Differential White Blood Cell Counts Research Articles

Comparison of the Results of Automatic Blood Analyser and Manual Peripheral Smear Method in Total and Differential Leukocyte Count in Goats

The Abacus Vet 5 (AV5) is a volumetric impedance-based automated haematology analyser that offers a total and 3-part differential (lymphocytes, neutrophils and monocytes) white blood cell (WBC) count in goats. This study aimed to compare the total and differential leukocyte counts (absolute and relative) measured with the AV5 haematology analyser with the results obtained by the manual method from blood smears in goats. It is also aimed to compare the compatibility between the two methods. The blood samples of 40 hair goats (9 healthy and 31 diseased) were analysed by both methods. The relationships between the values were evaluated with a correlation coefficient, and the agreements between the methods were assessed with the Bland-Altman method. The correlation between two methods were excellent for total WBC counts (rho = 0.963, p = 0.000), absolute neutrophils (rho = 0.964, p = 0.000), lymphocytes (rho = 0.928, p = 0.000), a good for the neutrophil percentages (rho = 0.824, p = 0.000), and a weak for absolute monocytes (rho = 0.426, p = 0.006). Although the bias for lymphocyte (−8.25 %) and neutrophil (10.02 %) percentages was relatively significant and the confidence intervals were wide, the agreement for all parameters was acceptable between the two methods in the Bland atman method. In conclusion, the AV5 haematology analyser performed well for total, and differential WBCs counts in goats. However, abnormal results should still be confirmed by a blood smear examination. In addition, instrument performance evaluations, including increased sample sizes, should be performed in further studies.

Leucocyte Profiles of Asymptomatic and Symptomatic HIV-1 Subjects in Irrua, EDO State, Nigeria

HIV is pandemic and remains a public health concern for many decades. This infection is associated with life threatening opportunistic infections and malignancies. The aim of this study is to look at the leucocyte profiles of HIV-1 positive subjects in Irrua, Edo state, Nigeria. A total of three hundred and forty four (344) HIV-1 subjects aged 17-60 years and of both sexes were recruited into the study. The HIV-1 subjects were divided into asymptomatic and symptomatic subjects. One hundred and fifty (150) apparently healthy HIV-1 negative subjects served as control. The white blood cells total (WBC total) count and differential leucocyte count (DLC) were determined using an automated blood analyzer (Sysmex KX-2IN). Results obtained revealed that the mean WBC total count (x103/µL) of the asymptomatic HIV-1 subjects (5.04 ± 1.14) and that of the control subjects (5.09 ± 1.24) did not show any significant difference (P>0.05). In contrast, the mean WBC total count of symptomatic HIV-1 subjects (4.14 ± 5.06) was significantly decreased (P<0.05) in comparison to that of control. However, age and sex did not affect the WBC total counts of the subjects studied. With respect to DLC, the mean neutrophil % of asymptomatic HIV-1 subjects (43.53 ± 8.84) was not statistically significant (P>0.05) in comparison to control (43.91 ± 5.91) .Whereas, symptomatic HIV-1 subjects (49.25±5.86) revealed a significantly higher (P<0.05) difference in relation to control (43.91 ± 6.25) and asymptomatic HIV-1 subjects. The mean lymphocyte count % of asymptomatic HIV-1 subjects (42.19 ± 6.25) and that of symptomatic HIV-1 subjects (43.32 ± 6.92) were significantly lower (P<0.05) compared to control (47.11 ± 8.33). Age and sex also did not affect the DLC of the study subjects. In conclusion, it has been revealed that the leucocyte profile of symptomatic HIV-1 subjects were significantly affected compared to asymptomatic and control subjects. It re-emphasizes the prognostic role of leucocyte counts (especially in low resource areas) in the diagnosis of symptomatic HIV-1 subjects in the study area.

Analytical variability and uncertainty in canine leukocyte ratios obtained with manual counts

This study aimed to determine the analytical imprecision of calculated neutrophil to lymphocyte (NLR) and lymphocyte to monocyte ratios generated from manual differential white blood cell (WBC) counts in peripheral blood smears, and to describe how to report the uncertainty around a single WBC ratio result. No information on the analytical imprecision of WBC ratios in dogs is available. Coefficient of variations (CVs) of paired readings of one operator on 105 smears (intraoperator variability) and of three operators on 301 smears (interoperator variability) were calculated. The interoperator agreement was examined with the Fleiss' kappa coefficient (κ). Observed total errors (TEos), expanded measurement of uncertainty (EMU) and reporting intervals (RIs) were also calculated. Median CVs ranged from 3.14 to 28.28 (intraoperator) and from 5.39 to 53.85 (interoperator). No agreement among operators was found around the cut-offs. TEos were higher than allowable total errors in 32%-88% of smears. EMU ranged from 0.10 to 1.13. According to the RI, the calculated WBC ratios should be rounded to the nearest 10. WBC ratios should be interpreted cautiously in dogs. The EMU should be reported to make the clinician aware of the uncertainty of these parameters. For example, an NLR result of 17 is needed to have high confidence that the result is above a cut-off of 6.

Machine Learning Models for Predicting Influential Factors of Early Outcomes in Acute Ischemic Stroke: Registry-Based Study.

BackgroundTimely and accurate outcome prediction plays a vital role in guiding clinical decisions on acute ischemic stroke. Early condition deterioration and severity after the acute stage are determinants for long-term outcomes. Therefore, predicting early outcomes is crucial in acute stroke management. However, interpreting the predictions and transforming them into clinically explainable concepts are as important as the predictions themselves.ObjectiveThis work focused on machine learning model analysis in predicting the early outcomes of ischemic stroke and used model explanation skills in interpreting the results.MethodsAcute ischemic stroke patients registered on the Stroke Registry of the Chang Gung Healthcare System (SRICHS) in 2009 were enrolled for machine learning predictions of the two primary outcomes: modified Rankin Scale (mRS) at hospital discharge and in-hospital deterioration. We compared 4 machine learning models, namely support vector machine (SVM), random forest (RF), light gradient boosting machine (LGBM), and deep neural network (DNN), with the area under the curve (AUC) of the receiver operating characteristic curve. Further, 3 resampling methods, random under sampling (RUS), random over sampling, and the synthetic minority over-sampling technique, dealt with the imbalanced data. The models were explained based on the ranking of feature importance and the SHapley Additive exPlanations (SHAP).ResultsRF performed well in both outcomes (discharge mRS: mean AUC 0.829, SD 0.018; in-hospital deterioration: mean AUC 0.710, SD 0.023 on original data and 0.728, SD 0.036 on resampled data with RUS for imbalanced data). In addition, DNN outperformed other models in predicting in-hospital deterioration on data without resampling (mean AUC 0.732, SD 0.064). In general, resampling contributed to the limited improvement of model performance in predicting in-hospital deterioration using imbalanced data. The features obtained from the National Institutes of Health Stroke Scale (NIHSS), white blood cell differential counts, and age were the key features for predicting discharge mRS. In contrast, the NIHSS total score, initial blood pressure, having diabetes mellitus, and features from hemograms were the most important features in predicting in-hospital deterioration. The SHAP summary described the impacts of the feature values on each outcome prediction.ConclusionsMachine learning models are feasible in predicting early stroke outcomes. An enriched feature bank could improve model performance. Initial neurological levels and age determined the activity independence at hospital discharge. In addition, physiological and laboratory surveillance aided in predicting in-hospital deterioration. The use of the SHAP explanatory method successfully transformed machine learning predictions into clinically meaningful results.

Hematological Profiles of Eligible Blood Donors at Kenyatta National Hospital, Kenya

Aim: To determine hematological profile of eligible blood donors at Kenyatta National Hospital (KNH), Kenya.
 Study Design: Adopted a cross-sectional study.
 Place and Duration of Study: Kenyatta National Hospital, between March 2021 and August 2021.
 Methodology: This study recruited 202 eligible blood donors comprising of 173 males and 29 females aged 18-57 years. Blood samples (4ml) were drawn from donated units into ethylene diamine tetraacetic acid (EDTA) tube. Hematological parameters were estimated using a complete blood count (CBC) analyzer (Humacount 5D®). A total of eighteen hematological parameters were analyzed. These parameters included; red blood cell (RBC) count, hemoglobin concentration, RBC indices, white blood cell (WBC) count, absolute and differential WBC and platelet (PLT) count. Results were presented in medians and 95% interquartile ranges and compared using Mann–Whitney U test.
 Results: The median counts for all hematological parameters were within the accepted reference ranges for the adult urban population in Kenya. The median and interquartile range for total red cell count was 4.9×106/µL [0.74], hemoglobin level was 14.3g/dL[1.8], hematocrit was 44.9% [5.1], white blood count was 4.9×103/µL [1.4] and platelet was 234×103/L [64]. Among the red cell parameters analyzed, male donors had a significantly higher RBC count (P<0.001), hematocrit (P=0.001) and hemoglobin (P<0.001) than female donors. Among white blood cell parameters analyzed, only lymphocytes (P=0.011) were significantly higher in female donors than male donors. Platelet count (P<0.001) was also significantly higher in females than male donors. 
 Conclusion: This study showed eligible donors at KNH had significant differences in red cell count, hematocrit, hemoglobin, lymphocytes and platelets between male and female donors. Additionally, it highlighted that some blood donors had hematological parameters below and above the recommended reference ranges. These findings support the need to review the current donor recruitment criteria recommending the inclusion of complete blood count in screening.

Short-term treatment with Atorvastatin selectively decreases Lymphocyte count

Statins are a chemically related group used as lipid-lowering agents, studies confirmed that statins have additional pleiotropic, cholesterol independent, effects mediated by inhibition of isoprenoid synthesis with subsequent inhibition of the downstream signaling molecules like Rho, Rac, and Ras. However, different statin members might have a distinctive effect on the immune system; thereby having different peripheral and cardiovascular actions, such extra-hepatic effects impose the preferences of one statin over another. The present study aimed to identify the role of the short-term utilization of atorvastatin on leukocyte concentration as a representative in vivo marker for immunomodulation. Two widely used statin agents were included in the study- the lipophilic (atorvastatin) versus the hydrophilic (rosuvastatin) for comparison. Blood samples were withdrawn from the two statin groups, before and after therapy, and an automated differential white blood cell count was performed to determine the difference between the studied samples. The results showed that short-term use of atorvastatin, but not rosuvastatin, was associated with a selective reduction of lymphocyte count (p<0.0001). The study concluded that lymphocyte levels were reduced significantly after short-term use of atorvastatin; an effect which might need to be considered in certain immunological disease associated with cardiac ones.

Immunological Biomarkers in Blood to Monitor the Course and Therapeutic Outcomes of COVID-19.

The COVID-19 pandemic has posed a great challenge to the medical community because little is known about its clinical course, therapeutic options, and laboratory monitoring tools for diagnosis, prognosis, and surveillance. This review focuses on immune biomarkers that can be measured in peripheral blood in a clinical laboratory under routine conditions to monitor the innate immune system response in the acute phase, as well as the adaptive immune response established both after infection and vaccination. A PubMed search was performed covering January 2020 to June 2021 to extract biomarkers suitable for monitoring the immune response and outcome of COVID-19 and therapeutic interventions, including vaccination. To monitor the innate immune response, cytokines such as interleukin-6 or acute phase reactants such as C-reactive protein or procalcitonin can be measured on autoanalyzers complemented by automated white blood cell differential counts. The adaptive immune response can be followed by commercially available enzyme-linked immune spot assays to assess the specific activation of T cells or by monitoring immunoglobulin A (IgA), IgM, and IgG antibodies in serum to follow B-cell activation. As antigens of the SARS-CoV-2 virus, spike and nucleocapsid proteins are particularly suitable and allow differentiation between the immune response after infection or vaccination. Routine immune monitoring of COVID-19 is feasible in clinical laboratories with commercially available instruments and reagents. Strategies such as whether biomarkers reflecting the response of the innate and adaptive immune system can be used to make predictions and assist in individualizing therapeutic interventions or vaccination strategies need to be determined in appropriate clinical trials. Promising preliminary data are already available based on single-center reports and completed or ongoing vaccination trials.

JAK1 signaling in dendritic cells promotes peripheral tolerance in autoimmunity through PD-L1-mediated regulatory Tcell induction.

Dendritic cells (DCs) induce peripheral Tcell tolerance, but cell-intrinsic signaling cascades governing their stable tolerogenesis remain poorly defined. Janus Kinase 1 (JAK1) transduces cytokine-receptor signaling, and JAK inhibitors (Jakinibs), including JAK1-specific filgotinib, break inflammatory cycles in autoimmunity. Here, we report in heterogeneous DC populations of multiple secondary lymphoid organs that JAK1 promotes peripheral Tcell tolerance during experimental autoimmune encephalomyelitis (EAE). Mice harboring DC-specific JAK1 deletion exhibit elevated peripheral CD4+ Tcell expansion, less regulatory Tcells (Tregs), and worse EAE outcomes, whereas adoptive DC transfer ameliorates EAE pathogenesis by inducing peripheral Tregs, programmed cell death ligand 1 (PD-L1) dependently. This tolerogenic program is substantially reduced upon the transfer of JAK1-deficient DCs. DC-intrinsic IFN-γ-JAK1-STAT1 signaling induces PD-L1, which is required for DCs to convert CD4+ Tcells into Tregs invitro and attenuated upon JAK1 deficiency and filgotinib treatment. Thus, DC-intrinsic JAK1 promotes peripheral tolerance, suggesting potential unwarranted DC-mediated effects of Jakinibs in autoimmune diseases.

Comparison of the diagnostic accuracy of monocyte distribution width and procalcitonin in sepsis cases in the emergency department: a prospective cohort study

BackgroundEarly diagnosis and treatment of patients with sepsis reduce mortality significantly. In terms of exploring new diagnostic tools of sepsis, monocyte distribution width (MDW), as part of the white blood cell (WBC) differential count, was first reported in 2017. MDW greater than 20 and abnormal WBC count together provided a satisfactory accuracy and was proposed as a novel diagnostic tool of sepsis. This study aimed to compare MDW and procalcitonin (PCT)’s diagnostic accuracy on sepsis in the emergency department.MethodsThis was a single-center prospective cohort study. Laboratory examinations including complete blood cell and differentiation count (CBC/DC), MDW, PCT were obtained while arriving at the ED. We divided patients into non-infection, infection without systemic inflammatory response syndrome (SIRS), infection with SIRS, and sepsis-3 groups. This study’s primary outcome is the sensitivity and specificity of MDW, PCT, and MDW + WBC in differentiating septic and non-septic patients. In addition, the cut-off value for MDW was established to maximize sensitivity at an optimal level of specificity.ResultsFrom May 2019 to September 2020, 402 patients were enrolled for data analysis. Patient number in each group was: non-infection 64 (15.9%), infection without SIRS 82 (20.4%), infection with SIRS 202 (50.2%), sepsis-3 15 (7.6%). The AUC of MDW, PCT, and MDW + WBC to predict infection with SIRS was 0.753, 0.704, and 0.784, respectively (p < 0.01). The sensitivity, specificity, PPV, and NPV of MDW using 20 as the cutoff were 86.4%, 54.2%, 76.4%, and 70%, compared to 32.9%, 88%, 82.5%, and 43.4% using 0.5 ng/mL as the PCT cutoff value. On combing MDW and WBC count, the sensitivity and NPV further increased to 93.4% and 80.3%, respectively. In terms of predicting sepsis-3, the AUC of MDW, PCT, and MDW + WBC was 0.72, 0.73, and 0.70, respectively. MDW, using 20 as cutoff, exhibited sensitivity, specificity, PPV, and NPV of 90.6%, 37.1%, 18.7%, and 96.1%, respectively, compared to 49.1%, 78.6%, 26.8%, and 90.6% when 0.5 ng/mL PCT was used as cutoff.ConclusionsIn conclusion, MDW is a more sensitive biomarker than PCT in predicting infection-related SIRS and sepsis-3 in the ED. MDW < 20 shows a higher NPV to exclude sepsis-3. Combining MDW and WBC count further improves the accuracy in predicting infection with SIRS but not sepsis-3.Trial registration The study was retrospectively registered to the ClinicalTrial.gov (NCT04322942) on March 26th, 2020.

Evaluation of total and differential white blood cell counts in workers exposed to lead

Introduction: Lead is a toxic heavy metal that has adverse health effects on blood parameters. About 80% of lead produced is used in batteries, especially vehicle batteries. Therefore, the present study aimed to assess the hematological changes, including total and differential white blood cell (WBC) counts in battery workers exposed to lead, and compare with the non-exposed group. Materials and Methods: This cross-sectional study was carried out in a battery industry in Semnan city. The study population consisted of 78 battery workers and 78 healthy non-exposed office workers. A hematology cell counter was used to determine the total, and differential WBC counts. Blood lead level was measured in accordance with the NIOSH method 8003. Results: Blood lead levels were about two times higher than the TLV recommended by the American Conference of Governmental Industrial Hygienists (ACGIH) for this compound (20 µg/dl). The level of WBC (8.07± 2.55 mm3 blood×103 vs. 7.27 ± 1.58 mm3 blood×103) was significantly higher, while the level of monocyte was significantly lower (6.96 ± 1.72 % vs. 7.67 ± 1.87 %) in the exposed group than in the non-exposed group. After adjustment for potential confounders such as age and work history, a significant association between exposure to lead and WBC and monocyte levels was reported. Conclusion: The present study's findings indicated that exposure to lead was associated with total and differential white blood cells changes in the exposed group compared to the non-exposed group.

Comparative effects of Curcuma longa and curcumin on paraquat-induced systemic and lung oxidative stress and inflammation in rats.

Objective:Comparative effect of Curcuma longa (C. longa) ethanolic extract and curcumin on paraquat (PQ)-induced systemic and lung oxidative stress and inflammation were evaluated in the present study.Materials and Methods:Control animals were exposed to normal saline and PQ group to 54 mg/m3 PQ aerosols (8 times, each time for 30 min). Treatment groups were exposed to PQ and treated with 150 and 600 mg/kg/day C. longa, or 30 and 120 mg/kg/day curcumin after PQ exposure period for 16 days. Total and differential white blood cells (WBC) and oxidative markers were measured both in bronchoalveolar lavage (BALF) and blood at the end of the study.Results:Total and differential WBC counts as well as malondialdehyde (MDA) level were significantly increased but total thiol content and the activities of catalase (CAT) and superoxide dismutase (SOD) were reduced in both the BALF and blood of the PQ group in comparison with the control group (p<0.05 to p<0.001). Both doses of C. longa and curcumin diminished MDA level, total and differential WBC counts in the blood and BALF but increased CAT and SOD activities in both of them compared to PQ group (p<0.05 to p<0.001). The effects of C. longa and curcumin high dose on most variables were markedly more than low dose (p<0.05 to p<0.001). Furthermore, the effects of curcumin on some variables were markedly more than C. longa (p<0.05 to p<0.001).Conclusion:Both C. longa and curcumin improved PQ-induced systemic and lung inflammation and oxidative stress, but the effect of curcumin was more prominent.

Cellular and Biochemical Effects of Combined X-Ray Radiation and Storage on Whole Blood.

BackgroundEvaluating the impact of ionizing radiation on stored blood is relevant since blood banks are major assets in emergency conditions such as radiation incident/attack. This study aimed to fill our knowledge gap of combined radiation and storage effects on blood.MethodsBlood collected from 16 anesthetized rats was anticoagulated, aliquoted into storage bags, and assigned to 8 groups using protocols combining storage (1-day vs 3-day 4oC) plus irradiation (75 Gy vs 0 Gy - control). Bags were positioned inside an X-ray irradiator (MultiRad-350). Complete blood count, differential white blood cell count, biochemistry, and hemostasis were analyzed (≥7 bags/group).ResultsNa+, bicarbonate, glucose, and pH significantly reduced, while K+, Cl−, and lactate increased by storage. Coagulation measures were not significantly altered after radiation. White blood cell count and most cell types were numerically reduced after radiation, but changes were statistically significant only for monocytes. No significant alterations were noted in aggregation or rotational thromboelastometry parameters between irradiated and control.ConclusionsEvaluating cellular/biochemical parameters aids in assessing stored blood adequacy after radiation. Data suggest that fresh or cold-stored blood can sustain up to 75 Gy without major critical parameter changes and may remain suitable for use in critically ill patients in military/civilian settings.

Clinical significance of platelet-lymphocyte ratio in systemic lupus erythematosus patients: Relation to disease activity and damage

Aim of the workTo assess platelet–lymphocyte ratio (PLR) in systemic lupus erythematosus (SLE) patients and study its clinical significance, its relation to disease activity and damage. Patients and methodsThis study included 52 adult SLE patients and 50 matched control. All patients were subjected to full clinical examination, disease activity was measured by SLE disease activity index (SLEDAI), and damage was assessed by using Systemic Lupus International Collaborating Clinics Damage Index (SLICC-DI). Laboratory and immunology profiles included the complete blood count (CBC) with differential white blood cell (WBC) counts and estimation of PLR, erythrocyte sedimentation rate (ESR), liver and kidney function, alkaline phosphatase (ALP), serum calcium (Ca) and phosphorous (P), lipid profile, 24hr urinary protein, renal biopsy, anti-nuclear antibody (ANA), anti-double stranded deoxyribonucleic acid (anti-dsDNA), serum complements (C3,C4). ResultsThe mean age of SLE patients was 33.1 ± 9.2 years (20–58 years), with mean disease duration of 5.4 ± 5.02 years (0.25–20 years). The PLR was significantly higher in patients (189.9 ± 136.4; 23.9–782.9) than control (95 ± 29.9; p < 0.0001). The WBC and platelets count was comparable between patients and control (7.1 ± 1.7 x103/mm3 and 243.4 ± 51.3 x103/mm3; p = 0.3 and p = 0.51 respectively). The lymphocytic count was significantly lower in patient compared to control (1.9 ± 1.1 x103/mm3 vs 2.7 ± 0.8 x103/mm3)(p < 0.0001). PLR would significantly predict activity (p = 0.02) with a sensitivity of 94.3% and specificity of 100% at a cut-off value of 33.6. There was no association of PLR with the damage index. ConclusionPLR might be considered a valuable and un-expensive tool in assessment and prediction of SLE disease activity.

Impact of Sex on Circulating Leukocytes Composition in COPD Patients.

PurposeChronic obstructive pulmonary disease is characterized by chronic inflammatory response both at the lung site and at the systemic level. Abnormalities in circulating leukocytes have been reported to occur in COPD patients and have been often shown to correlate with the decline in lung function. COPD affects men and women at a virtually comparable rate, even though distinct sex specific symptoms, progression and therapeutic implications have been described. Nonetheless, these sex-associated differences have not been analyzed in terms of circulating leukocytes. To assess the impact of sex on the changes of circulating immune cells in COPD patients.Patients and MethodsBlood samples were collected from 50 COPD patients (31 males, 19 females) and 63 age and sex-matched controls (35 males, 28 females) enrolled in this pilot study. Complete blood cell count and multi-parametric flow cytometry analysis were performed to characterize the leukocyte populations and subsets.ResultsMale COPD patients are distinguished from controls by a significant increase in white blood cell counts, neutrophil total and differential counts, and neutrophil-to-lymphocyte ratio. Conversely, a generalized leukocyte decrease discriminated female COPD patients from the related controls. The impact of sex is further remarked by a decrease in adaptive immune cell subpopulations in males as opposed to a consistent increase of innate immune cell types in females correlating with disease severity.ConclusionThese data indicate that the definition of specific changes of circulating leukocytes to be used as reliable biomarkers of the disease severity cannot be accomplished irrespectively of sex.

Antitrypanosomal activity of hydromethanol extract of leaves of Cymbopogon citratus and seeds of Lepidium sativum: in-vivo mice model

BackgroundTrypanosomiasis is one of the neglected tropical diseases of both humans and animals which decreases their productivity and causes death in the worst scenario. Unavailability of vaccines, the low therapeutic index of trypanocidal drugs, and the development of resistance lead to the need for research focused on developing alternative treatment options especially from medicinal plants. The present study was aimed to investigate antitrypanosomal activities of leaves of Cymbopogon citratus and seeds of Lepidium sativum in in-vivo mice model.MethodsThe plant extracts were prepared by maceration using 80% methanol and reconstituted with 10% dimethyl sulfoxide (DMSO) to have the desired concentration. The test doses were adjusted to 100, 200 and 400 mg/kg based on the toxicity profile. The plants extracts were administered to the respective groups of mice after the 12th day of field isolate T. congolense inoculation for seven consecutive days. The level of parasitemia, bodyweight, packed cell volume (PCV), and differential white blood cell counts were measured.ResultsThe in -vivo test results revealed that both plant extracts had dose-dependent antitrypanosomal activity. Both crude extracts showed a significant reduction in parasite load (P < 0.05), increased or prevent the fall of PCV value (P < 0.05), decreased lymphocytosis and increased neutrophil counts (p < 0.05) and improved bodyweight but significant bodyweight increment (P < 0.05) was observed only in C. citratus treated mice compared to the negative and positive controls.ConclusionThe present study concluded that the crude extracts of leaves of C. citratus and seeds of L. sativum had antitrypanosomal effects. Both plants extracts reduced parasitemia level, prevented anemia and improved bodyweight of treated mice. Comparative results from all tested parameters showed that the best activities were observed with C. citratus treated groups of mice.

White blood cell count profiles in multiple sclerosis during attacks before the initiation of acute and chronic treatments

Multiple sclerosis (MS) is a major demyelinating disease of the central nervous system; however, its exact mechanism is unknown. This study aimed to elucidate the profile of white blood cells (WBCs) in the acute phase of an MS attack. Sixty-four patients with MS at the time of diagnosis and 2492 age- and sex-adjusted healthy controls (HCs) were enrolled. Data regarding the blood cell counts were compared between the groups. The total WBC (p < 0.0001), monocyte (p < 0.0001), basophil (p = 0.0027), and neutrophil (p < 0.0001) counts were higher in the MS group than in the HC group, whereas the lymphocyte and eosinophil counts did not differ. Adjustments for the smoking status and body mass index yielded the same results. The total and differential WBC counts of the patients with MS did not correlate with the counts of T2 hyperintense brain lesions or the levels of neurological disturbance. In summary, patients with MS showed elevated counts of total WBCs, monocytes, basophils, and neutrophils at the time of diagnosis. However, the clinical relevance of these biomarkers in the context of the development and progression of MS remains unclear.

Total and differential white blood cell count and cause-specific mortality in 436 750 Taiwanese adults

Background and aimsWhite blood cell (WBC) count is an easily obtainable biomarker of systematic inflammation. Our study aimed to investigate the associations of differential WBC count with all-cause and cause-specific mortality in a general Asian population. Methods and resultsCox proportional hazards model was used to evaluate the associations of WBC count with mortality separately for men and women, with adjustment for multiple variables including age, smoking, and other lifestyle factors. Stratified analyses by age, smoking, diabetes, and hypertension were conducted to explore potential effect modification.Elevated WBC count was significantly associated with increased mortality risk. The adjusted hazard ratios of total WBC (10th decile compared to decile of lowest risk) for all-cause mortality were 1.42 (95% CI: 1.33, 1.53) for men and 1.54 (95% CI: 1.42, 1.68) for women. Similar risks were observed for neutrophils, monocytes, and neutrophil/lymphocyte (NL) ratio. The highest deciles of neutrophils, monocytes, and NL ratio were also positively associated with risk of cardiovascular/cerebrovascular, cancer, and respiratory mortality after adjusting for covariates. Results for all-cause mortality remained statistically significant for participants who were <60 years old, non-smokers, non-diabetic, and non-hypertensive. ConclusionsTotal and differential WBC counts (neutrophils, monocytes, and NL ratios) are positively associated with increased risk of all-cause mortality, cardiovascular and cerebrovascular, cancer, and respiratory mortality among Taiwanese adults.

Temporal Evolution of White Blood Cell Count and Differential: Reliable and Early Detection Markers for Surgical Site Infection Following Spinal Posterior Decompression Surgery.

Introduction For early detection of surgical site infection (SSI) following spinal decompression surgery, we compared temporal changes in the values of laboratory markers that are not affected by operative parameters. Methods The study included 302 patients, which were divided into an SSI group (patients who developed deep SSI) and a non-SSI group for analysis. We reviewed data on C-reactive protein level, total white blood cell (WBC) count, and WBC differential percentage and count before spinal decompression, on postoperative day 1, and on postoperative day 4. We identified laboratory markers that are not affected by operative parameters (operating time, intraoperative blood loss, and number of operative segments). Laboratory markers with a significant difference observed between the peak or nadir value and the value in the subsequent survey day were considered as an indicator of SSI. We examined the utility of each indicator by calculating sensitivity and specificity. Furthermore, we investigated the utility of the combination of all five indicators (wherein the recognition of one marker was considered positive). Results Temporal changes in five laboratory markers were considered indicators of SSI. The changes from postoperative day 1 to postoperative day 4 were as follows: (1) increased WBC count (42% sensitivity, 88% specificity), (2) increased neutrophil percentage (25% sensitivity, 96% specificity), (3) increased neutrophil count (25% sensitivity, 94% specificity), (4) decreased lymphocyte percentage (25% sensitivity, 95% specificity), and (5) decreased lymphocyte count (25% sensitivity, 85% specificity). The combination of these five markers showed a 50% sensitivity, 81% specificity, and 0.65 AUC. Conclusions Five markers were found to be reliable indicators of SSI following spinal decompression surgery because they were not affected by operative parameters. The combination of all five indicators had moderate sensitivity and high specificity. Therefore, this may be reliable and useful for the early detection of SSI.

Relationship between rotating shift work and white blood cell count, white blood cell differential count, obesity, and metabolic syndrome of nurses

ABSTRACT This study investigated the relationship between working rotating shifts and white blood cell (WBC) count, WBC differential count (DC), obesity, and metabolic syndrome of nurses. Samples were obtained from a total of 720 nurses who had received health checkups at a large teaching hospital in Taiwan. Among these nurses, 500 worked rotating shifts, and the remaining 220 nurses worked fixed daytime shifts. We used binary logistic regression to identify the risk factors of obesity or metabolic syndrome. The results indicate that nurses working rotating shifts had a significantly higher WBC count than those working fixed daytime shifts. WBC count was an independent factor relating to an overly large waist circumference or overly high body mass index (BMI) of nurses. For every 103/μL increase in WBC count, the risk of waist circumference exceeding 90 cm and 80 cm respectively in male and female nurses increased by 46%, and for every 103/μL increase in WBC count, the risk of a BMI 24 kg/m2 in nurses increased by 50%. Similarly, WBC count and work type were independent factors influencing the metabolic syndrome of nurses. For every 103/μL increase in WBC count, the risk of metabolic syndrome occurring in nurses increased by 65%. Nurses working rotating shifts were at a 3.34 times greater risk of having metabolic syndrome than those working fixed daytime shifts. The mean age of our participants was 29.54 years old, and only approximately 4% of the participants had metabolic syndrome. Among these nurses, we found that high WBC was correlated with an overly large waist circumference and overly high BMI. Furthermore, the nurses working rotating shifts may have been at greater risk of metabolic syndrome than those working fixed daytime shifts, and increases in WBC were also associated with the occurrence of metabolic syndrome.

Brain stem death induces pro-inflammatory cytokine production and cardiac dysfunction in sheep model

IntroductionOrgans procured following brain stem death (BSD) are the main source of organ grafts for transplantation. However, BSD is associated with inflammatory responses that may damage the organ and affect both the quantity and quality of organs available for transplant. Therefore, we aimed to investigate plasma and bronchoalveolar lavage (BAL) pro-inflammatory cytokine profiles and cardiovascular physiology in a clinically relevant 6-h ovine model of BSD. MethodsTwelve healthy female sheep (37–42 Kg) were anaesthetized and mechanically ventilated prior to undergoing BSD induction and then monitored for 6 h. Plasma and BAL endothelin-1 and cytokines (IL-1β, 6, 8 and tumour necrosis factor alpha (TNF-α)) were assessed by ELISA. Differential white blood cell counts were performed. Cardiac function during BSD was also examined using echocardiography, and cardiac biomarkers (A-type natriuretic peptide and troponin I were measured in plasma. ResultsPlasma concentrations big ET-1, IL-6, IL-8, TNF-α and BAL IL-8 were significantly (p < 0.01) increased over baseline at 6 h post-BSD. Increased numbers of neutrophils were observed in the whole blood (3.1 × 109 cells/L [95% confidence interval (CI) 2.06–4.14] vs. 6 × 109 cells/L [95%CI 3.92–7.97]; p < 0.01) and BAL (4.5 × 109 cells/L [95%CI 0.41–9.41] vs. 26 [95%CI 12.29–39.80]; p = 0.03) after 6 h of BSD induction vs baseline. A significant increase in ANP production (20.28 pM [95%CI 16.18–24.37] vs. 78.68 pM [95%CI 53.16–104.21]; p < 0.0001) and cTnI release (0.039 ng/mL vs. 4.26 [95%CI 2.69–5.83] ng/mL; p < 0.0001), associated with a significant reduction in heart contractile function, were observed between baseline and 6 h. ConclusionsBSD induced systemic pro-inflammatory responses, characterized by increased neutrophil infiltration and cytokine production in the circulation and BAL fluid, and associated with reduced heart contractile function in ovine model of BSD.