Complete Blood Count Tests Research Articles

Systemic immune-inflammation landscape in brain metastasis needing neurosurgical resection: Analysis of 230 consecutive cases in a single center.

BackgroundSystemic immune‐inflammation states across the heterogeneous population of brain metastases are very important in the context of brain‐immune bidirectional communication, especially among the patients needing neurosurgical resection. Four blood cell ratios based on complete blood count (CBC) test serving as prognostic biomarkers have been highlighted by previous studies, including systemic immune‐inflammation index (SII), neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and lymphocyte‐to‐monocyte ratio (LMR). However, the presurgical systemic immune‐inflammation landscape in brain metastasis needing neurosurgical resection is limited.MethodsPatients with brain metastases admitted to the Department of Neurosurgery at the National Cancer Center, Cancer Hospital of Chinese Academy of Medical Sciences between January 2016 and December 2019 were included. Based on peripheral blood cell counts in CBC test before neurosurgical resection, four systemic immune‐inflammation biomarkers (SII, NLR, PLR, and LMR) were calculated. We characterized the changes of SII, NLR, PLR, and LMR in patients with brain metastasis before neurosurgical resection and the associations of these types of immune‐inflammation states with patient demographics. In parallel, the corresponding data from the relative healthy populations without systemic diseases were enrolled as the control in the present study.ResultsBrain metastases induced systemic immune‐inflammation perturbation, which was characterized by a significant increase in SII (p < .01) and NLR levels (p < .01) and a significant decrease in the LMR level (p < .01) in comparison with the healthy control group. Moreover, patients with male gender, less Karnofsky Performance Status (KPS) scores (<70), specific pathological subtypes, extracranial transfer, and history of both systemic and radiation therapy may have significant differences in one or more of these biomarkers, which indicated poorer systemic immune‐inflammation states.ConclusionsThis study provides evidence that brain metastasis is associated with perturbations in presurgical systemic immune‐inflammation states. We should pay attention to the systemic immune‐inflammation perturbations following brain metastasis in clinic, especially in the subpopulations with high risks.

Significance of Immature Platelet Fraction in Diagnosed Patients of the Immune Thrombocytopenic Purpura

Objective: Determination of significance of immature platelet fraction (IPF%) in diagnosed patients of Immune thrombocytopenic purpura (ITP).&#x0D; Study Design: It was a cross-sectional study.&#x0D; Place and Study Duration: Haematology department, Armed forces Institute of Pathology (AFIP), Rawalpindi Pakistan June 2021 to December 2021.&#x0D; Methodology: Patients of all ages and genders diagnosed with ITP and platelets less than 100 x 109/L after a review of peripheral blood film were included in the study. Detailed history and examination were made, complete blood count (CBC) test was done on Sysmex XN-3000 automated haematology analyzer. Peripheral blood was stained with Leishman stain and examined under a microscope to rule out pseudo thrombocytopenia and the presence of abnormal cells and dysplasia. After adequate quality and control, the immature platelet fraction was performed on Sysmex XN 3000.&#x0D; Results: Seventy-two diagnosed cases of immune thrombocytopenic purpura were part of the study. The mean age of the patients was 21.00±14.50 years. 34 (48%) patients were males, and 38 (52%) were females. The mean platelet count was 49.40±24.60. Mean IPF was 17.90±9.50 per microliter. Immature platelet fraction (IPF%) was raised in all the patients with immune thrombocytopenic purpura, confirming our hypothesis that IPF% was an independent predictor for the detection of ITP.&#x0D; Conclusion: Immature platelet fraction is a unique parameter that can pick patients having thrombocytopenia due to peripheral destruction, including immune thrombocytopenic purpura.

Automated multi-class classification of lung diseases from CXR-images using pre-trained convolutional neural networks

According to the World Health Organization (WHO), Pneumonia, COVID-19, Tuberculosis, and Pneumothorax are the leading death causes in the world. Coughing, sneezing, fever, and shortness of breath are common symptoms. To detect them, several tests such as molecular tests (RT-PCR), antigen tests, Monteux tuberculin skin test (TST), and complete blood count (CBC) tests are needed. But these are time-consuming processes and have an error rate of 20% and a sensitivity of 80%. So, radiographic tests like computed tomography (CT) and an X-ray are used to identify lung diseases with the help of a physician. But the risk of these lung diseases’ diagnoses overlapping features in chest radiographs is a worry with chest X-ray or CT-scan images. To accurately classify one of four diseases with healthy images demands the automation of such a process. There is no method for identifying and categorizing these lung diseases. As a result, we were encouraged to use eight pre-trained convolutional neural networks (CNN) to classify various lung diseases into COVID-19, pneumonia, pneumothorax, tuberculosis, and normal images from the chest X-ray image dataset. This classification process is divided into two phases. In the training phase, the CNNs are trained with the Adam optimizer with a maximum epoch of 30 and a mini-batch size of 32. In the classification phase, these trained networks are used to classify diseases. In both phases, the dataset is color preprocessed, resized, and undergoes data augmentation. For this, we used eight pre-trained CNNs: Alexnet,Darknet-19, Darknet-53, Densenet-201, Googlenet, InceptionResnetV2, MobilenetV2, and Resnet-18. Finally, we concluded that the best one to classify these diseases. Among these networks, Densenet-201, achieved the highest accuracy of 97.2%, 94.28% of sensitivity, and 97.92% of specificity for K=5. For K=10, it achieved 97.49% of accuracy, 95.57% of sensitivity, and 97.96% of specificity and for K=15, achieved 97.01% of accuracy, 96.71% of sensitivity, and 97.17% of specificity. Hence, the proposed method outperformed the existing state-of-the-art methods. Finally, our proposed research could aid clinicians in making quick conclusions concerning lung problems so that treatment can proceed.

Prevalence of lymphopenia in patients with Fontan circulation without protein losing enteropathy

BackgroundLymphopenia without protein losing enteropathy (PLE) is found in patients with Fontan circulation on long term follow up. Fontan associated liver disease (FALD) is a serious complication in these patients. ObjectiveThe objective of this study is to assess the prevalence of asymptomatic lymphopenia in patients with Fontan circulation and its associations with other hematological and liver function parameters. MethodsRetrospective cohort study involving 48 patients with Fontan circulation. All patients had yearly complete blood count and liver function tests performed during their routine follow up. Patients with PLE were excluded. Lymphopenia defined as absolute lymphocyte count (ALC) < 1000 cells/μL and its correlation with other hematological and liver enzymes were studied. ResultsLymphopenia was present in 9 (18.75 %) patients and was found after 10 years of post Fontan duration in 7 patients, at 5.5 years in 1 patient, and at 6.7 years in 1 patient. The mean ALC of patients with and without lymphopenia was 748 ± 190.8 versus 2053 ± 844.9 cells/μL (P = 0.002). Patients with lymphopenia had lower total white blood cell count (3.9 ± 1.9 versus 6.02 ± 2.1 × 109/L, P = 0.006) and platelet counts (180.7 ± 94.6 versus 253.6 ± 80.3 × 109/L, P = 0.02). Lymphopenia correlated with elevated aspartate transaminase (AST) (43.2 ± 9 versus 29.8 ± 6.98 IU/L, P = 0.006), Gamma glutamyl transpeptidase (GGTP) (69.5 ± 61 versus 29.8 ± 6.98 IU/L, P = 0.04) and AST – platelet ratio index (APRI) (0.7 ± 0.5 versus 0.3 ± 0.1, P = 0.001). ConclusionAsymptomatic lymphopenia is common in patients with Fontan circulation. Identification of lymphopenia with associated thrombocytopenia, elevated AST, GGTP, and APRI are necessary as these are the markers of hepatic fibrosis. Further investigations, such as MRI and liver biopsy, can be considered in these patients.

Predictors of atrial fibrillation in patients with COVID-19

Early diagnosis of atrial fibrillation (AF) predictors in coronavirus disease 2019 (COVID-19) and the appointment of additional therapy to prevent arrhythmias will improve the prognosis of patients.Aim. To identify predictors of AF in patients with COVID-19.Material and methods. This retrospective study included 1473 patients hospitalized with COVID-19. Depending on AF occurrence, the patients were divided into 2 groups as follows: group I included 95 patients with AF episodes during hospitalization; group II consisted of 1378 patients who did not have AF during hospitalization. All patients underwent a complete blood count and urine tests, a biochemical and coagulation blood tests, 12-lead electrocardiography, chest computed tomography (CT), and echocardiography.Results. Chest CT found that lung tissue involvement in patients of group I was significantly greater than in group II (p&lt;0,05). The number of patients with significant lung involvement &gt;50% (CT-3 and CT-4) was significantly higher in the AF group than in the control group. The average room air oxygen saturation upon admission to the hospital were significantly lower in patients with AF than in the comparison group (p&lt;0,05). Multivariate analysis showed that following factors have a significant effect on AF development in COVID-19 patients: age &gt;60 years, hypertension, coronary artery disease, heart failure, increased left atrial volume, large lung tissue involvement, and increased interleukin- 6 level.Conclusion. There are two following groups of predictors initiating AF in COVID-19: generally known (older age, cardiovascular disease, increased left atrial volume) and those that determine the severe COVID-19 course (large lung damage and high interleukin-6 levels).

Thyroid Stimulating Hormone in Patients with Macrocytic Anemia

Background Aims: The study aimed to examine the frequency of hypothyroidism among patients with macrocytic anemia and to compare this with the frequency of megaloblastic anemia.Materials and Methods: Routinely transferred specimens for a complete blood count test were sent to the hematology lab in our institution and prospectively screened for high mean cell volume (MCV). A total of 100 cases with macrocytosis were examined for the levels of thyroid stimulating hormone (TSH), vitamin B12 and folate levels. Statistical analysis was performed to investigate a potential association between hypothyroidism and other variables. Results: There were 52 women and 48 men. The range of age was 21–83, with a mean of 59 years. The mean MCV was 104.18 fL, while the mean hematocrit was 35.96%. Fifty-three (53%) patients had anemia. Eighteen (18%) patients had TSH level above the normal range qualifying for hypothyroidism. Among these, eight (44%) had low hematocrit and six (33%) a concomitant megaloblastic anemia. The presence of high TSH level did not show a statistically significant correlation with gender, age, vitamin B12, folate or hematocrit levels.Conclusions: Hypothyroidism is commonly present in patients with macrocytosis. Its frequency is comparable with megaloblastic anemia, and both can occur simultaneously. Routine TSH level testing is recommended in patients with macrocytosis even if hematocrit level is normal or if the patient has megaloblastic anemia.

Metabolite, protein, and tissue dysfunction associated with COVID-19 disease severity

Proteins are direct products of the genome and metabolites are functional products of interactions between the host and other factors such as environment, disease state, clinical information, etc. Omics data, including proteins and metabolites, are useful in characterizing biological processes underlying COVID-19 along with patient data and clinical information, yet few methods are available to effectively analyze such diverse and unstructured data. Using an integrated approach that combines proteomics and metabolomics data, we investigated the changes in metabolites and proteins in relation to patient characteristics (e.g., age, gender, and health outcome) and clinical information (e.g., metabolic panel and complete blood count test results). We found significant enrichment of biological indicators of lung, liver, and gastrointestinal dysfunction associated with disease severity using publicly available metabolite and protein profiles. Our analyses specifically identified enriched proteins that play a critical role in responses to injury or infection within these anatomical sites, but may contribute to excessive systemic inflammation within the context of COVID-19. Furthermore, we have used this information in conjunction with machine learning algorithms to predict the health status of patients presenting symptoms of COVID-19. This work provides a roadmap for understanding the biochemical pathways and molecular mechanisms that drive disease severity, progression, and treatment of COVID-19.

Multi-class classification algorithms for the diagnosis of anemia in an outpatient clinical setting.

Anemia is one of the most pressing public health issues in the world with iron deficiency a major public health issue worldwide. The highest prevalence of anemia is in developing countries. The complete blood count is a blood test used to diagnose the prevalence of anemia. While earlier studies have framed the problem of diagnosis as a binary classification problem, this paper frames it as a multi class (three classes) classification problem with mild, moderate and severe classes. The three classes for the anemia classification (mild, moderate, severe) are so chosen as the world health organization (WHO) guidelines formalize this categorization based on the Haemoglobin (HGB) values of the chosen sample of patients in the Complete Blood Count (CBC) patient data set. Complete blood count test data was collected in an outpatient clinical setting in India. We used Feature selection with Majority voting to identify the key attributes in the input patient data set. In addition, since the original data set was imbalanced we used Synthetic Minority Oversampling Technique (SMOTE) to balance the data set. Four data sets including the original data set were used to perform the data experiments. Six standard machine learning algorithms were utilised to test our four data sets, performing multi class classification. Benchmarking these algorithms was performed and tabulated using both10 fold cross validation and hold out methods. The experimental results indicated that multilayer perceptron network was predominantly giving good recall values across mild and moderate class which are early and middle stages of the disease. With a good prediction model at early stages, medical intervention can provide preventive measure from further deterioration into severe stage or recommend the use of supplements to overcome this problem.

Length of hospital stay and risk factors associated with prognosis in COVID-19 patients: surprising results.

In this study, we aimed to investigate the risk factors that may affect the prognosis and length of hospital stay of COVID-19 patients, particularly immunoglobulin A. Patients admitted to the relevant department or intensive care unit with a diagnosis of COVID-19 between April 2020 and January 2021 were included in the study. Demographic characteristics of the patients and blood type, immunoglobulin A (IgA), C-reactive protein, D-dimer, procalcitonin, ferritin, troponin I, complete blood count, biochemical, and COVID-19 (SARS-CoV-2) reverse transcription polymerase chain reaction test results were evaluated retrospectively from the hospital files and data system. A total of 164 COVID-19 patients were included in this study. The median age was 72 (range: 30-95) years and the gender distribution of women and men was 66/98 (40.2% vs. 59.8%, respectively). There was no statistically significant relationship between blood type and hospitalization time or mortality (p=0.497 and p=0.923, respectively). There was furthermore no statistically significant relationship between Rh group and the duration of hospitalization or prognosis (p=0.198 and p=0.827, respectively). There was no statistically significant correlation between IgA level and hospitalization time or prognosis (p=0.066, r=0.144). In the analysis of defined risk factors independently associated with death, the following were found to be significant indicators of mortality: leukopenia [beta: -2.973, OR (95% CI): 0.051 (0.003-0.891), p=0.041], glucose [beta: 0.014, OR (95% CI): 1.014 (1.001-1.028), p=0.037], D-dimer [beta: 0.001, OR (95% CI): 1.001 (1.000-1.001), p=0.023], duration of hospitalization [beta: -0.218, OR (95% CI): 0.804 (0.708-0.913), p=0.001], and duration of stay in the intensive care unit [beta: 0.348, OR (95% CI): 1.416 (1.186-1.690), p<0.001]. In our study, no relationship was found between IgA level and hospitalization time or mortality among COVID-19 patients. However, leukopenia and increased glucose, D-dimer, neutrophil count, urea, and durations of hospital and intensive care stays were found to be important predictors of mortality.

Efficacy of Kantakari Avaleha and its modified dosage form of Kantakari Avaleha granules in the management of bronchial asthma – An open-label randomized controlled clinical trial

Abstract Background: Bronchial asthma is a common chronic episodic respiratory disease that resemblance to Tamaka Shwasa in Ayurveda. Kantakari Avaleha is one of the primarily recommended formulations for the management of Shwasa (bronchial asthma), Kasa (cough), and Hikka (hiccup). Although Avaleha dosage forms are better medicaments, granules have an added advantage over them such as palatability, less moisture content, and easy handling. For this purpose, Kantakari Avaleha was modified into Kantakari Avaleha granules by modifying the operational procedures of Kantakari Avaleha. Aims: To evaluate and compare the efficacy of Kantakari Avaleha and Kantakari Avaleha granules in the management of bronchial asthma. Materials and method: A total of 69 patients with mild to moderate bronchial asthma were selected randomly and divided into groups A and B. Patients of groups A were treated with Kantakari Avaleha, whereas patients of groups B received Kantakari Avaleha granules. These dosage forms of Kantakari were given in the dose of six grams with lukewarm water before breakfast and dinner for 60 days and followed up for the next 30 days. Assessments were done before and after treatment as per the scoring patterns of international asthma guidelines of the Global Initiative for Asthma (GINA), Asthma Control Questionnaire (ACQ), Asthma Control Test (ACT), and Respiratory Rate (RR), Breath-Holding Time (BHT), Peak Expiratory Flow Volume (PEFV), and laboratory investigations such as complete blood count, liver and kidney function tests, and urine routine examination were also carried out. Paired t-test and Wilcoxon signed-rank test were applied to evaluate the effect of therapy in the individual group for the above-mentioned criteria. While the comparison of results between the groups was done by applying the coefficient of variation (CV). Results: Group A showed better results in most of the cardinal symptoms, ACT, and ACQ, except for BHT, RR, and GINA control in terms of CV. In both the groups, statistically, highly significant improvement was found as per the overall assessment of bronchial asthma such as ACQ, ACT, and number of episodes and the difference between the groups was statistically insignificant. Conclusion: Both dosage forms of Kantkari were found to be effective treatments for bronchial asthma with significant relieving capacity as internal use for over 2 months. Hence, Kantakari Avaleha granules could be substituted for Kantakari Avaleha.

Survival analysis and outcome prediction of COVID-19 patients: a retrospective observational study from tertiary referral hospital in Indonesia

Coronavirus Disease 2019 (COVID-19) pandemic has become a global concern. Recently, Indonesia contributed the third-highest number of new COVID-19 cases in the world. We provide supporting information for COVID-19 management. This retrospective cohort study was conducted at Dr. Soetomo General Hospital. Researchers collected demographics, comorbidity, initial laboratory tests, and complications data of patients. This study performed a comparative, survival, and Receiver Operating Characteristic (ROC) curve analysis. Survival analysis showed a decrease in the probability of survival associated with an increase in the variables of age, diabetes, white blood cell (WBC) count, and neutrophils percentage, and a decrease in lymphocytes percentage during hospitalization. Lymphocyte percentage, neutrophil-lymphocyte ratio (NLR), WBC count, neutrophil percentage, had an accuracy 0.727 (95%CI 0.642-0.812; p<0.001), 0.726 (95%CI 0.641-0.812; p<0.001), 0.706 (95%CI 0.615-0.796; p<0.001), and 0.700 (95%CI 0.612-0.788; p<0.001) respectively, in predicting worse outcome. Our study suggests routine complete blood count tests in the admission of a patient with COVID-19 infections, which can be used to determine the survival and prognosis of hospitalized patients.

Features Of Iron Metabolism In Patients With HIV Infection And Pulmonary Dissemination In Tuberculosis And Pneumonia: An Exploratory Case-Control Study

Background — Differential diagnosis of pneumonia vs. tuberculosis in patients with HIV infection and pulmonary dissemination syndrome is an important problem in contemporary clinical medicine. The goal of our study was to determine the features of iron metabolism in patients with HIV infection and pulmonary dissemination in tuberculosis and pneumonia. Methods — The case-control study was conducted on 42 cases (patients with tuberculosis, hereinafter referred to as Group 1) and 44 control subjects (patients with pneumonia, hereinafter referred to as Group 2). All of them had HIV infection and syndrome of pulmonary dissemination. For subjects in both groups, we analyzed clinical and social characteristics, along with laboratory data. We also examined hepcidin content, iron concentration, and ferritin level in blood serum, and performed statistical data processing. Findings — There were significant differences between cases and controls in terms of iron metabolism. Hepcidin and hemoglobin levels were statistically significantly higher (p &lt;0·001), whereas iron concentration was lower (p=0·0002) in patients with tuberculosis (cases). Furthermore, there were statistically significant differences between groups in CD4+ T-cell count, viral load, and RBC and WBC counts in complete blood count tests; in duration of complaints prior to hospital admission; and in terms of job stability. Conclusion — The quantitative parameters with the greatest statistical significance of the differences between the groups were iron concentration, hepcidin level, RBC count, WBC count, and CD4+ T-cell count.

Hilab system, a new point-of-care hematology analyzer supported by the Internet of Things and Artificial Intelligence

The complete blood count (CBC) is one of the most requested tests by physicians. CBC tests, most realized in conventional hematological analyzers, are restricted to centralized laboratories due to frequent maintenance, large devices, and expensive costs required. On the other hand, most handheld CBC devices commercially available show high prices and are not liable to calibration or control procedures, which results in poor quality compared to standard hematology instruments. The Hilab system is a small-handed hematological platform that uses microscopy and chromatography techniques for blood cells and hematimetric parameters analysis through artificial intelligence, machine learning, and deep learning techniques. For clinical evaluation of the handheld CBC device, 450 blood samples were analyzed. The samples encompassed normal (82%) and pathological conditions (18%), such as thalassemias (2.2%), anemias (6.6%), and infections (9.2%). For all analytes, accuracy, precision, method comparison, and flagging capabilities of the Hilab System, were compared with the Sysmex XE-2100 (Sysmex, Japan) results. The sample source (venous and capillary) influences were also evaluated. Pearson correlation, Student t test, bias, and the Bland–Altman plot of each blood count analyte were calculated and shown. The significance level was set at p ≤ 0.05. For clinical evaluation, Hilab System and the Sysmex XE-2100 showed a strong correlation (r ≥ 0.9) for most evaluated parameters. In the precision study, analytes showed CV inside the limits established according to European Federation of Clinical Chemistry and Laboratory Medicine guidelines. The flagging capabilities of the Hilab system, compared to the manual microscopy technique, presented high sensibility, specificity, and accuracy. Venous and capillary samples (p > 0.05) do not differ statistically. Considering the need for point-of-care CBCs, the study indicated that the Hilab system provides fast, accurate, low cost, and robust analysis for reliable clinical use.

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio, Novel Biomarkers and Applications in Urology: An Update

Blood cells play a vital role in homeostasis that can interact with numerous conditions such as inflammation, immune responses, hemostasis, and oncogenesis. The complete blood count test is an inexpensive and regular tool that provides a lot of informative markers revealing shifts in the different blood cell types in case of acute inflammation and prothrombotic phase. Among them, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are emerging biomarkers as the indicators and predictors for varied inflammatory responses and oncologic diseases. These markers were extensively studied in cardiovascular diseases, rheumatic diseases, colorectal, gastric lung, and ovarian cancer, as well as other diseases. In Urology field, higher NLR and PLR could be utilized for predicting prognosis and diagnosis of urinary tract infection states as well as urologic cancer diseases, such as prostate cancer, bladder cancer, and upper tract urothelial carcinoma. Also, in comparison to individuals without kidney stones, forbearing along with the kidney stones had greater NLR and PLR rates. This article aims to review some scientific evidence for the applications of NLR and PLR in Urology.

Red Cell Distribution Width and Its Association with Neonatal Bacteremia: A Case-Control Study

Background: Bacteremia is a major cause of prolonged hospital stay and mortality in neonates and its early diagnosis remains a challenge to pediatricians. Red cell distribution width (RDW) is a component of a complete blood count test which is accessible and inexpensive and has been reported to be a possible diagnostic marker for neonatal bacteremia. This study determined the association of RDW with neonatal bacteremia in term and preterm neonates. Methodology: This is a retrospective case-control study of 26 bacteremic neonates as cases and 104 non-bacteremic neonates, either symptomatic or with risk factors for bacteremia, as controls. Included newborns were seen between January 1, 2010 to September 30, 2021. Laboratory data obtained were CBC, C-reactive protein and blood culture. Results: RDW values between bacteremic and non-bacteremic neonates were not significantly different. There was an association between RDW and neonatal bacteremia at an RDW level of &gt; 16.1, where the likelihood of bacteremia was three times higher compared with lower RDW values. Significantly lower levels of hemoglobin, hematocrit, RBC count, WBC count, platelet count, MCH and MCHC, and a higher CRP level were seen among bacteremic neonates compared to those who were not. The median RDW for both term and preterm neonates was close to 16, with a narrow inter-quartile range at 1 and 2 for controls and cases, respectively. The range (minimum to maximum) of RDW values of bacteremic preterm neonates was more variable than those of term neonates. Using RDW to detect bacteremia, it had an equivocal discriminatory power or AUC of 0.6056. We found insufficient evidence to demonstrate a correlation between RDW and other CBC parameters, except for MCHC. For MCHC, the results suggest a very weak and indirect correlation. Conclusion: RDW was not significantly different between bacteremic and non-bacteremic neonates, but there was a suggested association between RDW and bacteremia at an RDW level of &gt; 16.1, at which level there was a 3-fold risk for bacteremia.

Effects of Ketone Salt Supplementation on Blood Health Parameters in Adults Diagnosed with Post-traumatic Stress Disorder

ObjectivesThe purpose of this study was to determine if ketone salt administration for six-weeks alters blood health parameters, specifically variables from the comprehensive metabolic panel and complete blood count test, in adults diagnosed with post-traumatic stress disorder (PTSD). MethodsThis clinical trial consisted of a randomized, double-blinded, placebo-controlled design. Participants included males and females between the ages of 18–65 diagnosed with PTSD. Participants were randomized to either consume a control or ketone salt supplement twice a day for 6-weeks. Blood samples via a venous blood draw were collected before and after the six-week supplementation period. Blood analyses included a comprehensive metabolic panel and a complete blood count test. A series of 2 × 2 mixed ANOVAs (time: pre- and post-intervention; group: control or ketone salt) were used to analyze the collected data for each of the dependent variables. ResultsOf the 16 subjects that finished the study, 12 had complete pre- and post- comprehensive metabolic panel and complete blood count test results. There were main effects of group for the variables aspartate aminotransferase, alanine transaminase, and mean corpuscular volume, which were significantly greater in the control group than in the ketone group (p < .05 for each). However, no significant interaction effect between group and time for any of the dependent variables was observed (p > .05 in all cases). The results demonstrate that the control and ketone salt supplements did not alter any of the variables in the comprehensive metabolic panel or complete blood count test when compared from baseline to post-six-week supplementation. ConclusionsBeta-hydroxybutyrate, a ketone body, may reduce anxiety and other sympathetic driven measures associated with PTSD, however, it is important to ensure ketone supplements to do not cause adverse effects in this populations before implementing them for possible therapeutic effects. The findings from this pilot study suggest that prolonged ketone salt supplementation may be further examined as a therapeutic option as it did not result in negative blood health outcomes. Funding SourcesPruvit Ventures, Inc. and the College of Education at Augusta University financially supported this study.

Hypokalemia : what correlation with psychotic relapse ?

IntroductionHypokalemia is often detected on standard biological assessments of patients hospitalized for psychiatric disorders. Many explanations are advanced by clinicians like insufficient food intake or drug effects. But what if there was a relationship between this ionic disorder and psychotic relapses?ObjectivesTo assess the frequency of hypokalemia in patients hospitalized for a psychotic relapse and to study its relationship with certain clinical characteristics.Methods This is a cross-sectional study conducted over a 3-month period (july-september 2021), including 37 male patients diagnosed with schizophrenia and hospitalized in a psychiatric unit for a psychotic relapse. Patients had blood collection before medication that was sent for a complete blood count and blood chemistry testing.ResultsBlood potassium level ranged from 2.92 to 4.87 mmol/L with an average of 3.74 mmol/l. Half patients ( 54.1% , N=20 ) had hypokalemia. Among them, two had electric signs on their ECG and two had physical symptoms. In patients with hypokalemia, the cause of hospitalization was the agitation in 80% of cases versus 58.8% in patients with normal potassium levels. The correlation was not significant between hypokalemia and the use of a restraint (p=0.160) or the somatic history (p=0.495).Conclusionshypokalemia is an ionic disorder that should be detected in patients with schizophrenia. It exposes the patient to the risk of a sudden death, especially with use of antipsychotics that are at a high risk for torsade de pointes.DisclosureNo significant relationships.

Survival analysis and outcome prediction of COVID-19 patients: a retrospective observational study from tertiary referral hospital in Indonesia.

Coronavirus Disease 2019 (COVID-19) pandemic has become a global concern. Recently, Indonesia contributed the third-highest number of new COVID-19 cases in the world. We provide supporting information for COVID-19 management. This retrospective cohort study was conducted at Dr. Soetomo General Hospital. Researchers collected demographics, comorbidity, initial laboratory tests, and complications data of patients. This study performed a comparative, survival, and Receiver Operating Characteristic (ROC) curve analysis. Survival analysis showed a decrease in the probability of survival associated with an increase in the variables of age, diabetes, white blood cell (WBC) count, and neutrophils percentage, and a decrease in lymphocytes percentage during hospitalization. Lymphocyte percentage, neutrophil-lymphocyte ratio (NLR), WBC count, neutrophil percentage, had an accuracy 0.727 (95%CI 0.642-0.812; p<0.001), 0.726 (95%CI 0.641-0.812; p<0.001), 0.706 (95%CI 0.615-0.796; p<0.001), and 0.700 (95%CI 0.612-0.788; p<0.001) respectively, in predicting worse outcome. Our study suggests routine complete blood count tests in the admission of a patient with COVID-19 infections, which can be used to determine the survival and prognosis of hospitalized patients.

Correlation between red blood cell distribution width, neutrophil to lymphocyte ratio, and neutrophil to platelet ratio with 3-month prognosis of patients with intracerebral hemorrhage: a retrospective study

BackgroundRed cell distribution width (RDW) is a parameter that indsicates the heterogeneity of red blood cell size and could be a prognostic factor in some diseases. Also, intracerebral hemorrhage (ICH) is considered a vascular event with a high mortality rate. We aimed to examine the role of RDW, neutrophil to lymphocyte ratio (NLR), and neutrophil to platelet ratio (NPR) in predicting the prognosis of patients with ICH.MethodsThis is a retrospective cohort study conducted on 140 patients with ICH admitted to the neurology ward and intensive care unit (ICU) in Imam Reza Hospital, Tabriz, Iran. Demographic data, National Institutes of Health Stroke Scale (NIHSS), and complete blood count test parameters were evaluated within 24 h after hospitalization. These variables were collected and re-evaluated three months later.ResultsThe mean age of the study population was 61.14 (± 16) years and 51% were male. The mean NLR (p = 0.05), neutrophil count (p=0.04), platelet count (p = 0.05), and NIHSS (p<0.01) had a significant difference between the deceased patients and those who partially recovered after three months. The ROC curve showed that NIHSS (area under curve (AUC): 0.902), followed by NPR (AUC: 0.682) variables had the highest AUC.ConclusionRDW could be a relevant prognostic factor and predictor in determining 3-months survival in ICH. Nevertheless, further large-scale prospective cohorts might be needed to evaluate the associations.

Safety and immunogenicity of live intranasal pertussis vaccine GamLVP in the experimental infant hamadryas baboon model

Introduction. The Gamaleya National Center of Epidemiology and Microbiology has developed a live intranasal pertussis vaccine, GamLVP, for protection against whooping cough. It is indicated for vaccination of infants and revaccination of adults of all age groups. Preclinical studies on suckling mice or rats and adult monkeys as well as clinical trials involving adult volunteers demonstrated safety and efficacy of the GamLVP vaccine. The expansion of the GamLVP vaccine to be used for vaccination of infants requires additional preclinical studies to assess its safety and immunogenicity in the most suitable experimental model of infant hamadryas baboons (Papio hamadryas).The aim of the study was to assess safety and immunogenicity of the GamLVP vaccine administered intranasally for a single dose, two-dose, and three-dose immunization of P. hamadryas infants.Materials and methods. The study was performed in three 1–2-month-old P. hamadryas infants kept, together with their mothers, in a separate cage. The results of the complete blood count and biochemical profile tests were measured before and after the immunization and experimental infection. The enzyme immunoassay (EIA) was used to detect any changes in the levels of specific IgG antibodies in sera from the mothers and infants; the agglutination test (AT) was used to measure titers of total anti-pertussis antibodies.Results. The intranasal immunization of P. hamadryas infants with the GamLVP vaccine triggered development of a specific humoral immune response mediated by IgG antibodies (pertussis toxin + filamentous hemagglutinin), increased titers of total agglutinating anti-pertussis antibodies, caused no local and systemic reactions, caused no changes in the complete blood count and biochemical profile. The experimental infection of the GamLVPimmunized P. hamadryas infants did not cause any changes in the laboratory blood test values and any clinical manifestations typical of the pertussis infection.