Leukocytosis Research Articles

Case of Metastatic Canine Transmissible Venereal Tumor in a Dog: Clinical and Cytological Evaluation

Canine transmissible venereal tumor (TVT) is a naturally occurring, transmissible neoplasm primarily affecting the genitalia in dogs. Though generally benign, it can rarely metastasize to other body parts. This report describes a rare case of metastatic TVT in a 2-year-old female Boerboel, presenting with a large, ulcerated vulvar mass and metastases to the popliteal lymph node and mammary glands. Clinical findings included progressive mass growth, emaciation, and systemic symptoms. Hematological tests revealed non-regenerative anemia and elevated white blood cell count, while cytological examination identified neoplastic round cells with high nucleus-to-cytoplasm ratios and mitotic figures. The dog was treated with vincristine chemotherapy, metronidazole, vitamin C, and a diet supplemented with crude sap extract of Telfairia occidentalis at 120 mg/kg once daily. Significant tumor regression and clinical improvement were observed after four weeks, although persistent anemia and borderline hypoproteinemia were noted. By the fifth week, the mass had notably reduced, and the dog's condition continued to improve, though some hemorrhage remained. This case highlights the rare occurrence of metastatic TVT and underscores the effectiveness of vincristine in treatment, emphasizing the need for prompt diagnosis and management despite its generally low metastatic rate.

Construction and validation of a predictive model for allergic rhinitis complicating children with bronchial asthma.

This study aimed to investigate the factors influencing the complication of allergic rhinitis in children with bronchial asthma and to construct a nomogram model to predict the occurrence of allergic rhinitis. A total of 190 children with bronchial asthma admitted to our hospital from August 2020 to August 2024 were retrospectively analyzed. The children were randomly divided into the training cohort (133 cases) and validation cohort (57 cases) in a ratio of 7:3. The children in the modeling set were divided into an allergic rhinitis group (n=44) and a nonallergic rhinitis group (n=89) depending on the presence or absence of concomitant allergic rhinitis. A total of 62 cases in 190 children with bronchial asthma had complications with allergic rhinitis, with an incidence of 32.63%. In the training cohort, compared with the children in the nonallergic rhinitis group, percentage of smokers in the household, C-reactive protein (CRP), white blood cell count (WBC), and neutrophils/lymphocytes (NLR) were significantly higher in the allergic rhinitis group (P < 0.05). Multivariable logistic regression analysis showed that smokers in the household; IgE; early use of antibiotics; and elevated CRP, WBC, and NLR were all risk factors for the complication of allergic rhinitis in children with bronchial asthma (P < 0.05). A nomogram prediction model was constructed based on the above risk factors. The C-index of the nomogram was 0.919 (95% CI: 0.742-0.934) and 0.841 (95% CI: 0.773-0.902) for the training cohort and validation cohort, respectively. The Hosmer-Lemeshow test results of the training and validation cohorts were both P > 0.05, suggesting a good model fit. The results of DCA showed that the training and validation cohorts had good threshold probability and clinical net benefit. Smokers in the household, IgE, CRP, WBC, and NLR levels were all risk factors for the complication of allergic rhinitis in children with bronchial asthma. A nomogram model based on these risk factors may be a valuable clinical tool for predicting allergic rhinitis in children with bronchial asthma.

Association of plasma microRNA-16-5p and abdominal aortic calcification in maintenance hemodialysis patients

Recent studies have shown that microRNA-16-5p (miR-16-5p) plays a crucial role in the pathological mechanism of vascular calcification. Nevertheless, the expression profile of miR-16-5p in maintenance hemodialysis (MHD) patients who are predisposed to vascular calcification remains unknown. This study aims to investigate the potential associations between calcification risk and serum miR-16-5p expression among MHD patients. This cross-sectional study involved 132 MHD patients from the Dialysis Center of Beijing Friendship Hospital between 1 January 2019 and 31 December 2020. The degree of calcification in MHD patients was assessed using the Abdominal aortic calcification (AAC) score, and miR-16-5p expression was quantified using quantitative real-time polymerase chain reaction (qRT-PCR) with the 2–ΔΔCT method. Statistical analyses, including spearman correlation, linear regression and logistic regression analysis were used to explore the associations between laboratory parameters and AAC score. Calcifications were observed in 79(59.80%) patients. The linear regression showed a one-quartile decrease in miR-16-5p expression led to a significant increase in the AAC score by 5.336 (95% CI: 2.670–10.662, p = 0.000). Multivariate logistic regression analyses revealed that decreased miR-16-5p expression, reduced serum urea nitrogen, elevated white blood cell count, and longer dialysis vintage were significantly associated with an increased incidence of vascular calcification. The Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC) of the miR-16-5p-based logistic regression model was 0.842 (95% CI: 0.771–0.913, p = 0.000). There was an independent association between miR-16-5p expression and calcification degree. Lower miR-16-5p expression levels seem to be a potential risk factor of vascular calcification in MHD patients.

Robotic-assisted Kasai portoenterostomy for child biliary atresia.

The Kasai procedure (KPE) is an important treatment for biliary atresia (BA), the most common cause of neonatal obstructive jaundice. To investigate the efficacy of robotic-assisted Kasai portoenterostomy (RAKPE) in patients with BA. Clinical data of 10 patients with BA who underwent RAKPE at the Seventh Medical Center of the People's Liberation Army General Hospital between December 2018 and December 2021 were retrospectively analyzed. One patient underwent Open Kasai portoenterostomy (OKPE) due to intraoperative bleeding. Consequently, nine patients were included in this study. Fifty-two patients who underwent OKPE during the same period served as the control group. Preoperative and postoperative biochemical indexes, surgery-related indexes, and postoperative clearance of jaundice (CJ) were recorded and statistically analyzed. RAKPE was successfully completed in all nine patients, with an average total operative time of 352.2 minutes (including intraoperative cholangiography). Milk feeding resumed on an average 9.89 days postoperatively, and the average time of drainage tube removal was 18.11 days. All patients were followed up for 6 months to 2 years. The liver function indicators and bilirubin levels in 8 patients returned to normal within 3 months after surgery. Three patients developed recurrent cholangitis after discharge, with elevated white blood cell counts, liver function indicators, and bilirubin levels, requiring hospitalization for intravenous antibiotic treatment. The duration of cholangitis ranged from 5 to 8 months post-surgery. To date, no subsequent cases of cholangitis have occurred. All patients have normal liver function and bilirubin levels, with no intrahepatic bile duct dilatation on ultrasonography. Statistical analysis comparing these indicators with those of patients who underwent OKPE showed that the RAKPE group had longer operative times and postoperative drainage tube removal durations. However, there were no significant differences in intraoperative blood loss, postoperative oral milk intake resumption, postoperative hospital stay, or CJ at 3 months post-surgery. RAKPE is technically feasible, safe, and effective for treating BA. Once the technique is mastered, RAKPE may achieve CJ outcomes comparable to those of OKPE.

Clinical efficacy of efgartigimod combined with intravenous methylprednisolone in the acute phase of neuromyelitis optica spectrum disorders

BackgroundNeuromyelitis Optica Spectrum Disorders (NMOSD) comprise a group of autoimmune-mediated, inflammatory, demyelinating central nervous system diseases caused by aquaporin-4 (AQP4) IgG autoantibodies. Efgartigimod is a human IgG Fc fragment that reduces antibody titers by targeting the neonatal Fc receptor (FcRn). This study documents the efficacy of efgartigimod combined with intravenous methylprednisolone (IVMP) in the acute phase of NMOSD.MethodsIn this retrospective study, the medical records of NMOSD patients with acute attack who received efgartigimod plus IVMP or IVMP were reviewed. Treatment efficacy was assessed by the Expanded Disability Scale Score (EDSS) before and one month after treatment. Any side effects that occurred during the treatment period were recorded.ResultsThis study was performed on 11 patients (efgartigimod plus IVMP group [n = 4] and IVMP group [n = 7]). Efgartigimod plus IVMP was effective and had a satisfactory safety profile. EDSS was reduced by 0.5 ± 0.32 compared with the IVMP group (0.27 ± 0.02). Immunoglobulin was decreased in three patients, and the immunoglobulin G (IgG) levels gradually increased approximately 8 weeks after the last administration. Hyperlipidemia and elevated white blood cell count were common side effects. No infections or deaths occurred.ConclusionsEfgartigimod plus IVMP treatment is safe and well-tolerated in patients with acute-phase NMOSD.

Prevalence and sequelae of asymptomatic Clostridioides difficile colonization in children with inflammatory bowel disease.

Colonization by Clostridioides difficile is common in children with inflammatory bowel disease (IBD) and complicates both the management of IBD and the diagnosis of C. difficile infection (CDI). There is a paucity of data on rates, risk factors, and outcomes associated with asymptomatic C. difficile colonization in children with IBD. We enrolled and prospectively followed 87 children with IBD without acute gastrointestinal symptoms. Twelve patients (13.8%) tested positive for C. difficile and were considered to have asymptomatic colonization. Elevated white blood cell count was associated with C. difficile colonization based on univariate regression. Three of the 12 (25%) C. difficile colonized patients were diagnosed with CDI in the 90 days following screening for C. difficile, versus 0 of the 75 who tested negative for C. difficile (p = 0.002). This data set the stage for further longitudinal tracking of children with IBD for C. difficile colonization and associated outcomes.

Tsukamurella conjunctivitidis peritonitis diagnosed by 16S rRNA gene sequencing in a patient undergoing peritoneal dialysis.

Peritoneal dialysis (PD)-associated peritonitis remains a serious and life-threatening complication in patients undergoing PD. Majority of peritonitis cases are caused by bacteria, with coagulase-negative Staphylococcus being the most common cause. Tsukamurella species are obligate aerobic gram-positive bacilli found in various environments; however, peritonitis caused by Tsukamurella species in association with PD is rare, with few reports of infections caused by T. conjunctivitidis, including PD-associated peritonitis. We describe a rare case of peritonitis caused by T. conjunctivitidis in a patient undergoing PD. A 62-year-old man undergoing PD was referred to our hospital for fever and abdominal pain lasting for 4days and was diagnosed with PD-associated peritonitis based on abdominal pain, cloudy effluent, elevated white blood cell count in the peritoneal fluid, and presence of gram-positive rods in the effluent culture. Yellow-grayish, dry, membrane-like colonies were observed on a blood agar plate. The isolated strain was identified as T. conjunctivitidis through 16S rRNA gene sequencing. Because the PD-associated peritonitis was refractory to antibiotics, the PD catheter was removed, and the patient was switched to hemodialysis on day 21 of admission. Clinicians should consider peritonitis caused by T. conjunctivitidis as a differential diagnosis in cases where diagnosis using routine examination is challenging. Notably, 16S rRNA gene sequencing is a useful diagnostic tool for identifying T. conjunctivitidis. Further analyses of similar cases are required to understand the characteristics of such infections and establish adequate diagnostic methods and treatment regimens.

Clinical Diagnosis of Acute Noma: Essential Infection Markers and Clinical Presentations.

In clinical settings, understanding the markers and clinical signs of infection is critical for timely diagnosis and treatment. However, a point-of-care diagnostic test is lacking for noma, a debilitating orofacial infectious disease. This retrospective study reviewed electronic medical records (EMRs) and paper medical records (PMRs) of noma patients from Facing Africa (235 EMRs), Yekatit 12 Hospital (68 PMRs), and Project Harar (33 PMRs) in Ethiopia to identify essential infection markers and clinical presentations of acute noma. The review identified seven acute noma patients aged 4-9 years. The patients presented with facial edema, pain, anorexia, ecchymosis, excessive salivation, and drooling, as well as specific symptoms such as visual disturbances, high fever, foul odor, halitosis, and local tenderness. Laboratory findings included elevated white blood cell counts (13,500-14,500 cells/mcL), C-reactive protein levels (107-148 mg/L), and erythrocyte sedimentation rates (65-90 mm/hour). At >85 ng/mL, procalcitonin levels were particularly high. Accurate diagnosis of noma requires a comprehensive approach that includes thorough clinical examination, appropriate disease stage classification, medical history review, and laboratory testing. The study highlights the critical infection markers and clinical presentations associated with acute noma that may aid in early diagnosis of the disease. Further research with a much larger number of participants is needed. However, given the difficulty in identifying acute noma cases due to the rapid progression and very high mortality of the disease and the challenge of accessing acute noma cases owing to various socioeconomic barriers, the results of this small study are still relevant.

Clinical Insights and Management Strategies for Acute Obstructive Suppurative Pancreatic Ductitis: A Retrospective Study of 82 Rare Cases.

Acute obstructive suppurative pancreatic ductitis (AOSPD) is a rare condition with limited diagnostic and treatment information. This study aims to expand understanding by analyzing the clinical characteristics and management of AOSPD. We analyzed 81 AOSPD cases (1993-2024) from the literature and 1 case from the First Affiliated Hospital of Anhui Medical University. Additionally, 60 acute-on-chronic pancreatitis (CP) cases from our hospital were matched and compared with AOSPD with CP in demographics, laboratory findings, and imaging results. The majority of AOSPD patients were male (66, 80.5%), with a median age of 60 years. CP was present in 60 patients (73.2%), while 18 (22.0%) had pancreatic tumors. Pancreatic juice cultures were positive in 47 patients (90.4%). Key treatments included endoscopic pancreatic stenting (44, 53.7%) and endoscopic nasopancreatic drainage (31, 37.8%). All follow-up patients showed clinical improvement. Compared to acute-on-CP, AOSPD with CP was more prevalent in older males with a history of pancreaticobiliary intervention, alcohol consumption, and smoking. AOSPD with CP patients typically presented with fever, elevated white blood cell counts, increased C-reactive protein levels, pancreatic stones, and dilated pancreatic ducts. Interestingly, a lower proportion of AOSPD with CP patients exhibited elevated serum amylase levels (p < 0.05). AOSPD primarily affects middle-aged and elderly males with chronic pancreatic disease and prior pancreaticobiliary intervention. Imaging and pancreatic juice culture aid diagnosis. Compared to acute-on-CP, AOSPD with CP displays distinct clinical characteristics. Timely and accurate diagnosis and treatment can lead to favorable short-term outcomes for patients with AOSPD.

Assessing the association between cigarette smoking and blood C-reactive protein levels using restructured cohort data

IntroductionCigarette smoke exposure is known to induce inflammation, leading to elevated levels of inflammatory markers such as white blood cell (WBC) count and C-reactive protein (CRP). Despite extensive research on this relationship, longitudinal studies are limited. We aimed to explore the association between cigarette smoke exposure and WBC count and CRP levels by restructuring community cohort data. MethodsData from a community cohort of the Korean population, followed biennially from 2001 to 2018, were utilized. Smoking status was determined through self-administered questionnaires. WBC and CRP levels were measured in a central laboratory with stringent quality control. Cohort data were restructured into pairs representing before and after measurements. We analyzed smoking effects on WBC and CRP using pairwise before-after tests based on changes in smoking status. Furthermore, parallel group analyses comparing changes in smoking status to no change were conducted. ResultsAnalysis included 4336 pairs for WBC and 3068 pairs for CRP from 10,030 participants. Pairwise analysis showed a significant decrease in WBC transitioning from current smoker to non-smoker and an increase from non-smoker to current smoker. Parallel group analysis demonstrated a significant decrease in WBC transitioning from current smoker to non-smoker compared to remaining current smoker, and an increase from non-smoker to current smoker compared to remaining non-smoker. CRP did not exhibit significant associations in either analysis. ConclusionsIn a community cohort, cigarette smoking was associated with elevated WBC count. However, CRP levels did not consistently reflect inflammation associated with cigarette smoking.

Telomerase Gene Expression in Relation to Serum Protein and Hematological Parameters in Acute Myeloid Leukemia Patients.

Acute myeloid leukemia (AML) is a hematological malignancy marked by the abnormal proliferation of myeloid precursor cells (blasts) in the bone marrow and peripheral blood, leading to disrupted blood cell production. The telomerase reverse transcriptase (hTERT), a key component of the telomerase enzyme, is often overexpressed in various cancers, including AML, contributing to cellular immortality. This study aimed to investigate the expression levels of the hTERT gene, serum protein concentrations, and hematological parameters in newly diagnosed AML patients, comparing these findings to AML patients in remission and healthy controls. Blood samples were collected from three groups: 10 newly diagnosed AML patients, 35 AML patients in remission, and 40 healthy controls. Hematological parameters, including white blood cell (WBC), red blood cell (RBC), platelet (PLT), and hemoglobin (Hb) levels, were measured. Serum hTERT protein concentrations were analyzed using enzyme-linked immunosorbent assay (ELISA), and hTERT gene expression was assessed through reverse transcription-quantitative PCR (RT-qPCR). The study demonstrated that newly diagnosed AML patients had significantly higher hTERT gene expression and serum protein levels compared to both remission patients and healthy individuals. Hematological analyses revealed elevated WBC counts alongside reduced RBC, PLT, and Hb levels in AML patients relative to controls. Increased hTERT expression and serum protein levels are valuable biomarkers for diagnosing and monitoring AML. These findings highlight the therapeutic potential of targeting hTERT and underscore the importance of conducting further studies on larger patient cohorts to validate these results.

A COMPARATIVE STUDY OF PREVALENCE OF SURGICAL SITE INFECTION USING POVIDONE IODINE VS CHLORHEXIDINE ALCOHOL IN PREOPERATIVE SKIN PREPARATION IN ABDOMINAL HERNIAS

Background: Surgical site infections (SSIs) are among the most common complications following abdominal surgeries, including hernia repairs. These infections significantly contribute to patient morbidity and healthcare burden, especially in resource-limited settings. Preoperative skin antisepsis is a critical factor in SSI prevention, with agents such as povidone iodine (PI) and chlorhexidine alcohol (CA) frequently used. However, their comparative efficacy in reducing SSI rates remains an area of clinical interest, necessitating further exploration. Objective: To compare the prevalence of SSIs in patients undergoing preoperative skin preparation with povidone iodine versus chlorhexidine alcohol during abdominal hernia repair. Methods: This comparative non-randomized controlled trial was conducted at CMH, Rawalpindi, from May 2022 to February 2023. A total of 300 patients scheduled for hernia repair were enrolled and divided equally into two groups: group A (PI) and group B (CA). Group allocation was performed using a single-blinded technique to minimize bias. Preoperative skin preparation was conducted with a 10% PI solution for group A and a CA solution (2% chlorhexidine in 70% alcohol) for group B. Patients were followed up for 30 days post-surgery to evaluate the presence of SSIs, defined as purulent discharge, fever, elevated white blood cell count, swelling, or erythema at the surgical site. Data were analyzed using SPSS version 22, with statistical significance set at p ≤ 0.05. Results: The study included 300 patients with a mean age of 40.42 ± 8.71 years, of whom 124 (41.30%) were male and 176 (58.70%) were female. The overall SSI frequency was 69 (23.00%). SSI was significantly higher in the PI group compared to the CA group, with rates of 34.00% (51/150) versus 12.00% (18/150), respectively (p &lt; 0.001). Conclusion: Chlorhexidine alcohol is significantly more effective than povidone iodine in reducing the prevalence of SSIs in abdominal hernia surgeries. Its use should be preferred for preoperative skin antisepsis to improve surgical outcomes.

Analysis of the clinical characteristics of patients with Kawasaki disease complicated with cholestasis

BackgroundTo explore the clinical characteristics, related factors, and prognosis of Kawasaki disease (KD) combined with acute febrile cholestasis and improve the understanding of the liver complications of KD to avoid misdiagnosis and missed diagnosis.MethodsWe retrospectively analyzed the demographic, clinical, and laboratory data of 1803 patients with KD between January 2019 and July 2023 in our hospital. Based on the presence of cholestasis, patients were divided into the cholestatic and control groups. Logistic regression analysis was performed for the statistically significant indicators between the two groups to examine the risk factors for KD with coronary artery abnormalities (CAA) and intravenous immunoglobulin (IVIG) unresponsiveness. Additionally, patients with KD and cholestasis were compared with patients with acute febrile cholestasis due to other causes during the same period.ResultsCompared to the control group (n = 1720), patients in the cholestatic group (n = 83) were older, had higher levels of white blood cell count (WBC), C-reactive protein (CRP), D-dimer, N-terminal pro-brain natriuretic peptide (NT-proBNP), a shorter fever duration, and high incidences of IVIG unresponsiveness and CAA. KD was the leading cause of acute febrile cholestasis in children (72.6%). In the multivariate logistic regression analysis, younger age, cholestasis, hypoalbuminemia, and a high NT-proBNP level were risk factors for IVIG unresponsiveness, whereas male sex, longer fever duration before treatment, and high alanine aminotransferase (ALT), and CRP levels were risk factors for CAA.ConclusionKD with cholestasis was associated with a higher risk of IVIG unresponsiveness and coronary artery abnormalities. KD was the leading cause of acute febrile cholestasis in children. Attention to the possibility of KD is warranted in children with acute febrile cholestatic jaundice, especially if associated with elevated WBC, CRP, and D-dimer levels, or hypoalbuminemia.

Distribution of Necrotizing fasciitis Using the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) Score Among Patients Attending a Tertiary Hospital in Chennai.

Background Necrotizing fasciitis (NF) is a rapidly progressing infection with a high mortality rate, requiring prompt diagnosis and treatment. The Laboratory Risk Indicator for NF (LRINEC) score has emerged as a useful tool for early risk stratification. Methods A cross-sectional study was conducted on 112 patients diagnosed with NF in a tertiary hospital in Chennai. Clinical data, including LRINEC scores and associated laboratory parameters, were collected and analyzed. The relationship between LRINEC scores and risk factors, such as gender, comorbidities (diabetes mellitus [DM] and peripheral vascular disease [PVD]), recent trauma, C-reactive protein (CRP) levels, white blood cell count (WBC) counts, and creatinine levels, was assessed. The treatment approaches and complications were also reviewed. Results The LRINEC score effectively stratified patients: 51.8% were at low risk, 33.9% at moderate risk, and 14.3% at high risk. Significant associations were found between higher LRINEC scores and elevated CRP, WBC count, creatinine levels, and low sodium levels (p < 0.001). DM and PVD were important comorbidities influencing disease severity. Conservative treatments, including hygroscopic dressings and antibiotics, were successful in 83.9% of cases, while 16.1% required surgical debridement. Complications included delayed wound healing (14.3%) and skin grafting (1.8%). Conclusion The LRINEC score is an effective tool for the early diagnosis and stratification of NF. Its use in clinical practice helps guide decision-making, particularly regarding early interventions and improving patient outcomes.

Risk factors for surgical site infection after general surgery in HIV-infected patients: a retrospective study

BackgroundAs the number of HIV-infected patients increased, the number of patients requiring general surgery has subsequently increased. However, impairment of immune function due to HIV infection increases the risk of postoperative surgical-site infection and significant harm to patient health. This study aimed to examine the risk factors for surgical-site infection after general surgery.MethodsThe patients’ data were from Zunyi fourth hospital medical information system. Machine learning based Boruta algorithm were used for variable screening. Univariable and multivariable logistic regression and restricted cubic spline analysis were performed to examine the relationship between significant variables and surgical-site infection.ResultsA total of 125 general surgery postoperative HIV-infected patients participated in the study. Surgical-site pathogen culture identified Escherichia coli, Klebsiella pneumoniae, and mixed bacteria as the three most common pathogens causing Surgical-site infection. Univariable and multivariable logistic regression analysis to adjust for risk factors identified type III surgical incision (OR = 9.92, 95% CI = 1.28–76.75) and elevated preoperative white blood cell (WBC) count (OR = 1.30, 95% CI = 1.12–1.51) as independent risk factors for postoperative surgical-site infection, whereas CD4 + T lymphocyte count greater than 400 cells/µL was identified as a protective factor (OR = 0.23, 95% CI = 0.09–0.60) while. The restricted cubic spline analysis results directly reflected the dose-response relationship between continuous variables and postoperative surgical-site infection.ConclusionsType III incision and an elevated WBC count pose a higher risk of postoperative surgical-site infection. A CD4 + T lymphocyte counts greater than 400 cells/µL provided a protective effect of lower risk of surgical site infection. Preoperative serum neutrophil percentage, albumin level, red blood cell count, and serum urea level within a specific range were beneficial in reducing the risk of incisional infections. Our research provides a theoretical basis for clinical practice.

Risk Factors for Postoperative Urinary Tract Infections in Paediatric Hydronephrosis: A Retrospective Analysis.

Paediatric hydronephrosis frequently necessitates surgical intervention. However, postoperative urinary tract infections (UTIs) are common and challenging. This retrospective cohort study aimed to identify UTI risk factors following an operation for paediatric hydronephrosis. Paediatric patients with hydronephrosis who underwent operation from January to December 2023 were studied. Patients were categorised into no UTI and UTI groups. Demographics, surgical history, pre/postoperative factors, imaging, and lab values were compared. A total of 111 patients were enrolled, with 98 in the no-UTI group and 13 in the UTI group. The UTI group had significantly more previous surgeries and longer surgical duration (p < 0.05). Preoperative factors associated with UTI occurrence included higher hydronephrosis grade, absence of antibiotic prophylaxis, presence of vesicoureteral reflux (VUR), abnormal preoperative urine cultures, and ureteral stent placement (p < 0.05). The UTI group exhibited more extended hospital stays, higher rates of postoperative fever, reoperation, and readmission within 30 days (p < 0.05). Postoperative imaging and laboratory findings were also significantly different (p < 0.05). The UTI group had elevated white blood cell count, C-reactive protein levels, serum creatinine, and urine white blood cell count (p < 0.05). Other potential risk factors included constipation, family history of UTI, bladder dysfunction, history of recurrent UTI, and use of prophylactic antibiotics. Multivariate logistic regression analysis indicated that while antibiotic prophylaxis and preoperative urine culture results negatively correlated with UTI occurrence, other factors were positively correlated, with the number of previous surgeries having the most significant impact on UTI occurrence (odds ratio (OR) = 20.617; 95% confidence interval (CI): [0.718, 0.802]; p < 0.001). Multiple factors contribute to the risk of postoperative UTI for paediatric hydronephrosis, highlighting the need for tailored interventions to mitigate risks and improve outcomes.

A sex-based analysis of complete blood count features during acute, untreated Lyme disease.

Although lymphopenia has been described in acute Lyme disease (LD), the complete blood count (CBC) has not been comprehensively examined, nor have sex-based analyses been conducted. We analyzed CBC values and identified sex-based trends among patients with early LD by comparing both to controls without a history of LD and to patients' pre-morbid values. We enrolled participants from the Mid-Atlantic US with diagnostic erythema migrans and controls with no history of LD. CBC results were obtained, and patient information was recorded using standardized instruments. We also calculated a neutrophil-to-lymphocyte ratio (NLR). We used linear regression to test that CBC results would differ (a) between antibiotic-naive patients with early LD and controls and (b) by measures of acute disease severity. We also performed stratified analyses to assess sex-based differences. In total, 236 antibiotic-naive patients with early LD had significantly lower lymphocytes (β = -0.34, p < 0.001) and significantly higher monocytes (β = 0.09, p = 0.002) and NLRs (β = 0.99, p < 0.001) than 61 controls in adjusted analyses. Lymphocytes, monocytes, and NLRs also changed significantly from pre-morbid to acute LD (p < 0.001 for all). Only the NLR was consistently significantly associated with disease severity. A higher proportion of male patients with early LD had acute lymphopenia than female patients with early LD (31.93% vs. 19.66%, p = 0.03); this difference was not present among controls. The presence of lymphopenia and the absence of an elevated total white blood cell count make LD an important diagnostic consideration in patients presenting with undiagnosed infectious syndromes in endemic regions. This may be especially true for male patients.

Outcome differences of emergency cesarean delivery in the delivery room versus the operating room: A study based on propensity score matching.

This study sought to compare the risks and outcomes associated with category I cesarean section procedures performed in the delivery room versus those performed in the operating room. The analysis included 126 singleton pregnant women who underwent inpatient delivery at the Second People's Hospital of Nanning between January 2021 and May 2024. Following propensity score matching, 21 cases were in the delivery room group, and 105 cases were in the operating room group. Parameters under investigation encompassed decision-to-delivery interval, incision-to-delivery interval, surgical duration, intraoperative blood loss, postoperative antibiotic duration, postoperative hospital stay length, postoperative fever incidence, adverse neonatal outcomes, and blood routine parameters. The decision-to-delivery interval was significantly shorter in the delivery room group than in the operating room group. Conversely, the delivery room group exhibited longer surgical durations, higher blood loss, prolonged postoperative antibiotic usage, extended hospital stays, and elevated white blood cell counts with statistical significance (p < 0.05). Nevertheless, no notable variations were observed between the groups in maternal and neonatal outcome indicators, such as adverse neonatal outcomes and postoperative fever rates. The outcomes suggest that the delivery room group showed increased risks compared with the operating room group, potentially indicating heightened vulnerabilities to bleeding and infection. Hence, it is advisable for patients to undergo surgery in the operating room unless the delivery room is equipped with sterile surgical facilities or in cases of urgent necessity.

Increased pathogen exposure of a marine apex predator over three decades.

Environmental changes associated with global warming create new opportunities for pathogen and parasite transmission in Arctic wildlife. As an apex predator ranging over large, remote areas, changes in pathogens and parasites in polar bears are a useful indicator of changing transmission dynamics in Arctic ecosystems. We examined prevalence and risk factors associated with exposure to parasites and viral and bacterial pathogens in Chukchi Sea polar bears. Serum antibodies to six pathogens were detected and prevalence increased between 1987-1994 and 2008-2017 for five: Toxoplasma gondii, Neospora caninum, Francisella tularensis, Brucella abortus/suis, and canine distemper virus. Although bears have increased summer land use, this behavior was not associated with increased exposure. Higher prevalence of F. tularensis, Coxiella burnetii, and B. abortus/suis antibodies in females compared to males, however, could be associated with terrestrial denning. Exposure was related to diet for several pathogens indicating increased exposure in the food web. Elevated white blood cell counts suggest a possible immune response to some pathogens. Given that polar bears face multiple stressors in association with climate change and are a subsistence food, further work is warranted to screen for signs of disease.

Association Between White Blood Cell Counts at Diagnosis and Clinical Outcomes in Venous Thromboembolism - From the COMMAND VTE Registry-2.

White blood cell (WBC) counts were reported to be a risk factor for acute adverse events in patients with venous thromboembolism (VTE). However, there are limited data on VTE patients without active cancer. The COMMAND VTE Registry-2 was a multicenter study enrolling 5,197 consecutive patients with acute symptomatic VTE. We divided 3,668 patients without active cancer into 4 groups based on WBC count quartiles (Q1-Q4) at diagnosis: Q1, ≤5,899 cells/μL; Q2, 5,900-7,599 cells/μL, Q3, 7,600-9,829 cells/μL; and Q4, ≥9,830 cells/μL. Patients in Q4 more often presented with pulmonary embolism (PE) than patients in Q1, Q2, and Q3 (68% vs. 37%, 53%, and 61%, respectively; P<0.001). The proportion of massive PEs among all PEs was higher in Q4 than in Q1, Q2, and Q3 (21% vs. 3.4%, 5.8%, and 11%, respectively; P<0.001). Compared with Q1, Q2, and Q3, patients in Q4 had a higher cumulative 5-year incidence of all-cause death (17.0%, 15.2%, 16.1%, and 22.8%, respectively; P<0.001) and major bleeding (10.9%, 11.0%, 10.3%, and 14.4%, respectively; P=0.002). The higher mortality risk of Q4 relative to Q2 was consistent regardless of the presentations of VTEs. An elevated WBC count on VTE diagnosis was associated with a higher risk of mortality and major bleeding regardless of VTE presentation, suggesting the potential usefulness of WBC counts for further risk stratification.