Tests Complete Blood Research Articles

Identification the early components of metabolic syndrome and some hematological test alteration related to cigarette, water pipe and dual smoking among young healthy adults: cross-sectional study

Introduction: Tobacco epidemics permitted premature death and disability due to pathophysiological alterations related to distinct smoking patterns through cigarettes or waterpipes; the latter became as prominent as cigarettes. The preliminary intentions of this study were to explore the mutual correlation of metabolic syndrome (MetS) elements with alterations in some hematological, renal, and hepatic function biomarkers due to different tobacco smoking patterns, including cigarette smokers, waterpipe smokers, and dual smokers.Methods: A total of 100 participants were equally distributed among non-smokers, exclusive cigarette smokers or water pipe smokers, and dual smokers that were recruited in Raparin district in this cross-sectional study from from 01-09-2022 to 20-12-2022. The whole group of participants were healthy, non-diabetic, normotensive, non-alcoholic, and non-coffee drinkers. A complete blood test (CBC), body mass index (BMI), lipid profile index, blood pressure, glucose hemostasis, liver enzymes such as aspartate aminotransferase (AST) and alanine transaminase (ALT)], renal excretes [involving creatinine and urea] were measured by the Cobas C111 chemical analyzer (Roche Diagnostics, Switzerland) and the Cobas e411 immunoassay analyzer subsequently (Roche Diagnostics, Switzerland). The glucose reagent strips and a Glucometer II (Miles Inc., Diagnostics Division, Elkhart, IN, USA) were used to obtain fasting blood glucose (FBG) readings, which yielded a quantitative test comparable to approved laboratory methods.Results: Some Hematological parameters including hematocrit (HCT) and red blood cells (RBCs) had a tendency to be lower in smokers’ samples compared to non-smokers, However, White blood cells (WBCs) were higher in smokers compared to non-smoker samples. Lipid profile makers including cholesterol and triglyceride including Triglyceride (TG) and total cholesterol (TC) low density lipoprotein (LDL) were higher in smokers compared to non-smokers. Fasting glucose and liver function tests including AST, ALT was higher in smokers in comparison with non-smokers. Conclusion: Our findings demonstrate that tobacco smoking directly modulates hemostasis and increases the risk of the development of metabolic syndrome components. Noteworthy, the tendency to develop MetS was more prevalent among dual smokers.

Preoperative blood tests provide diagnostic and prognostic information about patients with hepatocellular carcinoma.

Our aim was to assess parameters derived from preoperative blood tests as diagnostic or prognostic markers in patients with operable hepatocellular carcinoma (HCC). We included 210 patients who underwent liver resection as the first treatment for suspected hepatocellular adenoma (HCA) or HCC (January 2010-December 2022). Parameters originated from preoperative complete blood count and biochemical blood tests were examined for associations with clinicopathological parameters and survival. There were 31 cases of HCA and 179 cases of HCC. Fibrosis-4 index (FIB-4)≥0.77 provided the best diagnostic accuracy for differentiating between HCA and HCC [area under the curve: 0.914, P < 0.001, sensitivity: 93.8%, specificity: 82.8%, positive predictive value (PPV): 96.9%, negative predictive value (NPV): 69.9%]. Patients with T2-T4 tumours had higher levels of aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) ( P < 0.001), liver function tests index ( P = 0.005), platelets-liver function tests index (PLFTI) ( P = 0.011), and α-fetoprotein (AFP) ( P < 0.001), but the diagnostic accuracy was mediocre. Patients with moderately or poorly differentiated tumours had higher levels of FIB-4 ( P = 0.023), and AFP ( P = 0.001), providing high PPV (89.4 and 95.1%, respectively). Albumin to alkaline phosphatase ratio (ALB/ALP)>0.508 [hazard ratio (HR): 0.501, P = 0.009], FIB-4>1.41 (HR: 2.272, P = 0.007), PLFTI>0.087 (HR: 1.849, P = 0.016), and AFP>3.1 (HR: 3.066, P = 0.006) provided statistically significant results in relation to disease-free survival, and ALB/ALP>0.389 (HR: 0.505, P = 0.036) provided statistically significant results in relation to overall survival. Preoperative blood tests provide useful information in treatment-naive surgical candidates with suspected HCC regarding distinguishing from HCA, tumour differentiation, and risk of disease recurrence and death.

Machine learning and traditional analysis of the interaction between cardiovascular diseases and hematological malignancies

Abstract Background Cardiovascular diseases and clonal hematopoiesis of indetermine potential (CHIP), the premalignant state of hematological cancers, exhibit reciprocal interactions. While the presence of CHIP confer a risk for heart failure, it is unclear if cardiovascular diseases are associated with elevated risk hematological cancers. Purpose To determine the association between cardiovascular diseases (CVD) and cardiovascular risk, and hematological cancer. Methods We evaluated 27,231 adults, free of CVD and cancer, who participated in preventive healthcare program between 2000-2018. Each participant underwent a complete physical evaluation, blood test and exercise stress test at baseline. CVD was defines as ischemic heart disease, stroke, atrial fibrillation or hypertension. Then, we used machine learning and traditional survival analysis to evaluate the association between CVD and hematological cancer. For machine learning, we used the random forest method using Curat package in r, and incorporated all continuous variables gathered into the model (70% training, 30% test). For survival analysis, we first matches each CVD patient to a control patient by propensity scores to balance for age, sex, smoking, diabeles mellitus, renal function, body mass index and length of follow-up. Then, we compared the CVD and non-CVD patients using cox proportional hazard regression. Results Using machine learning, we found that the strongest predictors for hematological cancer in our cohort are low eGFR, age, high atherosclerosis cardiovascular disease score (ASCVD) and BMI. Of note, systolic and diastolic blood pressure were also strong predictors of hematological cancer (Figure A). Then, we matched 5500 CVD patients to controls with median follow-up of 9.2 years (Interquartile range 5-15 years). During follow-up, 1380 developed cancer. Of them, 186 developed hematological cancer. We used cox proportional hazard regression and Kaplan Mayer method to determine the risk and hazard ratio of developing hematological cancer (Figure B-C). Compared with subjected without CVD, patients with CVD were 91% more likely to develop cancer during follow-up, and 62% more likely to develop hematological cancer (Figure C, HR=1.61. 95%CI 1.21-2.16). Moreover, the 10-year risk to develop hematological cancer was 1.9% for patients with CVD and 1.0% for individuals without CVD (Figure D). Notably, the increased incidence of hematological cancers included 38% increase in cases of leukemia but only 11% increase in cases of lymphoma. Conclusions Using machine learning and traditional analysis we show that CVD risk and CVD were associated with increased incidence of hematological cancer. Understanding this relationship could lead to advances in cardiovascular and cancer treatment and could ultimately help to improve patient outcomes.

BLOOD VISCOSITY AND GIT DISORDERS OF HCV PATIENTS

Background: Hepatitis C virus (HCV) infection is a blood-borne viral illness responsible for significant morbidity and mortality all over the world. The current study aims to determine the role of HCV in increasing blood viscosity that is accompanied by attacks and serious heart disorders, in addition to knowing the effect of this infection on irritations and disorders of the digestive system. Methods: The practical side included collecting blood samples from 50 HCV infected persons and 50 healthy persons as a control group. Laboratory and clinical tests were carried out at Al-Diwaniyah General Teaching Hospital, where HCV was determined by checking for antibodies using the ELISA test, while blood viscosity was determined by knowing the percentage of red blood cells (hemocrit) as part of the complete blood test. Gastrointestinal tract (GIT) diseases were diagnosed using gastroendoscopy and x-rays, in addition to investigations Helicobacter pylori (H. pylori). Result: ulcers and stomach acidity with colitis together (A,B,D) were in high rates in patients (58%) compared with healthy people (6%) and produced this is a clear statistical difference (p&lt;0.05). Moreover, Blood viscosity increased (71.54%) with a rise titer of HCV in patients blood (18.38 logIU/mL) that associated with appearance of strong positive linear correlation (r= 0.965, p= 0.004). In conclusion: HCV leads to serious complications, especially the digestive system and circulation, and the risk of these disorders increases with the increased survival of the virus C in the patient's liver. Therefore, it is necessary to use appropriate treatments, especially effective modern treatments represented by Harvoni.

Usefulness of the SARC-F questionnaire and the measurement of the hand grip strength in predicting short-term mortality in older patients hospitalized for acute heart failure.

Sarcopenia is a potentially reversible syndrome that increases the risk of cardiogenic cachexia and adverse outcomes in older patients with heart failure (HF). Despite its clinical significance, sarcopenia remains underdiagnosed due to the complexities of comprehensive assessment in patients with acute HF. This study aimed to evaluate whether the SARC-F questionnaire, its inviduals components,and the handgrip strength test (HGS) can predict short-term prognostic risk in very old patients recently discharged after acute HF. We consecutively enrolled patients aged 75years or older hospitalized with acute HF in the Geriatrics Unit of a tertiary care hospital. All patients underwent physical examination, complete blood tests, point-of-care ultrasound, and a comprehensive geriatric assessment, including physical performance through SARC-F and HGS. The thirty-day post-discharge mortality rate was assessed by phone interview. Out of 184 patients hospitalized with acute HF who were enrolled in the study (mean [SD], 86.8 [5.9] years, 60.3% female), 47 died within 30days after discharge. By multivariate logistic analysis, HGS (β = -0.73 ± 0.03, p = 0.008) and SARC-F [adjusted OR = 1.18 (CI 95% 1.03-1.33), p = 0.003] resulted independently associated with mortality. Furthermore, two SARC-F sub-items, namely, limitation in rising from a chair and history of falls [aOR: 3.26 (CI95% 1.27-8.34), p = 0.008; aOR: 3.30 (CI 95% 1.28-8.49), p = 0.01; respectively] emerged as determinants of 30-days mortality. SARC-F and HGS test independently predict 30-day post-discharge mortality in oldest-old patients hospitalized for acute HF.

The relationship between severity of periapical periodontitis and next-generation systemic inflammatory biomarkers in children with early childhood caries

IntroductionEarly childhood caries (ECC) is closely associated with poor oral hygiene and cariogenic diet. Untreated ECC results in recurrent odontogenic infections and local and systemic consequences. In this study, our goal is to assess the relationship between the intensity of odontogenic infection-associated periapical periodontitis and new generation of systemic inflammatory markers (SII, NLR, PLR) in ECC-affected children.Material and method95 healthy patients in early childhood and demonstrating periapical periodontitis who underwent dental treatment under general anesthesia (GA) in the last two years were included in the present study. Their periapical statuses were dichotomized as mild and severe. Periapical Index (PAI) scores of 2 and 3 were regarded as “mild” whereas 4 and 5 as “severe”. Of the complete blood test (CBC) parameters, systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), neutrophilic granulocyte (NEUT), lymphocyte (LYMPH) and platelet (PLT) were recorded. The relationship between the degree of periapical pathology and the evaluated markers was assessed using Receiver Operating Characteristic (ROC) analysis.ResultsResults of the present study revealed that mean NLR, SII and NEUT index scores of the patients having severe periapical periodontitis were statistically higher than those of the ones with mild pathology (p < 0.05). A positive, statistically significant interrelationship was found between the number of teeth demonstrating a PAI score of severe periapical periodontitis with the signs of exacerbation (PAI 5) and NLR and SII values (p < 0.05). Area under the ROC curve (AUC) values for NLR and SII were determined as 66.8% and 66.6% respectively, indicating that classification performance was sufficient and statistically significant (p < 0.05).ConclusionPostponing the management of odontogenic infections will induce some complications such as, infective endocarditis and cause the systemic inflammatory process to continue by aggravating the systemic effects of local lesions. Thus, underlying mechanism should be eliminated and oral hygiene should be maintained, also novel biomarkers may be recommended to be used for the decision-making process for the teeth with persistent periapical lesions unresponsive to treatment.

Inflammatory Bowel Disease in Children

Background: Pediatric inflammatory bowel disease (IBD) is an idiopathic inflammatory disease in the digestive system with chronic onset, which often presents with unique and atypical phenotypes. This study aimed to dissect the important features of inflammatory bowel disease in children Discussion: The two types of inflammatory bowel disease (IBD) are ulcerative colitis (UC) and Crohn’s disease (CD). In children, IBD may exhibit classic symptoms such as weight loss, abdominal pain, and bloody diarrhea. However, many patient present with atypical symptoms such as isolated poor growth, anemia, or other extraintestinal manifestations. Early diagnosis of IBD in children is crucial as delayed diagnosis may lead to serious complications like bowel narrowing or abnormal connections, and stunted growth. The recommended initial evaluations in a pediatric patient with suspected IBD are complete blood test, stool examination, endoscopy and imaging. Furthermore, the aims of IBD treatment in children are to improve quality of life, relieve symptoms, promote normal growth, and prevent complications, all while minimizing medication side effects. Conclusion: Early diagnosis and treatment are essential in managing pediatric IBD. Additionally, addressing the disease's impact on bone health, growth, development, and psychosocial well-being is also crucial to achieve comprehensive management.

Distribution of and Relationships between Epidemiological and Clinicopathological Parameters in Canine Leishmaniosis: A Retrospective Study of 15 Years (2009-2023).

Leishmaniosis is a vector-borne disease caused by protozoan parasites of the genus Leishmania, which are zoonotic and have an important impact on animal and public health globally. Between 2009 and 2023, blood samples from domestic dogs with clinical suspicion of leishmaniosis were received from 286 veterinary medical centres throughout mainland Portugal. An enzyme-linked immunosorbent assay (ELISA) was utilised to detect antibodies against Leishmania infantum antigens. Additionally, a complete blood count and tests for total proteins, urea, creatinine and alanine aminotransferase, as well as protein electrophoresis, were also performed. No significant relationship between sex and breed was observed. The age distribution was bimodal, with the highest prevalence of disease occurring at 2-5 years of age and a secondary peak occurring at 6 years or over (p < 0.001). No statistical correlation was observed between creatinine and urea across the ELISA serological groups. In contrast, both the gamma globulin levels (r = 0.45; p < 0.001) and the albumin/globulin ratio (r = -0.36; p < 0.001) exhibited moderate correlations with the ELISA. These findings support recent seroprevalence studies in dogs, with some geographical areas in Northern Portugal exhibiting the highest values, which may be the result of geographical shifts in parasite circulation due to climate change.

Relationship of inflammatory indices with left atrial appendage thrombus or spontaneous echo contrast in patients with atrial fibrillation.

Inflammatory indices derived from complete blood tests have been reported to be associated with poor outcomes in patients with atrial fibrillation (AF). The data about the relationship between inflammatory indices and left atrial appendage thrombus (LAAT) or dense spontaneous echo contrast (SEC) are limited. To explore the value of inflammatory indices for predicting the presence of LAAT or dense SEC in nonvalvular AF patients. A total of 406 patients with nonvalvular AF who underwent transesophageal echocardiography were included and divided into two groups based on the presence (study group) or absence (control group) of LAAT or dense SEC. Inflammatory indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), were calculated from complete blood analysis. The associations of inflammatory indices with LAAT/dense SEC were analyzed using logistic regression. LAAT and dense SEC were detected in 11 (2.7%) and 42 (10.3%) patients, respectively. The PLR only showed an association with LAAT/dense SEC in the univariate model. Elevated NLR (odds ratio [OR] = 1.48, 95% confidence interval [CI]: 1.11-1.98, P = 0.007) and reduced LMR (OR = 0.59, 95%CI: 0.41-0.83, P = 0.003) were found to be independent risk factors for the presence of LAAT/dense SEC. The areas under the NLR and LMR curves for predicting LAAT/dense SEC were 0.73 (95%CI: 0.66-0.80, P < 0.001) and 0.73 (95%CI: 0.65-0.81, P < 0.001), respectively, while the cutoff values were 2.8 (sensitivity: 69.8%; specificity: 64.0%) and 2.4 (sensitivity: 71.7%; specificity: 60.6%), respectively. Increased NLR and decreased LMR may predict LAAT/dense SEC in patients with nonvalvular AF.

Gambaran Hematologi dari Pemberian Anestesi Kombinasi Ketamin-Xilazin dan Ketamin-Diazepam pada Pelaksanaan Kastrasi Anjing

Carrying out castration on dogs requires anesthesia to prevent movement and relieve pain during the operation. The aim of this study was to determine the effect of administering two combinations of general anesthesia, ketamine - xylazine and ketamine-diazepam on the blood features of dogs undergoing castration procedures. The dogs used in this study were 6 dogs, domestic breed, male and aged between six months and one year. Blood sampling from the cephalic antebrachii vein of 1 ml was carried out twice, thirty minutes before surgery and sixty minutes after surgery. The average results of post-operative complete blood tests in dogs given ketamine (10 mg/kg body weight, iv) – xylazine (1 mg/kg body weight, iv) anesthesia, include: total erythrocyte count 5.84 x 106/µL, haemoglobin 12.27 g/dL, haematocrit 36.7%, and leukocytes 15.4 x 103/µL. The average results of post-operative complete blood tests in dogs given ketamine (10 mg/kg body weight, iv)–diazepam (0.2 mg/kg body wight, iv) anesthesia, include: total erythrocyte count 5.98 x 106/µL, haemoglobin 11.77 g/dL, haematocrit 36.23%, and leukocytes 16.4 x 103/µL. Based on the results of statistical analysis using the independent t-test, the number of erythrocytes, haemoglobin, haematocrit and post-operative leukocytes between the two groups was not significantly different (P&gt;0.05). The use of the combination of ketamine-xylazine and ketamine - diazepam during castration did not cause changes in the number of erythrocytes, haemoglobin, haematocrit and leukocytes.

Kegiatan Skrining Pemeriksaan Hemoglobin dan Hematokrit terhadap Penyakit Anemia pada Kelompok Lanjut Usia di Panti Werda Hana

Anemia in the elderly is a common condition characterized by a decrease in red blood cells or hemoglobin levels, causing various health problems. Anemia is defined as a hemoglobin level below 13 g/dL in men and 12 g/dL in women. Various factors, such as inadequate nutritional intake, chronic inflammation, and kidney disease, often cause anemia in this population. Untreated anemia impacts quality of life, increases hospitalization rates, the risk of falls, and cognitive decline, and is independently associated with higher mortality from cardiovascular stress. This activity uses the PDCA (Plan-Do-Check-Action) method to screen and treat anemia in elderly participants Hana Nursing Home. We conducted complete blood tests on 61 respondents to evaluate their hematological profile. The blood test results revealed an average hematocrit of 36.15% for the participants, and anemia in 11 (18.03%) men and 19 (31.15%) women. Routine hemoglobin screening and effective management are essential for early detection and intervention, thereby improving the quality of life of the elderly. Keywords: Anemia, Elderly, Hemoglobin, Hematocrit

Is there a relationship between the severity of obstructive sleep apnea syndrome and the systemic immune inflammation index?

AimVascular dysfunction, oxidative stress and systemic inflammation are considered responsible for the pathophysiology of Obstructive sleep apnea syndrome (OSAS). It is thought that desaturation due to apnea–hypopnea attacks in OSAS patients activates inflammatory pathways. In this study, we aimed to reveal the relationship between inflammation parameters Systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratios (PLR) severity of OSAS in patients who underwent polysomnography in our hospital’s sleep laboratory.MethodsWe grouped our 171 patients who were followed up in our sleep laboratory with the diagnosis of OSAS according to their AHI values. We evaluated the correlation of SII, NLR, and PLR values obtained from the complete blood tests of our patients with OSAS diagnosis and OSAS severity.ResultsThe mean NLR, PLR and SII values of patients with OSAS were statistically significantly higher than those without OSAS (p < 0.05). A positive correlation of 18% was found between the presence of OSAS and the SII value (p = 0.016). No statistically significant difference was found when comparing OSAS severity and NLR, PLR and SII values (p > 0.05).ConclusionWe observed that SII, NLR and PLR parameters, which are rapidly assessable systemic inflammation markers of this process, were independently associated in patients diagnosed with OSAS and that there was no change in SII, NLR, and PLR parameters with OSAS severity.

AN ACUTE MYOCARDIAL INFARCTION IN A VERY YOUNG MAN DUE TO HYPERHOMOCYSTEINEMIA

Abstract Introduction A young 17–year–old boy smoker and obese was admitted to our cardiology unit for continuous oppressive chest pain radiating to the left arm that had arisen three days earlier. In the emergency room, he had performed blood tests with evidence of an increased troponin and an electrocardiogram that showed mild ST–elevation in inferior leads with ST depression in aVL. We performed an urgent transthoracic echocardiography examination that was unremarkable Investigation Once diagnosed with acute ST–segment elevation myocardial infarction, the patient underwent emergency coronary angiography. Coronary angiography highlighted an intermediate stenosis of the first branch diagonal to the proximal tract and a possible occlusion of the periapical branch of the anterior descending artery. It was decided not to perform PTCA as we could not exclude a distal coronary dissection and considering the vessel was of small caliber. We decided to complete the diagnostic process by performing a cardiac MRI showing edema in the apex and distal inferior wall and transmural gadolinium enhancement at the level of the septum and inferior wall of the distal section. In the context of the damaged wall a focal area of hypointensity to be referred to the "no–reflow" phenomenon Management The patient was treated with DAPT, low molecular weight heparin and high dose statin. A few hours after the coronary angiography the patient stopped having chest pain and remained asymptomatic for the rest of the hospital stay. We performed complete blood tests including with evidence of hyperhomocysteinemia. The lipid panel was normal. Hematological consultation recommended folate and Vitamine B12 treatment. After 12 months the patient is asymptomatic, has stopped smoking and continues to take DAPT. He repeated the echocardiogram which showed no alterations. Genetic testing was performed after hospital discharge and was positive for Methylenetetrahydrofolate reductase (MTHFR) homozygous mutation Conclusion Our clinical case shows a rare case of acute myocardial infarction in a very young person. Diagnosis and treatment were complicated by the extreme distality of the occlusion and the few modifiable risk factors identified (smoker, obesity and hyperhomocysteinemia). Hyperhomocysteinemia is an often underestimated cardiovascular risk factor associated with a high risk of cardiovascular events and multivessel coronary disease that should be sought in all young patients with AMI.

The relationship between menorrhagia, iron deficiency, and anaemia in recreationally active females: An exploratory population based screening study

ObjectivesIron deficiency, anaemia, and menorrhagia – or heavy menstrual bleeding – are interrelated conditions that are highly prevalent and commonly underrecognised in exercising females of reproductive age. This study utilised a screening tool to identify risk factors and symptoms associated with heavy menstrual bleeding, iron deficiency, and anaemia in this population. DesignAn observational, cross sectional survey study was employed. Methods1042 active females (aged 18–65) completed a comprehensive screening questionnaire and 887 (85 % compliance) provided a fingerprick blood sample for haemoglobin (Hb) concentration measurement. Women that presented as anaemic (defined as a [Hb] < 120 g/L) or deemed to be at risk of iron deficiency (120 < [Hb] < 130 g/L) were asked to complete follow-up blood tests to screen for iron studies. ResultsAverage [Hb] was 134.2 ± 12.1 g/L, with 94 individuals considered anaemic (10.6 %). Of the sample, 104 underwent follow-up blood tests; 51 (~49 %) presented with iron deficiency (defined as ferritin <30 μg/L). Based on survey responses, 274 (30.9 %) participants were determined to have heavy menstrual bleeding. Those presenting with heavy menstrual bleeding were younger, exercised fewer hours per week, and were more likely to have a history of iron deficiency or anaemia (all p < 0.05). Participants reporting a history of anaemia or iron deficiency were more likely to have heavy menstrual bleeding (anaemia: 39.7 %; iron deficiency; 36.9 %; both p < 0.05). ConclusionsIn this cohort of exercising females of reproductive age, the prevalence of anaemia was 10.6 %. There is a strong association between heavy menstrual bleeding and a self-reported history of iron deficiency and anaemia. Greater awareness of heavy menstrual bleeding and its relationship with iron deficiency and anaemia is needed in this population. Non-invasive screening should be conducted to raise awareness and further understand the associated risk factors and symptomatology.

Hemoglobin, Ferritin, and Lactate Dehydrogenase as Predictive Markers for Neonatal Sepsis.

(1) Background: This study evaluates the predictive effectiveness of biomarkers in diagnosing newborn sepsis. (2) Methods: This was a case-control study conducted on neonates hospitalized at the Clinical Hospital "Louis Turcanu", Timisoara, Romania, from October 2018 to July 2023. Using a vacutainer collection device, venous blood was collected at admission for complete blood tests, including ferritin, hemoglobin, LDH, and blood culture analysis. Neonates were divided into two groups: sepsis-positive and sepsis-negative. The outcome of interest was a diagnosis of sepsis. (3) Results: Data from 86 neonates, 51 of whom had been confirmed to have sepsis, were analyzed. This study found no significant difference in gestational age, infant weight, fetal growth restriction, or APGAR score between neonates with and without sepsis. However, there was a higher incidence of sepsis among neonates delivered via cesarean section. Neonatal patients with sepsis showed significantly higher levels of neonatal serum ferritin and LDH compared to those without sepsis. Ferritin and LDH biomarkers demonstrated excellent discriminatory capabilities in diagnosing neonatal sepsis. Logistic regression analysis revealed a significant association between elevated ferritin and LDH levels and the likelihood of neonatal sepsis, while anemia did not show a significant association. (4) Conclusions: LDH and ferritin concentrations are found to be predictive biomarkers for neonatal sepsis, indicating a potential role in detecting susceptible neonates and implementing prompt interventions to improve patient outcomes.

Cardiovascular screening outcomes in the Dutch survivorship care program for Hodgkin lymphoma survivors.

Hodgkin lymphoma (HL) survivors are at increased risk of cardiovascular disease (CVD) due to former lymphoma treatment. In 2013, cardiovascular screening for 5-year HL survivors according to national guidelines was implemented in Dutch survivorship clinics. We aim to assess the following: (1) adherence to screening guidelines and (2) the yield of (risk factors for) CVD in the screening program. The study population consisted of 5-year HL survivors who received survivorship care at three University Medical Centers from 2013 to 2016 through 2021. Patient characteristics, cardiovascular screening procedures, and outcomes were collected from the medical records. In 186 survivors eligible for cardiovascular screening (mean age 47.8years, 60.8% female), the following diagnostics were performed: complete blood tests (81.0%, median frequency: yearly instead of advised 5-yearly evaluation), electrocardiogram (93.0%), echocardiography (94.6%). Fifty-five percent of survivors had at least one modifiable cardiovascular risk factor (i.e., current smoking, overweight, new/insufficiently controlled hypertension, dyslipidemia, or diabetes). Screening detected ≥ 1 CVD in 31.1% of survivors. Among survivors with available echocardiography report (n = 106), screening detected new aortic and/or mitral valve dysfunction(s) in 51.0% (with grades 3-4 in 4.9%) and impaired left ventricular ejection fraction in 10.3%. Adherence to the screening guidelines in the Dutch HL survivorship care program was reasonable to good and a substantial number of actionable (risk factors for) CVD were diagnosed. Our findings inform HL survivors at high risk of late cardiotoxicity about cardiovascular screening findings and demonstrate appropriate therapeutic actions after diagnosis of (risk factors for) CVD.

Influence of ABCB1 3435C&gt;T Polymorphism on Methotrexate Safety in Patients with Psoriasis — A Secondary Publication

Background: Methotrexate is a highly effective systemic treatment for moderate to severe psoriasis, but drug toxicity may limit its use. Recent evidence suggests that it is necessary to take into account the individual characteristics of methotrexate pharmacokinetics, which are determined by the presence of polymorphisms of genes encoding methotrexate carrier proteins, to predict the risk of methotrexate-induced toxicity. Aim: The research aims to assess the associations of ABCB1 rs1045642 (3435C&gt;T) polymorphism with methotrexate safety for patients with moderate and severe psoriasis. Methods: The study included 75 psoriasis patients treated with methotrexate with 21 days of follow-up duration. Data on adverse drug reactions (ADR) were collected using a clinically structured questionnaire, and complete and biochemical blood tests, and urinalysis were performed. The severity of ADR was assessed using visual analog scales and the CTCAE toxicity scale. The severity of gastrointestinal ADR was assessed using the GSRS questionnaire. Genotyping was carried out by real-time PCR. Results: Gastrointestinal toxicity was detected in 38 patients (50.67%). The mean GSRS score was 7.97 ± 9.18. Analysis of differences in the ADR incidence showed the presence of statistically significant differences in the frequency of ADR in the gastrointestinal tract: the toxic effect of methotrexate was more often observed in carriers of the T allele of the ABCB1 rs1045642 polymorphism (3435C&gt;T), (CC: 2 (14.3%), TC: 18 (52.9%), TT: 18 (66.7%), P = 0.006). Binomial regression demonstrated the presence of a statistically significant effect of the rs1045642 single-nucleotide polymorphism of the ABCB1 gene on the incidence of ADR from the gastrointestinal tract (OR = 8.64, P = 0.008). Conclusion: An association of ABCB1 rs1045642 single-nucleotide polymorphism with the safety of methotrexate therapy in patients with moderate and severe psoriasis was revealed. The data obtained can be used to personalize the prescription of methotrexate to psoriasis patients.

Comparison of Preoperative and Postoperative Neutrophil/Lymphocyte Ratio in Predicting Mortality in Neonates with Intestinal Atresia

Abstract Objective Congenital intestinal atresia is one of the most common surgical pathologies in the neonatal period. This study aimed to compare the efficacy of preoperative neutrophil/lymphocyte ratio (NLR) and postoperative NLR in predicting early mortality in neonates with intestinal atresia. Methods The data of 38 newborns with intestinal atresia operated on in our hospital between January 2016 and March 2023 were retrospectively analyzed. Patients' gestational age, gender, birth weight, other congenital anomalies, operative findings, length of hospital stay, sepsis, and mortality rates were recorded. NLR was calculated by analyzing preoperative and postoperative day 1 complete blood tests. Results Of the patients included in the study, 60.5% were male and 39.5% were female. The median birth weight was 2,468 g (600–3,800 g), and the median gestational age was 36 weeks (28–40 weeks). Gender, number of areas of atresia in the gut, and development of sepsis were not associated with mortality. Mortality was observed at a lower rate in duodenal atresia when compared with the other types of atresia (p &lt; 0.05). The mortality was higher in patients with prematurity, low birth weight, long duration of mechanical ventilation, and severe congenital anomalies (p &lt; 0.05). Preoperative lymphocyte and neutrophil counts were not found to be predictive of mortality. The mortality rate increased as the postoperative lymphocyte count decreased and as the neutrophil count increased (p &lt; 0.05). The preoperative and postoperative NLR was not useful in predicting mortality, the development of sepsis, or the need for reoperation. Conclusion It is possible to predict early mortality in newborns with intestinal atresia who underwent surgery with neutrophil and lymphocyte counts on the first day after surgery. However, early NLR is not useful in predicting prognosis after surgery in newborns.

Monitoring trends in the absolute lymphocyte count and the neutrophil-to-lymphocyte ratio in patients with breast cancer receiving eribulin

BackgroundStudies have shown that the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR) are related to the outcomes in patients with breast cancer receiving specific chemotherapies. However, the reports have focussed on the initial blood test and there is a lack of evidence or data to support that dynamic changes of ALC or NLR are associated with the patients’ survival outcomes.MethodsWe retrospectively reviewed electronic medical records from patients with breast cancer treated with eribulin from 2015 to 2019 at our institution. Blood test data were available prior to starting eribulin (baseline), and at 1, 3 and 6 months after initiating eribulin. We classified the patients into ALC and NLR high and low groups using the following cut-offs: 1000/µl for ALC and 3 for NLR. We defined ALC and NLR trends as increasing or decreasing compared with the initial data. We assessed the associations between the ALC and NLR with progression-free survival and overall survival.ResultsThere were 136 patients with breast cancer treated with eribulin. Of these patients, 60 had complete blood tests and follow-up data. Neither a high ALC nor a low baseline NLR was associated with the survival outcome. One month after initiating eribulin treatment, a high ALC and a low NLR were significantly associated with longer progression-free survival (p = 0.044 for each). Three months after initiating eribulin, a high ALC was significantly associated with better overall survival (p = 0.006). A high NLR at 3 or 6 months after initiating eribulin was associated with worse overall survival (p = 0.017 and p = 0.001, respectively). The ALC and NLR trends across times were not associated with survivals.ConclusionWe showed that 1, 3 and 6 months after initiating eribulin, a high ALC and a low NLR may be related to the patients’ survival outcomes. The ALC and NLR trends were not associated with survival. Accordingly, we believe patients who maintain a high ALC and a low NLR may have better clinical outcomes after initiating eribulin.

PNEUMONIA AND DEMODICOSIS IN CROSSBREED POMERANIAN

A Pomeranian breeddog named Beb aged 1,5 years with a body weight of 3,4 kg, experiencing respiratory problems namely coughing and yellowish nasal discharge, as well as skin problems with complaints of nausea. The purpose of this case report article is to determine the cause of the cough and skin disease that occurred in the case dog and the effectiveness of the treatment performed. During physical examination, there was a cough with moderate intensity, at the end of the cough the animal seemed to be trying to expel something from its throat. The skin showed alopecia, scale, crusts and hyperpigmentation. Radiographic examination showed radiopaque spots on the lungs. Nasal swab examination microscopically found neutrophils, skin scraping examination microscopically found Demodex canis mites. Complete blood test results showed that the case dog had hypochromic macrocytic anemia, thrombocytopenia, and lymphopenia. Based on history taking, physical examination, and supporting examination, the case dog was diagnosed with pneumonia and demodecosis. The case animal was treated with amoxicillin-clavulanic acid (15mg/kg BW; orally; twice daily; for one week and ivermectin (600 µg/kg BW subcutaneously). Symptomatic therapy was given diphenhydramine HCl (1 mg/kg BW; intramuscularly), then continued with diphenhydramine HCl (3mg/kg BW; orally; twice daily). Supportive therapy given was Livron B-Plex® and fish oil orally one tablet per day. Dogs were bathed using soap with sulfur content. The results of the 2-week treatment showed no nasal discharge, no coughing, the animal no longer exhibited nausea, the morning crusts on the ear edges had disappeared, and new hair had started to grow on the neck and back of the case animal. Owners are advised to keep their dogs out of contact with other dogs to speed up the healing process. Owners are advised to improve nutrition, hygiene, grooming, and routine vaccination and deworming.