of Astragalus vulpinus herbal extracts requires additional research.

Pseurotin D inhibits delayed type IV hypersensitivity response

Pseurotins, secondary metabolites of fungi, represent a group of bioactive natural products with newly recognized biological activities, including the modulation of specific immune response. However, the type of immune response affected by pseurotins and the mechanistic details underlying these effects are still not understood. Thus, the aim of the current study was to examine the effects of pseurotin D on delayed-type IV hypersensitivity (DTH) reaction induced by chicken ovalbumin in vivo and to examine the effects of pseurotin D on major types of leukocytes responsible for DTH development in vitro. Pseurotin D significantly decreased paw swelling, the major symptom of DTH, as well as the DTH-related production of pro-inflammatory cytokine IL-1β, IL-4, IL-6, IFN-γ and anti-inflammatory cytokine IL-10 in paws tissue, spleen enlargement, and DTH-related changes in leukocyte counts in peripheral blood. In vitro, pseurotin D mediated a decrease in the proliferation and differentiation of both Th1 and Th2 cells, as was concluded on the basis of the inhibition of the gene expressions of Gata3 and Tbx21 and the production of effector cytokines IFN-γ and IL-13 in vitro. Further, pseurotin D significantly inhibited the activation and differentiation of B cells, as was documented by the significant inhibition of B cell proliferation, CD138 expression, and IgE production. In conclusion, the results show the potential of pseurotin D to inhibit DTH reaction, this phenomenon involving the inhibition of the activation and differentiation of both T cells and B cells.

CLINICAL AND EPIDEMIOLOGICAL FEATURES OF CORONAVIRUS DISEASE (COVID-19) IN CHILDREN OF DIFFERENT AGE GROUPS

Aim of the study: to establish anamnestic, epidemiological, clinical and laboratory features in children of different age groupswith laboratory confirmation of SARS-CoV-2 in the course of the circulation period of the Omikron strain.Material and methods. 51 children, aged 0-18 years, with coronavirus infection manifestations and a positive PCR test forSARS-CoV-2 during the circulation period of the Omicron strain were followed up. The children had hemogram, serum glucose level, CRP, procalcitonin, coagulogram, PCR test for SARS-CoV-2, and chest radiography.Results. It was established that 23 children with SARS-CoV-2 (45.2 %) had little contact with ARVI. Almost 75% of childrenunder one year of age had a negative rapid test for SARS-CoV-2. The main complaint at the time of hospitalization in children was fever (94.1%). A change in leukocyte count was found to be present in only 47% of the children. Lymphocytosis with monocytosis prevailed in the leukocytic formula over granulocytosis (58.8 and 43.1%, respectively) (p&lt;0.05). Chest radiography revealed pneumonia in 39.3% of children, and the inflammatory process was more often localized in the right lung (62.5%) (p&lt;0.05). Sixty percent of children with pneumonia had blood saturation levels ≥ 95, 30% of children were between 92-94%, and only two children (10%) had blood saturation levels ≤ 91. An increase in serum fibrinogen B was detected in 35.3% of patients with pneumonia, and an increase in serum procalcitonin in 23.5% of patients with pneumonia. In 96.1% of children body temperature normalization occurred during the first five days of inpatient treatment, with 41.2% of children already on the first day.Conclusions. Thus, among patients with laboratory-confirmed SARS-CoV-2 infection in the course of the circulation period ofthe Omicron strain, children under the age of 6 prevailed. About half of all children (45.2%) had contact with ARVI patients. The main complaint of the children at the time of hospitalization was fever, which was within the range of subfebrile and febrile figures, thirty children had hyperthermia. Changes in hemogram parameters were detected in 47% of children, with leukocytosis predominantly in young children, but leukopenia was characteristic of school-age children. X-ray signs of acute bronchitis were found in 43.1% of children, and 39.3% of children had signs of segmental or multisegmental pneumonia, mainly in school-aged children with rightsided lesions in most cases. Every tenth child with pneumonia had low blood saturation levels (≤91%), and every third child with pneumonia had increased serum fibrinogen B and procalcitonin. While staying at the hospital, normalization of body temperature was observed in the first five days in the majority of patients, and in almost a half of cases (41,2%) - during the first day.

Race, Genotype, and Azathioprine Discontinuation : A Cohort Study.

Thiopurines are an important class of immunosuppressants despite their risk for hematopoietic toxicity and narrow therapeutic indices. Benign neutropenia related to an ACKR1 variant (rs2814778-CC) is common among persons of African ancestries. To test whether rs2814778-CC was associated with azathioprine discontinuation attributed to hematopoietic toxicity and lower thiopurine dosing. Retrospective cohort study. Two tertiary care centers. Thiopurine users with White or Black race. Azathioprine discontinuation attributed to hematopoietic toxicity. Secondary outcomes included weight-adjusted final dose, leukocyte count, and change in leukocyte count. The rate of azathioprine discontinuation attributed to hematopoietic toxicity was 3.92 per 100 person-years among patients with the CC genotype (n= 101) and 1.34 per 100 person-years among those with the TT or TC genotype (n= 1365) (hazard ratio [HR] from competing-risk model, 2.92 [95% CI, 1.57 to 5.41]). The risk remained significant after adjustment for race (HR, 2.61 [CI, 1.01 to 6.71]). The risk associated with race alone (HR, 2.13 [CI, 1.21 to 3.75]) was abrogated by adjustment for genotype (HR, 1.13 [CI, 0.48 to 2.69]). Lower last leukocyte count and lower dosing were significant among patients with the CC genotype. Lower dosing was validated in an external cohort of 94 children of African ancestries prescribed the thiopurine 6-mercaptopurine (6-MP) for acute lymphoblastic leukemia. The CC genotype was independently associated with lower 6-MP dose intensity relative to the target daily dose of 75 mg/m2 (median, 0.83 [IQR, 0.70 to 0.94] for the CC genotype vs. 0.94 [IQR, 0.72 to 1.13] for the TT or TC genotype; P= 0.013). Unmeasured confounding; data limited to tertiary centers. Patients with the CC genotype had higher risk for azathioprine discontinuation attributed to hematopoietic toxicity and lower thiopurine doses. Genotype was associated with those risks, even after adjustment for race. National Institutes of Health.

Elevated Serum Leukocytes are Predictive of Cardiac Injury Following Aneurysmal Subarachnoid Hemorrhage

ObjectivesAneurysmal subarachnoid hemorrhage (aSAH) accounts for 5% of strokes but results in significant morbidity and mortality. In addition to systemic inflammation, up to half of patients develop cardiac injury; however, the relationship between systemic inflammation and cardiac injury after aSAH is unknown. We investigated changes in leukocyte counts in relation to cardiac dysfunction Materials and methodsWe reviewed the records of consecutive patients with SAH at our large academic medical referral center. The inclusion criteria were aSAH and available cardiac troponin I (cTnI) levels within 48 h of admission. The primary outcome was cardiac injury, defined as cTnI ≥0.04 ng/mL (lab reference range 0.01–0.03 ng/mL). We compared baseline characteristics, including serum leukocyte counts and performed univariable and multivariable logistic regression analysis to determine whether changes in leukocyte subpopulations predict cardiac injury. ResultsOf 288 SAH patients, 250 met inclusion criteria. Of these, 116 (46.4%) had elevated cTnI. In univariable analysis, total leukocyte count (p < 0.001), absolute neutrophil count (ANC, p < 0.001), and absolute monocyte count (p = 0.013), were associated with elevated cTnI. in multivariable analysis, total leukocyte count (OR=1.079, p = 0.037) and ANC (OR=1.081, p = 0.044) remained predictors of elevated cTnI. Adjusted ANC distinguishes between aSAH patients with normal and elevated TnI (area under the curve=0.766, p < 0.001) with specificity of 89.2%. ConclusionsElevated total leukocytes and ANC are independently associated with cardiac injury in aSAH. Systemic inflammatory responses after aSAH may play a role in cardiac dysfunction, warranting additional studies to further characterize how cardiac inflammation after aSAH drives subsequent morbidity and mortality.

Prediction of Hospital Discharge Outcome from Changes in Cerebrospinal Fluid/serum Albumin Quotient and Cerebrospinal Fluid Lactate Dehydrogenase in Patients with Cryptococcal meningitis

Aim: This study aims to provide reliable prognostic factors for patients with cryptococcal meningitis (CM). Patients & methods: Clinical characteristics and laboratory findings of CM patients were retrospectively reviewed. Results: Sixty-three patients with CM were enrolled and 38/63 were confirmed to be HIV serology positive. Among clinical characteristics, headache, nausea and/or vomiting, and fever were the most common symptoms. Among cerebrospinal fluid (CSF) parameters, changes in leukocyte count, lactate dehydrogenase and chloride were significantly associated with theoutcome. An increased CSF/serum albumin quotient (QAlb) was indicative of an unfavorable outcome in HIV-negative patients. Conclusion: CSF lactate dehydrogenase and QAlb may improve the prediction of outcomes in patients with CM.

Associations of Baseline and Changes in Leukocyte Counts with Incident Cardiovascular Events: The Dongfeng-Tongji Cohort Study.

Aim: The aim of the present study was to investigate the associations of baseline and longitudinal changes in leukocyte counts with incident cardiovascular disease (CVD). Methods: We conducted a prospective study to investigate the associations of baseline and 5-year changes in leukocyte counts with incident CVD and its subtypes in middle-aged and elderly Chinese. We estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD using the Cox proportional-hazards models. Results: In the analyses of baseline total leukocyte count of 26,655 participants, compared with the lowest quartile (＜4.71×109/L), participants in the fourth quartile (＞6.70×109/L) had 11% higher risk for CVD. Consistent with total leukocyte count, neutrophil count also exhibited a significant positive association with the risk of CVD. In the analyses of 5-year changes in total leukocyte count of 11,594 participants, the changes in leukocyte count were categorized into three groups, i.e., the decreased group (＜25%), stable group (25%–75%), and increased group (＞75%). Compared with participants in the stable group (−1.18 to 0.44×109/L), participants in the increased group (＞0.44×109/L) had 14% higher risk for CVD. We also observed significant positive associations of the changes in neutrophil and monocyte counts with the risk of CVD. Furthermore, the total leukocyte count in the second or third tertile at the first follow-up with a 5-year increase was related to higher CVD risk. Conclusion: High baseline total leukocyte count and a 5-year increase in total leukocyte count were related to higher CVD risk.

Effect of immunonutrition on serum levels of C-reactive protein and lymphocytes in patients with COVID-19: a randomized, controlled, double-blind clinical trial.

Introduction: patients with COVID-19 undergo changes in leukocyte count, respiratory disorders, and an increase in inflammatory substances. To improve the inflammatory condition, some nutrients can be used, including arginine, omega-3 fatty acids and nucleotides. This study aims to evaluate how oral immunonutrient supplements affects serum C-reactive protein (CRP) levels and lymphocyte count in patients with COVID-19. Methods: in this double-blind clinical trial, we randomized 43 adult patients with COVID-19 to receive a standard high-protein normocaloric supplement (control) or an immunonutrient-enriched supplement (experiment) for 7 days. The primary outcome was to evaluate changes in total lymphocyte count and serum level of CRP. The assessment of risk and nutritional status of these patients was also performed. Results: forty-three patients with mean age of 41.5 (± 1.8) years were followed up, 39.5 % of them women. The mean body mass index was 27.6 (± 0.8) kg/m² and 58.1 % had low nutritional risk. In the experiment group, there was a CRP reduction of 23.6 (± 7.5) mg/L, while in the control branch the decrease was 14.8 (± 12.1) mg/L (p = 0.002). There was an increase in lymphocytes in the experiment group (+367.5 ± 401.8 cells/mm³) and a reduction in the control group (-282.8 ± 327.8 cells/mm³), although there was no statistical significance (p = 0.369). Relative risk (RR) of treatment in reducing CRP by 30 % or more was 4.45 (p < 0.001; 95 % CI, 1.79-11.07). RR in increasing lymphocyte count by 30 % or more was 1.28 (p = 0.327; 95 % CI, 0.67-2.45). Conclusion: we conclude that immunonutrient supplements seem to reduce CRP levels more than standard high-protein normocaloric supplements.

In memory of Academician A.I. Vorob'ev, Russian Academy of Medical Sciences and Russian Academy of Sciences Stability of Granulopoiesis Chronology under R(G)-DHAP Immuno-chemotherapy-Induced Cytotoxic Stress in Non-Hodgkin’s Lymphomas

Background. Chronology of granulopoiesis based on periodic hematopoiesis model has been thoroughly studied. However, the pattern of influence of immunotherapy-induced cytotoxic stress on the biological rhythm of a stem cell development requires further investigation. The interaction of antitumor drugs with normal hematopoietic cells is relevant for assessing the intensity of chemotherapy adverse events. Besides, there is a demand for studying hematopoiesis under cytotoxic stress to predict immunological reactivity as a condition for efficacy of immunotherapeutic agents, the effect of which is based on cell immunity. Aim. To study the chronological pattern of leukocyte count dynamics after R(G)-DHAP immunochemotherapy in non-Hodgkin’s lymphomas. Materials &amp; Methods. The dynamics of leukocyte count changes after R(G)-DHAP immunochemotherapy was analyzed using the data of 39 treatment courses in 19 non-Hodgkin’s lymphomas patients. After 18 out of 39 cycles of treatment granulocyte colony-stimulating factor (G-CSF) was administered to prevent granulocytopenia, in other cases the previously planned hematopoietic stem cell mobilization was performed according to the accepted protocol. Results. Time to activation of spontaneous granulopoiesis depends neither on G-CSF stimulation, nor on the total dose of growth-stimulating factor and corresponds on average to Day 10 or Day 11 of the break from the last day of immunochemotherapy. The tendency of shorter agranulocytosis duration on prophylactic use of G-CSF is associated with transient hyperleukocytosis at an early stage after completing immunochemotherapy. Regimens with platinum-based drugs, like R(G)-DHAP, are suggested to be combined with immunochemotherapeutic agents in patients with the failure of first-line chemotherapy. The time interval preceding myelopoiesis activation within the first days of the break between the courses is likely to contribute to the initiation of treatment with immunotherapeutic drugs after second-line chemotherapy. Conclusion. The determination of granulopoiesis dynamics under R(G)-DHAP immunochemotherapy-induced cytotoxic stress enables to plan the optimum G-CSF regimen and to predict the optimum timing of immune antitumor effect combined with chemotherapy.