Inflammatory Parameters In Patients Research Articles

Design of a phase 3, randomized, double-blind, placebo-controlled, 48-week study to evaluate the efficacy and safety of cendakimab in adult and adolescent patients with eosinophilic esophagitis

BackgroundEosinophilic esophagitis (EoE) is a chronic, immune-mediated inflammatory condition that interferes with normal food ingestion, negatively impacting quality of life (QoL). Treatment options include proton pump inhibitors, corticosteroids, biologics, or dietary elimination; however, ∼1/3 of patients remain insufficiently controlled. The pathogenesis of EoE involves interleukin-13 (IL-13); therefore, targeted IL-13 inhibition may be beneficial. In a phase 2 study, cendakimab, a recombinant, humanized anti–IL-13 monoclonal antibody, significantly reduced mean esophageal eosinophil counts and improved other inflammatory parameters in patients with EoE. These findings prompted further investigation of the efficacy and safety of cendakimab in adults and adolescents with EoE in a phase 3 registrational study (NCT04753697), the design of which is presented here. MethodsThis multicenter, multinational, randomized, double-blind, placebo-controlled, 48-week, treat-through study plans to enroll 399 adults and adolescents. Randomized patients (1:1:1) will receive subcutaneous administration of 1) cendakimab 360 mg once weekly (QW) for 48 weeks, 2) cendakimab 360 mg QW for 24 weeks followed by cendakimab 360 mg every other week (with matching placebo on alternative weeks to maintain the blind) for 24 weeks, or 3) placebo QW for 48 weeks. Co-primary endpoints are mean change from baseline in dysphagia days and proportion of patients with eosinophil histologic response, defined as peak esophageal eosinophil count ≤6 per high-power field, at 24 weeks. Secondary and exploratory endpoints will address endoscopic and histologic features, QoL, safety, and pharmacokinetic assessments. ConclusionThis phase 3 pivotal study will determine whether cendakimab provides an effective, safe, targeted treatment for patients with EoE.

Lymphocyte-to-Monocyte Ratio Predicts Survival for Intraductal Papillary Mucinous Neoplasm with Associated Invasive Carcinoma of the Pancreas: Results from a High-Volume Center.

Intraductal papillary mucinous neoplasm (IPMN) is an important precursor lesion of pancreatic cancer. Systemic inflammatory parameters are widely used in the prognosis prediction of cancer; however, their prognostic implications in IPMN with associated invasive carcinoma (IPMN-INV) are unclear. This study aims to explore the prognostic value of systemic inflammatory parameters in patients with IPMN-INV. From 2015 to 2021, patients with pathologically confirmed IPMN who underwent surgical resection at Peking Union Medical College Hospital were enrolled. The clinical, radiological, and pathological data of the enrolled patients were collected and analyzed. Preoperative systemic inflammatory parameters were calculated as previously reported. Eighty-six patients with IPMN-INV met the inclusion criteria. The lymphocyte-to-monocyte ratio (LMR) was the only systemic inflammatory parameter independently associated with the cancer-specific survival (CSS). An LMR higher than 3.5 was significantly associated with a favorable CSS in univariate (hazard ratio [HR] 0.305, p = 0.003) and multivariate analyses (HR 0.221, p = 0.001). Other independently prognostic factors included the presence of clinical symptoms, cyst size, N stage, and tumor differentiation. Additionally, a model including LMR was established for the prognosis prediction of IPMN-INV and had a C-index of 0.809. Preoperative LMR could serve as a feasible prognostic biomarker for IPMN-INV. A decreased LMR (cutoff value of 3.5) was an independent predictor of poor survival for IPMN-INV.

Dynamics of Inflammatory Parameters After Endovascular and Open Infrarenal Abdominal Aneurysm Repair

Background: The aim of this paper was to investigate the dynamics of inflammatory parameters in patients after infrarenal abdominal aneurysm surgery.Methods: The retrospective study included patients with operated infrarenalabdominal aneurysm, divided into two groups. First group were patients that underwent endovascular aneurysm repair procedure (EVAR), and second group were patients that had open surgery. General data and inflammatory parameters (CRP, leukocytes, platelets, and fibrinogen) had been taken during hospitalization, compared mutually and analyzed.Main findings:All inflammatory parameters, observed preoperatively, were close to referent range. Serum CRP values in EVAR patients raised after operation, but returned to the reference range more quickly as well as leukocyte count. Around the middle of their own hospital stay and at the day of discharge, the group operated on by the open method had statistically significant higher platelet values than the EVAR group. During the preoperative period and in the middle of hospitalization, the group operated on by the open method shows higher fibrinogen values, while the opposite is at the day of discharge, where the EVAR group shows statistically significantly higher fibrinogen values.Principal conclusions: Observed serum inflammatory parameters (CRP, leukocytes, fibrinogen, and platelets) in different phases of hospitalization were lower; closer to the reference value in patients with infrarenal abdominal aneurysm that underwent EVAR, compared to patients operated by the open surgery method. Also, the observed parameters, except fibrinogen, returned to the reference value faster in patients who underwent EVAR.Key words: abdominal aortic aneurysm, endovascular aneurysm repair, inflammatory parameters

Validation of Inflammatory Prognostic Biomarkers in Pleural Mesothelioma.

Evoked from asbestos-induced inflammation, pleural mesothelioma represents a fatal diagnosis. Therapy ranges from nihilism to aggressive multimodality regimens. However, it is still unclear who ultimately benefits from which treatment. We aimed to re-challenge inflammatory-related biomarkers' prognostic value in times of modern immune-oncology and lung-sparing surgery. The biomarkers (leukocytes, hemoglobin, platelets, neutrophils, lymphocytes, monocytes, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), C-reactive protein (CRP)) and clinical characteristics (age, sex, histology, therapy) of 98 PM patients were correlated to overall survival (OS). The median OS was 19.4 months. Significant OS advantages (Log-Rank) were observed in multimodal treatment vs. others (26.1 vs. 7.2 months, p < 0.001), surgery (pleurectomy/decortication) vs. no surgery (25.5 vs. 3.8 months, p < 0.001), a high hemoglobin level (cut-off 12 g/dL, 15 vs. 24.2 months, p = 0.021), a low platelet count (cut-off 280 G/L, 26.1 vs. 11.7 months, p < 0.001), and a low PLR (cut-off 194.5, 25.5 vs. 12.3 months, p = 0.023). Histology (epithelioid vs. non-epithelioid, p = 0.002), surgery (p = 0.004), CRP (cut-off 1 mg/dL, p = 0.039), and platelets (p = 0.025) were identified as independent prognostic variables for this cohort in multivariate analysis (Cox regression, covariates: age, sex, histology, stage, CRP, platelets). Our data verified the previously shown prognostic role of systemic inflammatory parameters in patients treated with lung-sparing surgery within multimodality therapy.

The use of calprotectin and other inflammatory parameters in the investigation of pseudoexfoliation syndrome concomitant glaucoma and systemic diseases.

The present study aimed to investigate the value of calprotectin and other inflammatory parameters in patients with glaucoma and systemic diseases accompanying pseudoexfoliation syndrome (PEX-S). This prospective study included 45 PEX-S patients and 45 non-PEX control patients. Patients were investigated for the presence of glaucoma, cardiovascular disease (CVD), ischemic brain disease (IBD), Alzheimer's disease, and neurosensory hearing loss (NSHL). After excluding diseases that may affect inflammatory parameters, a detailed biomicroscopic examination, and blood tests were performed for the patients. Glaucoma, CVD, NVK, Alzheimer's disease, and NSHL were high in the PEX-S group ( P = 0.01, P = 0.01, P = 0.04, P = 0.04, and P = 0.03, respectively). Calprotectin, ferritin, neutrophil-to-platelet ratio, and lymphocyte-to-platelet ratio were found to be high in the PEX-S group ( P < 0.01, P = 0.04, P < 0.01, and P < 0.01, respectively). On evaluating the relationship between PEX-S and glaucoma and systemic diseases, it was found that elevated calprotectin increased the risk of glaucoma by 4.36 times and elevated neutrophil-to-lymphocyte ratio (NLR) increased the risk of CVD by 3.23 times in PEX-S patients ( P = 0.02 and P = 0.03, respectively). This study demonstrated the value of calprotectin elevation in detecting concomitant glaucoma in PEX-S patients and, in addition, the value of NLR elevation in detecting concomitant CVD.

15 Evaluation of several hematological and inflammatory parameters in patients with alopecia areata and their correlation with disease severity

15 Evaluation of several hematological and inflammatory parameters in patients with alopecia areata and their correlation with disease severity

Genetic glucocorticoid receptor variants differ between ethnic groups but do not explain variation in age of diabetes onset, metabolic and inflammation parameters in patients with type 2 diabetes.

The effect of excess glucocorticoid receptor (GR) stimulation through glucocorticoid medication or cortisol on glucose metabolism is well established. There are genetic GR variants that result in increased or decreased GR stimulation. We aimed to determine the prevalence of genetic GR variants in different ethnic groups in a cohort of patients with type 2 diabetes, and we aimed to determine their association with age of diabetes onset and metabolic and inflammation parameters. A cross-sectional analysis was performed in a multiethnic cohort (n = 602) of patients with established type 2 diabetes. Polymorphisms in the GR gene that have previously been associated with altered glucocorticoid sensitivity (TthIIII, ER22/23EK N363S, BclI and 9β) were determined and combined into 6 haplotypes. Associations with age of diabetes onset, HbA1c, hs-CRP and lipid values were evaluated in multivariate regression models. The prevalence of the SNPs of N363S and BclI was higher in Dutch than in non-Dutch patients. We observed a lower prevalence of the SNP 9β in Dutch, South(East) Asian and Black African patients versus Turkish and Moroccan patients. We did not detect an association between SNPs and diabetes age of onset or metabolic parameters. We only found a trend for lower age of onset and higher HbA1c in patients with 1 or 2 copies of haplotype 3 (TthIIII + 9β). The prevalence of genetic GR variants differs between patients of different ethnic origins. We did not find a clear association between genetic GR variants and age of diabetes onset or metabolic and inflammation parameters. This indicates that the clinical relevance of GR variants in patients with established type 2 diabetes is limited.

Inflammatory parameters and color alterations of dental bleaching in patients wearing fixed orthodontic appliance: a randomized clinical trial

BackgroundMany orthodontic patients request dental bleaching during orthodontic treatment to achieve a faster aesthetic resolution, however, no attention has been paid to the inflammatory processes that can occur when both therapies are indicated together. So, this clinical trial evaluated the inflammatory parameters and color alterations associated with dental bleaching in patients wearing a fixed orthodontic appliance.MethodsThirty individuals aged between 18 and 40 years were equally and randomly allocated into three groups: FOA (fixed orthodontic appliance), BLE (dental bleaching), and FOA + BLE (fixed orthodontic appliance + dental bleaching). The orthodontic appliances and the bleaching procedures were performed in the maxillary premolars and molars. For dental bleaching a 35% hydrogen peroxide was used. The gingival crevicular fluid (GCF) and nitric oxide (NO-) levels were evaluated at different time-points. Color evaluation was performed using an Easyshade spectrophotometer at baseline (FOA, FOA + BLE, BLE), one month after (FOA + BLE) and 21 days after appliance removing (FOA + BLE and FOA groups), in each tooth bleached. The ANOVA and Tukey’s tests, with a significance level of 5%, were used for statistical analysis.ResultsThe GCF volume in the FOA + BLE and FOA groups significantly increased at the time points evaluated (p < 0.001); however, this did not occur in the BLE group (p > 0.05). On the other hand, NO- levels significantly decreased during dental bleaching with or without fixed orthodontic appliances (FOA + BLE and BLE groups; p < 0.05), while no significant changes were observed in the FOA group (p > 0.05). Significant changes in color were observed in the FOA + BLE and BLE groups compared to in the FOA group (p < 0.01). However, the presence of fixed orthodontic appliance (FOA + BLE) negatively affected the bleaching efficacy compared to BLE group (p < 0.01).ConclusionsDental bleaching did not increase the inflammatory parameters in patients wearing fixed orthodontic appliance. However, in the presence of orthodontic appliances, the bleaching efficacy was lower than that of bleaching teeth without orthodontic appliances.Trial registrationRBR-3sqsh8 (first trial registration: 09/07/2018).

Evolution of Status of Trace Elements and Metallothioneins in Patients with COVID-19: Relationship with Clinical, Biochemical, and Inflammatory Parameters.

The inflammatory reaction and pathogenesis of COVID-19 may be modulated by circulating trace elements (Iron (Fe), Zinc (Zn), Copper (Cu), Manganese (Mn)) and Metallothioneins (MTs). Thus, the present study aimed to investigate their relationship with clinical, biochemical, and inflammatory parameters in patients with COVID-19 at the early Intensive Care Unit (ICU) phase. Critically ill patients (n = 86) were monitored from the first day of ICU admission until the third day of stay. Serum samples were used to assess mineral levels via Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and MT levels via differential pulse voltammetry. Levels of Cu and MTs were significantly decreased after 3 days (p < 0.05), increasing the prevalence of Cu-deficient values from 50% to 65.3% (p = 0.015). Fe and Zn were shown to have a predictive value for mortality and severity. The present study suggests trace element deficiency may be a risk factor during early ICU treatment of COVID-19, as it is related to different biochemical and clinical parameters, indicating a possible beneficial effect of restoring proper levels of these micronutrients.

The association between symptomatic carotid stenosis and hematological parameters

Background &amp; Objectives: Symptomatic carotid artery stenosis (SCAS) is one of the most important causes of ischemic stroke. We aimed to investigate the relationship between hematological and inflammatory parameters in patients with SCAS and controls. Method: Patients who underwent digital subtraction angiography for SCAS were evaluated retrospectively. Patients with carotid stenosis greater than 50% who had a stroke in the last six months were included in the study. Clinical and sociodemographic characteristics, stent characteristics, filter use, balloon dilatation status, arch type, presence of contralateral occlusion, and complication status were recorded. Hemogram was evaluated using fluorescence flow cytometry. Data were analyzed among patients with SCAS, ischemic stroke patients without stenosis and healthy control group. Results: SCAS was higher in patients with advanced age, male, hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, and a history of stroke as compared to healthy individuals (p&lt;0.001). Smoking and atrial fibrillation were higher in group without carotid stenosis and who had ischemic stroke (p&lt;0.001). Hemoglobin and hematocrit values were higher in healthy control group (p=0.001). Red blood cell distribution width (RDW) and platelet/lymphocyte ratio (PLR) were higher in SCAS patients (p&lt;0.001); Neutrophil and neutrophil/lymphocyte ratio (NLR) was higher in the group with stroke and without stenosis (p &lt;0.001). There was no relationship between blood parameters and procedure technical features and complications (p&gt; 0.05). Conclusion: Hematologic parameters like PLR, NLR and RDW level are correlated with SCAS. PLR, NLR and RDW value can be an inexpensive and useful biomarker for predicting SCAS.

Neutrophil-to-high-density-lipoprotein-cholesterol ratio and mortality among patients with hepatocellular carcinoma.

Inflammatory responses and lipid metabolism disorders contribute to the development and prognosis of hepatocellular carcinoma (HCC). This study aimed to investigate the prognostic value of lipid-related inflammatory parameters in patients with HCC. From January 2010 to June 2017, we enrolled 1,639 patients with HCC at Beijing Ditan Hospital. Multivariate Cox regression analysis and area under the receiver operating characteristic (AUC) analysis were used to evaluate and compare the predictability and reliability of high-density lipoprotein cholesterol (HDL-C), neutrophil-to-HDL-C ratio (NHR), monocyte-to-HDL-C ratio (MHR), and lymphocyte-to-HDL-C ratio (LHR) values. A restricted cubic spline was used to explore the association between the NHR and 3-year mortality in patients with HCC. Differences in survival rates were estimated using the Kaplan-Meier method and compared using the log-rank test. The results were validated in an internal cohort between July 2017 and October 2019 (n = 373). After adjusting for confounding variables, NHR was independently associated with 3-year mortality, both as a continuous and categorical variable (both p < 0.05). The correlation between the mortality and the MHR and LHR was not statistically significant. The NHR showed a suitable prognostic value (AUC at 3 years: 0.740), similar to that of the Model for End-stage Liver Disease (MELD) (AUC at 3 years: 0.761). In the validation cohort, the AUC of the NHR was 0.734 at 3 years. The optimal cut-off values of NHR and MELD were 3.5 and 9, respectively. The 3-year survival rates in the low- (NHR < 3.5 and MELD <9) and high-risk (NHR ≥ 3.5 and MELD ≥9) groups were 81.8 and 19.4%, respectively, in the training cohort, and 84.6 and 27.5%, respectively, in the validation cohort. Baseline NHR is a promising prognostic parameter for mortality in patients with HCC and patients with NHR ≥ 3.5 and MELD ≥9 have a high mortality rate.

Evaluation of the Selected Parameters of Inflammation in Patients with Haemorrhagic Stroke

Introduction. In the acute phase of stroke, the development of inflammation within the stroke focus can be observed.Therefore, in response to the inflammatory process in the brain, an inflammatory reaction occurs in the peripheral blood.Aim. The aim of the study was to assess the parameters of inflammation in peripheral blood in a group of patientswith haemorrhagic stroke.Material and Methods. The study included 64 patients with haemorrhagic stroke hospitalized at the Stroke Centreof the Department of Neurology, University Hospital no. 1 in Bydgoszcz. The type and location of the stroke wereverified by a head CT scan performed on the first day of hospitalization. On the first day of stroke, together withroutine laboratory tests, the level of CRP1, WBC1, PCT, OB and fibrinogen1 was determined. CRP2, WBC2 andfibrinogen2 levels were repeated on the 14th day of stroke. Patients with infection were excluded from the study.Non-parametric statistical methods were used in the analysis: the Mann–Whitney test, the Kruskal–Wallis test andthe Spearman correlation coefficient.Results. Subcortical localization of the haemorrhagic focus was found in the majority of patients. Both baselineand control CRP and WBC values were outside the laboratory range. There were no statistically significant differencesbetween the baseline and control CRP and WBC values, while the control fibrinogen level was significantly higherthan baseline (p&lt;0.041). Patients who died and/or those with impaired consciousness had statistically significantlyhigher values of inflammatory parameters (except OB, PCT and FIBR1) compared to patients who survived andwere conscious.Conclusions. In our study, we observed a significant increase in fibrinogen levels 14 days after the onset of the stroke.In addition, the control level of fibrinogen correlated with the size of the haemorrhagic focus and the clinical conditionof the patients. Further research is needed in this area. (JNNN 2023;12(1):3–8)

The Impact of Whole-Body Cryotherapy on Endothelium Parameters in Patients with Ankylosing Spondylitis.

The aim of the study was to assess the effect of whole-body cryotherapy (WBC) with subsequent exercise training (WBC group) or exercise-only training (ET group) on endothelium inflammation parameters in patients with ankylosing spondylitis (AS). The WBC procedure lasted 3 min, and exercise training consisted of one 60 min session a day, which was the same in each group. The ET group was compared to the WBC group. Endothelium (high-sensitivity C-reactive protein (hsCRP), soluble P-Selectin, soluble vascular cell adhesion molecule-1 (sVCAM-1), neopterin), and oxidative stress (lipid hydroperoxide (LHP), protein sulfhydryl (PSH), lipofuscin, paraoxonase-1(PON-1), and albumin) parameters were estimated 1 day before and 1 day after the completion of the study. A significant decrease in hsCRP, sP-Selectin, sVCAM-1, and neopterin concentrations was observed in the WBC group after the treatment. After the treatment, in both groups, LHP and lipofuscin levels and PON-1 activity decreased significantly. The observed drop in these parameters was higher in the WBC group compared to the ET group. Albumin concentration increased in the WBC group after treatment. Procedures of WBC have a beneficial effect on endothelium parameters in AS patients; therefore, this method can be applied in the treatment of this group of patients.

The effects of phytosomal curcumin supplementation on clinical symptoms, and inflammatory and oxidative stress biomarkers in patients with migraine: A protocol for a randomized double-blind placebo-controlled trial.

Migraine is one of the most common diseases. Curcumin with anti-oxidative and anti-neuroinflammatory properties might have beneficial effects in migraine patients. This study will be conducted to evaluate the effects of a phytosomal preparation of curcumin on clinical signs, oxidative stress, and inflammatory parameters in patients with migraine. This is a randomized, double-blind, placebo-controlled, clinical trial in which, 60 patients with migraine will be assigned to receive a daily dose of 250 mg of phytosomal curcumin for 8 weeks (intervention group) or 250 mg maltodextrin as a placebo for the same duration (control group). Before and after the study, frequency, duration, and severity of the attacks, quality of life and sleep, mood status, high-sensitivity C-reactive protein (hs-CRP), Nitric Oxide (NO), and oxidative stress factors will be measured. It seems that phytosomal formulation of curcumin (a solid dispersion preparation of curcumin with phosphatidylserine) with high bioavailability, can cross the blood-brain barrier (BBB) and result in decreased neuroinflammation, oxidative stress, and neurotoxicity. This way, phytosomal curcumin might lead to reduction of headaches and other complications of migraine and increase the quality of life of patients with migraine.

Investigation of Electrocardiogram and Inflammation Parameters in Patients with First Episode Mania

Aim: This study examined inflammation markers and electrocardiogram data in patients with first-episode mania (FEM). It aimed to examine the inflammation processes in the early stages of the disease and the frontal QRS-T (fQRS-T) angle in bipolar disorder (BD). Materials and Methods: After exclusion criteria, 53 FEM patients and 59 healthy controls (HC) were included in the study. Sociodemographic, electrocardiogram (ECG) and lab data of the participants were evaluated. Results: Mean of age and gender distribution did not differ between the groups (p=.743, p=.294, respectively). The heart rate of the FEM group was significantly higher than the HC group (p&lt;.001). fQRS-T was significantly wider in the FEM group than in healthy controls (p=.20). Albumin was significantly lower in the FEM group than in the HC group (p&lt;.001). CRP and CAR values were significantly higher in the FEM group than in HC (p=.009 and p=.011, respectively). In the FEM group, HDL value was significantly lower than HC, while LDL value was significantly higher than HC (p=&lt;.001 and p=.001, accordingly). MHR and AIP values were significantly greater in the FEM group than in HC (p=&lt;.001 and p=.006, respectively). The fQRS-T angle in FEM patients was associated with MHR (r=.37). Conclusion: This study is unique in evaluating inflammatory markers, fQRS-T angle, and heart rate in FEM patients. In this study, we found significantly higher inflammatory markers of MHR, CRP, and CAR in FEM patients in the control group. We found that these findings were consistent with the literature. Since the fQRS-T angle was wider in the FEM group, the cardiovascular risk may be increased in the early stages of BD disease.

Varikoselli hastalarda sistemik immün enflamasyon endeksi ve hematolojik enflamatuvar parametrelerinin değerlendirilmesi: Kontrollü bir çalışma

OBJECTIVES: This study aims to evaluate the relationship between varicocele and inflammation using hematological inflammatory parameters in patients with varicocele and systemic immune inflammation (SII) index, and to contribute to the etiopathogenesis of varicocele. MATERIAL and METHODS: The study included 56 healthy volunteers, and 59 patients who were diagnosed to have varicocele in the urology clinics of Erzurum City Hospital between May 2018 and December 2021. Patient files were retrospectively investigated and the data of whole blood analysis were recorded. Parameters obtained from whole blood analysis and systemic immune inflammation index were compared between groups. RESULTS: A total of 59 adult male who have diagnosed as varicocele were included in the patient group and 56 healthy adult volunteers were included in the control group. When the two groups were compared in terms of body mass index and mean age, there was no statistically significant difference. (p=0.915 and p=0.25, respectively). Lymphocyte count was significantly reduced in the patient group (p&lt;0.001). Neutrophil/Lymphocyte ratio (NLR), Monocyte/Lymphocyte ratio (MLR), Platelet/Lymphocyte ratio (PLR) and SII index were found to be significantly higher in the patient group when compared for both groups (p&lt;0.001, p=0.033, p&lt;0.001 and p=0.005, respectively). There was no relation between the grade of varicocele and hematological inflammatory parameters or systemic inflammation index in the patient group. When we examined the relationship between semen parameters and SII index in patients with varicocele, we found that lymphocyte count, neutrophil count, NLR and SII index were significantly higher in patients with abnormal semen parameters compared to patients with normospermic varicocele (respectively; p=0.004, p=0.003, p&lt;0.001 and p&lt;0.001) SII has the best predictive power in predicting Impaired Semen Quality in varicocele patients among inflammatory parameters. CONCLUSION: SII index and hematological inflammatory parameters can show that inflammation is one of the factors playing a role in varicocele pathogenesis. Our study has important results showing the relationship between hematological inflammatory parameters and especially SII index and semen parameters in patients with varicocele. Prospective, randomized studies with larger numbers of patients and control groups should be conducted in order to investigate whether SII index and hematological inflammatory parameters can be used in the diagnosis, follow-up and treatment of varicocele. Keywords: varicocele, inflammation, systemic immune inflammation index

Prognostic significance of preoperative computed hematological inflammatory parameters in patients with breast cancer

Breast cancer is the most common malignant disease among women, constituting around a quarter of all cancers in women worldwide. This type of cancer is mainly affected by genetic, environmental, and lifestyle factors such as nutrition and physical activity. A retrospective study including 192 women with breast cancer was performed for six years (from 2015 to 2021). We investigated the relationship between indirect hematological parameters, neutrophil-to lymphocyte ratio – NLR, plateletsto-lymphocyte ratio – PLR, systemic immune-inflammation index – SII and the treatment outcome. Additionally, we also followed the overall survival (OS) rate. The obtained results report assessed parameters before and after surgical intervention. Of importance is to emphasize that at a cut-off value of 2.65 (P = 0.001) and 3.30 (P &lt; 0.001), a decline in the NLR value was noticed after surgical removal of the breast cancer. The same decrease was observed for SII after surgery (P &lt; 0.001). Through the study, SII has been shown to be a more relevant parameter compared to NLR and PLR. The study outcome recommends the cut-off value of 2.65 as the optimal for NLR in predicting the effectiveness and successfulness of the surgical procedure.

Total cholesterol/high-density lipoprotein and inflammatory parameters in patients with polycystic ovary syndrome.

In this study, the hormone profile, lipid profile, and inflammatory parameters of patients with polycystic ovary syndrome were compared with those of non-polycystic ovary syndrome patients to determine predictive markers in young polycystic ovary syndrome patients who have not yet had children. Patients' age, height, weight, body mass index, waist circumference, degree of hirsutism, and ultrasound findings were recorded. Hormone profile, lipid levels, ratio of complete blood count parameters, monocyte/high-density lipoprotein ratio, and total cholesterol/high-density lipoprotein ratio were compared between groups. No statistically significant differences were found between groups in terms of age, weight, waist circumference, body mass index, and dysmenorrhea (p>0.05). A significant relationship was found between the height and the degree of hirsutism in the groups (p<0.05). It was found that prolactin, total testosterone, and dehydroepiandrosterone sulfate levels were statistically significantly higher in the polycystic ovary syndrome group compared to the control group. The polycystic ovary syndrome group had hemoglobin, leukocytes, lymphocytes, neutrophils, platelets, and statistically higher ratios of total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein. No statistically significant relationships were found between homeostatic model assessment insulin resistance, neutrophil-to-lymphocyte ratio, and monocyte-to-high-density lipoprotein ratio between the groups (p<0.05). There was no significant difference in systemic immune inflammation index values between the groups. Polycystic ovary syndrome patients are at risk for short- and long-term complications, and the use of the total cholesterol/high-density lipoprotein, Low-density lipoprotein/high-density lipoprotein, and triglycerides/high-density lipoprotein ratios in clinical practice during the follow-up of these patients may allow easy follow-up for patients. The health status of polycystic ovary syndrome patients can be objectively determined by tracking these outcomes at regular intervals.

Systemic immune-inflammation index and other inflammatory parameters in patients receiving biological or targeted synthetic DMARDs for inflammatory rheumatic disease

Objective: To investigate the short – and long-term dynamics in inflammation markers [systemic immune-inflammation index (SII), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/ monocyte ratio (LMR)] before and after biological disease-modifying antirheumatic drugs (bDMARD) or targeted synthetic DMARD (tsDMARD) treatment. Patients and Methods: Two hundred twenty-six patients (115 women, 47±13.8 years) were included. Age, gender, disease duration, and treatments were recorded retrospectively. Complete blood counts including neutrophil, lymphocyte, platelet, monocyte and acute phase reactants were noted at the visit before the biological treatment, at the 3rd month, 6th month, and the last visit on medication. SII, NLR, PLR and LMR were calculated, and their dynamics over time were compared. Results: Significant changes were observed over time in all parameters reflecting inflammation (SII, NLR, PLR, LMR, ESR, and CRP) (p&amp;lt;0.05). In the correlation analysis of changes at baseline and six months, significant correlations with ΔESR were observed with ΔCRP, ΔPLR, ΔSII and ΔNLR (p&amp;lt;0.05), but no correlation with LMR was detected. Also, significant correlations with ΔCRP were noted with ΔNLR, ΔSII, ΔPLR, and ΔLMR (p&amp;lt;0.05). Conclusion: Significant and favourable changes were observed in all inflammatory parameters after treatment, and this variation remained stable as long as the drug was continued.

Application of the Clustering Technique to Multiple Nutritional Factors Related to Inflammation and Disease Progression in Patients with Inflammatory Bowel Disease.

Diet and nutritional status affect intestinal inflammation in patients with inflammatory bowel disease (IBD). The aim of this study was to use a cluster analysis to assess structural similarity between different groups of parameters including short-chain fatty acid (SCFA) levels in stool as well as hematological and inflammatory parameters (such as serum C-reactive protein (CRP) and proinflammatory and anti-inflammatory cytokines). We also assessed similarity between IBD patients in terms of various biochemical features of disease activity and nutritional status. A total of 48 participants were enrolled, including 36 patients with IBD and 12 controls. We identified four main meaningful clusters of parameters. The first cluster included all SCFAs with strong mutual correlations. The second cluster contained red blood cell parameters and albumin levels. The third cluster included proinflammatory parameters such as tumor necrosis factor-α, CRP, platelets, and phosphoric, succinic, and lactic acids. The final cluster revealed an association between zonulin and interleukins IL-10, IL-17, and IL-22. Moreover, we observed an inverse correlation between IL-6 and body mass index. Our findings suggest a link between nutritional status, diet, and inflammatory parameters in patients with IBD, which contribute to a better adjustment of the nutritional treatment.