Changes In Complete Blood Count Research Articles

Bischofia javanica and Phaleria macrocarpa nano herbal combination on blood and liver-kidney biochemistry in Oral Squamous Cell Carcinoma-induced rats

This research explores a contemporary approach to managing Oral Squamous Cell Carcinoma (OSCC) by integrating nano-technology into herbal production, combining Bischofia javanica leaves and Phaleria macrocarpa fruits. Benzo[a]pyrene (BaP)-induced OSCC rats were treated with nano herbals from Bischofia javanica leaves, Phaleria macrocarpa fruits, a combination of both, and Vitamin C as a control. Blood and organ analyses were compared with negative and positive controls. BaP induction in OSCC revealed cell transformation into carcinoma, confirmed by Papanicolaou staining. OSCC induction also caused significant changes in Complete Blood Count (CBC) and serum lipid profile. Nano herbals from both plants showed potential in reducing hematological and lipid damage in OSCC, especially in white blood cells, red blood cells, hemoglobin, and platelets. Statistical analysis also indicated that the combination of nano herbals was more effective in reducing (Low-Density Lipoprotein) LDL and total cholesterol levels than uncombined use while increasing (High-Density Lipoprotein) HDL levels comparable to Vitamin C. Liver and kidney functions were also significantly affected by OSCC, with nano herbals showing potential in normalizing albumin levels and positively impacting liver enzymes. In conclusion, both individually and in combination, nano herbals from Bischofia javanica leaves, and Phaleria macrocarpa fruits have the potential to be a promising treatment strategy for OSCC.

Complete blood count changes in sudden sensorineural hearing loss caused by Streptococcus suis bacterial meningitis at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar from January 2019 – May 2023

Introduction: Sudden sensorineural hearing loss (SSNHL) is an emergency case that requires immediate and comprehensive management. This condition can be caused by Streptococcus suis bacterial meningitis. Complete blood counts (CBC) examinations are often carried out in SSNHL patients that caused by infection. Some CBC components can be clinical indicators of the severity and prognosis of SSNHL. Objective: To find out the differences in CBC among S. suis bacterial meningitis patients with SSNHL and S. suis bacterial meningitis patients with normal hearing at Prof. Dr. I.G.N.G. Ngoerah Hospital Denpasar from January 2019 – May 2023. Methods: This study used an analytical research design using a retrospective case control method to compare CBC results (hematocrit, NLR, PLR, MLR, RDW and MPV) in 40 cases patients with SSNHL due to S. suis bacterial meningitis and 40 controls patients with S. suis bacterial meningitis patients with normal hearing. Result: In this study, it was found that there is no significant difference between case group compared to control group in terms of CBC results. The mean hematocrit value was 40.67 (± 4.45) in cases and 40.87 (± 4.08) in controls, with p-value 0.842. The mean MPV value was 9.82 (± 1.58) in cases and 9.33 (± 1.78) in controls, with p-value 0.200. The mean NLR value in the case group was 24.46, while in the control group it was 28.79, with p-value 0.124. The mean PLR value in the case group was 200.01, while in the control group it was 247.80, with p-value 0.126. The mean MLR value was 1.33 in cases and 1.19 in controls, with p-value 0.303. The mean RDW value was 12.98 in cases and 12.81 in controls, with p-value 0.950. Conclusion: From 40 people suffering SSNHL due to S. suis bacterial meningitis it was found that most of research subjects are men (75%) and the average age of subjects is 53 years. This study found that there were no significant differences between the results of mean hematocrit, NLR, PLR, MLR, RDW and MPV in patients with SSNHL due to S. suis bacterial meningitis compared to controls.

Complete Blood Count, C-reactive Protein, and Erythrocyte Sedimentation Rate Changes in People with Brucellosis

Background: Brucellosis is a major health and economic problem in many parts of the world, including the Middle East. Blood disorders such as anemia, leukopenia, and thrombocytopenia can be seen in brucellosis. However, laboratory findings of this disease are different. Therefore, this study aimed to investigate the changes in complete blood count (CBC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) in people with brucellosis in Gonabad community health centers.
 Methods: During the 4 years from May 2016 to May 2019, a prospective study was performed on 221 patients with brucellosis. According to the national guidelines for brucellosis, titers greater than 1/80 for Wright and more than 1/40 for 2-ME were considered positive cases of brucellosis. Using the checklist, information related to CBC, CRP, and ESR test parameters was collected.
 Results: The results showed that out of 221 patients studied, 58.4% were male and 41.6% were female. The mean age was 44.9±19.8 years for men and 49.3±17.3 years for females. High ESR was seen in 43.4% and positive CRP in 59.7% of patients. Leukopenia in 8.6%, leukocytosis in 9%, neutropenia in 6.8%, neutrophilia in 9.5%, lymphopenia in 3.6%, lymphocytosis in 10%, anemia in 17.2% and thrombocytopenia in 9.5% of patients were seen.
 Conclusion: Brucellosis in endemic areas should be considered in the differential diagnosis of patients presenting with thrombocytopenia. Also in high Wright titers, CRP is a more valuable indicator than ESR.

Evaluation of Complete Blood Count Changes in Patients Undergo Hemodialysis in Shendi Town, Sudan

Background: Chronic Renal failure is a major health problem and affects the economic and social status of patients. In Sudan, according to the ministry of health records, the prevalence of renal failure is increasing by approximately 70 to 140 new patients undergoing dialysis each year. This high frequency is thought to be due to epidemic malarial infection, which is well known to cause glomerulonephritis. Methods: This is a cross-sectional descriptive study conducted in Shendi town during the period from September 2021 to January 2022, and aimed to determine hematological parameters in hemodialysis patients. A total of venous blood samples were collected in EDTA anticoagulant containers then mix well and transfer to the laboratory, following standard procedures to prevent contamination, then count complete blood count automatically. Results: Statistical analysis by SPSS showed that the Mean of HB in pre and post-hemodialysis was(7.4g/dl and7.9 g/dl), the mean PCV in pre and post-hemodialysis was(22.7% and 25.8%), the mean of RBCs count in pre and post hemodialysis was(2.6x1012cell/l and 2.8x1012cell/l), the mean of WBCs count in pre and post hemodialysis was(5.4x109/L and 5.1x109/L), the mean of platelet count in pre and post hemodialysis was(152000cell/mm3 and 146000cell/mm3), the mean of the MCV in pre and post-hemodialysis was(86.7fl and 89.0fl), the mean of MCH in pre and post-hemodialysis was(28.3pg and 28.2pg) and the mean of MCHC pre and in post hemodialysis (32.8g/dl and 31.9g/dl). Conclusion: The study concluded that the hematological parameters in Shendi town in Hemodialysis patients cause an increase in RBCs, Hb, PCV, and lymphocyte count, no significant effect on PLTs, red cell indices not affected by hemodialysis and remain within normal range and women more affected than men as well as elder people.

The Effects of Geranylgeraniol on Blood Safety and Sex Hormone Profiles in Healthy Adults: A Dose-Escalation, Randomized, Placebo-Controlled Trial

Geranylgeraniol (GG), an ingredient extracted from the South American annatto plant, has been shown to benefit bone and muscle health, is crucial in the biosynthesis of menaquinone-4 and coenzyme Q10, and has pain and inflammation reduction activities. However, no known studies to date have demonstrated the safety and impact of GG supplementation in humans. This 8-week, randomized, placebo-controlled, dose-escalated trial was conducted to determine the effect of GG on blood safety and hormone markers in healthy adults. Sixty-six males and females between 30 and 49 years of age were supplemented with either GG or a placebo (PLA) for 8 weeks, with dose escalation from 150 mg to 300 mg occurring after 4 weeks in the treatment group. Changes in complete blood count and comprehensive metabolic panels were analyzed for whole study groups (males and females) while changes in sex hormone panels were analyzed for males and females independently. There were no significant changes in complete blood count, comprehensive metabolic panel, progesterone, estradiol, sex–hormone binding globulin, or dihydrotestosterone (p > 0.05). An exploratory analysis of testosterone levels in a subgroup of males with baseline (Pre) total testosterone < 700 ng/dL (GG = 15; PLA = 13) demonstrated a significant increase (p < 0.05) from Pre to Week 8 in total-, free-, and bioavailable testosterone (+7.5%, +15.0%, and +14.8%, respectively). This study demonstrates that GG does not significantly change the composition of blood chemistry, hematology, or sex hormone profiles in adult males or females. Given the effects observed in the exploratory analysis in a subgroup of males, GG supplementation may be beneficial for testosterone enhancement in male populations subject to low testosterone (i.e., aging males and those with late-onset hypogonadism), but further research is needed.

Machine Learning for Identification of High-Risk Clonal Haematopoiesis Using Blood Count Data

Introduction: Clonal haematopoiesis (CH) is a common, age-related phenomenon associated with an increased risk of myeloid malignancies (MM), raising the prospect of screening to identify individuals at high risk of progression from CH to MM. The nature of the driver mutation(s) is the major determinant of the risk of progression to MM. Presently, the identification of these mutations relies on next generation sequencing (NGS) of blood DNA, making it impractical to identify those at risk at scale. We previously reported that the presence of CH is associated with changes in complete blood count (CBC) parameters such as the red cell distribution width (RDW), mean corpuscular volume (MCV) and others. However, individual parameters have limited discriminative power to distinguish those with CH versus those without. Here, we present a machine learning (ML) pipeline applied to a combined CBC dataset, which can be harnessed to improve our ability to identify individuals with high likelihood of carrying CH, who can subsequently be prioritised for genetic testing. Methods: Whole exome sequencing (WES) data from 454,052 UK Biobank (UKB) participants were analysed using Mutect2 to detect CH-driver mutations across the exons of 43 CH-associated genes. Germline variants were filtered using a panel of ormal and a one-sided exact binomial test. A final set of driver mutations was derived by filtering variants based on a pre-defined list of recurrent CH mutations or recurrence of >= 7 times in haematological cancers in the catalogue of somatic mutations in cancer. Fields pertaining to blood count variables were extracted and filtered to remove individuals with missing data, extreme outliers, highly correlated parameters and variables with near zero-variance resulting in 434,057 participants with complete datasets. Individuals were annotated as “CH” or “no-CH”; a Random Forest (RF) binary classifier was optimised on age, sex and 13 blood count variables as features. To quantify the robustness and stability of the model, the RF optimisation was iterated ten times, on a customised cross validation approach by using a different random sample from the majority (control) class each time. All ML models were constructed using the Caret package (R version 3.6.3). Results: We first found that RF classifiers to identify the presence of CH overall performed poorly (median AUC: 0.640/0.671 for any/large clone VAF >=10% CH respectively). However, gene-specific models showed that the presence of CH associated with mutations in certain high risk genes ( SF3B1, SRSF2, JAK2, CALR) could be predicted from blood counts more confidently (median AUC 0.776, 0.834, 0.933, 0.849 respectively). By contrast, mutations in the more common CH driver genes ( DNMT3A and TET2) could not be accurately predicted from blood count data (median AUC 0.618 and 0.666 respectively) (Figure 1). In light of these findings, we proceeded to build a single RF model to predict the presence of high-risk CH associated with mutations in any of SF3B1, SRSF2, JAK2 or CALR. This performed well, with median AUC of 0.816/0.888 for any/large clone high-risk CH respectively (Figure 2). Our RF models were also able to give insights into novel blood count association with specific types of CH; in particular we found that the basophil count was an important predictor of the presence of CH driven by mutation in codon K57 of the GNB1 gene. To investigate this further, we analysed basophil counts in the UKB and confirmed that basophilia (basophils >0.2 x 10 9/L) was more common amongst carriers of GNB1-K57 mutations (14/234 = 5.9%) than controls (2597/433,863 = 0.5%). Conclusions: Data-driven ML models applied to blood count data can identify individuals with high-risk CH driven by genes associated with progression to myelodysplastic syndrome and myeloproliferative neoplasms, who should be prioritised for genetic testing for somatic mutations. The future integration of raw blood analyser and longitudinal blood count data into predictive models would be an important next step towards improving our ability to identify individuals that may harbour CH and help facilitate the introduction of large-scale screening for the phenomenon.

Novel Bone Marrow/HSC-Targeted, Megakaryocyte-Derived Extracellular Vesicle Delivery Modality for In Vivo Gene Therapy

Gene therapy lacks tools to deliver in a safe and tissue-targeted manner. Limitations include toxicity, off-target effects due to targeting, and inability to repeat dose. We have developed a novel megakaryocyte-derived extracellular vesicle (MkEV)-based non-viral gene therapy delivery platform that preferentially targets bone marrow in vivo. Here we present work showing that STRM.BIO MkEVs: 1) pass through the liver and spleen to preferentially target bone marrow in mice and non-human primates (NHPs); 2) can selectively deliver pDNA cargo to long term HSCs to drive reporter protein expression exclusively in bone marrow following intravenous delivery in mice; and 3) present a platform to develop and deliver targeted gene therapies in vivo that are safe for repeat dosing. Our vision is to open the door to the future of medicine for patients living with rare diseases worldwide and bring gene therapy to life. Primary human CD34+ hematopoietic stem and progenitor cells (hHSPCs) were differentiated into megakaryocytes in vitro. MkEVs were harvested and loaded with pDNA via electroporation, followed by DNase treatment to remove free cargo. For in vivo biodistribution and cargo-mediated protein expression studies, STRM.BIO MkEVs were exogenously labeled with fluorescent dye (PKH26, Cell Tracker Deep Red, and/or DiD), loaded with cargo, and IV-injected into mouse tail veins (wild type or NSG) or NHPs (cynomolgus monkeys). Tissues were collected 16-48h after IV injection, with MkEV tissue biodistribution quantified by dye fluorescence (Mean Fluorescence Intensity (MFI), plate reader) normalized to tissue weight or genomic DNA input, and pDNA cargo quantified by qPCR. Additionally, quantification of MkEVs+ cells was performed by flow cytometry analysis of murine bone marrow derived sub-populations (lineage negative, c-Kit +, Sca-1 + (LSK); lineage positive (Lin +); and, long-term HSCs (LT-HSCs; Lin -/CD150 +/CD201 +)) cells. Protein expression from MkEV-loaded pDNA cargo was similarly determined by plate reader fluorescence data and confocal microscopy. In mouse biodistribution studies, DiD-labeled MkEVs were predominantly detected in bone marrow, followed by liver and spleen 16h-post tail vein injection (plate reader analyses: Bone Marrow - 1.1e 4 ± 0.2 SD; Liver - 9.6e 3 ± 1.0 SD; Spleen - 1.8e 4 ± 0.2 SD. MFI/g tissue; n=3mice/group). Flow cytometry analyses show MkEVs preferentially targeted the hematopoietic compartment (of the MkEV+ cells, 94 ± 1% CD45+ vs 6 ± 1% CD45-, respectively), specifically, the HSPCs (68%, LSK) and LT-HSCs (100%) 48h post intravenous delivery via tail vein injection. Pharmacokinetic studies show that while MkEVs can circulate through highly vascularized tissues like the liver and spleen, they accumulate in the bone marrow. Strikingly, miRFP encoded by the pDNA was exclusively detected in bone marrow (p<0.0001 vs. all other tissues; Fig. 1). In NHPs, dye-labeled MkEVSs were loaded with a MkEV-driven eGFP reporter plasmid. Studies showed preferential biodistribution to bone marrow, and preferential qPCR amplification of the pDNA cargo in bone marrow (both MFI/ ACTB and GFP/ ACTB were significantly higher vs. all other tissues: range p<0.05 through p<0.0001), Fig. 2. A tolerability and repeat dosing study was performed in NHPs. Monkeys were injected with 4 weekly doses of STRM.BIO MkEVs and serial bloodwork was obtained 6h post dose for cytokine evaluation and 5 days post dose for end organ damage assessment (n=4). The study showed no evidence of kidney, hematologic, or liver damage as evidenced by normal creatinine and electrolytes, no significant changes in complete blood counts, coagulation parameters, or liver function tests. There was no evidence of significant cytokine release or inflammatory changes on tissue histology. These data confirm that MkEVs are non-toxic and the platform is amenable to repeat dosing. Taken together, these data establish an advanced gene therapy platform that can target bone marrow specifically following in vivo administration in both mice and NHPs, potentially eliminating the need for current ex vivo approaches to treat rare blood disorders, and providing the critical ability to repeat dose as required in clinic. STRM.BIO is leveraging our platform to develop gene therapies for rare blood diseases in people.

Parameters of Complete Blood Count and Blood Chemistry during Treatment of Patients with MDR/XDR Pulmonary Tuberculosis with a Short-Course Regimen Containing Bedaquiline, Pretomanid, and Linezolid

The objective: assessment of changes in the parameters of complete blood count, clinical urine tests, and blood chemistry during chemotherapy of patients with MDR/XDR pulmonary tuberculosis receiving the short-course regimen containing bedaquiline, pretomanid, and linezolid (B-Pa-L).Subjects and Methods. 18 patients with MDR/pre-XDR/XDR pulmonary tuberculosis were enrolled into the study. They all received treatment at Central Tuberculosis Research Institute from 2015 to 2022.Results. In the course of chemotherapy of these patients, changes in laboratory test results were noted at different times. Abnormal changes in complete blood count were detected in 10/18 (55,6%) patients during chemotherapy for the 1st time. Hemoglobin levels, erythrocyte and leukocyte counts decreased. Hematuria and bacteriuria were detected by clinical urine test. Proteinuria was observed in almost in half of the patients. Elevated serum potassium level was frequently noted. Blood chemistry demonstrated elevated levels of ALT and AST, which is typical of cytolytic effect on hepatocytes of drugs within chemotherapy. In most cases, all above abnormalities were degree 1 of toxicity and resolved within 2-4 weeks after they were detected. Abnormalities in grade 2-3 of toxicity were mainly observed in patients receiving linezolid at the dose of 1200 mg/day. In most cases, the above abnormalities were detected during the first 4 weeks of chemotherapy.

Role of chest computed tomography in the diagnosis of SARS-CoV-2 pneumonia in children

Background: First PCR-confirmed COVID-19 cases among Russian children were reported in early March 2020. Chest computed tomography (CT) is the most sensitive imaging modality in diagnosing early signs of viral lung damage. Limited data are available on clinical and laboratory features of COVID-19 in children and on their correlation with imaging findings. Studying COVID-19 features in children is crucial for modern medicine, which makes our research relevant.Objective: To determine the diagnostic efficacy and correlation between laboratory, clinical, and CT findings in children and adolescents with COVID-19.Materials and methods: From February 2020 to February 2021 372 patients with suspected COVID-19 were admitted to Morozov Children’s City Clinical Hospital (Moscow, Russian Federation). This retrospective study included 158 patients who presented with positive oropharyngeal and nasopharyngeal swab results, IgM and IgG test results, changes in complete blood count, blood biochemistry and coagulation test results, clinical symptoms, and suspected SARS-CoV-2 pneumonia based on chest CT findings.Results: Chest CT sensitivity and specificity for diagnosis of SARS-CoV-2 pneumonia were up to 98% and 85%, respectively. We considered that severe respiratory motion artifacts in young children under general anesthesia adversely affected the diagnostic efficacy. Sensitivity and specificity in this group were up to 89% and 71%, respectively.Conclusions: Viral pneumonia signs on chest CT scans were statistically significantly more frequent in children with cough, respiratory failure signs, lymphopenia, and increased D-dimer and C-reactive protein levels. One of these signs or a combination of them are an indication for chest CT in children with suspected SARS-CoV-2 pneumonia.

The Effects of Therapeutic Intermittent Hypoxia Implementation on Complete Blood Count Parameters: An Experimental Animal Model

Objective: Intermittent hypoxia (IH) implementation is a method performed by intermittently decreasing oxygen concentration in inhaled air at specific rate. This method varies between studies in terms of its application. This study aims to examine the changes in Complete Blood Count (CBC) parameters caused by IH implementation at therapeutic dose ranges with a single model.
 Methods: Ten Sprague Dawley type adult male rats were divided into two groups. In the study group, FiO2 level of inhaled air, was reduced to 10% in hypoxic cycle. 5 minutes normoxia-hypoxia cycle was used in each 30 minutes experiment period for study group. Control group remained in normoxic air for 30 minutes. 1 cc of blood was taken from mandibular vein from all rats at the end of 6th day. CBC analyzes were performed and differences between two groups were investigated.
 Results: Significant differences were detected in some CBC parameters between the two groups. It was determined that significant increase in MONO (p

Effect of eradication treatment for Helicobacter pylori on complete blood count and inflammatory parameters

Background and aims: Previously Helicobacter pylori (H. Pylori) infection was held responsible for changes in complete blood count and inflammatory parameters. But changes in these parameters after eradication treatment was not entirely evaluated. This study was designed to evaluate the effect of eradication threatment for H. pylori infection on inflammatory markers and complete blood count parameters. Materials and method: This single center observational study enrolled participants who came to internal medicine outpatient clinics because of dyspeptic complaints and who were diagnosed to have H. pylori infection after endoscopic evaluation, between July 2021 and January 2022. Participants who were tested negative for H. pylori stool antigen test eight weeks after eradication treatment were included. Complete blood count and infammatory parameters before and after eradication treatment were compared. Results: Mean participant age was 43.84±12.59 years. There were significant decreases in C-reactive protein (CRP), platelet to lymphocyte ratio (PLR) and neutrophile to lymphocyte ratio (NLR) after eradication. Changes in platelet counts and mean platelet volumes (MPV) were insignificant. Conclusion: CRP, PLR and NLR were significantly lower after eradication for H. pylori. These parameters may be useful, simple, available and non-invasive tests that may be used in evaluation of eradication treatment for H. pylori.

Evaluation of the effectiveness of empirical and computational methods for determining volumes of blood loss in the surgical treatment of burned patients

Relevance. The problem of determining intraoperative blood loss in combustiology remains relevant today. With the variety of existing methods of its assessment, the issue of optimizing transfusion therapy remains debatable. Intention. To evaluate effects of the eschar excision area on the complete blood count and to compare results of computational methods for determining volumes of blood loss with actual volumes of blood exfusion. Methodology. 73 burned patients were included in the retrospective study. Early surgical excision with simultaneous autodermoplasty was performed in all patients. To achieve the study purposes, the intervention areas were compared with changes in hemoglobin, hematocrit, volume and number of red blood cells. The prospective study included 20 volunteers who donated 450 ml of the whole blood. In this group, donated volumes were compared with calculated volumes of blood loss (according to PG. Budny and G.D. Warden). The data obtained were processed via Microsoft Office Excel 2007 and IBM SPSS Statistics 20.0 using descriptive, parametric and nonparametric statistics. Results and Discussion. According to the retrospective analysis, actual areas of excision were not consistently related to the changes in complete blood count in the postoperative period. Based on the results of prospective analysis, we were able to reveal correlations between actual volumes of blood loss and changes in hemoglobin concentrations in somatically healthy volunteers (by PG. Budny). There were no similar correlations between volumes of blood loss and decreased hematocrit (by G.D. Warden). Conclusion. According to the results of the study, we couldn't confirm the effectiveness of empirical methods for determining volumes of blood loss in burned patients. The PG. Budny formula gives representative results of blood loss volumes in healthy volunteers. However, the effectiveness of this method in combustiology requires further research.

The efficacy of curcumin-piperine co-supplementation on clinical symptoms, duration, severity, and inflammatory factors in COVID-19 outpatients: a randomized double-blind, placebo-controlled trial

BackgroundCOVID-19 pandemic has made the disease a major global problem by creating a significant burden on health, economic, and social status. To date, there are no effective and approved medications for this disease. Curcumin as an anti-inflammatory agent can have a positive effect on the control of COVID-19 complications. This study aimed to assess the efficacy of curcumin-piperine supplementation on clinical symptoms, duration, severity, and inflammatory factors in patients with COVID-19.MethodsForty-six outpatients with COVID-19 disease were randomly allocated to receive two capsules of curcumin-piperine; each capsule contained 500 mg curcumin plus 5 mg piperine or placebo for 14 days.ResultsMean changes in complete blood count, liver enzymes, blood glucose levels, lipid parameters, kidney function, and c-reactive protein (CRP) were not significantly different between the two groups. There was a significant improvement in health status, including dry cough, sputum cough, ague, sore throat, weakness, muscular pain, headache, and dyspnea at week 2 in both curcumin-piperine and placebo groups (P value < 0.05); however, the improvement in weakness was more in the curcumin-piperine group than with placebo group (P value 025).ConclusionThe present study results showed that curcumin-piperine co-supplementation in outpatients with COVID-19 could significantly reduce weakness. However, in this study, curcumin-piperine co-supplementation could not significantly affect the other indices, including biochemical and clinical indices.Trial registrationIranian Registry of Clinical Trials IRCT20121216011763N46. 2020-10-31

Effect of Plasma and Blood Donations on Levels of Perfluoroalkyl and Polyfluoroalkyl Substances in Firefighters in Australia

Elevated levels of blood perfluoroalkyl and polyfluoroalkyl substances (PFASs) have been associated with a range of adverse health outcomes. Firefighters have been exposed to PFASs in firefighting foams and have previously been shown to have higher PFAS levels in blood samples than the general population. No interventions have been shown to reduce PFAS levels. To examine the effect of blood or plasma donations on PFAS levels in firefighters in Australia. This 52-week, open-label, randomized clinical trial enrolled participants from May 23 to August 23, 2019. Participants were 285 Fire Rescue Victoria staff or contractors with serum levels of perfluorooctane sulfonate (PFOS) of 5 ng/mL or more who were eligible to donate blood, had not donated blood in the 3 months prior to randomization, and were able to provide written informed consent. Analysis was performed on an intention-to-treat basis from May to July 2021. Firefighters with baseline PFOS levels of 5 ng/mL or more were randomly assigned to donate plasma every 6 weeks for 12 months, donate blood every 12 weeks for 12 months, or be observed only. The primary end points were changes in the serum PFOS and perfluorohexane sulfonic acid (PFHxS) levels after 12 months of plasma or blood donations or after observation only. Secondary end points included changes in serum PFAS levels from week 52 to week 64, changes in other PFASs, and changes in complete blood count, biochemistry, thyroid function, and lipid profile from screening to week 52. A total of 285 firefighters (279 men [97.9%]; mean [SD] age, 53.0 [8.4] years) were enrolled; 95 were randomly assigned to donate plasma, 95 were randomly assigned to donate blood, and 95 were randomly assigned to be observed. The mean level of PFOS at 12 months was significantly reduced by plasma donation (-2.9 ng/mL; 95% CI, -3.6 to -2.3 ng/mL; P < .001) and blood donation (-1.1 ng/mL; 95% CI, -1.5 to -0.7 ng/mL; P < .001) but was unchanged in the observation group. The mean level of PFHxS was significantly reduced by plasma donation (-1.1 ng/mL; 95% CI, -1.6 to -0.7 ng/mL; P < .001), but no significant change was observed in the blood donation or observation groups. Analysis between groups indicated that plasma donation had a larger treatment effect than blood donation, but both were significantly more efficacious than observation in reducing PFAS levels. Plasma and blood donations caused greater reductions in serum PFAS levels than observation alone over a 12-month period. Further research is needed to evaluate the clinical implications of these findings. anzctr.org.au Identifier: ACTRN12619000204145.

Significant changes in Complete Blood Count (CBC) and blood coagulation in SARS-CoV-2 infection: A retrospective study

Introduction: The aim of this work is to explore all the abnormalities of the hemogram and hemostasis tests in patients with severe COVID disease. Methods: A cohort of patients with COVID-19 admitted to Avicenna military hospital in Marrakech during the 6 months from April to October 2020 was retrospectively analyzed. The baseline data of laboratory tests, including complete blood count (CBC) and coagulation tests. Results: A total of 218 individuals were enrolled, with 82 patients meeting the criteria for severe covid and admitted to the intensive care unit, and 136 considered stable and admitted to the medicine departments. The average age of patients with severe covid is significantly higher than non-severe patients (65.21 ± 5.71 versus 49.13 ± 7.81, p = 0.038). Between the groups with severe and non-severe COVID-19: only platelets, lymphocytes and D-dimer showed statically significant difference (P= 0.0001, 0.003 and 0.0001 respectively). But the differences were relatively small for the other parameters. The calculated parameters NLR, d-NLR, and LMR did not differ statistically between the two study groups with the exception of PLR, which was positively correlated with the severity of COVID (P= 0,007). The ROC analysis showed that the best area under the curve (AUC) was obtained with platelet rate, D-dimer and PLR (0.86, 0.73 and 0.69 respectively) with the best cut-offs (250 g/L, 0.5mg/l and 300 correspondingly). Conclusion: Thrombocytopenia, lymphopenia, increased PLR and D-dimers are often encountered during severe Covid and can be used as a predictive marker for the severity of the disease.

Significant changes in Complete Blood Count (CBC) and blood coagulation in SARS-CoV-2 infection: A retrospective study

Significant changes in Complete Blood Count (CBC) and blood coagulation in SARS-CoV-2 infection: A retrospective study

Hematological and immunological responses to naturally occurring bovine respiratory disease in newly received beef calves in a commercial stocker farm.

The objective was to determine temporal changes in hematological and immune parameters in response to naturally occurring bovine respiratory disease (BRD) in commercially managed stocker calves. Forty newly weaned beef steers purchased from auction markets were housed at a commercial stocker operation in Crossville, TN. Blood samples, rectal temperature, and thoracic ultrasonography (TUS; 1: normal to 3: severe) were collected on days 0, 7, 14, and 21. Castration status (FC: freshly castrated; PC: previously castrated) was determined on arrival based on presence of a fresh castration site at the scrotum. Calves received antibiotics for BRD based on clinical severity scoring (CSS; 0: moribund, 4: moribund) and rectal temperature. Complete blood counts (CBC) were performed. Calves were categorized based on the number of treatments (NumTrt) received (0x, 1x, and 2x). Temporal variations in CBC and immune parameters were analyzed using mixed model repeated measure ANOVA (Proc GLIMMIX; SAS 9.4). Variation of CBCs and immune parameters based on TUS was determined using mixed model ANOVA. There was a NumTrt by day interaction effect on the responses of white blood cells (WBC) (P = 0.04) and haptoglobin (HPT) (P = 0.04). On day 21, WBC were greater in the 2x NumTrt group than other groups, but there were no differences in WBC between NumTrt levels on other days. Haptoglobin was greater in the 2x group on days 14 and 21 than 0x or 1x. Red blood cells (RBC) (P = 0.02) and WBC (P = 0.04) differed between FC and PC groups, and lower RBC and WBC were observed in the FC group. A castration status × day effect for mean corpuscular volume (MCV; P = 0.04) was observed where FC group had higher MCV at days 14 and 21 than the PC group. Tumor necrosis factor-α differed based on NumTrt (P = 0.03) and higher concentrations were found in 2x group. We observed a day effect for IL-1β (P = 0.009) and TNF-α (P = 0.001). Significant effect of TUS on HPT at day 14 (P = 0.0004) and day 21 (P = 0.002) was observed. Combining HPT and platelet explained 15% of the variability in treatment status on a given day, whereas HPT and hemoglobin explained 10% of the variability in lung consolidation status. Although hematological and immunological parameters varied largely in our study, the potential of combining HPT with hematological variables should be studied further. Results from this study would help in understanding temporal changes in CBC and immune parameters in newly received stocker cattle.

Clinical and immunological characteristics of moderate-to-severe forms of COVID-19 at different levels of the tissue damage marker (lactate dehydrogenase)

Objective: To study the features of the immune status in patients with a moderate-to-severe course of COVID-19, depending the levels of blood lactate dehydrogenase.Materials and Methods: A total of 24 patients with a moderate-to-severe form of COVID-19 were examined. The control group consisted of 21 healthy volunteers. Methods: clinical, paraclinical (computed tomography of the lungs; complete blood count, blood biochemistry; immunological studies), statistical.Results: Changes in complete blood count and blood biochemistry in patients with moderate-to-severe COVID-19 consist in granulocytosis, lymphopenia, monocytopenia, and an increase in the level of C-reactive protein, lactate dehydrogenase, with a simultaneous decrease in the total protein content. In patients with high levels of lactate dehydrogenase, a redistribution of lymphocyte populations towards B-cells was revealed with a decrease in the total number of T-cells. At the same time, there was a decrease in the production of IgM and IgG and a simultaneous increase in the synthesis of IgA.Conclusions: The increase in blood LDH in COVID-19 patients is associated with a decrease in the content of T-cells due to severe lymphopenia, and a simultaneous increase in the content of B-cells without adequate enhancement of their antibody production function.

Multinational Study on the Clinical and Genetic Features of the ERCC6L2-Disease

Biallelic mutations in ERCC6L2 were first reported to cause bone marrow failure (BMF). Additionally, we recently described a strong predisposition to erythroid lineage-restricted acute myeloid leukemia (AML-M6). Today, 31 ERCC6L2-mutated cases have been reported. This study aims to further explore the clinical and molecular features, as well as outcomes, of the ERCC6L2 patients.By June 2021, we have gathered clinical and genetic characteristics of 46 subjects in 31 families with biallelic germ line ERCC6L2 mutations from Finland (n = 21), France (n = 8), Israel (n = 1), Sweden (n = 4), and referred to a center in the United Kingdom (n = 12). Extension of the data collection from additional countries is ongoing.According to our data, ERCC6L2-disease often presents first as mild and fluctuating cytopenias with underlying bone marrow (BM) hypoplasia. With increasing age, patients develop clonal hematopoiesis with somatic mutations in TP53, and ultimately myelodysplastic syndrome (MDS) leading to a very high-risk acute myeloid leukemia.The median age of the patients at first referral to a hematologist was 18 years (range 6-65 years old). Characteristic changes in complete blood count (CBC) were mild thrombocytopenia, leukopenia, and sometimes macrocytosis. In individual pediatric or adolescent cases, more pronounced pancytopenia has also been noted. Severe BM hypoplasia was detected in many patients despite only mild changes in the CBC indicating that examining the histology of the BM biopsy, in addition to BM aspirate and CBC, is crucial. Also spontaneous, possibly transient, recovery of CBC in a few patients has occurred. All but one patient above 10 years of age, and with data from somatic mutation analysis (n = 17), carried one to four somatic TP53 mutations in their bone marrow. Among the 46 subjects, nine have been diagnosed with MDS and nine with AML (six with The French-American-British subtype M6, erythroleukemia; three with non-specific subtypes). Interestingly, increased reticulin fibrosis in the BM has been identified in at least three out of nine patients with MDS. In the nine patients diagnosed with AML, the median age of the appearance of leukemia was 37 years (range 20-65). Characteristic of TP53-mutated AML, all leukemia patients had complex hematologic karyotype and have deceased, despite intensive therapy, within one year of diagnosis.Approximately half of the patients with ERCC6L2-disease have been identified in Finland. The great majority of the patients (20/21) carry the same biallelic ERCC6L2 mutation (NM_020207.7) c.1424delT (p.Ile475ThrfsTer36). None of the Finnish families (n = 14) are consanguineous, but according to them, the ancestries reside in North-Eastern Finland indicating a founder effect. A more detailed genealogical analysis is ongoing and we suggest ERCC6L2-disease to be added to the Finnish Disease Heritage as the first cancer predisposition syndrome. Like many of the conditions identified in genetic isolates, ERCC6L2-disease is not restricted to Finland. Thus the current global effort to define the phenotype, as well as further molecular studies, will bring guidance to clinicians for tailoring follow-up and therapies for patients with ERCC6L2-disease. As a novel entity in the field of inherited bone marrow syndromes, we want to increase the awareness of ERCC6L2 -disease and encourage clinics to integrate ERCC6L2 into their germ line testing. DisclosuresSiitonen: celgene: Membership on an entity's Board of Directors or advisory committees; Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees; abbvie: Membership on an entity's Board of Directors or advisory committees; Janssen-Cilag: Consultancy, Membership on an entity's Board of Directors or advisory committees; Brystol Myers Squibb: Consultancy; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees; amgen: Honoraria.

Dietary therapeutic and preventive food products in complex therapy of gastroinal tract diseases associated with Helicobacter pylori

Introduction. The paper presents modern literature and clinical research data on the efficacy and safety of dietary therapeutic and prophylactic foods in the complex therapy of diseases associated with Helicobacter pylori. Aim. To assess the efficacy and safety of the use of dietary therapeutic and prophylactic food products in the complex therapy of diseases of the gastrointestinal tract associated with Helicobacter pylori. Materials and methods. To evaluate the efficacy of dietary therapeutic and prophylactic food products such as Vegetable Puree Soup with Herbs and Oatmeal, Oatmeal Porridge with Herbs and Flax Seed, Protein-Sea Buckthorn Cocktail (LEOVIT Nutrio LLC), the main group of patients with gastrointestinal diseases (n = 41) was formed, which was further divided into four subgroups. Each of three subgroups received one specialty food product, and the fourth subgroup received all three products. Changes in complete blood count were evaluated using Sysmex XT-2000i analyzer, those in proteinograms – using SAS1, SAS2 protein fraction analyser and those in metabolic liver disorders, lipid profile and glucose level – using Konelab PRIME 30i (Thermo Fisher Scientific) analyzer. All parameters were studied three times: before use, 14 and 60 days after use of the products. Results and discussion. After 14 days, complaints of lack of appetite decreased in the main group, discomfort in the epigastrium, feeling of heaviness and nausea decreased. After 60 days, 100% of patients reported no heartburn, belching, nausea, pain, rumbling in the abdomen, appetite and stool returned to normal. There was a marked significant (p &lt; 0.05) decrease in the level of alpha-1 globulin against the background of an increase in albumin, a decrease in the concentration of CRP and ESR, the levels of leukocytes and neutrophils in all subgroups of the main group after 60 days. Conclusions. The investigated products are safe, no adverse reactions were noted, including the phenomena of intolerance and allergies, and are recommended for use in dis[1]eases of the gastrointestinal tract associated with Helicobacter pylori.