Differential White Blood Cell Counts Research Articles

A comparative study of blood cell count in four automated hematology analyzers: An evaluation of the impact of preanalytical factors.

Differential white blood cell counts are frequently used in diagnosis, patient stratification, and treatment selection to optimize therapy responses. Referral laboratories are often used but challenged with use of different hematology platforms, variable blood shipping times and storage conditions, and the different sensitivities of specific cell types. To extend the scientific literature and knowledge on the temporal commutability of blood samples between hematology analyzers, we performed a comparative ex-vivo study using four of the most utilized commercial platforms, focusing on the assessment of eosinophils given its importance in asthma management. Whole blood from healthy volunteers with and without atopy (n = 6+6) and participants with eosinophilic asthma (n = 6) were stored under different conditions (at 4, 20, 30, and 37°C, with or without agitation) and analyzed at different time points (3, 6, 24, 48 and 72h post-sampling) in parallel on the Abbott CELL-DYN Sapphire, Beckman Coulter DxH900, Siemens ADVIA 2120i and Sysmex XN-1000V. In the same blood samples, eosinophil-derived neurotoxin (EDN), eosinophil activation and death markers were analyzed. All platforms gave comparable measurements of cell differentials on fresh blood within the same day of sampling. However, by 24 hours, significant temporal and temperature-dependent differences were observed, most markedly for eosinophils. None of the platforms performed perfectly across all temperatures tested during the 72 hours, showing that handling conditions should be optimized depending on the cell type of interest and the hematology analyzer. Neither disease status (healthy vs. asthma) nor agitation of the sample affected the cell quantification result or EDN release. The eosinophil activation markers measured by flow cytometry increased with time, were influenced by temperature, and were higher in those with asthma versus healthy participants. In conclusion, hematology analyzer, time window from sampling until analysis, and temperature conditions must be considered when analyzing blood cell differentials, particularly for eosinophils, via central labs to obtain counts comparable to the values obtained in freshly sampled blood.

Measurement uncertainty in manual white blood cell differential count

Measurement uncertainty in manual white blood cell differential count

Improving diagnostics using extended point-of-care testing during in-home assessments of older adults with signs of emerging acute disease: a prospective observational non-randomised pilot and feasibility study

BackgroundDelayed recognition of acute disease among older adults hinders timely management and increases the risk of hospital admission. Point-of-Care testing, including Focused Lung Ultrasound (FLUS) and in-home analysis of biological material, may support clinical decision-making in suspected acute respiratory disease. The aim of this study was to pilot test the study design for a planned randomised trial, investigate whether in-home extended use of point-of-care testing is feasible, and explore its’ potential clinical impact.MethodsA non-randomised pilot and feasibility study was conducted during September–November 2021 in Kolding Municipality, Denmark. A FLUS-trained physician accompanied an acute community nurse on home-visits to citizens aged 65 + y with signs of acute respiratory disease. The acute community nurses did a clinical assessment (vital signs, capillary C-reactive protein and haemoglobin) and gave a presumptive diagnosis. Subsequently, the physician performed FLUS, venipuncture with bedside analysis (electrolytes, creatinine, white blood cell differential count), nasopharyngeal swab (PCR for upper respiratory pathogens), and urine samples (flow-cytometry). Primary outcomes were feasibility of study design and extended point-of-care testing; secondary outcome was the potential clinical impact of extended point-of-care testing.ResultsOne hundred consecutive individuals were included. Average age was 81.6 (SD ± 8.4). Feasibility of study design was acceptable, FLUS 100%, blood-analyses 81%, PCR for upper respiratory pathogens 79%, and urine flow-cytometry 4%. In addition to the acute community nurse’s presumptive diagnosis, extended point-of-care testing identified 34 individuals with a condition in need of further evaluation by a physician.ConclusionOverall, in-home assessments with extended point-of-care testing are feasible and may aid to identify and handle acute diseases in older adults.

Utility of Red Blood Cell Distribution Width to Albumin Ratio and Hemoglobin to Red Blood Cell Distribution Width Ratio as Biomarkers in Pediatric Sepsis

Objectives − The objective was to compare these parameters in children with severe and non-severe sepsis and to evaluate their utility in predicting mortality. Material and Methods − A cross-sectional study conducted in the Pediatric Intensive Care of a dis- trict hospital in India. The hematological parameters of 54 children with severe sepsis and 55 with non-severe sepsis were analysed.Results − The children with severe sepsis had significantly lower HRR (Hemoglobin-RDW ratio) with higher RDW, plateletcrit and RAR as compared to those with non-severe sepsis. There were no significant differences between the groups with respect to the differential and total white blood cell counts or their ratios and other platelet indices. As compared to the survivors, non-survivors had significantly lower HRR with higher RDW and RAR. At a cut-off value of 3.845, RAR was 79.2% sensitive and 59% specific and at a cut-off value of 0.712 HRR was 77.8% sensitive and 60% specific in prediction of mortality.Conclusions − Children with severe sepsis had higher RAR and lower HRR when compared with children with non-severe sepsis. Significantly higher RAR and lower HRR were also noted among non-survivors as compared to survivors. The biomarkers RAR and HRR are readily available and useful in predicting mortality in children with sepsis.

The association of blood eosinophil counts and FEV1 decline: a cohort study.

Accelerated lung function decline is characteristic of chronic obstructive pulmonary disease (COPD). However, the association between blood eosinophil counts and lung function decline, accounting for current smoking status, in young individuals without prevalent lung disease is not fully understood. This is a cohort study of 629 784 Korean adults without COPD or a history of asthma at baseline who participated in health screening examinations including spirometry and differential white blood cell counts. We used linear mixed effects model to estimate the annual change in FEV1 (mL) by baseline blood eosinophil count, adjusting for covariates including smoking status. We also performed a stratified analysis by baseline and time-varying smoking status. During a mean follow-up of 6.5 years (maximum of 17.8 years), the annual change in FEV1 (95% confidence interval [CI]) in participants with eosinophil counts <100, 100-199, 200-299, 300-499, and ≥500 cells/µL in the fully adjusted model were -23.3 (-23.9, -22.7), -24.3 (-24.9, -23.7), -24.8 (-25.5, -24.2), -25.5 (-26.2, -24.8), and -26.8 (-27.7, -25.9) mL, respectively. When stratified by smoking status, participants with higher eosinophil count had a faster decline in FEV1 than those with lower eosinophil count in both never- and ever-smokers, which persisted when time-varying smoking status was used. Blood eosinophil counts were associated with a faster lung function decline among healthy individuals without lung disease, independent of smoking status. The findings suggest that blood eosinophil counts contribute to the risk of faster lung function decline, particularly among younger adults without a history of lung disease.

Assessment of CD4, CD8 and White Cell Parameters Amongst HIV Seronegative Pregnant Subjects in Port Harcourt, Nigeria

Pregnancy involves maternal immunological adjustments to accommodate the fetus and maintain a strong immune defense against potential pathogens. The present study evaluated the changes in CD4, CD8, white blood cell (WBC) and total lymphocyte count (TLC) amongst HIV seronegative pregnant subjects in Port Harcourt, Nigeria. A total of 302 female subjects (18-39 years) were recruited for the study. They consisted of 205 pregnant subjects and 97 non-pregnant subjects which served as the control. All subjects were screened for HIV type 1 and type 2 using standard test kits. Total and differential white blood cell counts were determined using a haematology auto analyzer while the total lymphocyte count (TLC) was obtained by multiplying total white blood cell count (TWC) with percentage lymphocyte count. The CD4 and CD8 cell counts were analyzed using the automated flow cytometry analyzer while the CD4:CD8 cell count ratio was obtained by dividing the CD4 cell count value by that of CD8. The result of the study shows a statistically significant decrease in CD4 and CD8 cell counts, lymphocyte and total lymphocyte counts and an increase in neutrophil count in all the trimesters of pregnancy when compared to the non-pregnant control (p&amp;lt;0.05). Also, there was a significant increase in WBC during the third trimester and a similar decrease in monocyte count in the first and third trimesters of pregnancy. The evidence from the present study concludes that pregnancy modifies the maternal immune response to ensure fetal survival and the protection of the mother from invading pathogens as reported in the increase in total WBC, neutrophil and monocyte counts and a reduction in TLC, CD4 and CD8 counts. The study recommends routine assessments of these crucial cellular immune markers for pregnant women during antenatal visits.

Neutrophil-lymphocyte and Platelet-lymphocyte Ratios of Pregnant Women Living with HIV/AIDS

Background: Chronic inflammation, a factor for high mortality, persists throughout the pregnancy period of women living with human immunodeficiency Virus (HIV).&#x0D; Aim: To determine whether pregnancy alone or the combined effects of HIV and pregnancy are the sources of the inflammation, this study evaluated the predictive variables for inflammation, lymphocyte ratio (NLR), and Platelet-Lymphocyte Ratio (PLR).&#x0D; Materials and Methods: A population of 128 women, aged 15-49 years were grouped into 4; Group A- 32 HIV positive and pregnant, Group B- 32 HIV negative and pregnant, Group C- 32 HIV positive not pregnant, Group D- 32 HIV negative not pregnant (control group). Differential white blood cell and platelet count methods were used to determine the neutrophil (N), Lymphocyte (L) and platelet (P) counts. The ratio calculation method was used to derive the NLR and PLR.&#x0D; Results: NLR was significantly higher for group A (2.62±0.41) compared to groups B (2.25 ± 0.18); C (0.95 ± 0.07); D (1.68 ± 0.19) at p ≤ 0.00. However, the NLR of groups A and B (p ≤ 0.05) were not significantly different, PLR was significantly higher for group A (9.86±1.12) compared to groups B (6.65 ± 1.12); C (5.35 ± 0.47); D (6.34 ± 0.43). There was no significant difference in blood pressure across the groups, significant difference was however observed in their Body Mass Index.&#x0D; Conclusion: Hence, Inflammation may have been caused by pregnancy alone.

Comparison of the Haematological Parameters of Indigenous and Exotic ‎Dogs in Maiduguri, Nigeria

Health status of dogs may be assessed with haematological parameters, but adaptation to environmental stress can lead to adjustment of these normal parameters. This study was designed to compare the haematological parameters of indigenous and exotic dogs in Maiduguri during the hot dry season. Forty apparently healthy indigenous (n = 20) and exotic(n = 20) dogs of both sexes and aged from 3-48 months were used. Blood sample (5 ml) was collected from the cephalic vein of each dog in EDTA bottles. Parameters were determined using microhaematocrit method for packed cell volume (PCV), haemocytometery for red blood cell (RBC) count and total white blood cell (TWBC) count, cyanmethemoglobin method for haemoglobin concentration (Hb), and examination of stained blood smear for relative differential white blood cell (WBC) count. Mean corpuscular volume (MCV) and haemoglobin concentration (MCHC), and absolute differential WBC counts were calculated. The TWBC and neutrophil counts were significantly (p &lt; 0.05) higher in indigenousthan exotic dogs. Exotic females had significantly (p &lt; 0.05) lower MCHC and neutrophil count than indigenous females and all males. Age significantly (p &lt; 0.05) affected MCV, but the highest value was recorded in young exotic dogs. Adult indigenous dogs had significantly (p &lt; 0.05) higher neutrophil count than young indigenous and all exotic dogs. Monocyte count was significantly (p &lt; 0.05) higher in young than adult exotic and all indigenous dogs. However, haematologicalvalueswere within standard reference intervals for dogs.

A retrospective study of ovarian tissue cryopreservation in female patients with hematological diseases for fertility preservation.

To investigate the effect and safety of ovarian tissue cryopreservation (OTC) for fertility preservation in female patients with hematological diseases. We designed a retrospective study. The clinical data of patients with hematological diseases undergoing OTC admitted to Peking University People's Hospital from April 2017 to January 2023 were analyzed and summarized. A total of 24 patients were included in the study, including 19 patients with malignant hematological diseases and 5 patients with non-malignant hematological diseases. The former included 14 patients with acute leukemia, 1 patient with chronic leukemia, and 4 patients with myelodysplastic syndrome, while the latter 5 patients were aplastic anemia (AA). 16 patients had received chemotherapy before OTC. The average age of 24 patients was 22.80 ± 6.81years. The average anti-Mullerian hormone (AMH) was 1.97 ± 2.12ng/mL, and the average follicle-stimulating hormone (FSH) was 7.01 ± 4.24IU/L in examination before OTC. FSH was greater than 10.0IU/L in 4 cases. The pre-OTC laboratory tests showed that the average white blood cell (WBC) count was (3.33 ± 1.35) × 109/L, the average hemoglobin was 91.42 ± 22.84g/L, and the average platelet was (147.38 ± 114.46) × 109/L. After injection of recombinant human granulocyte colony-stimulating factor (rhG-CSF), blood transfusion, and iron supplementation in pre-OTC treatment, the average WBC count was (4.91 ± 3.07) × 109/L, the average hemoglobin was 98.67 ± 15.43g/L, and the average platelet was (156.38 ± 103.22) × 109/L. Of the 24 patients, 22 underwent laparoscopic bilateral partial oophorectomy and oophoroplasty, and 2 underwent laparoscopic unilateral oophorectomy. The average duration of OTC was 59.54 ± 17.58min, and the average blood loss was 32.1 ± 41.6mL. The maximum blood loss was 200mL. There was no significant difference in WBC count and hemoglobin concentration after OTC compared to pre-OTC period. Only the platelet count after OTC surgery was significantly different from that before surgery ([134.54 ± 80.84 vs. 156.38 ± 103.22] × 109/L, p < 0.05). None of the 24 patients had serious complications after OTC. 2 patients had mild infection symptoms, but both recovered well. 23 patients underwent hematopoietic stem cell transplantation (HSCT) after OTC. The median and interquartile range from OTC to the pretreatment of HSCT was 33 (57) days, and the median and interquartile range from OTC to HSCT was 41 (57) days. Seven of them began pretreatment of HSCT within 20days and began HSCT within 30days after OTC. All patients were followed up. Of the 23 patients who underwent HSCT after surgery, 22 presented with amenorrhea and 1 with scanty menstrual episodes. Seven patients underwent hormone replacement therapy (HRT) after HSCT. A patient with AA underwent ovarian tissue transplantation (OTT) 3years after HSCT and resumed regular menstruation 6months after OTT. Ovarian tissue cryopreservation has a promising future in fertility protection in patients with hematological diseases. However, patients with hematological malignancies often have received gonadotoxic therapy before OTC, which may be accompanied by myelosuppression while patients with non-malignant hematological diseases often present with severe hemocytopenia. So perioperative complete blood count of patients should be paid attention to. There was no significant difference in the WBC count and hemoglobin concentration in patients with hematological diseases before and after OTC surgery, and the platelet count decreased slightly within the normal range. Infection is the most common post-OTC complication, and HSCT pretreatment can be accepted as early as the 10th day after OTC. OTC has no adverse effects on patients with hematological diseases and does not delay HSCT treatment. For young patients with hematological diseases, OTC is an effective method of fertility preservation.

The Role of Rosmarinic Acid in the Protection Against Inflammatory Factors in Rats Model With Monocrotaline-Induced Pulmonary Hypertension: Investigating the Signaling Pathway of NFκB, OPG, Runx2, and P-Selectin in Heart.

Shortness of breath and syncope are common symptoms of right ventricular failure caused by pulmonary arterial hypertension (PAH), which is the result of blockage and increased pressure in the pulmonary arteries. There is a significant amount of evidence supporting the idea that inflammation and vascular calcification (VC) are important factors in PAH pathogenesis. Therefore, we aimed to investigate the features of the inflammatory process and gene expression involved in VC in monocrotaline (MCT)-induced PAH rats. MCT (60 mg/kg, i.p.) was used to induce PAH. Animals were given normal saline or rosmarinic acid (RA) (10, 15, and 30 mg/kg, gavage) for 21 days. An increase in right ventricular systolic pressure was evaluated as confirming PAH. To determine the level of inflammation in lung tissue, pulmonary edema and the total and differential white blood cell counts in the bronchoalveolar lavage fluid were measured. Also, the expression of NFκB, OPG, Runx2, and P-selectin genes was investigated to evaluate the level of VC in the heart. Our experiment showed that RA significantly decreased right ventricular hypertrophy, inflammatory factors, NFκB, Runx2, and P-selectin gene expression, pulmonary edema, total and differential white blood cell count, and increased OPG gene expression. Therefore, our research showed that RA protects against MCT-induced PAH by reducing inflammation and VC in rats.

Paradoxical eosinophilic and cytokine responses to oral corticosteroid treatment in patients with asthma exacerbations

BackgroundThymic stromal lymphopoietin (TSLP) orchestrates eosinophilic inflammation, which may increase in asthma exacerbations. On the contrary, miR-1 inhibits TSLP-mediated eosinophil trafficking in lung endothelium. Whether the balance of TSLP and miR-1 levels determines the response to oral corticosteroids during the treatment of asthma exacerbations remains unknown. ObjectiveTo investigate the involvement of TSLP/miR-1 axis in inflammatory response to OCS treatment for asthma exacerbations. MethodsWe measured the concentrations of TSLP and other inflammatory cytokines and miR-1 expression during acute asthmatic exacerbations treated with standard oral corticosteroids (OCS) in a real-life setting. Twenty eight consecutive patients with acute asthma exacerbations treated with OCS for 1 week at the Emergency Department (ED) were studied prospectively. Steroid responders (SR) were identified by a significant reduction in blood eosinophils, whereas paradoxical responders (PR) showed no markedly decreased or even increased absolute blood eosinophil counts after OCS treatment. Differential white blood cell counts, blood cytokine levels and miR-1 expression within and between groups were compared before and after OCS treatment. The baseline cytokine concentrations in both groups were compared with those of stable asthmatics (SA). ResultsOCS treatment significantly reduced TSLP levels in steroid responders whereas this effect did not occur in paradoxical responders (P = 0.006 and P = 0.742, respectively). In contrast, miR-1 expression was unchanged in steroid responders in response to OCS, whereas it was markedly reduced in the paradoxical responders, despite higher expression at baseline compared with stable asthmatics, which may account for slower resolution of the exacerbation. ConclusionsIn some asthmatic patients with acute exacerbations who do not suppress eosinophils after a course of OCS, there is a paradoxical decrease in plasma miR-1 and increase in TSLP compared with steroid responders, which may result in slower clinical recovery.

Rosmarinic acid improves tracheal smooth muscle responsiveness and lung pathological changes in ovalbumin-sensitized rats

Objective: To evaluate the effect of rosmarinic acid on tracheal smooth muscle responsiveness and lung pathological changes in ovalbumin-sensitized rats. Methods: Rats were randomly divided into six groups: the control group, the asthmatic group, and the asthmatic groups treated with dexamethasone (1 mg/kg; oral gavage) or three doses of rosmarinic acid (0.5, 1, and 2 mg/kg; oral gavage). For induction of asthma, rats received intraperitoneal injections and inhalation of ovalbumin. After 21 days, bronchoalveolar lavage fluid and lung samples were collected for histopathological analyses. Moreover, total and differential white blood cell counts were determined. Results: The rosmarinic acid-treated group had significantly lower tracheal smooth muscle responses to methacholine than the asthmatic group. In addition, rosmarinic acid reduced white blood cell count and the percentages of eosinophils, monocytes, and neutrophils while increasing the percentage of lymphocytes. Ovalbumin-induced lung pathological changes were significantly improved by treatment with rosmarinic acid. Conclusions: Rosmarinic acid improves tracheal smooth muscle responsiveness and lung pathological changes in ovalbumin-sensitized rats.

Alterations in haematological indices of indomethacin-ulcerated rats treated with Persea americana seed and Bryophyllum pinnatum leaf ethyl acetate fraction

This study determined the alterations in haematological parameters of indomethacin-ulcerated rats treated with P. americana seed (PAS) and B. pinnatum leaf (BPL) ethyl acetate fraction. Fifty (50) healthy Wistar albino rats were randomly assigned into ten (10) groups of five (5) animals each according to body weight (100-120 g). Animals in group I served as normal control; the rats in groups III-X were pre-treated with 20 mgKg-1 b. wt. Omeprazole (STD), 400 mgKg-1 b. wt. PAS, 400 mgKg-1 b. wt. BPL, 400 mgKg-1 b. wt. PAS + BPL (1:1), 400 mgKg-1 b. wt. PAS + BPL (1:2), 400 mgKg-1 b. wt. PAS + BPL (1:3) respectively for 21 days. Thereafter, animals in groups II-X were induced for gastric ulcer by intubation of 30 mgKg-1 b. wt. indomethacin after being fasted for 24 hours. The animals were sacrificed after 4 hours and the complete blood count was determined using an automated hematology analyzer. Results obtained from the study showed significant (p&lt;0.05) elevation in the total and differential white blood cell count of Wistar rats in the indomethacin-induced gastric ulcer control group and ethyl acetate fraction treated groups. Indomethacin, PAS, and BPL ethyl acetate fraction and the combinations did not cause marked changes in red blood cell indices. However, platelet count was significantly (p&lt;0.05) reduced by the combinations of the P. americana seed and B. pinnatum leaf ethyl acetate fraction. These findings demonstrated that indomethacin induction resulted in a significant increase in the total white blood cell and platelet count when matched with the control group; this was similarly seen in PAS+BPL (1:3) and PAS+BPL (3:1) combinations of PAS and BPL. The result is suggestive of a compromise in the hemostatic capability of the blood in rats treated with some combinations of P. americana seed and B. pinnatum leaf ethyl acetate fraction.

A comparison study between the Siemens ADVIA 120 and manual method for the differential white blood cell count in goats.

Although widely used, the ADVIA 120 hematology analyzer has not been previously validated for determining the differential leukocyte count in goats. The aim of this study was to compare the differential leukocyte counts provided by the ADVIA 120 (A-diff) and the manual method (M-Diff) in goats. EDTA blood samples that were analyzed within 4 h of collection were used in the study. The following exclusion criteria were applied: inappropriately filled tubes or tubes containing clots, erroneous ADVIA peroxidase cytograms, and blood smears of poor quality. The A-Diff was compared with the M-Diff performed by two independent observers on 200 leukocytes. Forty samples were included after previously excluding eight samples. The correlation between the A-Diff and M-Diff was very strong for eosinophils (r = .870, p < .001) and strong for lymphocytes (r = .796, p < .001) and neutrophils (r = .730, p < .001), while no significant correlation was observed for monocytes (r = .026, p = .872). The Passing-Bablok regression analyses revealed statistically significant constant errors for neutrophils (5.83%; 95% confidence interval [CI]: 0.41%, 12.18%) and eosinophils (1.89%; 95% CI: 1.17%, 2.71%). Bland-Altman analyses showed a statistically significant negative bias for lymphocytes (-5.0%) and a statistically significant positive bias for eosinophils (2.2%). The very low basophil percentages precluded a meaningful method comparison. The ADVIA 120 overall demonstrated good performance for the differential WBC count in goats under the conditions of this study. Therefore, it can be considered suitable for routine hematologic screening in goats. Nonetheless, it should be emphasized that any abnormal result should be confirmed with a blood smear evaluation.

Cognition and its relationship with differential white cell count among obese undergraduates in Nigeria

Abstract Introduction: Studies have linked obesity with cognitive impairment and low-grade inflammation; however, results have been inconsistent. The aim of this study was to compare global cognitive function and its relationship with indices of obesity and total and differential white blood cell (WBC) counts in obese and normal-weight undergraduates in Kano, Nigeria. Materials and Methods: Eighty participants (40 obese and 40 normal weights) were randomly recruited for this case–control descriptive study. Anthropometric indices were measured according to the World Health Organization’s Stepwise protocol; global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while the WBC count was performed by manual Leishman staining technique. Data were analyzed on statistical package for social science using an independent t-test, Chi-square test of association, Pearson’s correlation, and simple linear regression. Results: The mean age of the participants is 24 years, obese a year older (t = -2.2, P = 0.030). There was no significant difference in global cognitive function score (MoCA score) between the obese and normal-weight participants (t = -1.08, P = 0.283). However, 40% of the normal weight and 42% of the obese participants had mild cognitive impairment. Similarly, the two groups did not differ in total and differential WBC count except for %monocyte, which was higher in normal-weight participants (t = 2.22, P = 0.029). None of the anthropometric and WBC indices correlated with the MoCA score; however, %monocyte was negatively correlated with body mass index (BMI) (r = -0.244, P = 0.029), waist circumference (r = -0.216, P = 0.050), hip circumference (r = -0.234, P = 0.037), and wait-to-height ratio (r = -0.245, P = 0.028) among the whole while %lymphocyte was negatively correlated with BMI (r = -0.311, P = 0.050) among obese participants. Conclusion: Obesity is not associated with a decline in cognitive function and inflammation in obese and normal-weight undergraduates in Nigeria.

Sex differences in plasma metabolites in a guinea pig model of allergic asthma.

Sex seems to be a contributing factor in the pathogenesis of bronchial asthma. This study aimed to find sex-related differences in metabolome measured by hydrogen-1 nuclear magnetic resonance ((1)H NMR) spectroscopy in healthy and ovalbumin (OVA)-sensitized guinea pigs. Adult male and female animals were divided into controls and OVA-sensitized groups. OVA-sensitization was performed by OVA systemic and inhalational administration within 14 days; on day 15, animals were killed by anesthetic overdose followed by exsanguination. Blood was taken and differential white blood cell count was measured. Left lung was saline-lavaged and differential cell count in the bronchoalveolar lavage fluid (BALF) was measured. After blood centrifugation, plasma was processed for (1)H NMR analysis. Metabolomic data was evaluated by principal component analysis (PCA). Eosinophil counts elevated in the BALF confirming eosinophil-mediated inflammation in OVA-sensitized animals of both sexes. Sex differences for lactate, glucose, and citrate were found in controls, where these parameters were lower in males than in females. In OVA-sensitized males higher glucose and lower pyruvate were found compared to controls. OVA-sensitized females showed lower lactate, glucose, alanine, 3-hydroxy-butyrate, creatine, pyruvate, and succinate concentrations compared to controls. In OVA-sensitized animals, lactate concentration was lower in males. Data from females (healthy and OVA-sensitized) were generally more heterogeneous. Significant sex differences in plasma concentrations of metabolites were found in both healthy and OVA-sensitized animals suggesting that sex may influence the metabolism and may thereby contribute to different clinical picture of asthma in males and females.

The Effects of Hyperglycaemia on the Chemotherapy of Diminazene aceturate in Trypanosoma brucei-infected Dogs

The effects of hyperglycaemia on the outcome of treatment with diminazene aceturate in dogs infected with Trypanosoma brucei was evaluated using the following parameters; parasitaemia, packed cell volume, red blood cell count, haemoglobin concentration, total white blood cell count and differential counts, survivability, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, total protein, and cholesterol. A total of 12 Nigerian local dogs, of both sexes were used in this study. They were randomly, assigned into four groups of three dogs each. Group A was uninfected non hyperglycaemic non treated, group B infected non hyperglycaemic treated, group C infected hyperglycaemic non treated and group D infected hyperglycaemic treated. No mortality was recorded in group A, while groups B, C and D survived 33%, 100% and 67% mortalities respectively. There was total clearance of the parasites in the treated groups (B and D) on days 18 and 20 post infection (PI) respectively (days 6 and 8 post treatment). However, there was a relapse of infection in group D on day 22 PI (day 11 PT) and no relapse occurred in group B. Infections caused a significant decrease (p&lt;0.05) in all the red cell parameters (PCV, Hb concentrations and RBC counts) in group C, but no significant (P&gt;0.05) decrease was observed in groups C and D. The mean AST and ALT of group D were significantly (P&lt;0.05) higher than the other groups, while the mean ALP of groups A and D did not show any significant (P&gt;0.05) difference, but were significantly (P&lt;0.05) lower than groups C and B. The mean total protein of group A was significantly (P&lt;0.05) higher than the infected groups, while the infected groups C, B and D did not show any significant (P&gt;0.05) difference. It was concluded from the study that, hyperglycaemic resulted in diminished effectiveness of diminazene aceturate in Nigerian local breeds of dogs

Complete Blood Count Reporting Among Hospitals in the United States

Background Complete blood count (CBC) is the most common test performed in hematology-oncology. A typical CBC report contains over 10 elements. Simplifying the report by removing nonessential elements may benefit clinicians and patients. Little is known about what elements are reported by various hospitals in the US. The objective of our study was to describe how hospitals in the US report CBC. Methods After approval from the Mayo Clinic institutional review board, we obtained hospital CBC reported elements from the Epic electronic medical records Care Everywhere health information exchange. CBCs from 2020-2023 were included. For each hospital, we determined the city and state where it's located. We obtained the number and type of elements reported in the CBC and compared the findings between academic and community hospitals. Results We collected CBC data from 139 hospitals across 43 states and 102 cities (Figure 1). Fifty-four percent were community hospitals while 46% were academic hospitals. The median number of elements reported by all hospitals was 21 (range, 12-24). This was not different (P=0.98) between academic (median 22 [range, 12-24]) and community hospitals (median 21 [range, 14-24]; Figure 2). The distribution of hospitals according to the number of CBC elements reported were as follows: 12-15 (6%), 16-19 (13%), 20 (25%), 21(6%), 22 (18%), 23 (19%), and 24 (13%). A minority of the hospitals did not report % white blood cell differential count (9.4%) or mean platelet volume (20.9%). Nucleated red blood cell and immature granulocyte count were reported frequently, 46.0% and 56.8%, respectively. However, the frequency of reporting these four elements were similar between academic and community hospitals. Conclusions We found substantial variations in CBC reporting among US hospitals even within academic and community hospitals. Most hospitals reported 20 or more elements, twice as many as the hospitals reporting the least number of elements. There is an opportunity to simplify and standardize CBC reporting, which will minimize physician burnout and distraction as well as decrease patient concern and query.

COVID-19 screening in low resource settings using artificial intelligence for chest radiographs and point-of-care blood tests

Artificial intelligence (AI) systems for detection of COVID-19 using chest X-Ray (CXR) imaging and point-of-care blood tests were applied to data from four low resource African settings. The performance of these systems to detect COVID-19 using various input data was analysed and compared with antigen-based rapid diagnostic tests. Participants were tested using the gold standard of RT-PCR test (nasopharyngeal swab) to determine whether they were infected with SARS-CoV-2. A total of 3737 (260 RT-PCR positive) participants were included. In our cohort, AI for CXR images was a poor predictor of COVID-19 (AUC = 0.60), since the majority of positive cases had mild symptoms and no visible pneumonia in the lungs. AI systems using differential white blood cell counts (WBC), or a combination of WBC and C-Reactive Protein (CRP) both achieved an AUC of 0.74 with a suggested optimal cut-off point at 83% sensitivity and 63% specificity. The antigen-RDT tests in this trial obtained 65% sensitivity at 98% specificity. This study is the first to validate AI tools for COVID-19 detection in an African setting. It demonstrates that screening for COVID-19 using AI with point-of-care blood tests is feasible and can operate at a higher sensitivity level than antigen testing.

Complement factor H Y402H polymorphism results in diminishing CD4+ T cells and increasing C-reactive protein in plasma

Age-related macular degeneration (AMD) is a common cause of visual loss among the elderly. Genetic variants in the gene encoding complement factor H (CFH) have been identified as an AMD susceptibility gene, however, the mechanistic link is debated. Here, we investigated the link between the CFH Y402H genotype and low-grade inflammation. We recruited 153 healthy individuals, 84 participants with dry stages of AMD, and 148 participants with neovascular AMD. All participants were subjected to detailed retinal examination, and interview regarding comorbidities and lifestyle. Blood samples were analyzed for level of C-Reactive Protein (CRP), white blood cell differential count, and stained with fluorescent antibodies to differentiate CD4+ and CD8+ T cells. CFH Y402H genotyping was performed using an allele-specific polymerase chain reaction genotyping assay. Splenocytes from young and aged wild type and Cfh null mutant C57BL/6J mice were examined for CD4+ and CD8+ T cells. Healthy individuals with the CFH Y402H at-risk polymorphism HH had higher levels of CRP and lower proportions of CD4+ T cells compared to persons with the YH or YY polymorphism (P = 0.037, Chi-square). Healthy individuals with the HH polymorphism displayed lower proportions of CD4+ T cells with ageing (P < 0.01, one-way ANOVA), whereas both young and aged Cfh null mutant mice displayed lower proportions of CD4+ T cells (P < 0.001 and P < 0.05; unpaired t test). Participants with dry AMD and the HH polymorphism had similarly lower proportions of CD4+ T cells (P = 0.024, one-way ANOVA), but no difference in CRP-levels. In the neovascular stage of AMD, there was no difference in proportion of CD4+ cells or CRP levels according to genotype. The risk-associated CFH genotype is associated with an age-related decrease in proportion of CD4+ T cells and increased levels of CRP in healthy individuals. This indicates that decreased complement regulation results in extensive changes in innate and adaptive immune compartments that precede development of AMD.