High Lactate Dehydrogenase Levels Research Articles

Clinical Characteristics of Patients With Progressive and Non-progressive Coronavirus Disease 2019: Evidence From 365 Hospitalised Patients in Honghu and Nanchang, China.

Background: Coronavirus disease (COVID-19) has swept around the globe and led to a worldwide catastrophe. Studies examining the disease progression of patients with non-severe disease on admission are scarce but of profound importance in the early identification of patients at a high risk of deterioration.Objectives: To elucidate the differences in clinical characteristics between patients with progressive and non-progressive COVID-19 and to determine the risk factors for disease progression.Study design: Clinical data of 365 patients with non-severe COVID-19 from 1 January 2020 to 18 March 2020 were retrospectively collected. Patients were stratified into progressive and non-progressive disease groups. Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for disease progression.Results: Compared with patients with non-progressive disease, those who progressed to severe COVID-19 were older and had significantly decreased lymphocyte and eosinophil counts; increased neutrophil and platelet counts; lower albumin levels; higher levels of lactate dehydrogenase, C-reactive protein (CRP), creatinine, creatinine kinase, and urea nitrogen; and longer prothrombin times. Hypertension, fever, fatigue, anorexia, bacterial coinfection, bilateral patchy shadowing, antibiotic and corticosteroid administration, and oxygen support had a significantly higher incidence among patients with progressive disease. A significantly longer duration of hospital stay was also observed in patients with progressive disease. Bilateral patchy shadowing (OR = 4.82, 95% CI: 1.33–17.50; P = 0.017) and elevated levels of creatinine (OR =6.24, 95% CI: 1.42–27.40; P = 0.015), and CRP (OR = 7.28, 95% CI: 2.56–20.74; P < 0.001) were independent predictors for disease progression.Conclusion: The clinical characteristics of patients with progressive and non-progressive COVID-19 were significantly different. Bilateral patchy shadowing and increased levels of creatinine, and CRP were independent predictors of disease progression.

COMPARATIVE STUDY of SOME BIOCHEMICAL PARAMETERS AMONG of COVID-19 SYMPTOMS and NON COVID-19 SYMPTOMS IN-DIVIDUALS

Nowadays in the Kurdistan region of Iraq, the number of patients have common symptoms with COVID-19 infection rapidly increased. 123 patients which they had common symptoms with COVID-19 and 94 healthy control individuals (non-COVID-19) were subjected for quantitative analysis for each one of the following biochemical parameters, Lactate dehydrogenase (LDH), Creatine Phosphokinase (CPK), and C-reactive protein (CRP) in Erbil, Kurdistan Region of Iraq. We analyze clinical features and compared the differences between COVID-19 and non-COVID-19 symptoms. Among the healthy control individuals, the absolute value of LDH, CPK Creatine Kinase and CRP were determined in between the normal range, and in compare with patients with COVID-19 symptoms their values were smaller and, the P value was (P ＜0.05). All three biochemical parameters increased among patients with COVID-19 symptoms, but more significantly, steadily increase was observed only in LDH value in age above and under 40 years (284.43±10.29 and 321.23±16.32 U/L), and p-value was (0.0488). Male patients had higher levels of LDH (299.32±11.42 U/L), CPK Creatine Kinase (195.90±26.65 mg/L), and C-Reactive Protein (5.86±3.96 mg/L) in compared with the female patients. Our study suggested that among patients who have COVID 19 symptoms, increased LDH is the advised and helpful biochemical marker among routine panel for COVID-19 infection evaluation. Also, CRP levels were positively correlated with male patients when compared with the healthy control.

What is the normal composition of pericardial fluid?

ObjectiveBiochemical and cytological pericardial fluid (PF) analysis is essentially based on the knowledge of pleural fluid composition. The aim of the present study is to identify reference intervals (RIs) for...

Venous thromboembolism and COVID-19: a single center experience from an academic tertiary referral hospital of Northern Italy

Preliminary evidence supports the notion that COVID-19 patients may have an increased susceptibility to develop venous thromboembolism (VTE). However, the magnitude of this association still needs to be defined. Furthermore, clinical predictors of thrombogenesis, and the relationship with the inflammatory status are currently unknown. On this basis, we conducted a retrospective, observational study on 259 consecutive COVID-19 patients admitted to an academic tertiary referral hospital in Northern Italy between March 19th and April 6th, 2020. Records of COVID-19 patients with a definite VTE event were reviewed for demographic information, co-morbidities, risk factors for VTE, laboratory tests, and anticoagulation treatment. Twenty-five cases among 259 COVID-19 patients developed VTE (9.6%), all of them having a Padua score > 4, although being under standard anticoagulation prophylaxis since hospital admission. In the VTE subcohort, we found a significant positive correlation between platelet count (PLT) and either C reactive protein (CRP) (p < 0.0001) or lactate dehydrogenase (LDH) (p = 0.0013), while a significant inverse correlation was observed between PLT and mean platelet volume (p < 0.0001). Platelet-to-lymphocyte ratio significantly correlated with CRP (p < 0.0001). The majority of VTE patients was male and younger compared to non-VTE patients (p = 0.002 and p = 0.005, respectively). No significant difference was found in d-dimer levels between VTE and non VTE patients, while significantly higher levels of LDH (p = 0.04) and IL-6 (p = 0.04) were observed in VTE patients in comparison to non-VTE patients. In conclusion, our findings showed a quite high prevalence of VTE in COVID-19 patients. Raised inflammatory indexes and increased serum levels of pro-inflammatory cytokines should raise the clinical suspicion of VTE.

Analysis of the Factors Associated with Negative Conversion of Severe Acute Respiratory Syndrome Coronavirus 2 RNA of Coronavirus Disease 2019

AIM: To understand the factors associated with negative conversion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, targeted surveillance and control measures can be taken to provide scientific basis for the treatment of the disease and to improve the prognosis of the disease.&#x0D; METHODS: Using the method of retrospective cohort study, we collected the data of Coronavirus Disease 2019 (COVID-19) patients in Tongji Hospital of Wuhan, China from 10 January to 25 March, 2020. Among the data of 282 cases, 271 patients, according to whether the negative conversion happened, were divided into negative conversion group and control group. We made the quantitative variables into classification; Chi-square test single-factor and Cox regression were used in univariate analysis and extracted 30 meaningful variables, then through the collinearity diagnosis, excluded the existence of collinear variables. Finally, 22 variables were included in Cox regression analysis.&#x0D; RESULTS: The gender distribution was statistically significant between two groups (p &lt; 0.05). While in the negative conversion group, the patients of non-severe group occupied a large proportion (p &lt; 0.001). The median time for the negative conversion group was 17 days, and at the end of the observation period, the virus duration in control group was 24 days (p &lt; 0.05). A total of 55 variables were included in univariate analysis, among which 30 variables were statistically different between the two groups. After screening variables through collinearity diagnosis, 22 variables were included in the Cox regression analysis. Last, lactate dehydrogenase (LDH), age, fibrinogen (FIB), and disease severity were associated with negative conversion of SARS-CoV-2 RNA.&#x0D; CONCLUSION: Our results suggest that in the treatment of COVID-19, focus on the age of more than 65 years old, severe, high level of LDH, FIB patients, and take some targeted treatment, such as controlling of inflammation, reducing organ damage, so as to provide good conditions for virus clearance in the body.

Identifying adolescent and young adult patients with sickle cell disease at highest risk of death.

Identifying adolescent and young adult patients with sickle cell disease at highest risk of death.

Pneumocystis jirovecii pneumonia in diffuse large B-cell Lymphoma treated with R-CHOP.

The aim of this study was to estimate the incidence of and risk factors for Pneumocystis pneumonia (PCP) infection in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The medical records of 739 DLBCL patients who received R-CHOP between May 2004 and January 2019 were retrospectively evaluated. Patients were divided into two groups: those who received primary PCP prophylaxis (prophylaxis group) and those who did not (control group). The incidence rate of PCP in each group was calculated, and risk factors for PCP were evaluated in the control group. Baseline characteristics were significantly different between the two groups. Compared to the 602 patients who did not receive prophylaxis, the prophylaxis group (n=137) had poor prognostic factors of older age, high lactate dehydrogenase (LDH) levels, advanced Ann Arbour stage, and high International Prognostic Index (IPI) risk scores. None of the patients receiving PCP prophylaxis developed PCP, while the incidence of PCP in the control group was 8.1% (definite cases 5.5% and probable cases 2.7%). Out of the 49 patients who developed PCP, 10 patients (20.4%) were admitted to the intensive care unit, and the PCP-related death rate was 16.3% (8/49). This study showed that PCP prophylaxis is highly effective against PCP infection and may help guide prevention of PCP during R-CHOP treatment in DLBCL patients.

The Predictive Value of Lactate Dehydrogenase in Patients with Chemoradiotherapy for Esophageal Squamous Cell Carcinoma

Increasing evidence has indicated that higher levels of lactate dehydrogenase (LDH) is associated with poor prognosis in various malignancies; however, the correlation between LDH levels and clinical outcomes in esophageal squamous cell carcinoma (ESCC) has been poorly studied. The objective of this study was to assess whether LDH has prognostic value in patients with ESCC undergoing chemoradiotherapy. A total of 614 ESCC patients were enrolled in this retrospective study from January 1, 2012 to December 31, 2016.The optimal cutoff points for LDH were determined by X-tile software. we analyzed the association between the levels of LDH and clinicopathological characteristics, as well as the relationship between LDH levels and responses. Kaplan-Meier method with log-rank test was used to explore the prognostic value for overall survival (OS) and progression-free survival (PFS). And then We examined the prognostic value for OS and PFS by univariate and multivariate Cox regression models. A 1:3 propensity score matching was used to compensate for differences in baseline characteristics. The optimal cutoff points of LDH was 134U/L. The median OS in the high LDH group was 31.3 months, and more than 50% of patients with low LDH were still survive to the last follow-up (P = 0.020).The median PFS of low LDH and high LDH were 40.1 and 18.0 months, respectively (P = 0.010).Gender,Cyfra21-1,tumor length, cN/M stage, treatment options and LDH were independent prognostic indicators for OS. Gender, Cyfra21-1, tumor length, cN/M stage, treatment options, chemotherapy cycles, and LDH were independent prognostic indicators for PFS. Unfortunately, there was no significant difference for OS and PFS by Kaplan–Meier method after matching, but the survival curve showed a tendency to separate between the two groups. The present study revealed the existence of a significant association between the pretreatment serum LDH level and OS in patients with ESCC receiving treatment with chemoradiotherapy as well as a significant association with PFS. It implied that the management of patients with high LDH levels should be changed. However, it is worth noting that this conclusion was not certified after matching. Although the consistent conclusions were not obtained in predicting the prognosis of ESCC patients with LDH before and after matching, a multicenter, large-sample prospective study is needed to further verify the conclusions of this study before this method can be applied to conventional clinical studies.

Survival Disparities of Diffuse Large B-Cell Lymphoma in a Community-Based Inner-City Cancer Center

BackgroundDiffuse large B-cell lymphoma (DLBCL) comprises approximately 30% of all non-Hodgkin lymphomas. Multiple studies have demonstrated race-based disparities in survival among patients with DLBCL across all stages of disease, in the era both before and after rituximab. The etiology for the racial disparities in survival among patients with DLBCL is still unknown. Moreover, the Revised International Prognostic Index (R-IPI), a tool that predicts the DLBCL patients’ outcome, has not yet been validated in African Americans (AA). Patients and MethodsWe conducted a cohort study of patients diagnosed with DLBCL from January 1, 2007, to December 31, 2017, from our tumor registry in a single community-based inner-city cancer center. We abstracted demographic, clinical, histopathologic, treatment, and R-IPI variables. A total of 181 patients (47.5%) with biopsy-proven DLBCL were included in the retrospective analysis. The median age was 65 years, 47% were men, 41% were AA, and 44% were white. ResultsThe AA group had a younger median age, higher lactate dehydrogenase levels, higher frequency of B symptoms, and higher HIV infection than the non-AA group. The AA group had significantly decreased median overall survival than the non-AA group (15.7 months; 95% confidence interval, 10.3 to 23.9, vs. 93.6 months; 95% confidence interval, 61.5 to 142.6, respectively; P < .001). The survival disparities persisted after excluding patients with HIV and who did not receive chemotherapy. In addition, AA race predicts a reduced survival by univariate and multivariate analysis. ConclusionAA with DLBCL may have a poorer prognosis than the non-AA population. Further studies should investigate the biology of DLBCL in the AA population.

Clinical laboratory characteristics in patients with suspected COVID-19: One single-institution experience.

ObjectivesSince December 2019, the outbreak of coronavirus disease 2019 (COVID‐19) has become a worldwide pandemic. The aim of the study is to investigate the demographic, clinical, and laboratory characteristics in suspected COVID‐19 patients in our institution.MethodsIn this retrospective study, we investigated suspected COVID‐19 patients admitted to the University of Alabama at Birmingham with a request for an interleukin‐6 send‐out test, from March 28 to June 27, 2020. Patients' demographic, clinical, and laboratory characteristics were collected by chart review.ResultsFifty patients suspected with COVID‐19 were included in our study, of whom 24 patients were positive with severe acute respiratory syndrome coronavirus‐2 infection and 26 were negative. During the observation period, 30 patients were discharged, 17 died during hospitalization, and three remained in hospital. Compared to non‐COVID‐19 patients, COVID‐19 patients had older age, more comorbidities, and elevated levels of inflammation markers such as erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP), serum ferritin, and lactate dehydrogenase (LDH). However, there was no significant difference in laboratory data between survivors and nonsurvivors in COVID‐19 patients in our study.ConclusionThis study indicated that potential risk factors of older age, multiple comorbidities, and high levels of ESR, CRP, serum ferritin, and LDH could help the clinician to identify potential COVID‐19 patients. However, this data needs to be further validated in a larger population.

Clinical Characteristics and Prognosis of Patients with Relapsed or Refractory Diffuse Large B-Cell Lymphoma

To investigate the clinical characteristics of relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) and the factors affecting overall survival (OS) time. The clinical data of 14 R/R DLBCL patients admitted to the Hainan Hospital of Chinese PLA General Hospital from April 2012 to March 2019 were analyzed retrospectively and the overall response rate (ORR) after the end of different treatments was estimated. Kaplan-Meier method was used to describe the survival curve, and Log-rank test was used to compare whether different survival curves showed statistically different. There were 8 males and 6 females with a median age of 51 (26-75) years old and the median course of treatment before R/R was 7 (4-13). Finally, 11 patients achieved remission, 6 patients of which showed complete remission, and 5 patients showed partial remission, with the median ORR duration at 2.5 (0-51) months. All patients in the group of ibrutinib combined with second-line chemotherapy achieved remission (4/4), it was equivalent to the high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HDC-AHSCT) group (4/4), which was significantly higher than that of the other second-line group (3/6). The median OS time of patients was 17 (6-76) months. The survival of patients receiving ibrutinib combined with second-line chemotherapy and HDC-AHSCT was significantly better than that of patients not receiving ibrutinib combined with second-line chemotherapy and HDC-AHSCT. Normal lactate dehydrogenase, IPI score＜3 at diagnosis, and CR/PR after treatment could improve the survival time of patients. The duration of remission for R/R DLBCL patients is short and the prognosis is very poor. The survival time of patients with high level of lactate dehydrogenase, IPI score≥3 at diagnosis and SD/PD after treatment is significantly shortened. Ibrutinib combined second-line chemotherapy and HDC-AHSCT can improve the efficacy and survival of R/R DLBCL patients.

Drain management after distal pancreatectomy based on a predictive model, including drainage fluid amylase and biochemical inflammatory markers: a preliminary study

Introduction Postoperative pancreatic fistula (POPF) is the Achilles’ heel of distal pancreatectomy. Surgeons use abdominal drains for early prediction, diagnosis, and timely management of POPF. The utility of drainage fluid in the prediction and diagnosis of POPF is a matter of debate. Patients and methods This is a retrospective cohort study of all patients who underwent distal pancreatectomy between January 2018 and January 2020. The present study aims to evaluate the association between drainage fluid amylase (DFA) and systemic inflammatory markers in the prediction of clinically relevant POPF. Results This study included 44 patients with a mean age of 40.3±16.3 years, and the female : male ratio was 2.7 : 1. POPF occurred in 11 (25%) patients. Of them, nine (20.5%) patients were managed by additional ultrasound-guided tube drainage. Higher drainage fluid amount and DFA-D1 were associated with a higher risk of POPF (P=0.036, and 0.009, respectively). The leukocytic count was significantly higher in POPF in the third postoperative day (POD) (P=0.032). POPF group had a significantly higher level of serum lactate dehydrogenase (LDH) on the fourth POD (P=0.001). Patients with high DFA-D1 (>330 IU/l), rising leukocytic count, and high serum LDH were significantly at higher risk of POPF (9/11 developed POPF, P=0.0001). Conclusion DFA-D1, rising leukocytic count, and high serum LDH level compromised a more robust predictive model for POPF. The cutoff value of DFA proposed by the ISGPF is applicable when combined with leukocytic count and serum LDH. Prospective large-scale studies are needed.

Significance changes in the levels of myocardial enzyme in the child patients with Mycoplasma Pneumoniae Pneumonia

Mycoplasma is a gram-negative with thin wall bacterium that in humans, Mycoplasma pneumoniae causes pneumonia. This experiment was designed to explore the changes of myocardial enzymes in the mycoplasma pneumoniae pneumonia (MPP) child patients, and analyze the clinical value of these changes, in combination with the relevant indicators, symptoms and signs, in the evaluation of the pneumonia mycoplasma infection. For this aim, a total of 120 child patients with MPP in the acute phase,120 child patients with MPP in the recovery phase and 120 healthy children were simultaneously enrolled into this study to detect the levels of aspartate aminotransferase (AST), creatine kinase (CK), Creatine Kinase Isoenzyme (CK-MB) and lactic dehydrogenase (LDH) in blood. Results showed that MPP patients in the acute phase had higher levels of LDH, CK, CK-MB, AST, PCt, CRP, MPV, PDW, PCt, percentage of neutrophils, WBC count in the peripheral blood and ESR than those of the patients in the recovery patients and healthy children, while the level of PLT was lower (all P&lt;0.05). In the acute phase, the level of CK-MB correlated to the fever, fever duration, extrapulmonary organ damage (except for the myocardial damage) and the antibody titer of MP (all P&lt;0.05). It was concluded that in the acute phase of MMP, the level of CK-MB could not only reflect the myocardial damage readily but also the infection of MP as well as the resultant inflammation and disease progression, which could effectively guide the diagnosis and treatment of MPP.

Early Relapse Risk in Patients with Newly Diagnosed Multiple Myeloma Characterized by Next-generation Sequencing.

Duration of first remission is important for the survival of patients with multiple myeloma. From the CoMMpass study (NCT01454297), 926 patients with newly diagnosed multiple myeloma, characterized by next-generation sequencing, were analyzed to evaluate those who experienced early progressive disease (PD; time to progression, TTP ≤18 months). After a median follow-up of 39 months, early PD was detected in 191/926 (20.6%) patients, 228/926 (24.6%) patients had late PD (TTP >18 months), while 507/926 (54.8%) did not have PD at the current follow-up. Compared with patients with late PD, patients with early PD had a lower at least very good partial response rate (47% vs. 82%, P < 0.001) and more frequently acquired double refractoriness to immunomodulatory drugs (IMiD) and proteasome inhibitors (PI; 21% vs. 8%, P < 0.001). Patients with early PD were at higher risk of death compared with patients with late PD and no PD (HR, 3.65; 95% CI, 2.7-4.93; P < 0.001), showing a dismal median overall survival (32.8 months). In a multivariate logistic regression model, independent factors increasing the early PD risk were TP53 mutation (OR, 3.78, P < 0.001), high lactate dehydrogenase levels (OR, 3.15, P = 0.006), λ-chain translocation (OR, 2.25, P = 0.033), and IGLL5 mutation (OR, 2.15, P = 0.007). Carfilzomib-based induction (OR, 0.15, P = 0.014), autologous stem-cell transplantation (OR, 0.27, P < 0.001), and continuous therapy with PIs and IMiDs (OR, 0.34, P = 0.024) mitigated the risk of early PD. Early PD identifies a high-risk multiple myeloma population. Further research is needed to better identify baseline features predicting early PD and the optimal treatment approaches for patients at risk.

Association of demographic, clinical, laboratory, and radiological characteristics with outcomes of COVID-19 patients: A systematic review and Meta-analysis

Objectives: The aim of this meta-analysis was to assess association between a composite clinical outcome (severe infection/ required ICU admission/ death) of COVID-19 pneumonia and demographic, clinical, laboratory and radiological findings of these patients. Methods: A literature search was conducted using the databases PubMed, Medline, Scopus and Web of Science till July. Relative risk (RRs), standardized mean difference (SMDs) and 95% confidence intervals (CIs) were pooled using random-effects models. We described overall estimates of relevant data of clinical importance from 116,260 COVID-19 pneumonia patients including 19,628 with composite end points from 40 observational studies of 5 countries. Results: The result showed that male gender (RR=1.24, p 64 years (RR=2.52, P <.001) followed aggravated course. Delayed hospitalization (SMD=.75, p= 0.005), presence of co-morbidity (RR= 1.76, p<.001) and multiple co-morbidities (RR=1.50, p<.001) were associated with higher risk of fatal course. Pooled data reported significantly high neutrophil-lymphocyte ratio (SMD=10.79, p<.001), low lymphocyte-to-C-reactive protein ratio (SMD=-3.89, p<.001), low platelet count (SMD=-1.622, p<.001), prolonged prothrombin time (SMD=0.98, p<.001), high lactate dehydrogenase (SMD=6.260, p<.001), D-dimer (SMD=1.92, p<.001), creatine kinase (SMD=1.68, p= 0.001) and interleukin-6 level (SMD=2.84, P=.001) in patients with fatal outcome. Funnel plots and Egger’s tests did not reveal any significant publication bias. Conclusions: Features like older age, male gender, presence of co-morbidities and delayed hospitalization along with the laboratory findings consistent with infection, immune system activation, coagulation disorder and tissue damage could help clinicians to identify COVID-19 patients with poor prognosis at an early stage. J Microbiol Infect Dis 2019; 9(3):121-135.

Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes.

Studies have confirmed COVID-19 patients with diabetes are at higher risk of mortality than their non-diabetic counterparts. However, data-driven evidence of factors associated with increased mortality risk among hospitalized COVID-19 patients with diabetes is scarce in South Korea. This study was conducted to determine the mortality rate and identify risk factors of mortality among hospitalized COVID-19 patients with type 2 diabetes in Gyeongsangbuk-do province, South Korea. In this hospital-based, cross-sectional study, we enrolled a total of 324 patients with confirmed COVID-19, hospitalized at two of the tertiary level healthcare facilitates of Gyeongsangbuk-do, South Korea from 18 February to 30 June 2020. Demographic and clinical data and laboratory profiles were analyzed and multivariate logistic regression analysis was used to identify risk factors of mortality among diabetic patients with COVID-19. Of the 324 patients, 55 (16.97%) had diabetes mellitus. The mean age of all study subjects was 55 years, and the mean age of those with diabetes was greater than that of those without (69.8 years vs. 51.9 years). Remarkably, the mortality rate was much higher among those with diabetes (20.0% vs. 4.8%). Multivariate logistic regression analysis revealed that an older age (≥70 years) and a high serum lactate dehydrogenase (LDH) levels significantly predicted mortality among hospitalized COVID-19 patients with diabetes. Our study cautions more attention to be paid to patients with diabetes mellitus hospitalized for COVID-19, especially those aged ≥ 70 years and those with a high serum LDH level, to reduce the risk of mortality.

AML-029: The Prognostic Significance of Serum Lactate Dehydrogenase Level in Egyptian AML Patients

Context Acute myeloid leukemia (AML) is a clonal heterogeneous disorder. Poor-risk cytogenetics, and older age have been considered adverse risk factors for AML survival. Other factors that may predict prognosis are not as well described. Elevated lactate dehydrogenase (LDH) levels are considered as an unfavorable prognostic factor for several malignancies, including acute leukemias, due to the tumor burden activity which reflects the function of leukemic cell turnover and cell destruction. Objective The current study intended to determine the clinical characteristics and risk factors affecting the outcome of patients with AML. Design This was an observational prospective study from October 2016 till 2017. Setting It was carried out in the Hematology unit at Oncology Center Mansoura University (OCMU). Patients This study was carried out on 40 de novo AML patients in comparison with 10 adult healthy controls. They were M/F 19/21 (47.5/52.5%), mean age 44.3±15.1 years. The FAB classification: 20% were M1, 25% were M2, 32.5% were M4, 17.5% were M5, 5% were M6 and no M0 or M7, and M3 was excluded. Four patients (10%) had a favorable risk, 33 (82.5%) had an intermediate risk, and 3 patients (7.5%) with unfavorable risk. At the end of the study,11 were alive. Interventions The patients were subjected to the routine history taking, physical examination, and laboratory investigations for the workup of AML. The enrolled cases received standard induction, consolidation and salvage chemotherapy protocols. Main Outcomes Measures: The median LDH level was 731.5 (188-6292) U/L. It was highly elevated in almost all patients [39 out of the 40 enrolled patients]. Results Cox regression analysis was conducted for prediction of overall survival (OS) within studied AML patients; using age, gender, laboratory and conventional karyotyping as covariates. High LDH levels were associated with shorter cumulative 1 year OS within studied AML patients in uni- (P=0.018, HR: 1.012, 95% CI 1.005-1.071) and multivariate (P= 0.031, HR: 1.023, 95% CI 1.002-1.091) analyses. Conclusions High LDH levels are considered as poor prognostic factor for prediction of shorter survival. Those patients who have higher LDH levels at diagnosis should be closely observed.

Diagnostic accuracy of time to first positivity of blood cultures for predicting severe clinical outcomes in children with pneumonia-related bacteremia

Early recognition of severe clinical outcomes in children with pneumonia-related bacteremia is vitally important because of the high mortality. This study aims to explore risk factors for severe clinical outcomes...

Comorbidity and prognostic factors on admission in a COVID-19 cohort of a general hospital

Antecedents and objectiveTo describe clinical features, comorbidity, and prognostic factors associated with in-hospital mortality in a cohort of COVID-19 admitted to a general hospital. Material and methodsRetrospective cohort study of patients with COVID-19 admitted from 26th February 2020, who had been discharged or died up to 29th April 2020. A descriptive study and an analysis of factors associated with intrahospital mortality were performed. ResultsOut of the 101 patients, 96 were analysed. Of these, 79 (82%) recovered and were discharged, and 17 (18%) died in the hospital. Diagnosis of COVID-19 was confirmed by polymerase chain reaction to SARS-CoV2 in 92 (92.5%). The mean age was 63 years, and 66% were male. The most frequent comorbidities were hypertension (40%), diabetes mellitus (16%) y cardiopathy (14%). Patients who died were older (mean 77 vs 60 years), had higher prevalence of hypertension (71% vs 33%), and cardiopathy (47% vs 6%), and higher levels of lactate dehydrogenase (LDH) and reactive C protein (mean 662 vs 335 UI/L, and 193 vs 121mg/L respectively) on admission. In a multivariant analysis the variables significantly associated to mortality were the presence of cardiopathy (CI 95% OR 2,58–67,07), levels of LDH≥345 IU/L (CI 95% OR 1,52–46,00), and age≥65 years (CI 95% OR 1,23–44,62). ConclusionsThe presence of cardiopathy, levels of LDH≥345 IU/L and age≥65 years, are associated with a higher risk of death during hospital stay for COVID-19. This model should be validated in prospective cohorts.

Protective effects of dexmedetomidine on hypoxia/reoxygenation injury in cardiomyocytes by regulating the CHOP signaling pathway.

Hypoxia/reoxygenation (H/R) injury in myocardial cells occurs frequently during cardiac surgery and affects the prognosis of patients. The present study aimed to investigate the protective effects of dexmedetomidine (Dex) on H/R injury and its association with the C/EBP-homologous protein (CHOP) signaling pathway. An H/R model was constructed in H9C2 cells to investigate the effects of Dex on H/R injury. Cell viability, apoptosis and lactate dehydrogenase (LDH) levels were determined by MTT, flow cytometry and 2,4-dinitrophenylhydrazine colorimetric assays, respectively. The expression levels of inflammatory factors were measured by reverse transcription-quantitative PCR (RT-qPCR), and CHOP and glucose-regulated protein-78 (Grp78) expression levels were detected by RT-qPCR and western blotting. CHOP was overexpressed or knocked down to detect the cell viability, apoptosis, LDH level and the expression levels of inflammatory factors and Grp78. The results demonstrated that in the H/R group, cell viability was lower and apoptosis was higher, and that higher levels of LDH and inflammatory factors were present compared with those in the Dex+H/R group. Silencing of CHOP significantly reversed the H/R-reduced cell viability, high apoptotic rate and LDH levels, as well as the elevated expression levels of inflammatory factors and Grp78 caused by H/R injury, whereas the overexpression of CHOP inhibited cell viability and promoted apoptosis, elevated LDH level and expression of inflammatory factors and Grp78 compared with the negative control. Additionally, pretreatment with Dex significantly alleviated the H/R injury; thus, Dex may protect H9C2 cells against H/R induced cell injury, possibly by suppressing the CHOP signaling pathway.