Complete Blood Cell Research Articles

Ethylenediaminetetraacetic Acid-Dependent Pseudothrombocytopenia Discovered During Preoperative Evaluation: A Case Report

Pseudothrombocytopenia (PTCP) can be caused by various factors, and misdiagnosing it as true thrombocytopenia can cause significant risks to the patient. When using ethylenediaminetetraacetic acid (EDTA) as an anticoagulant in a complete blood cell (CBC) test, EDTA-dependent PTCP can occur in approximately 0.1% to 0.2% of cases. Anesthesiologists review various medical findings during the preoperative evaluation process, one of which is the blood test results. PTCP can lead to unnecessary interventions or treatments before surgery, potentially harming the patient. This study presents a case of PTCP discovered during preoperative evaluation of a patient diagnosed with pancreatic cancer. As anesthesiologists, ensuring the optimal condition of the patient before surgery is paramount, and this case highlights the importance of proper management and in-depth consideration when encountering patients suspected of having PTCP.

Predictive value of serum inflammatory markers in retinopathy of prematurity

PurposeTo evaluate the relationship between the development of retinopathy of prematurity (ROP) and neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR).Material and methodsThe medical records of 153 preterm infants born before the 34th week of gestation, were retrospectively reviewed. Complete blood cell (CBC) and C-reactive protein (CRP) results measured within the first 24 h of life were recorded. NLR, LMR and PLR were calculated by dividing neutrophil count by lymphocyte count, lymphocyte count by monocyte count, and platelet count by lymphocyte count, respectively. Analysis of possible risk factors related with ROP development was evaluated using logistic regression analysis. Results were compared between infants with and without ROP.ResultsA total of 153 infants, of which 64 (41.9%) with ROP and 89 (58.1%) without ROP, were included in the study. While lymphocyte count and LMR were found to be significantly lower in infants with ROP (p = 0.015 and p = 0.044), neutrophil count and NLR were found to be significantly higher (p = 0.021 and p = 0.046, respectively). No significant difference were observed in platelet and monocyte count and PLR (p = 0.808, p = 0.170 and p = 0.075, respectively). Multivariate logistic regression analysis revealed that gestational age, birth weight and NLR were major risk factors for the development of ROP (OR:0.59; p = 0.01, OR:1.00; p = 0.02 and OR: 2.56; p = 0.02, respectively).ConclusionThis study supports that, in addition to prematurity, NLR on the first postnatal day has a significant predictive value in ROP.

Insights into the clinical impact of complete blood cell inflammatory markers on body composition variations and fatty liver grading in Iranian adults undergoing bariatric surgery: a retrospective longitudinal study.

In bariatric surgery, inflammatory biomarkers predict outcomes. Limited research on complete blood cell (CBC) markers stresses the need for correlation study. This research explores links between CBC inflammatory markers, body changes, and fatty liver grades in Iranian bariatric patients. This retrospective longitudinal study examined 237 bariatric surgery patients who satisfied the inclusion criteria and were deemed eligible for participation. These criteria encompassed patients who had undergone sleeve or mini-bypass surgery and were aged between 18 and 65 years. The study gathered demographic data, pre and post-surgery changes in CBC inflammatory biomarkers [neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), MPV-to-platelet count ratio (MPV/PC), and red cell distribution width (RDW)] and fatty liver grades. Additionally, it recorded pre and post-surgery changes in body composition, such as weight, muscle mass (MM), fat mass (FM), and fat-free mass (FFM). The pre-surgery RDW marker significantly associated with FM changes, highlighting its predictive nature. While no significant association was found between changes in patients' fatty liver grade and baseline marker values, it's worth noting that individuals with higher MM at 3 months achieved a fatty liver grade of zero. Also, at 6 months, higher FFM and MM were also associated with reaching a fatty liver grade of zero. While the retrospective design of this study limits its findings to existing clinical data, future prospective research should collect additional samples, extend the observation time, and examine the long-term predictive value of these markers.

Development and validation of a machine learning-based interpretable model for predicting sepsis by complete blood cell parameters

BackgroundSepsis, a severe infectious disease, carries a high mortality rate. Early detection and prompt treatment are crucial for reducing mortality and improving prognosis. The aim of this research is to develop a clinical prediction model using machine learning algorithms, leveraging complete blood cell (CBC) parameters, to detect sepsis at an early stage. MethodsThe study involved 572 patients admitted to West China Hospital of Sichuan University between July 2020 and September 2021. Among them, 215 were diagnosed with sepsis, while 357 had local infections. Demographic information was collected, and 57 CBC parameters were analyzed to identify potential predictors using techniques such as the Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF), Support Vector Machine (SVM), and eXtreme Gradient Boosting (XGBoost). The prediction model was built using Logistic Regression and evaluated for diagnostic specificity, discrimination, and clinical applicability including metrics such as the area under the curve (AUC), calibration curve, clinical impact curve, and clinical decision curve. Additionally, the model's diagnostic performance was assessed on a separate validation cohort. Shapley's additive explanations (SHAP), and breakdown (BD) profiles were used to explain the contribution of each variable in predicting the outcome. ResultsAmong all the machine learning methods' prediction models, the LASSO-based model (λ = min) demonstrated the highest diagnostic performance in both the discovery cohort (AUC = 0.9446, P < 0.001) and the validation cohort (AUC = 0.9001, P < 0.001). Furthermore, upon local analysis and interpretation of the model, we demonstrated that LY-Z, MO-Z, and PLT-I had the most significant impact on the outcome. ConclusionsThe predictive model based on CBC parameters can be utilized as an effective approach for the early detection of sepsis.

Abstract 6030: Optimizing the therapeutic index of targeted α-particle radioimmuotherapy (TART) of HER2-positive breast cancer tumors in NRG mice with 225Ac-labeled trastuzumab

Abstract Introduction: Our aim was to optimize the therapeutic index of TART of HER2-positive BC in NRG mice by studying the effectiveness and normal tissue toxicity of trastuzumab IgG, F(ab’)2 or Fab modified with DOTA for complexing the α-particle emitter, 225Ac. Methods: The toxicity of [225Ac]Ac-DOTA-trastuzumab IgG, F(ab’)2 and Fab were assessed in NRG mice (n=5) injected i.v. with 2 and 4 kBq (total 80 μg) separated by 8 d. Body weight was monitored and complete blood cell (CBC) counts and alanine aminotransferase (ALT) and creatinine (CRE) were measured at 14 d post-injection (p.i.). TART was performed in NRG mice (n=7) with s.c. HER2-positive 164/8-1B/H2N.luc+ xenografts injected i.v. with 2 and 4 kBq (total 80 μg) separated by 8 d of [225Ac]Ac-DOTA-trastuzumab IgG, F(ab’)2 or Fab. Control mice received irrelevant [225Ac]Ac-DOTA-IgG, trastuzumab or saline. The tumor growth index (TGI=tumor volume/initial tumor volume) was measured and Kaplan-Meier median survival estimated. Tumor and normal tissue uptake (%ID/g) of [225Ac]Ac-DOTA-trastuzumab IgG, F(ab’)2 and Fab (4 kBq) in tumor-bearing NRG mice were measured up to 14 d p.i.. Results: [225Ac]Ac-DOTA-trastuzumab F(ab’)2 and Fab caused no decrease in CBC, while [225Ac]Ac-DOTA-trastuzumab IgG decreased white blood cells by 4.5-fold, platelets by 7.5-fold, red blood cells by 1.2-fold and hematocrit by 1.2-fold compared to saline-treated mice. [225Ac]Ac-trastuzumab F(ab’)2 or Fab caused no increase in ALT or CRE. Body weight was not decreased in all groups of mice. [225Ac]Ac-DOTA-trastuzumab IgG, F(ab’)2 or Fab inhibited tumor growth (TGI at 15 d = 2.5, 1.8, and 1.9, respectively) vs. saline or trastuzumab (TGI= 6.3 and 5.2; P=0.0047 and 0.0028). Median survival was increased to 46 d for mice treated with [225Ac]Ac-DOTA-trastuzumab F(ab’)2 vs. 29 d for Fab (P=0.008), 22 d for IgG (P=0.0005) and 15 d for saline (P=0.0005). Median survival for mice treated with [225Ac]Ac-DOTA-IgG was 20 d and for trastuzumab was 22 d. Tumor uptake of [225Ac]Ac-DOTA-trastuzumab IgG and F(ab’)2 at 48 h p.i. were 10.6 ± 0.6 and 8.7 ± 0.8, respectively, while uptake of [225Ac]Ac-DOTA-trastuzumab Fab at 18 h p.i. was 3.1 ± 0.5 %ID/g. Elimination from the blood was slowest for [225Ac]Ac-DOTA-trastuzumab IgG followed by F(ab’)2 then Fab. Spleen and liver uptake were greatest for [225Ac]Ac-DOTA-trastuzumab IgG but much lower for F(ab’)2 and Fab. Kidney uptake was highest for [225Ac]Ac-DOTA-trastuzumab Fab. Conclusion: [225Ac]Ac-DOTA-trastuzumab F(ab’)2 provided the highest therapeutic index, inhibiting tumor growth and improving survival while minimizing toxicity. TART with [225Ac]Ac-DOTA-trastuzumab F(ab’)2 is a promising new treatment for HER2-positive BC that could be more effective than trastuzumab. Citation Format: Misaki Kondo, Zhongli Cai, Conrad Chan, Raymond M. Reilly. Optimizing the therapeutic index of targeted α-particle radioimmuotherapy (TART) of HER2-positive breast cancer tumors in NRG mice with 225Ac-labeled trastuzumab [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6030.

The effect of thyme essential oil and endothelial progenitor stem cells on lipopolysaccharide-induced sepsis in C57BL/6 mice.

Sepsis is a potentially fatal syndrome related to severe systemic inflammation developed by infection. Despite different antimicrobial therapies, morbidity and mortality rates remain high. Herbs along with cell therapy have been introduced as a promising option to improve the symptoms of sepsis. The present study aimed to evaluate the therapeutic effect of simultaneous administration of thyme essential oil (TEO) and endothelial progenitor stem cells (EPCs) on lipopolysaccharide (LPS)-induced sepsis in C57BL/6 mice. Sepsis was induced in C57Bl/6J mice by intraperitoneal injection of LPS, followed 2h later by an intravenous injection of EPCs or oral administration of TEO or simultaneous administration of TEO and EPCs. After 10 days, the complete blood cell, renal and liver factors, serum levels of inflammatory cytokines, and angiogenic factors were measured. Simultaneous treatment with EPCs and TEO significantly increased the survival of mice with sepsis and modulated the inflammatory response by reducing the serum levels of pro-inflammatory cytokines. Moreover, this treatment significantly reduced the level of white blood cells and neutrophils and increased the number of red blood cells, the percentage of hematocrit, and hemoglobin. The combination of TEO with EPCs decreased organ injuries and was assessed by lower levels of the liver enzymes alanine aminotransferase and aspartate aminotransferase compared to the sepsis group. Administration of EPCs and TEO also significantly improved angiogenic factors, lung function, and toll-like receptor 4 expression. EPCs in combination with TEO increase survival in the LPS-induced sepsis mice model by acting on several targets. Thus, the combination of TEO with EPCs can be a feasible approach for the future clinical treatment and control of sepsis.

Relationship between ultrasonographically assessed biceps brachii muscle mass and complete blood cell and blood chemistry

Relationship between ultrasonographically assessed biceps brachii muscle mass and complete blood cell and blood chemistry

FSL-1: A Synthetic Peptide Increases Survival in a Murine Model of Hematopoietic Acute Radiation Syndrome.

In the current geopolitical climate there is an unmet need to identify and develop prophylactic radiation countermeasures, particularly to ensure the well-being of warfighters and first responders that may be required to perform on radiation-contaminated fields for operational or rescue missions. Currently, no countermeasures have been approved by the U.S. FDA for prophylactic administration. Here we report on the efficacious nature of FSL-1 (toll-like receptor 2/6 agonist) and the protection from acute radiation syndrome (ARS) in a murine total-body irradiation (TBI) model. A single dose of FSL-1 was administered subcutaneously in mice. The safety of the compound was assessed in non-irradiated animals, the efficacy of the compound was assessed in animals exposed to TBI in the AFRRI Co-60 facility, the dose of FSL-1 was optimized, and common hematological parameters [complete blood cell (CBC), cytokines, and bone marrow progenitor cells] were assessed. Animals were monitored up to 60 days after exposure and radiation-induced damage was evaluated. FSL-1 was shown to be non-toxic when administered to non-irradiated mice at doses up to 3 mg/kg. The window of efficacy was determined to be 24 h prior to 24 h after TBI. FSL-1 administration resulted in significantly increased survival when administered either 24 h prior to or 24 h after exposure to supralethal doses of TBI. The optimal dose of FSL-1 administration was determined to be 1.5 mg/kg when administered prior to irradiation. Finally, FSL-1 protected the hematopoietic system (recovery of CBC and bone marrow CFU). Taken together, the effects of increased survival and accelerated recovery of hematological parameters suggests that FSL-1 should be developed as a novel radiation countermeasure for soldiers and civilians, which can be used either before or after irradiation in the aftermath of a radiological or nuclear event.

Indicators of stress hematopoiesis in the blood predict COVID-19 progression in patients over 65 years old

ABSTRACT Objectives Advanced age is a well-established risk factor for severe coronavirus disease 2019 (COVID-19). Exacerbated inflammation affects multiple organs, among which hematopoiesis responds by increased output of various cells. We aimed to determine the association between COVID-19 progression and large immature cell (LIC) counts, changes in erythrocyte and platelet distribution widths (RDW, PDW) with reference to patients’ age. Methods A total of 755 patients with complete blood cell (CBC) analysis in the first 24 h of hospitalization were enrolled. Patients were divided into two groups: under and above 65 years of age. Results The LIC counts were different in both groups (p < 0.003). However, only the senior patients had markedly different values of RDW and PDW (p < 0.001). The receiver operating characteristic (ROC) curve analysis provided increased LIC (AUC = 0.600), RDW (AUC = 0.609), PDW (AUC = 0.556), and platelet to LIC ratio (AUC = 0.634) as significant in discriminating outcome in the older group. Importantly, these results were not repeated in the younger patients. In the elderly, the progression was predicted with LIC cut-off at ≥ 0.305 × 109/L (OR = 3.166) and RDW over 12.15% (OR = 2.081). Discussion Aging is characterized by a decline in immunological competence with a compromised control of inflammation leading to a proinflammatory state. This background together with the actions of pathogens may lead to emergency myelopoiesis. Conclusion Our results point to the important differences between age groups regarding CBC-related parameters of stress hematopoiesis during severe infection. Higher LIC, RDW and PDW levels were reliable in the early identification of COVID-19 progression only in the elderly.

The Impact of Fiber Source on Digestive Function, Fecal Microbiota, and Immune Response in Adult Dogs.

This study evaluated the impact of different fiber sources on intestinal function, fecal microbiota, and overall health in dogs. Twelve dogs were used in a crossover design, involving three periods of 6 weeks and three diets: a low-fiber diet (CTR), a cereal-fiber and beet-pulp-supplemented diet (BRA), and a fruit-fiber-supplemented diet (FRU). Each period included a digestibility trial and fecal and blood sampling in the last week. Short-chain fatty acids (SCFAs) and microbiota taxonomy (16S rRNA Illumina-MiSeq) and functionality (Shotgun-NovaSeq 6000) were determined in the feces. General biochemistry, complete blood cells, and lymphocyte subsets were also analyzed. The fiber-supplemented diets showed lower digestibility without significant changes in the fecal consistency. The BRA diet showed higher total SCFA concentrations (p = 0.056), with increases in alpha diversity and particular beneficial genera, such as Lachnospira, Bifidobacterium, and Faecalibacterium. The BRA microbiota was also associated with an overabundance of genes related to carbohydrate and amino acid metabolism. The FRU diet had a distinct impact on the microbiota composition and functionality, leading to higher levels of CD8 lymphocytes. These findings emphasize the importance of selecting the right fiber source when formulating dog diets, as it can have a differential impact on gut microbiota and animal health.

Bacterial Etiology and Antibiotic Susceptibility Profile in Neonatal Sepsis

Background: Sepsis is a leading cause of morbidity and mortality in neonates. Objectives: This study aimed to investigate the bacterial profile and antibiotic sensitivity in infants with sepsis. Methods: This cross-sectional study was conducted on 90 neonates with sepsis admitted to the neonatal intensive care unit of Namazi Hospital, a tertiary-level hospital, in Shiraz, Iran, from 2020 to 2021. Demographic and clinical data including gestational age, previous diseases, maternal infectious, underlying diseases, history and duration of premature rupture of the membrane and delivery, clinical symptoms (fever, reduced breastfeeding, and lethargy), laboratory results (complete blood cell and C-reactive protein), and results of blood and urine cultures were recorded and analyzed. Results: Among 90 neonates with sepsis, the average age was 6.7 ± 7.6 days; 54 were male (60.0%), and 36 were female (40.0%). Fifty (55.5%) neonates had early sepsis. Gram-negative organisms were grown in 61% of positive blood cultures; the most common was Klebsiella. Among Gram-positive organisms, Staphylococcus epidermidis was the most common. Most organisms were sensitive to colistin, and most were resistant to cefotaxime. There was a significant relationship between the age of onset of sepsis symptoms and birth weight in infants with positive blood cultures (P = 0.004) (r = 0.3). Conclusions: Gram-negative bacteria are the most common causes of sepsis, mainly resistant to aminoglycosides and cefotaxime. Therefore, increasing awareness about the optimal use of antibiotics is necessary to curb the increase in resistance levels.

Extra-Lymphatic Filariasis: A Study of Three Interesting Cases

Filariasis is a chronic disabling parasitic disease that causes a major public health problem in tropical countries like India. Wuchereria bancrofti is associated with almost 99.4% of cases. Filariasis not only affects the structure and function of lymphatic vessels but is also associated with extra-lymphatic pathology and diseases. Lymphatic filariasis is commonly found throughout the tropics and subtropics. While lymph nodes are the common sites, unusual sites include the breast, spleen, subcutaneous tissue, thyroid, bone marrow, urinary tract, sputum, bronchial washing, pleural and pericardial fluid. Patients from endemic areas presenting with swelling should be evaluated for filariasis. Here in present case series, the authors discussed three cases: filariasis of the breast with fibroadenoma, soft-tissue nodule, and splenic lesions, due to their extreme rarity and unusual sites. In the first case, 20 years old female patient presented with a lump in the left breast. The complete blood cell (CBC) revealed eosinophilia, but peripheral smears did not show the presence of microfilariae. On Fine Needle Aspiration Cytology (FNAC), smears showed Wuchereria bancrofti microfilaria in the background of fibroadenoma. The patient was treated with Diethylcarbamazine (DEC) for 21 days. Repeat CBC revealed a decrease in the absolute eosinophil count. Lumpectomy for fibroadenoma was performed, which showed fragments (dead) of the microfilarial parasite. The association of filariasis with fibroadenoma is possibly due to pre-existing subclinical filariasis when the neoplasm developed, as the patient hails from an endemic area. Filariasis presenting as a soft-tissue nodule is an uncommon incidence. In the second case discussed here, 30 years old female patient had soft-tissue swelling over the left elbow. Peripheral smear only revealed eosinophilia without any parasites. On FNAC, smears showed Wuchereria bancrofti microfilaria, along with lymphoid cells and a few eosinophils. The swelling subsided with DEC treatment, and repeat CBC showed a decrease in the absolute eosinophil count. The third case discussed here, involved an unknown 35 years old male, who was brought dead to the hospital. No clinical details were available. On autopsy, the spleen showed multiple white patches, ranging in size from 0.2 to 0.5 cm in diameter. All other organs were unremarkable. Microscopy showed many granulomas and numerous dead fragmented microfilariae. It was a case of isolated splenic filariasis, which is a rarely diagnosed entity. These unique cases will raise awareness of diagnosing and instituting proper therapy.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are early predictors of bronchopulmonary dysplasia.

To determine whether neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are correlated with bronchopulmonary dysplasia (BPD) on the first day of prematurity and to help with early warning, identification, and intervention in the development of BPD. From January 2017 to June 2022, newborns who were diagnosed with BPD conducted a retrospective cohort study. Complete blood cells were measured within the first 24 hours of life in preterm neonates of 32 gestational weeks with BPD as the observation group and non-BPD infants as the control group. In all groups, the NLR and PLR levels were measured. Both univariate and multivariate logistic regression analyses were used to evaluate the data. In this research 76 cases of non-BPD and 48 cases of BPD were used as controls. Compared with the non-BPD group, the NLR and PLR levels were considerably higher in the BPD group. Logistic regression analysis suggested that NLR and PLR were independent risk factors for BPD (OR [odds ratio]: 3.786; 95% CI [confidence interval]: 1.75-8.16; P < .05; OR: 3.391; 95% CI: 1.85-28.78; P < .05). The findings may demonstrate that higher NLR and PLR are independently and significantly associated with the development of BPD.

The Effects of Premedication with Desipramine on Bone Marrow Mobilization for Autologous Bone Marrow Transplantation in Multiple Myeloma

Background: Multiple myeloma (MM) management includes primary chemotherapy, followed by autologous bone marrow transplantation (ABMT) if the bone marrow gets cleared of cancerous cells. In some cases disease relapse may occur disease relapse may occur if complete clearance is not achieved. Transplantation was primarily performed through the bone marrow; however, peripheral blood has become more favored due to its safety and convenient collection in case of appropriate bone marrow mobilization which is a challenging issue. Objectives: The current study was aimed to investigate the effectiveness of desipramine application for bone marrow mobilization in multiple myeloma (MM) who were candidate for autologous bone marrow transplantation (ABMT). Methods: The current randomized clinical trial involved 122 MM patients who were candidate for ABMT. The participants were divided into two intervention groups: the first group (n = 63) received G-CSF only treatment, while the second group (n = 59) received a similar G-CSF treatment plus desipramine. The first group received 30 microgram intravenous G-CSF for five days and the second one was treated with G-CSF with similar pattern in combination with daily 100 mg desipramine initiated within three days before G-CSF treatment and continued until the last dose of G-CSF. CD34+ cells and complete blood cells and differentiation were assessed by the end of the interventions. Results: The findings of the study show that the number of CD34+ cells, white blood cells (WBC) and platelet (PLT) count were remarkably higher among the patients receiving the combination therapy compared to the G-CSF only treated group (P-value &lt; 0.001) within 5 days after the interventions; however, no significant differences were observed between the two groups when considering the stage of the disease and the frequency of chemotherapy sessions (P-value &gt; 0.05). Conclusions: Desipramine application led to significantly increased levels of CD34+ cells as the representatives of bone marrow mobilization. Besides, the patients treated with this regimen had higher serum levels of WBC and PLT; however, the disease stage and the number of chemotherapy sessions did not affect the response to the treatment.

Impact of qSOFA Score on the Outcome of Patients in ICU with Respiratory Tract Infection

Abstract Background The quick Sequential Organ Failure Assessment (qSOFA) score is a bedside prompt that may identify patients with suspected infections who are greater risk for poor outcome in the intensive care unit (ICU). Objectives To assess the impact of qSOFA score on the outcome of patients in ICU with respiratory tract infection. Patients and Methods This Observational prospective study study carried out at ICU department of Ain Shams University Hospitals and Al Mahala Chest Hospital during the period from 1 February 2020 till March 2021 and included 122 patients presented by respiratory infection. Diagnosis of infection based on clinical, laboratory, radiological and/or microbiological evidence in accordance with guidelines for diagnosis of infection. All patients subjected to full history, physical examination, full laboratory tests (including arterial blood gas, complete blood cell with differentiation, international normalized ratio, kidney function tests, liver function tests, random blood sugar, C-reactive protein, erythrocyte sedimentation rate, serum sodium and serum potassium), chest X-ray and/or computerized tomography of chest, sputum cytological analysis and sputum culture. Measurement of qSOFA done in all patients. Results The median of qSOFA score in survivors was 0 while in nonsurvivors 1 at admission and after 48 hours with a significant difference between both groups. In overall patients qSOFA cutoff 1 has sensitivity and specificity 70% &amp; 80.37%, respectively. Conclusion The qSOFA scores were associated with in hospital mortality, hospital admission, ICU admission, and hospital length of stay in patients likely to be admitted both with and without suspected infection, qSOFA is an easy tool that can be used to predict outcomes.

Influencing factors on morbidity and mortality in intertrochanteric fractures

We aimed to evaluate the effect of the patient’s clinical and paraclinical condition before and after surgery on short-term mortality and complication and long-term mortality. A retrospective cohort study was conducted and multivariate logistic regression was applied to determine the effect of demographic characteristics (sex, age, AO/OTA classification, height, weight, body mass index), medical history (hypertension, ischemic heart disease, diabetes mellitus, thyroid malfunction, cancer, osteoporosis, smoking) lab data (Complete blood cell, blood sugar, Blood Urea Nitrogen, Creatinine, Na, and K), surgery-related factors (Anesthesia time and type, implant, intraoperative blood transfusion, postoperative blood transfusion, and operation time), duration of admission to surgery and anticoagulant consumption on short-term mortality and complication and long-term mortality. Three hundred ten patients from November 2016 to September 2020 were diagnosed with an intertrochanteric fracture. 3.23% of patients died in hospital, 14.1% of patients confronted in-hospital complications, and 38.3% died after discharge till the study endpoint. ΔNumber of Neutrophiles is the primary determinant for in-hospital mortality in multivariate analysis. Age and blood transfusion are the main determinants of long-term mortality, and Na before surgery is the primary variable associated with postoperative complications. Among different analytical factors Na before surgery as a biomarker presenting dehydration was the main prognostic factor for in hospital complications. In hospital mortality was mainly because of infection and long-term mortality was associated with blood transfusion.

Red cell distribution width is an inflammatory predictor marker of contrast induced nephropathy in patients undergoing percutaneous coronary intervention

Red blood cell distribution width (RDW) is an inflammatory biomarker reported in complete blood cell (CBC) counts. High RDW defines a proinflammatory state. Contrast-induced nephropathy (CIN) is an important and common complication in percutaneous coronary intervention (PCI) treated patients. The current study was conducted to evaluate the role of RDW as a simple predictive inflammatory marker of CIN in PCI treated patients. The current prospective study enrolled 126 PCI treated patients. Laboratory investigations included CBC, liver function test, (HbA1C), lipid profile and serological tests. Serum urea and creatinine levels were obtained at baseline and 48 to 72 hours after PCI procedure, used to categorize for CIN. Diabetes mellitus, hypertension, and ischemic heart disease were present in 39 (31%), 44 (34.9%), and 23 (18.3%) patients, respectively. Of the studied patients, only 19 (15.1%) patients developed CIN. The hemoglobin level was significantly higher in the non-CIN group (13.49 ± 1.63 vs. CIN group 12.56 ± 1.62 mg/dl; p= 0.02). RDW was significantly higher among CIN group than non-CIN group (16.20 ± 2.60 vs. 13.83 ± 2.19 % (p&lt; 0.001). Delta creatinine (% change in creatinine level after 48 hour) was significantly higher in patients with CIN (59.17 ± 28.89 vs. non-CIN 33.62 ± 9.76; p&lt; 0.001). Predictors for CIN in patients who underwent PCI were old age high RDW high delta creatinine and amount of dye. At cut off &gt; 14.5%, RDW had 79% sensitivity, 70% specificity and 71.3% overall accuracy at AUC of 0.76. In conclusion, RDW may be simple and immediately available inflammatory biomarker and predictor for development of CIN in patients undergoing PCI.

Complete blood and absolute CD4+ve T lymphocyte counts of whole blood donors at a hospital blood center in Nigeria

Background: Comprehensive routine screening and adequate selection of the prospective whole blood donor protects his health and safety as well as that of the recipient. Objectives: The main objective of this study was to determine the complete blood and absolute CD4+ T lymphocyte cell counts of apparently healthy prospective whole blood donors. Participants and Methods: This was a hospital based prospective study. A form was designed by the researchers for data collection. The socio demographic status, complete blood cells and absolute CD4+vel counts of apparently healthy whole blood donors who had tested seronegative for HIV, hepatitis B and C markers was captured . Obtained data was analysed with the statistical package for the social scientist software version 20 Results: One hundred male (97.1%) and three female (2.9%) apparently healthy prospective whole blood donors were studied. The median age of study subjects was 30 years. Obtained median blood cell values were 13g/dl, 40%, 4.9/nl and 203.9/nl for haemoglobin concentration, haematocrit, total white cell and platelet counts respectively. The median values for the mean corpuscular haemoglobin concentration (MCHC), mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) of studied blood donors were 32.6g/dl,27.7pg and 85.7fl respectively. Observed prevalence of subnormal blood cell counts for haemoglobin concentration, total white cells and platelets were 12.6%, 25.2%, 13.6% respectively. Also subnormal values for MCHC, MCH, and MCV were 11.7%, 26.2%, 16.5% respectively among studied whole blood donors. No higher than normal blood cell count values were observed. Median values for erythrocyte sedimentation rate and CD4+ T lymphocytes were 8.4mm/hr and 876.2cells/µl respectively. The percentage of subnormal CD4+T lymphocyte count was18.4% Conclusion: A significant percentage of apparently healthy prospective whole blood donors had subnormal blood cell and CD+ve T lymphocyte values. Obtained normal values were comparable with local reference range reports from previous studies in Nigeria and other parts of Africa.

Establishment and validation of haematological reference intervals for newborns aged 5 to 28 days in Nanjing, China

ABSTRACTBackground:China lacks a standard for reference intervals (RIs) of complete blood cell (CBC) counts in newborns. This study aimed to determine local haematological RIs for newborns.Methods:This prospective study was conducted from January 2020 to December 2020 in Nanjing Maternity and Child Health Care Hospital. We collected capillary blood specimens from 497 healthy newborns aged 5–28 days. We calculated the RIs as nonparametric 2.5th to 97.5th percentiles and 90% confidence intervals following the EP28-A3c guideline. We validated the RIs in another 20 specimens from healthy newborns.Results:The RIs for the 18 CBC parameters were: white blood cell count 7.17–15.69 × 109/L; monocytes# 0.52–1.66 × 109/L; Mono% 5.7–14.1; eosinophils# 0.16–1.08 × 109/L; Eos% 1.5–8.9; Lymphocytes# 4.04–8.08 × 109/L; Lymph% 40.1–67.8; Neutrophils# 1.59–6.41 × 109/L; Neut% 18.1–46.7; Basophils# 0.00–0.04 × 109/L; Baso% 0.0–0.4; red blood cell count 3.38–5.89 × 1012/L; haemoglobin (Hb) 116–198 g/L; Hematocrit % 35.2–61.2; mean corpuscular Hb (MCH) 30.9–36.3 pg/L; MCH concentration 310–341 g/L; mean corpuscular volume 94.5–112.2 fL; and platelets 210–610 × 109/L. The RIs had a conformity rate of 90%–100% in the validation specimens.Conclusion:We established region-specific RIs for CBC parameters in healthy newborns to help diagnose haematological disease in neonates.

The chicken or the egg of lymphopenia in atopic eczema.

Lymphopenia has been documented in atopic eczema (AE) patients mostly in the setting of an active infection.1, 2 However, the question is whether lymphopenia is a primary problem in AE leading to infection or it is a secondary problem due to infection. In the study by Hollestein et al.,3 the authors conducted a retrospective review of a large electronic database (UK primary care electronic health record from CPRD GOLD). They included 71,731 adults with AE and 126,349 adults without AE. Using the definition of lymphopenia as having two lymphocyte counts of <1 × 109/L in 3 months, they showed that 4.1% (n = 2909) of AE patients had lymphopenia as compared to 3.7% (n = 4700) of controls without AE. The adjusted OR for lymphopenia in AE patients as compared to those without AE was 1.16 and this increased to 1.89 in patients with severe AE. Their data were appropriately adjusted for age, sex, ethnicity, smoking, co-morbidities and immunosuppressive drug use. In their secondary analysis, they confirmed an increased risk of skin and systemic infections including cellulitis, varicella zoster, gastroenteritis and urinary tract infection in AE patients as compared to controls. The authors also replicated their findings of lymphopenia in AE patients based in a US database, NHANES. Their data support the hypothesis that lymphopenia may predispose to increased infections in AE patients. A possible mechanism of lymphopenia in AE patients is due to the homing of systemic lymphocytes to inflamed skin. Their finding of a higher risk of lymphopenia in more severe AE is also consistent with this mechanism. While Hollestein et al. have provided a robust and well-controlled study that lymphopenia may be a primary problem in AE patients, the findings can only be inferred as an association, rather than cause-and-effect, due to the retrospective nature of the study. In a real-life clinical situation, complete blood cell (CBC) profile is normally sent when a patient is symptomatic, that is, during an illness or an infection. Acute lymphopenia is common with viral respiratory infections.4 In AE patients, CBC may also be sent together with viral or bacterial identification testing during a skin infection, which may be associated with lymphopenia.1, 2 AE patients are not known to have a primary immunodeficiency that predisposes them to have increased infection. However, skin and soft tissue infections are more common in AE patients due skin barrier defects and suppression of cutaneous innate immunity by type 2 cytokines.5 The results of Hollestein et al. are nevertheless interesting, and will need to be confirmed with prospective studies. None to declare. P. Ong reports no conflict of interest relevant to this article. Data sharing not applicable.