Differences In White Blood Cell Research Articles

Clinicopathological differences between patients with schistosomal appendicitis and non schistosomal appendicitis: A retrospectively study of past ten years

BACKGROUND Chronic schistosomiasis causes multiple organ and multiple system diseases, especially the digestive system. Schistosome eggs are mainly deposited in the stomach, liver and colorectal, but a few eggs are deposited in the appendix and cause disease. At present, there are few studies on schistosomal appendicitis. AIM To explore the differences in epidemiological, clinical and pathological characteristics between schistosomal appendicitis and non-schistosomal appendicitis over the past decade in order to assess the impact of schistosomiasis on appendicitis. METHODS The differences of general data, clinical data and laboratory examination data of patients with appendicitis from October 2013 to October 2023 were retrospectively analyzed. All patients were divided into two groups for analysis. There were 136 patients in schistosomal appendicitis group and 5418 patients in non-schistosomal appendicitis group. RESULTS Schistosomal appendicitis accounted for 2.45% of all patients with appendicitis, and the annual proportion in the past decade was 2.2%, 2.9%, 1.8%, 1.9%, 3.4%, 3.1%, 1.9%, 1.6%, 3%, 2.6%, respectively. The prevalence of schistosomal appendicitis was middle-aged and elderly males, with an average age of 61.73 ± 15.335 years. The main population of non-schistosomal appendicitis was middle-aged men, with an average age of 35.8 ± 24.013 years (P < 0.001). The distribution of pathological types of appendicitis was different between the two groups (P < 0.001). The incidence of acute suppurative appendicitis in non-schistosomal appendicitis was higher than that in schistosomal appendicitis [odds ratio (OR) = 0.504; 95% confidence interval (CI): 0.349-0.728; P < 0.001]. The proportion of acute attack of chronic appendicitis in schistosomal appendicitis was higher than that in non-schistosomal appendicitis (OR = 2.614; 95%CI: 1.815-3.763; P < 0.001). The proportion of schistosomal appendicitis patients complicated with colorectal cancer was higher than that of non-schistosomal appendicitis patients (OR = 5.087; 95%CI: 1.427-18.132; P = 0.012). There was no difference in clinical symptoms between the two groups. In the laboratory examination, there was a significant difference in white blood cells between schistosomal appendicitis and non-schistosomal appendicitis. The level of white blood cells in schistosomal appendicitis group was slightly higher than the upper limit of the normal range. Other statistically significant indicators were in the normal range. CONCLUSION Schistosomal appendicitis is a severe condition that is often associated with intestinal malignancies, potentially leading to a poor prognosis. Schistosomal appendicitis is more likely to be misdiagnosed and missed diagnosed in clinical work because of its nonspecific clinical manifestations and laboratory examination. It is crucial to differentiate schistosomal appendicitis in middle-aged and elderly male patients presenting with appendicitis, and to ensure early detection and treatment.

Comparison of postoperative inflammatory response between natural orifice specimen extraction surgery and conventional laparoscopy in the treatment of colorectal cancer: a meta-analysis and systematic review.

Natural orifice specimen extraction surgery (NOSES) has attracted attention because of its minimal invasiveness. This meta-analysis compared inflammatory response profiles and infectious complications between colorectal cancer (CRC) patients treated with NOSES and those treated with conventional laparoscopy (CL). Seven medical databases were searched up to February 2024.We included studies that examined changes in the inflammatory response and outcomes in the patients after NOSES surgery. The Cochrane tool and Newcastle-Ottawa Scale (NOS) were used to evaluate the quality of the studies. Pooled standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using either fixed- or random-effects models. Review Manager 5.4 (RevMan 5.4) and the R project were used for the meta-analysis. This meta-analysis included 22 studies. Pooled analyses revealed lower tumor necrosis factor-α (TNF-α) levels (SMD=-1.34,95% CI [-2.43, -0.25]; Z=2.40, P=0.02 and SMD =-1.49,95% CI [-2.15, -0.82]; Z=4.36, P<0.0001) and C reactive protein (CRP) levels (SMD=-0.56, 95% CI [-4.17, -2.50]; Z=2.19, P =0.03 and SMD =-1.24,95% CI[-1.77, -0.71]; Z=4.56, P<0.00001) on postoperative day 1 (POD1) and postoperative day 3 (POD3) for NOSES than for CL. Pooled analysis revealed significantly lower interleukin-6 (IL-6) levels in the NOSES group (SMD=-1.88,95% CI [-2.84, -0.93]; Z=3.88, P=0.0001) on POD3. There were no significant differences in white blood cell (WBC) count, procalcitonin (PCT) levels or the incidence of infectious complications between the two groups. NOSES has a superior inflammatory profile and does not increase the incidence of postoperative infectious diseases. The reported results should be validated in a larger population of CRC patients.

Hematological and plasma profiles and ticks and tick-borne pathogens in wild Formosan black bears (Ursus thibetanus formosanus)

BackgroundThe endangered Formosan black bear (Ursus thibetanus formosanus) is the largest native carnivorous mammal in Taiwan. Diseases, poor management, illegal hunting, and habitat destruction are serious threats to the survival of bear populations. However, studies on the impact of diseases on bear populations are limited. Therefore, this study aimed to establish a database of the hematological and plasma profiles of free-ranging Formosan black bears and investigate the occurrence of ectoparasites, blood parasites, and vector-borne pathogens.MethodsFormosan black bears were captured in Yushan National Park (YNP) and Daxueshan Forest Recreation Area (DSY) in Taiwan. Blood samples were collected from each bear for hematological analysis and plasma biochemistry using a hematology analyzer. Parasites and pathogens were detected using a thin blood smear with Wright–Giemsa staining and polymerase chain reaction (PCR) assay. Additionally, macroscopic ectoparasites were collected from bears to detect blood parasites and other pathogens. Moreover, the relationships between the bear variables (sex, age, and occurrence of parasites or pathogens), ectoparasites, and infectious agents were also analyzed.ResultsIn all, 21 wild bears (14 in YNP and 7 in DSY) were captured and released during the satellite tracking studies. Hematological analysis and plasma biochemistry indicated significant differences in white blood cells (WBC), segments, creatine kinase (CK), and lactate dehydrogenase (LDH) levels between foot snare and culvert-captured bears. Additionally, there were significant differences in total plasma protein (TPP), creatinine, Ca2+, Mg2+, and K+ levels between male and female bears. Moreover, pathogen-infected bears had significantly higher erythrocyte sedimentation rate (ESR; 30 min and 1 h) and globulin levels than uninfected bears. In total, 240 ticks were collected from 13 bears, among which eight adult tick species were identified, including Haemaphysalis flava, Haemaphysalis hystricis, Amblyomma testudinarium, Ixodes ovatus, Dermacentor taiwanensis, Haemaphysalis longicornis, Ixodes acutitarsus, Amblyomma javanense, and nymphs belonging to Haemaphysalis spp. PCR revealed that 13 (61.90%) and 8 (38.10%) bears harbored Hepatozoon ursi and Babesia DNA, respectively. Among the ticks examined, 157 (65.41%) and 128 (53.33%) samples were positive for H. ursi and Babesia, respectively.ConclusionsTo the best of our knowledge, this is the first study to establish a database of the hematological and plasma profiles of wild Formosan black bears and investigate ectoparasite infestation and Hepatozoon and Babesia spp. infection. In conclusion, these findings may serve as a reference for monitoring the health and population of locally endangered bears.Graphical

Occurrence and significance of elevated D-dimer levels in different types of osteomyelitis: a clinical study.

Plasma D-dimer levels >0.5 mg/L are encountered in various conditions besides venous thromboembolism (VTE). Recent studies use them as a prognostic indicator for systemic and inflammatory diseases. The clinical significance of abnormal levels is unclear in osteomyelitis patients with baseline elevation. Our study reviews the occurrence and significance of >0.5 mg/L D-dimer levels in different types of osteomyelitis. This study involved 125 individuals, out of which 94 were male and 31 were female. The patients were divided into two groups based on the results of bacterial culture testing. Group A comprised those who tested positive for bacterial culture, while group B included those who tested negative. Out of 68 samples tested, 56% were found to have Staphylococcus aureus. All 125 patients underwent blood testing, which included measuring the D-dimer levels, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and MHR monocyte to high-density lipoprotein cholesterol (HDL-C) ratio in different types of osteomyelitis. The statistical analysis of these tests was carried out. Although there were no significant differences in white blood cell (WBC) count, Neutrophil count, Lymphocyte count, or erythrocyte sedimentation rate (ESR) as well as the NLR, PLR, LMR, MHR, HDL-C ratio. The C-reactive protein (CRP) levels were significantly higher in group A (26.13±50.30) than in group B (10.76±18.70) (p<0.05). D-dimer levels were elevated in 40.8% of patients with bacterial culture-positive osteomyelitis, negative culture osteomyelitis, implants with fractures, and no trauma osteomyelitis. No correlation was found between the increase in D-dimer levels and the presence of bacterial culture or implant-related osteomyelitis in patients. No significant correlation was found between D-dimers and osteomyelitis, including positive bacterial cultures, implant-related osteomyelitis, or osteomyelitis without trauma. However, 40% of the patients had higher D-dimer levels.

Pro-inflammatory cerebrospinal fluid profile of neonates with intraventricular hemorrhage: clinical relevance and contrast with CNS infection.

Interpretation of cerebrospinal fluid (CSF) studies can be challenging in preterm infants. We hypothesized that intraventricular hemorrhage (IVH), post-hemorrhagic hydrocephalus (PHH), and infection (meningitis) promote pro-inflammatory CSF conditions reflected in CSF parameters. Biochemical and cytological profiles of lumbar CSF and peripheral blood samples were analyzed for 81 control, 29 IVH grade 1/2 (IVH1/2), 13 IVH grade 3/4 (IVH3/4), 15 PHH, 20 culture-confirmed bacterial meningitis (BM), and 27 viral meningitis (VM) infants at 36.5 ± 4weeks estimated gestational age. PHH infants had higher (p < 0.02) CSF total cell and red blood cell (RBC) counts compared to control, IVH1/2, BM, and VM infants. No differences in white blood cell (WBC) count were found between IVH3/4, PHH, BM, and VM infants. CSF neutrophil counts increased (p ≤ 0.03) for all groups compared to controls except IVH1/2. CSF protein levels were higher (p ≤ 0.02) and CSF glucose levels were lower (p ≤ 0.003) for PHH infants compared to all other groups. In peripheral blood, PHH infants had higher (p ≤ 0.001) WBC counts and lower (p ≤ 0.03) hemoglobin and hematocrit than all groups except for IVH3/4. Similarities in CSF parameters may reflect common pathological processes in the inflammatory response and show the complexity associated with interpreting CSF profiles, especially in PHH and meningitis/ventriculitis.

Differences in white blood cell proportions between schizophrenia cases and controls are influenced by medication and variations in time of day

Cases with schizophrenia (SCZ) and healthy controls show differences in white blood cell (WBC) counts and blood inflammation markers. Here, we investigate whether time of blood draw and treatment with psychiatric medications are related to differences in estimated WBC proportions between SCZ cases and controls. DNA methylation data from whole blood was used to estimate proportions of six subtypes of WBCs in SCZ patients (n = 333) and healthy controls (n = 396). We tested the association of case-control status with estimated cell-type proportions and the neutrophil-to-lymphocyte ratio (NLR) in 4 models: with/without adjusting for time of blood draw, and then compared results from blood samples drawn during a 12-h (07:00–19:00) or 7-h (07:00-14:00) period. We also investigated WBC proportions in a subgroup of medication-free patients (n = 51). Neutrophil proportions were significantly higher in SCZ cases (mean=54.1%) vs. controls (mean=51.1%; p = <0.001), and CD8+T lymphocyte proportions were lower in SCZ cases (mean=12.1%) vs. controls (mean=13.2%; p = 0.001). The effect sizes in the 12-h sample (07:00–19:00) showed a significant difference between SCZ vs. controls for neutrophils, CD4+T, CD8+T, and B-cells, which remained significant after adjusting for time of blood draw. In the samples matched for time of blood draw during 07.00–14.00, we also observed an association with neutrophils, CD4+T, CD8+T, and B-cells that was unaffected by further adjustment for time of blood draw. In the medication-free patients, we observed differences that remained significant in neutrophils (p = 0.01) and CD4+T (p = 0.01) after adjusting for time of day. The association of SCZ with NLR was significant in all models (range: p < 0.001 to p = 0.03) in both medicated and unmedicated patients. In conclusion, controlling for pharmacological treatment and circadian cycling of WBC is necessary for unbiased estimates in case-control studies. Nevertheless, the association of WBC with SCZ remains, even after adjusting for the time of day.

Clinical Characteristics of Enterococcus-Associated Peritonitis in Patients with Peritoneal Dialysis.

This study aims to investigate the clinical characteristics of enterococcus-associated peritonitis in patients with peritoneal dialysis (PD). In this retrospective study, patients with PD-associated enterococcal peritonitis (Group E) who were treated in our center between January 2010 and September 2020 were included. Patients with PD-associated streptococcus peritonitis (Group S) and patients with coagulase-negative staphylococcus peritonitis (Group CNS) were matched 1:1 as cohort-control groups. The clinical characteristics and prognosis of these patients were analyzed. A total of 21 peritonitis episodes were noted in nine males and nine females, with an average age of 60.33±14.79 years and an average dialysis duration of 63.56±35.23 months. Mixed infection was observed in 7 out of 21 cases. A total of 22 strains of enterococci were identified in bacterial culture, all sensitive to vancomycin. There were significant differences in white blood cell (WBC) count and blood urea nitrogen (BUN) level among three groups on admission (p<0.05). In all three groups, WBC count on the second and third day post-treatment was higher in Group E than in other groups (p<0.05). The cure rate in Group E was lower than in other groups (p<0.01). The mortality rate in Group E was slightly higher than in other groups (p>0.05). Kaplan-Meier analysis revealed a significant difference in the cumulative survival among three groups (p<0.05). Enterococcus peritonitis is a rare and severe complication of peritoneal dialysis. Although vancomycin is effective for the treatment of Enterococcus infection, Enterococcus peritonitis still has a high rate of treatment failure, poor response to treatment, and poor prognosis as compared to CNS and streptococcus-related infections.

Evaluation of hemogram parameters in neonatal diarrhoeic calves with and without gastrointestinal protozoa infections

Objective: The aim of this study was to compare the hemogram analysis results of neonatal diarrheal calves with and without gastrointestinal protozoa infection.&#x0D; Materials and Methods: A total of 21 neonatal calves with diarrhoea were examined within the scope of the study. A total of 21 neonatal calves with diarrhoea were examined within the scope of the study. Eleven of the cases were calves with gastrointestinal protozoa infection and 10 were calves without gastrointestinal protozoa infection. Demographic, clinical, and laboratory data of calves were evaluated.&#x0D; Results: When demographic data and vital signs were evaluated between the two groups, no statistically significant difference was found between the two groups (p&gt;0.05). However, when the hemogram values between the two groups were compared, it was determined that there was a significant difference in white blood cell (p=0.003) and neutrophil (p=0.01) numbers.&#x0D; Conclusions: Evaluating hemogram parameters should be taken into account as it is an inexpensive and easy-to-apply analysis and offers important outputs in the control and follow-up of neonatal calf health especially in neonatal calf diarrhoea cases which is one of the common diseases.

Re-examining the utility and validity of benign ethnic neutropenia: A narrative literature review.

To conduct a narrative literature review of published evidence documenting racial differences in white blood cells (WBCs) resulting in the legitimization of benign ethnic neutropenia (BEN) as a diagnosis. A search of English-language U.S.-based articles was undertaken using the following electronic databases: Medline (1860 to 1990); PsycINFO (1860 to 1990); and EMBASE (1860 to 1990), which resulted in a total of eight studies. A narrative literature review of the eight studies was conducted to assess how race was utilized in the study methods. Of the eight studies, several themes emerged within the scientific literature that demonstrate imprecise, problematic use of race in research practice. 1) Researchers embedded flawed notions of biological differences between racial groups (mostly focused on Black people compared to white people) within the research hypotheses, methods, and conclusions, 2) studies were unclear on how racial group membership was defined and identified within the study samples, 3) studies did not adequately account for structural or historical determinants of health that may drive racial differences in immune status (i.e., neutropenia). Given the limitations in this U.S.-based scientific literature, BEN is a diagnosis of limited construct validity that reinforces false notions of biological race, warrants renaming to remove "ethnic" language (to include "familial" or "hereditary"), and suggests a need for global expansion of the existing absolute neutrophil count reference ranges in the clozapine monitoring guidelines.

Experience of Peripheral Blood CD34+ Stem Cells Collection in Autoimmune Patients.

Autologous Hematopoietic Stem Cell Transplantation with or without CD34+ selection is being used successfully to treat patients with severe and refractory autoimmune disease. This study describes our experience of CD34+ stem cell mobilization, harvesting and selection in autoimmune patients based on conditions in Vietnam - the developing country. Eight autoimmune patients (four patients with Myasthenia Gravis and four patients with Systemic Lupus Erythematosus) underwent PBSC mobilization with granulocyte colony-stimulating factor (G-CSF) and cyclophosphamide. The apheresis was performed on a Terumo BCT Spectra Optia machine. CD34+ hematopoetic stem cells were collected from the leukapheresis by CliniMACS Plus device using CD34 Enrichment KIT. CD34+ cells, T and B lymphocytes were counted on a FACS BD Canto II device. Eight patients (4 MG and 4 SLE) including 5 females and 3 males were involved in this study. The mean age of the patients was 33.13 ± 16.64 years (ranging from 13 to 58 years). The average number of days for mobilization was 7.9 ± 1.6 days, whereas the average number of days for harvesting was 1.5 ± 0.5 days. There was no difference in the number of days for mobilization and harvesting between the MG and SLE groups. The number of CD34+ cells in peripheral blood (PB) on the day of harvesting was 108.37 ± 59.64 x 106 cells/L. There was a significant difference in white blood cell (WBC), neutrophil, monocyte, and platelet cell counts between before and after mobilization. On the day of stem cell harvesting, variables such as WBC, neutrophil, lymphocyte, monocyte, platelet, CD34+ cell counts, and hemoglobin were not different between the MG and SLE groups. The CD34+ recovery percentage following the CD34+ selection procedure was 68.8%, whereas almost 99.9% of the T and B lymphocytes, and NK cells in the PBSC products were eliminated. Very first attempts in mobilizing, harvesting, and selecting CD34+ stem cells were successful, paving the way for autoimmune patients to have autologous hematopoietic stem cell transplantation in Vietnam.

The Effect of Malaria Parasite Infection on Hematological Parameters in Sudanese Patients

Background: Malaria infection remains the most serious and widespread protozoan infection of humans and has been associated with different changes in hematological parameters. This study aimed to detect the effects of malaria infection on hematological parameters in Sudanese patients. Methods: This was a case–control study including 100 patients and 50 controls required from Kosti Teaching Hospital (Kosti City) from October 2, to November 11, 2020. All patients and controls were investigated for blood film for malaria, complete blood counts, and peripheral blood picture. The data were analyzed using SPSS version 16. Results: Hemoglobin (Hb) was decreased in 75% of our patients and in 10% of controls, P &lt; 0.000. Hematocrit (HCT) was decreased in 55% of patients and in 8% of controls, P &lt; 0.000. MCH was decreased in 33% of patients and in 12% of controls, P = 0.013. The mean corpuscular hemoglobin concentration (MCHC) was decreased in 30% of study patients and in 10% of controls, P = 0.002. The mean corpuscular volume was decreased in 34% of patients and in 8% of controls, P = 0.056. Platelet (PLTs) count was decreased in 46% of patients and 0% of controls, P &lt; 0.000. Platelet crit (PCT) was decreased in 75% of patients and in 16% of controls, P &lt; 0.000. Furthermore, there were differences in white blood cell (WBC) counts between malaria parasite patients and controls, P = 0.058. No significant difference in red blood cell counts was seen between malaria parasite patients and controls, P = 0.797. Conclusions: Malaria parasite infection linked to many changes in hematological parameter characterized by reduction in WBC counts, PLT counts, PCT, Hb level, HCT, MCH, and MCHC.

Study of the value of homocysteine levels in predicting cognitive dysfunction in patients after acute carbon monoxide poisoning

PurposeThe purpose of this research was to assess the value of homocysteine (HCY) levels in predicting cognitive dysfunction in patients after acute carbon monoxide (CO) poisoning.MethodsA total of 115 patients who were admitted to the emergency department of Yinzhou NO. 2 Hospital after CO poisoning between January 2017 and December 2021 were enrolled in this retrospective study. All patients were followed up for 1 month. According to the Mini–Mental State Examination (MMSE) scores, patients were divided into two groups. The demographic and clinical characteristics and magnetic resonance imaging (MRI) results were gathered and statistically analysed.ResultsTwenty-six and 89 patients were ultimately enrolled in the cognitive dysfunction and control groups, respectively. There were significant differences between the groups in terms of age, coma duration, and carboxyhaemoglobin (COHB), lactate and HCY levels (p < 0.05), but there were no significant differences in white blood cell (WBC) counts or aspartate transaminase (AST), alanine transaminase (ALT), creatinine, troponin T, creatinine kinase (CK), or creatinine kinase muscle and brain (CK-MB) levels (p > 0.05). Univariate and multivariate analyses identified that a higher HCY level (OR 2.979, 95% CI 1.851-5.596, p < 0.001) was an independent risk factor for patient cognitive dysfunction after acute CO poisoning. Linear regression analysis showed a negative correlation between MMSE scores and HCY levels (r = − 0.880, P < 0.001). According to the MRI results, the most common lesion site was the globus pallidus, and the central ovale, diffuse white matter, corona radiata, basal ganglia (other than the globus pallidus) and cerebral cortex were also involved.ConclusionsHigher HCY levels were associated with cognitive impairment and were independent risk factors for cognitive impairment after acute CO poisoning. The level of HCY was negatively correlated with the degree of cognitive impairment.

The effects of continuous renal replacement therapy with different anticoagulation methods on the expression of cytokines in severe acute pancreatitis

ObjectiveSevere acute pancreatitis (SAP) is a highly morbid condition in general population as well as in solid organ transplant (SOT) recipients. The present study aimed to investigate the effect of continuous renal replacement therapy (CRRT) with different anticoagulation methods on the expression levels of cytokines in SAP. MethodsA total of 120 patients with SAP, admitted into our hospital between September 2017 and July 2020, were enrolled as the research subjects and randomly divided into a control group (60 cases) and a study group (60 cases). CRRT with low molecular weight (LMW) heparin‑calcium anticoagulation was conducted on patients in the control group, and CRRT with topical citrate + low-dose LMW heparin‑calcium anticoagulation was conducted on patients in the study group. The expressions of cytokines in the two groups were compared after treatment. ResultsThere was no significant difference in white blood cells (WBC), C-reactive proteins (CRP), and procalcitonin (PCT) before treatment between the two groups (P > 0.05). After treatment, the levels of WBC (P = 0.006), CRP (P < 0.001), and PCT (P < 0.001) were significantly lower in the study group when compared with those in the control group. There was no significant difference in the concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) between the two groups before treatment (P > 0.05). After treatment, the concentrations of IL-6, IL-8, and TNF-α were significantly lower in the study group when compared with those in the control group. The APACHEII, SOFA and Ranson scores of the two groups were analyzed, and there was no difference between the two groups before treatment (P > 0.05). After treatment, the score of the study group was lower than that of the control group (P < 0.05). ConclusionCRRT with topical citrate + low-dose LMW heparin‑calcium anticoagulation in the treatment of patients with SAP reduces the levels of WBC, CRP, and PCT and the concentrations of cytokines, including IL-6, IL-8, and TNF-α. This inhibits the release of inflammatory mediators in patients with SAP and reduces damage to the body caused by the inflammatory response, thus effectively improving the patients' condition.

C-Reactive Protein and the Outcome of a Pediatric Emergency Department 7 Days Revisit.

Pediatric emergency department (PED) return visits represent an important quality of care metric and constitute a patient-centered outcome. C-reactive protein (CRP) is an inflammatory biomarker that is commonly used as screening tool in the PED. In this study, we assessed the clinical outcomes of children whose levels of CRP are 150 mg/L or higher at the initial PED visit and if such levels could be useful in predicting outcomes at a second PED visit. A historical cohort study of all patients who visited the PED between July 2007 and June 2017 and had a CRP value of 150 mg/L or greater in the setting of a febrile illness. Data of patients with a return visit to the PED within 7 days were assessed for an association between laboratory values, diagnosis and clinical outcome. One hundred thirty-six index visits were included in this study. One hundred fifteen (84.6%) of the revisits were discharged after their second visit, and 21 (15.4%) were admitted to the inpatient unit. Admitted patients did not differ from patients who were discharged home in diagnosis and CRP levels, but a difference in white blood cell and absolute neutrophil counts was observed. The intensity of the inflammatory response, as expressed by the high concentrations of CRP in children, does not seem to predict the outcome at a repeat PED visit within 7 days.

White Blood Cells, Platelets, Red Blood Cells and Gas Bubbles in SCUBA Diving: Is There a Relationship?

(1) Background: SCUBA diving can influence changes of several hematological parameters (HP) but the changes of HP in the decompression phases are still unclear. The aim of this study was to investigate any possible relationship between HP and predisposition to inert gas bubble formation after a single recreational dive. (2) Methods: Blood, obtained from 32 expert SCUBA divers, was tested for differences in white blood cells (WBC), granulocytes (GRAN), lymphocytes (LYM), and monocytes (MONO), red blood cells (RBC), and platelets (PLT) between bubblers (B) and non-bubblers (NB). (3) Results: We found inter-subject differences in bubble formation (considering the same diving profile performed by the divers) and a statistically significant higher number of total WBC, GRAN and LYM in NB as compared to the B divers in the pre and in the post diving sample, while no statistical differences were found for MONO and PLT. In addition, we did not find any statistically significant difference between NB and B in RBC. (4) Conclusions: Our results, even if in absence of investigated anti-inflammatory markers, could indicate a relationship between low WBC numbers and bubble formation. This aspect may explain a possible cause of inter-subject differences in bubble formation in divers performing the same dive profile.

Analysis of Risk Factors of Coagulation Dysfunction and Hemorrhage in Newly Diagnosed Hyperleukocytic Acute Myeloma Leukemia.

Purpose To explore whether and why abnormal coagulation function and hemorrhage can appear in patients with hyperleukocytic acute myeloid leukemia (HAML). Method We retrospectively reviewed the charts of 724 acute myeloid leukemia (AML) patients admitted with a white blood cell count of >100 × 109/L between 2010 and 2019 in order to analyze the coagulation index of patients with HAML and explore the correlation of abnormal coagulation. Result Prothrombin time (PT) was extended in group HAML compared with group non-HAML. Respiratory failure, intracranial hemorrhage, and infection were more common in the HAML group. Among the 76 HAML patients, there were 33 patients who had ≥3 abnormal items of coagulation index, and 51.5% of them had level 2 hemorrhage which was more than level 0 hemorrhage, and the difference is statistically significant (P < 0.01). Similarly, we can discover that 40.9% of patients with 2 abnormal items had level 2 hemorrhage in contrast to 0 abnormal items. The use of hydroxyurea had a significant effect on PT and D-dimer (DD). Survival analysis by the Kaplan–Meier method showed that there were statistically significant differences in white blood cell (WBC) count＞200 × 109//L and DD. Abnormal PT is associated with WBC count＞200 × 109//L, and abnormal activated partial thromboplastin time (APTT) is associated with HLA-DR mutation. Infection and respiratory failure were independent influencing factors for the coagulation of patients. Conclusion DD had a marked effect on the survival rate. Infection and respiratory failure were independent influencing factors for the coagulation of patients.

An interferon-related signature characterizes the whole blood transcriptome profile of insulin-resistant individuals\u2014the CODAM study

BackgroundWorldwide, the prevalence of obesity and insulin resistance has grown dramatically. Gene expression profiling in blood represents a powerful means to explore disease pathogenesis, but the potential impact of inter-individual differences in a cell-type profile is not always taken into account. The objective of this project was to investigate the whole blood transcriptome profile of insulin-resistant as compared to insulin-sensitive individuals independent of inter-individual differences in white blood cell profile.ResultsWe report a 3% higher relative amount of monocytes in the insulin-resistant individuals. Furthermore, independent of their white blood cell profile, insulin-resistant participants had (i) higher expression of interferon-stimulated genes and (ii) lower expression of genes involved in cellular differentiation and remodeling of the actin cytoskeleton.ConclusionsWe present an approach to investigate the whole blood transcriptome of insulin-resistant individuals, independent of their DNA methylation-derived white blood cell profile. An interferon-related signature characterizes the whole blood transcriptome profile of the insulin-resistant individuals, independent of their white blood cell profile. The observed signature indicates increased systemic inflammation possibly due to an innate immune response and whole-body insulin resistance, which can be a cause or a consequence of insulin resistance. Altered gene expression in specific organs may be reflected in whole blood; hence, our results may reflect obesity and/or insulin resistance-related organ dysfunction in the insulin-resistant individuals.

OR17. Clinical characteristics and risk factors of reduced ejection fraction in coronary artery disease patients undergoing percutaneous coronary intervention at sanglah hospital denpasar, bali, indonesia in 2021: a cross-sectional hospital-based study

Abstract Aims This study was conducted to determine the clinical characteristics and risk factors of reduced ejection fraction (EF) in coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI). Methods and Results Analytical observational study with a cross-sectional study design was conducted. All patients diagnosed with CAD and had a history of PCI at Sanglah Hospital from December 2020 – June 2021 were enrolled. Univariate analysis was performed to demonstrate the baseline characteristics of the patients. Chi-Square analysis was performed to determine the association between variables. Kruskal-Wallis analysis was performed to determine the differences in clinical characteristics between groups of patients based on the EF. There were 196 patients included in this study. Most of the patients were male (n = 135, 68.9%), with median age of 59 (22-81). The median of the EF was 59.2% (22-81). The most common comorbid found in the patients was hypertension (n = 108, 55.1%). Chi-Square analysis showed a significant association between hyperuricemia (p = 0.019; PR = 1.815; 95%CI= 1.163-2.831), arrhythmias (p = 0.002; PR = 2.271; 95%CI=1.491-3.459), and cardiomegaly (p = 0.011; PR = 1.722; 95%CI=1.151-2.577) with the reduced EF. In logistic regression analysis, arrhythmia (p = 0.009; PR = 4.191; 95%CI=1.426-12.320) was significantly associated with reduced EF. Kruskal-Wallis analysis showed a significant difference in white blood cell (p = 0.021), neutrophil (p = 0.027), and serum glutamic pyruvic transaminase (p = 0.013) in patients based on the EF. Conclusion The comorbidity of CAD had a significant association with the reduced EF. Early intervention against this factor can improve the quality of management in the patient.

반복적인 무호흡 잠수 시 항산화 반응의 변화

This study is about changes in antioxidant response during repeated apnea diving. The subjects are 16 male university students. The method is to measure MDA, SOD, red blood cell, lactic acid, blood suger, blood and heart rate at rest, after 5, 10, 15 and 20 times of repeated apnea diving in 5M diving pool. One-way ANOVA with repeated measure was performed to verify the difference in the mean between periods, and the LSD method was performed for post-hoc testing if there was any significance between groups. the statistical significance level was set as α=.05. As a result, there were significant differences in white blood cells, red blood cells, hemoglobin, hematocrit, blood glucose, lactic acid, and heart rate changes according to the number of times and time, but there were no changes in MDA and SOD. This showed that the intensity of apnea diving was low in male college students and there was no significant difference due to physical adaptation. Therefore, in future studies, in-depth studies of various variables appearing during apnea diving in various environments and conditions are required.

Predictive Factors and Amputation Level for Reamputation in Patients With Diabetic Foot: A Retrospective Case-Control Study

The aim of this study was to assess the rate and level of reamputation in patients who had a previous amputation from diabetic foot. We retrospectively analyzed patients who underwent amputation and reamputation due to diabetic foot in our clinic between 2011 and 2019. Fifty-nine were evaluated as the healed group after the first amputation and 55 were evaluated as the reamputation group. Given 55 patients who needed reamputation: there were 13 finger or ray, 23 transmetatarsal or syme, 18 transtibial, and 1 transfemoral in the first operation. We found the reamputation rate was 65.4% in distal amputations. When serum parameters were examined before the first amputation in each group, there was no statistically significant difference in white blood cells, neutrophils, lymphocytes, platelets, sedimentation, C-reactive protein, total protein, hematocrit, urea, creatinine, and HgA1c values. There was, however, a significant difference between groups in albumin levels. When comorbidities were assessed for smoking, hypertension, duration of diabetes, and number of debridements after the first surgery, a significant difference between groups was found. When peripheral artery disease and chronic renal failure were examined, no significant difference was observed. In our study, it was observed that the rate of reamputation was higher in distal level amputations for diabetic foot patients. Accordingly, albumin values, smoking, hypertension, duration of diabetes, number of debridements after surgery, were seen as risk factors for reamputation patients.