Laboratory Profile Research Articles

P-178. Crotalic snakebites accidents: the clinical and epidemiological profile of patients treated at toxicology unit of a reference center in Brazil

Abstract Background In Brazil, about 30,000 snakebites accidents are reported every year. Crotalus durissus is responsible for 9% of the cases. This study aimed to assess the clinical, epidemiological and laboratory profile of victims of crotalic accidents treated at a major toxicological reference in Brazil and the incidence of clinical complications. Methods Retrospective cohort study that analyzed medical records from victims of crotalic accidents treated at the Toxicology Unity of the reference center between January/2011 and December/2022. Suspected crotalic accidents with lack of clinical and laboratory diagnosis were excluded. Multivariate logistic regression was performed to evaluate the association between the severity of crotalic accidents with its factors, reported as odds ratio (OR) and 95% confidence intervals. Results From 411 patients included (median age 40 years, interquartile range [IQR] 23–56), 79.8% were men, 70.0% pardo, 74.0% of the accidents happened in rural areas and 77.6% of the bites were in lower limbs. Overall, 29.0% were late-admitted to the hospital ( >6 hours after the accident. Accidents were more frequent in summer (63.3%). Median hospital length of stay was 3 days (IQR 2-4). From those who had local manifestations (90.3%), pain was the most frequent symptom (80.5%). Regarding patients who had systemic manifestations (74.0%), neuroparalytic were the most frequent (66.7%), followed by myotoxic and hemolytic (37.8%), vagal (20.4%) and renal (17.3%). Four deaths were reported (1.0%). Age > 50 years (OR 1.85 [95% CI 1.11-3.11]), non-identification of the snake (OR 4.24 [95% CI 2.07-8.97]) and >6h until medical admission (OR 4.23 [CI 95% 2.55-7.12]) were associated with severe cases. Conclusion The results show the importance of the adequate and early management of crotalic accidents focusing on the main manifestations. The establishment of epidemiological, clinical and laboratory profiles related to severe cases is also important to help understand the socio demographic characteristics of the patients. Disclosures All Authors: No reported disclosures

P-771. Demographic and Clinical Characteristics of Adverse Reactions to anti-Tuberculosis Therapy: A Retrospective Analysis

Abstract Background Adverse reactions (AR) to anti-tuberculosis (anti-TB) therapy pose a significant challenge, leading to decreased treatment compliance, increased morbidity and mortality rates, and prolonged hospital length-of-stay. Methods This study examines the demographic, clinical, and laboratory profiles of patients diagnosed with tuberculosis and hospitalized at the Tor Vergata Policlinic in Rome between 2013-2023, who experienced adverse reactions requiring the interruption, suspension, or modification of anti-tuberculosis therapy, in the period 2013-2023. Results Out of 242 patients receiving treatment for tuberculosis, data regarding AR were available for 136 cases. Of these, 35.3% (48/136) experienced an AR attributable to anti-tuberculosis therapy, median age of 39 years (IQR 26.5-57), 72.9% male, 60.4% non-italians, and 41.6% undergoing treatment for pulmonary TB. The most common AR were hypertransaminasemia (52.2%), allergic reaction (25%), and cholestasis (8.3%). Patients with AR characterized by hypertransaminasemia/cholestasis compared to those with allergic reactions were younger (31 years (IQR 25-45) vs. 60.5 (IQR 36-69.5); p=0.012), more frequently of non-italian nationality (74.2% vs. 25.8%; p= 0.013), and had more frequently a negative Quantiferon test (41.9% vs. 8.3%; p= 0.03). Pirazinamide emerged as the drug most frequently linked to AR, being suspended in 62.5% of cases (20/29 due to hypertransaminasemia; 8/12 due to allergic reaction). In 76.2% of cases, the drug responsible for the AR was discontinued in favor of a fluoroquinolone. All ARs resolved upon suspension of the implicated drug. Among patients with AR, 65.3% recovered, and 13% died. Patients with AR had a lower lymphocyte count at treatment initiation compared to patients without AR (median 1150 (IQR 780-1940) vs 1460 (IQR 1035-2020), p=0.04) and had more frequently a negative Quantiferon test (29.2% vs 10.2%; p=0.012). Conclusion AR during TB therapy affected 35% of patients in our sample. Pyrazinamide was the most commonly implicated drug, and the reactions resolved upon discontinuation. A lower lymphocyte count at TB diagnosis in patients with AR might indicate an immune component, similar to IRIS, in their onset. However, further studies are warranted to explore this aspect. Disclosures All Authors: No reported disclosures

P-1246. Effect of BV100 on the Pharmacokinetics of Midazolam and its metabolite 1-hydroxymidazolam in healthy volunteers

Abstract Background We identified rifabutin as having potent antibacterial activity towards Acinetobacter baumannii under iron limiting conditions. BV100 (rifabutin for infusion) is under development for the treatment of serious infections due to A. baumannii A single center, open-label, 3-period fixed-sequence, phase I clinical drug-drug interaction study was conducted to evaluate the effect of BV100 on the pharmacokinetics (PK) of midazolam and its metabolite 1-hydroxymidazolam on healthy subjects. Methods The study included nonchildbearing females and males aged 18 to 55. The study was divided in three periods : On Day 1 (Period 1), each participant received a single 5 mg oral dose of midazolam syrup. After a 24-hour washout on Day 2, BV100 was given as a 300 mg intravenous infusion over 2 hours every 12 hours for 8 doses from Day 3 to Day 6 (Period 2). On Day 7 (Period 3), the 9th dose of BV100 was administered alongside a single 5 mg oral dose of midazolam. PK parameters for midazolam and its metabolite were assessed in plasma samples on Day 1 after midazolam administration alone and on Day 7 after midazolam administration following 8 BV100 doses from Day 3 to Day 6. Results No deaths, no SAEs, or other significant AEs occurred during this study. All 23 study subjects were eligible for safety analysis. Sixteen out of 23 subjects completed all 3 periods of the study. No clinically relevant effects of BV100 on clinical laboratory profiles (haematology, biochemistry, haemostasias, urinalysis) or vital signs (blood pressure, heart rate, respiration rate, body temperature) were observed in this study. Midazolam and 1-OH-midazolam plasma concentrations were higher when administered alone on Day 1 (Cmax = 33.36 ng/mL; AUC0-tlast = 99.20 h*ng/mL) compared to co-administration with BV100 on Day 7 (Cmax = 25.43 ng/mL; AUC0-tlast = 50.81 h*ng/mL). The elimination parameters indicate faster elimination for both midazolam and its metabolite on Day 7 compared to Day 1. Conclusion BV100 is considered a mild and weak inducer of midazolam according to EMA and FDA criteria, respectively. Multiple 300 mg IV doses of BV100, administered with and without midazolam to healthy subjects, were safe and well tolerated. Disclosures All Authors: No reported disclosures

P0928 Patient endotypes in ulcerative colitis revealed by longitudinal symptom trajectories under therapy

Abstract Background Ulcerative colitis (UC) poses unique challenges in patient care. Although therapies have led to better outcomes, only 20-30% of patients enter remission, and even fewer sustain it over time. A critical need remains in addressing three key areas: i) predicting which patients will enter remission, ii) tailoring treatments to individual patient needs, and iii) identifying novel therapeutic targets that can sustain long-term remission. Symptom trajectories under therapy offer an accessible approach to addressing these challenges and this work investigates their alignment with molecular responses to assess their clinical value. Methods Using a reverse translation approach, this study analyses longitudinal data from the etrolizumab phase 3 trials to gain insights into the UC patient population. Symptom response trajectories of 437 UC patients were tracked over 54 to 66 weeks using the partial Mayo Clinical Score (pMCS). Through unsupervised clustering of pMCS, we identified distinct subpopulations based on their patterns of disease activity. Clinical outcomes within these clusters were then examined, allowing us to uncover significant predictors of rapid and sustained remission. Molecular profiling using gene expression data was then performed, revealing the biological mechanisms that differentiate these patient groups and providing insights into their treatment responses. Results Our analysis revealed five distinct patterns of disease response and progression, from patients achieving rapid and deep remission to those with persistently high disease activity. These five symptom-based subgroups match closely with traditional clinical endpoints. We found that predictors of sustained remission, such as elevated albumin levels, low endoscopic scores, and reduced markers of inflammation (faecal calprotectin and C-reactive protein) aligned with these subgroups. In addition, molecular profiling highlighted specific differences in gene expression and immune cell activity, notably showing that patients with deep remission had an enrichment of anti-inflammatory signalling pathways, suggesting a biological basis for their favourable outcomes. Conclusion Longitudinal monitoring of symptom trajectories offers a non-invasive, easily measured and reliable proxy for early assessment of the likelihood of achieving deep, sustained remission in UC patients. These symptom patterns show strong concordance with endoscopic, laboratory, and molecular remission profiles. This approach aligns with the principles of personalised medicine by enabling i) dynamic symptom monitoring ii) application in Phase II trials to guide drug development by assessing if a patient is on the right path toward therapeutic success and iii) identification of novel therapeutic targets.

P1240 Overweight in patients with inflammatory bowel disease and the associated risk of malnutrition

Abstract Background Although inflammatory bowel disease(IBD) has traditionally been associated with malnutrition,the prevalence of overweight(0W)and obesity is currently increasing.Moreover, both overweight and chronic inflammation can elevate the risk of essential micronutrient deficiencies.The objective of this study is to investigate the prevalence of OW in a cohort of IBD patients and the associated risk of nutritional deficiencies Methods This is a cross-sectional study that consecutively included patients attending the day hospital for intravenous biologic that didn’t fulfill exclusion criteria (e.g. short bowel syndrome or oral nutritional supplements).All patients underwent weight and height measurements,assessment of IBD clinical activity (Harvey-Bradshaw Index[HBI] for Crohn's disease and Walmsley Index[WI] for ulcerative colitis and completion of the MUST(Malnutrition Universal Screening Tool) questionnaire. A blood test was also performed to obtain a comprehensive nutritional profile, and fecal calprotectin(FC)levels were measured Results A total of 93 patients were included. Baseline characteristics are summarized in TABLE 1.Regarding body mass index(BMI), 2 patients(2.5%) had a BMI below 18.5, 45 (57%) were classified as normal weight(BMI 18.5-25), and 32 (40.5%) were OW(BMI over 25). No differences were found in clinical activity ( HBI or WI) between OW and normal-weight patients(p=0.75 and p=0.57, respectively).However, a lower mean FC level was observed in overweight patients(166.2 µg/g vs. 445.1 µg/g),though this difference did not reach statistical significance(p=0.18).Similarly, no significant differences in C-reactive protein levels were observed between the two groups(5.13 mg/L vs. 2.6 mg/L; p=0.09).There were also no differences in the type of IBD, disease location or the line of biologic treatment among patients with or without OW. OW IBD patients showed a statistically significant association with higher levels of prealbumin, hemoglobin, triglycerides, and ferritin.No greater micronutrient deficiencies were identified in overweight patients compared to those with normal weight. The laboratory profiles of both groups are summarized in TABLE 2.Regarding the risk of malnutrition, using the self-completed portion of the MUST questionnaire to minimize potential BMI bias, it was identified that only 20% of patients with intermediate/high risk of malnutrition were OW(p=0.04) ( vs normal-weight patients; p=0.04) Conclusion OW is common in IBD patients,even among those with active inflammation and refractory response to advanced treatments. In our experience,OW IBD patients do not exhibit greater micronutrient deficiencies compared to normal-weight patients,though they do present characteristic laboratory alterations associated with OW

Proinflammatory cytokine genes and their polymorphic variants: clinical and laboratory profiles in the Federal Firefighting Service employees of the EMERCOM of Russia

Relevance. Genetic determinants of multifactorial diseases are critical for assessing the risk of genetic diseases and their prevention, especially among the workforce exposed to industry-related dangerous and aggressive occupational factors. Firefighters perform combat service duties in extremely unfavorable industrial environments associated with occupational diseases. Respiratory diseases are among the pathologies with highest incidence rates in firefighters. In addition to environmental factors, the development of these diseases (especially bronchial asthma and chronic obstructive pulmonary disease) is largely driven by impaired immune system – one of the three critical regulatory systems involved in pathogenetic mechanisms of various diseases, including inflammatory diseases. Polymorphic gene variants of inflammatory mediators – in particular cytokine genes and their receptors – mediate the immune system activity and can impact its functionality, susceptibility, or resistance to disease development.The objective is to analyze how interleukin 1β, 4, 6, 13, TNF and interleukin 6 receptor genes, as well as their polymorphic variants are associated with respiratory diseases and changes in the biomarker profiles showing immune response intensity in the employees of the Federal Firefighting Service of the EMERCOM of Russia. Methodology. Molecular genetic profiling and immunology tests were performed in 70 employees of the Federal Firefighting Service of the EMERCOM of Russia to analyze proinflammatory cytokine genes and their polymorphic variants. Real-timePCR was used to analyze the interleukin 1β, 4, 6, 13, TNF and interleukin-6 receptor genes and their polymorphic variants. Immunological examination evaluated the blood monocyte subpopulations and relative count of type 2 T-helper cells; flowcytometry and immunochemiluminescence assays were used to evaluate immune response biomarkers in peripheral blood and total immunoglobulin E (IgE) respectively.Results and discussion. The analysis provides evidence that minor alleles of most polymorphic cytokine genes are associated with a proinflammatory phenotype, which is especially apparent for genotypes comprising several minor alleles. Allele A at rs1 800 629 polymorphic TNF gene exposed a direct correlation with respiratory diseases, as well as with increased monocyte differentiation. Allele T of IL4 rs2243250 gene and allele A of IL1β rs16944 gene were associated with increased proinflammatory monocyte count. Elevated count of type 2 T-helper mediators of humoral response, especially of allergicorigin, was observed in individuals with C/C IL6 rs1 800 795 and G/G IL1β rs16944 genotype.Conclusion. The obtained results suggest that evaluation of cytokine gene polymorphic variants is a promising strategy to predict the risk of respiratory diseases in firefighters. Prompt assessment of genetic predisposition to a proinflammatory phenotype paves the way towards prevention and early detection of inflammatory diseases in this cohort of workers.

A decade-long analysis of 98 chronic myeloid leukemia patients: Laboratory data and clinical progress at a single center

Abstract: BACKGROUND: Chronic Myeloid Leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia chromosome (BCR-ABL1 fusion gene). CML primarily progresses through chronic, accelerated, and blast phases. While global studies on BCR-ABL1 fusion transcript types and their associations with clinical, laboratory, and prognostic profiles exist, such data is scarce in Malaysia. OBJECTIVES: This study aimed to determine the distribution of BCR-ABL1 fusion transcript types and evaluate their associations with demographic, clinical, laboratory, prognostic profiles, and disease outcomes among Malaysian CML patients. PATIENTS, MATERIALS AND METHODS: A total of 98 patients diagnosed with CML were identified at East Coast Hospital, Malaysia. This 12-year cross-sectional study was carried out using data extracted from patients’ medical records. Molecular results for BCR-ABL1 fusion genes were obtained using one-step multiplex reverse transcriptase polymerase chain reaction. RESULTS: Out of the 98 patients, 56% had e14a2, 41% had e13a2 fusion transcripts, while the remaining 2 patients had e14a3 transcripts. Additionally, 1 patient co-expressed both e13a2 and e14a2. Among patients with the major BCR-ABL1 transcript type, those with e14a2 fusion transcripts showed an older median age (P = 0.025), while patients with e13a2 fusion transcripts had significantly higher white blood cell (WBC) counts (P = 0.014). Furthermore, there were significantly more patients with blastic transformation in the e13a2 group (P = 0.038). The median latency period of CML was 12 months. The blast cell lineages consisted of myeloid (68.4%), followed by B-lymphoid (26.3%) and mixed phenotypic (5.3%). The differences in fusion transcript expression might influence certain parameters; for instance, older patients were associated with the e14a2 fusion transcript. Meanwhile, patients exhibiting e13a2 might have a higher WBC count at diagnosis and be more vulnerable to blastic transformation of CML. CONCLUSIONS: This study highlights the predominance of e14a2 fusion transcripts in Malaysian CML patients and its association with older age. The e13a2 transcript was linked to higher tumor burden and a higher rate of blastic transformation, suggesting potential prognostic significance. These findings underscore the importance of baseline molecular profiling for optimizing disease management.

Clinical and laboratory profile of HELLP Syndrome: integrative literature review

Clinical and laboratory profile of HELLP Syndrome: integrative literature review

Association between clinical laboratory indicators and WOMAC scores in Qatar Biobank participants: The impact of testosterone and fibrinogen on pain, stiffness, and functional limitation.

The association between baseline laboratory parameters and experienced well-being in healthy individuals remains uncertain. This study explored the relationship between clinical laboratory profiles and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness, and physical functional limitation in healthy individuals in Qatar. Clinical laboratory data were collected from 1,764 Qatar Biobank participants who also completed the WOMAC questionnaire: lipid profiles (high-density lipoprotein, low-density lipoprotein, cholesterol, and triglycerides), endocrine markers (TSH, T3, T4, estradiol, and testosterone), and two inflammatory markers (CRP and fibrinogen). Multiple linear regression was used with 11 clinical indicators as independent variables and the subscale and total WOMAC scores as dependent variables. Multivariate effects of each indicator on the outcomes were assessed, and univariate effects were examined when significant. Testosterone had a significant impact on all WOMAC subscales (pain, stiffness, and functional limitation) and the total WOMAC score. Higher testosterone levels were associated with a reduction in pain (β = -0.03, t = -3.505, p < 0.001, 95% CI = -0.052, -0.015), stiffness (β = -0.01, t = -2.265, p = 0.024, 95% CI = -0.018, -0.001), physical dysfunction (β = -0.08, t = -3.265, p = 0.001, 95% CI = -0.135, -0.034), and total WOMAC scores (β = -0.127, t = -3.444, p < 0.001, 95% CI = -0.199, -0.055). Elevated fibrinogen levels were associated with an increase in stiffness (β = 0.155, t = 2.241, p = 0.025, 95% CI = 0.019, 0.290), physical dysfunction (β = 1.17, t = 2.808, p = 0.005, 95% CI = 0.354, 1.997), and total WOMAC scores (β = 1.610, t = 2.691, p = 0.007, 95% CI = 0.437, 2.784). Testosterone may protect against pain, stiffness, and physical dysfunction, while high fibrinogen levels might be a surrogate of systemic inflammation that enhances stiffness and limits physical function. Measuring multiple clinical and laboratory markers in healthy individuals may enhance our understanding of the molecular mechanisms underlying pain.

Selective IgM deficiency: evaluation of 75 patients according to different diagnostic criteria.

Selective IgM deficiency (SIgMD) has recently been included in the inborn errors of immunity classification. SIgMD has conflicting diagnostic criteria and diverse clinical and immunological findings. We aimed to assess the clinical and laboratory profiles of patients with SIgMD and to compare the data of patients diagnosed using two inclusion criteria. This was a descriptive, retrospective, observational, collaborative study. Patients were included according to the following definitions: Group 1, IgM levels < 0.20g/L in children and < 0.30g/L in adults, and Group 2, serum IgM levels below 2SD and, for both, absence of associated immunological diseases or secondary causes. The protocol was approved by the Ethics Committee, and patients provided consent. In total, 75 patients were included: 37 (16M:21F; mean age, 52.92) and 38 (13M:25F; mean age, 53.47) in Groups 1 and 2, respectively. The most frequent clinical manifestations were allergic rhinitis (G1, 45.9%; G2, 36.8%), asthma (G1, 37.8%; G2, 28.9%), and pulmonary infections (G1, 27.03%; G2, 21.05%). Chromosomopathies (16.22%) and neoplasia (13.51%) were more frequent in G1, whereas URTI (23.68%) and skin infections (23.68%) were more common in G2. There was no difference in sex or mean age at symptom onset between both groups of patients. Regarding the clinical picture, 90.7% of the lesions were benign (68/75). Chromosomopathies may be associated with SIgMD, suggesting the need to quantify serum IgM levels in these cases. Considering the possibility of developing autoimmunity, neoplasia, and common variable immunodeficiency, it is advisable to follow up patients with SIgMD.

Association of Laboratory and Imaging Parameters in Different Types of Pancreatitis in Children in a Tertiary Care Hospital in Bangladesh

Background: Pancreatitis is an inflammatory condition of the pancreas, which might extend to local and distant extra-pancreatic tissues. It can be acute, acute recurrent or may be chronic. The diagnosis of different types of pancreatitis is based on a combination of clinical signs and symptoms, laboratory investigations and imaging techniques. Objective: To describe and find out the association of the laboratory and imaging profiles of different variety of pancreatitis in children. Methods: It was a an observational study conducted at the department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University from July 2018 through June 2020. A total of 48 cases were included in this study. The diagnosis of acute, acute recurrent and chronic pancreatitis was based on diagnostic criteria made by INSPPIRE group. Clinical characteristics, hematological, biochemical and imaging profile of the different variety of pancreatitis and their hospital outcome were observed. Result: Among 48 cases, acute recurrent pancreatitis were 56.3%. Mean age of the patients at presentation was 10.3 years. Laboratory tests showed serum calcium and C-reactive protein was significantly altered among acute, acute recurrent and chronic pancreatitis with characteristic imaging findings. Among imaging modalities, abdominal ultrasonogram showed swollen pancreas (58.3%) was significantly common in acute recurrent pancreatitis than chronic pancreatitis, whereas shrunken pancreas (28%) was significantly common findings in chronic pancreatitis. In addition to ultrasonogram, MRCP aided diagnosis of chronic pancreatitis. Complications developed in 25% of acute pancreatitis cases, which included hypocalcemia (58.3%), ascites (86.7%), pleural effusion (66.7%), pseudocyst (33.3%) and pancreatic necrosis (25%). Hospital stay was significantly prolonged in acute pancreatitis cases, when compared to other types of pancreatitis . Conclusion: Low calcium level and high CRP level were found in acute pancreatitis than in acute recurrent and chronic pancreatitis. Swollen pancreas with beaded and tortuous pancreatic ducts were found in case of chronic pancreatitis. Bangladesh J Child Health 2023; Vol 47 (2) : 95-102

A Study of 67 Cases with Disorders of Sex Development: An Experience of A Tertiary Care Hospital

Introduction: Disorder of sex development (DSD) is defined as a condition where the development of gonadal, chromosomal or anatomic sex is atypical. Objective: To study the clinical and laboratory profile of patients with disorders of sex development (DSD) and classify them. Methods: A retrospective study was conducted in BSMMU from 1st May 2016 to 31st December 2021 including all patients diagnosed with DSD. Data were obtained by reviewing the medical records of the patients. Results: A total 67 patients were diagnosed as DSD. Among them 30 patients (44.8%) had 46,XX DSD, 22 patients (32.8%) had 46,XY DSD, 13 patients (19.4%) had sex chromosome DSD and 2 patients (2.9%) had ovotesticular DSD. Majority (60%) of the patients with 46,XX DSD were diagnosed as congenital adrenal hyperplasia (CAH) followed by adrenal tumor (16.7%) and patients with partial trisomy of chromosome 9q (16.7%). Among 22 patients with 46,XY DSD, eight patients (36.3%) had androgen biosynthetic defect, 6 cases (27.2%) were under virilized CAH and 2 patients (9%) had androgen insensitivity syndrome. Majority of sex chromosome DSD were turner syndrome (69.2%). Only 2 patient had mixed gonadal dysgenesis. Thirteen percent of the children with 46, XX DSD were reared as male and 27% of the 46, XY DSD cases were reared as female. Conclusion: Congenital adrenal hyperplasia is the most common cause of DSD. Majority of 46 XY, DSD is due to androgen bio synthetic defect while CAH is the most common cause of 46XX, DSD. Rare chromosomal disorders are also found among DSD cases. Bangladesh J Child Health 2023; Vol 47 (2) : 103-108

Hospital mortality due to infective endocarditis: Analysis of risk factors in a developing country.

Infective endocarditis (IE) is a disease with high mortality that, in recent decades, has experienced changes in its epidemiology, pathogenesis, and microbiology. Therefore, understanding its landscape and risk factors for mortality is essential. To identify the epidemiological, clinical, laboratory, etiological, and echocardiographic profile of patients hospitalized with IE and to determine predictors for in-hospital mortality. This was a retrospective observational study that analyzed medical records of patients hospitalized for IE in a tertiary center from 2007 to 2023. Patients with a definitive diagnosis of IE according to the Duke criteria were included, while those without a definitive diagnosis, those transferred from other facilities, and minors were excluded. Univariate logistic regression was performed to assess the effect of each variable on in-hospital mortality, with a p-value considered significant if below 0.05. A total of 49 patients were included, most of whom were male (67.4%) with a mean age of 55.5 years. The main etiological agent was Staphylococcus spp. (56.66%), and the mitral valve was the most affected (60.86%). Stroke occurred in 28.57% of patients, and the in-hospital mortality rate was 36.7%. Identified predictors included prior stroke (p=0.017), stroke during hospitalization (p=0.015), and length of hospital stay (p=0.01). IE leads to high mortality, with prior stroke, stroke during hospitalization, and length of hospital stay identified as predictors of in-hospital mortality.

Clinical and Laboratory Profile, Management and Outcome of Pediatric Patients with COVID-19 Infection Admitted at the Zamboanga City Medical Center

Clinical and Laboratory Profile, Management and Outcome of Pediatric Patients with COVID-19 Infection Admitted at the Zamboanga City Medical Center

The association between erectile dysfunction and depression: a cross-sectional study of 21,139 Brazilian men.

This study aimed to investigate the relationship between depression and erectile dysfunction while controlling for sociodemographic, physical health, psychological, and lifestyle factors. Additionally, it aimed to compare erectile dysfunction with other clinical, laboratory, and behavioral variables among individuals with depression in the same population. We included 21,139 men (≥40 years) who underwent continuous health screening in a quaternary hospital in São Paulo between January 2008 and December 2018. The analysis included laboratory, clinical, and behavioral profile data. The multivariate model indicated that alcohol consumption, perceived stress, lower urinary tract symptoms, erectile dysfunction, body mass index, and triglyceride levels were independent and strong factors associated with depression in men. Additionally, higher levels of physical activity were found to be an independent and strong factor associated with reduced odds of depression in men (all p<0.001). Additionally, depressed men had a higher body mass index (28.50±4.35 versus 27.65±3.93kg/m², p=0.003), and increased prevalence of hypertension, diabetes mellitus , lower urinary tract symptoms, metabolic syndrome, nonalcoholic fatty liver, sedentary physical activity levels, active tobacco use, risk of alcohol consumption, and perceived stress. Erectile dysfunction was an independent and strong factor associated with depression in Brazilian men, highlighting the need for integrated treatment approaches addressing both conditions.

Metabolic bone disease in premature infants receiving parenteral nutrition: Incidence, clinical, laboratory and nutritional profile

BackgroundMetabolic bone disease (MBD) of newborns (NB) is characterized by tissue reduction and inadequate postnatal bone mineralization with clinical, laboratory, and/or radiologic repercussions between the third and twelfth weeks of postnatal life, which, in its most severe forms, can lead to a growth deficit and fractures. The aim of our study is to evaluate the incidence of MBD in premature patients receiving parenteral nutrition for >15 days in the neonatal intensive care unit (NICU) and assess their clinical and laboratory characteristics. MethodsSingle-center retrospective cohort study. From 2015 to 2020, patients <33 weeks of gestational age or <1500 g birth weight receiving parenteral nutrition for >15 days who met the metabolic bone disease criteria (alkaline phosphatase >800 U/L and phosphorus <3.5 mg/dL and/or compatible radiological alterations) were evaluated. Exclusion criteria: skeletal dysplasia, orthopedic surgeries, intraventricular hemorrhage grades III and IV, periventricular leukomalacia and chronic renal failure or severe liver disease. Clinical, laboratory and radiological data were collected during the first 90 days of life and/or discharge/death. ResultsThe MBD incidence was 17.7 % over a five-year period. The gestational age at birth was 26 ± 1.41 weeks; birth weight was 745 (592–858) grams; maximum alkaline phosphatase level was 1091 ± 243.87 U/L and phosphorus nadir was 2.45 ± 0.48 md/dL. Among the 14 patients with metabolic bone disease, twelve had laboratory diagnosis, six had radiological and four had both; two patients had fractures; 42 % of patients received enteral calcium and phosphorus supplementation, and 50 % received intravenous calcium replacement. ConclusionsMetabolic bone disease incidence was in accordance with international literature. The metabolic bone disease diagnosis was, in most cases, based on surveillance of laboratory tests. However, treatment for metabolic bone disease requires more active and preventive measures in risk groups.

Clinical and laboratory antenatal profile screening and its associate factors among pastoralist women in Northern Part of Kenya

IntroductionAll pregnant women are encouraged to visit Antenatal Care (ANC) during pregnancy to ensure their wellbeing and that of their unborn baby. World Health Organization (WHO) recommends that all pregnant women attend antenatal clinics for care at least eight times during pregnancy. During antenatal care a series of essential tests are done for pregnant women, both clinical examination and laboratory screenings to detect potential issues which will guide clinicians on management. This study aims to investigate the clinical examination and laboratory screening profile results of pastoralist pregnant women and its associated factors during their first ANC visit in Marsabit County, Kenya.MethodsA cross-sectional study was conducted among pregnant women who attended Integrated Maternal Mobile (IMMH) outreach clinics for ANC in 10 mobile pastoralist communities. Data were collected on demographic information, clinical examination information, and laboratory profile screening outcomes. Frequency and percentages were used to describe the categorical variables and means and standard deviations were used to describe the continuous variables. Bivariate and multivariate analysis was conducted using IBM SPPS 27.0 following STROBE guidelines. The level of significance was set at p &amp;lt; 0.05.ResultsData (N = 237) were extracted, the mean age was 26.62 ± 5.371, of which the majority were in the age group of 20–29, 212 (89.5%) were married 180 (75.9%) and multigravida, 27 (11.4%) visited ANC and 121 (51.1%) traveling more than 15 km to seek healthcare services. The mean weight was 55.56 ± 9.019 kg, mean blood pressure systolic was 118.94 ± 19.95 mmHg, and diastolic was 73.87 ± 13.46 mmHg. Out of all specimens processed and tested, 135 (57%) were anaemic with Hgb &amp;lt;11.5 g/dL), 6 (2.5%) had malaria, 8 (3.4%) were hepatitis B positive, and 21 (8.9%) showed intestinal infection. Those women who are illiterate displayed a 12-fold higher likelihood of becoming anaemic during pregnancy (OR 11.50, 95% CI: 2.47–53.47), and those who didn’t attend ANC also have a 5-fold higher likelihood of being anaemic (OR 5.43, 95% CI: 2.52–11.70).ConclusionAnaemia, hepatitis B, syphilis, malaria parasites, intestinal parasites, and urinary tract infections were observed among the study participants. Integrated outreach programs with laboratory screening and health education should be enhanced, and women within pastoralist communities should be empowered through health education.

Analysis of Clinical and Laboratory Profiles of Patients Hospitalized with Hemorrhagic Fever with Renal Syndrome in Southwestern South Korea.

Hemorrhagic fever with renal syndrome (HFRS) is caused by hantaviruses. Data of 34 patients with HFRS hospitalized at Chosun University Hospital, South Korea, between 2010 and 2021 were retrospectively analyzed. Nested reverse transcription polymerase chain reaction (RT-nPCR) targeting the L segment of hantavirus and sequencing were used for diagnosis. Most cases occurred in men and during the months of October through December. Common symptoms were fever, chills, gastrointestinal symptoms, and myalgia. The common laboratory abnormalities were thrombocytopenia, proteinuria, and elevated levels of serum creatinine, aspartate transaminase, alanine transaminase, and lactate dehydrogenase. Approximately 91.2% of patients had the Hantaan virus with a new genotype cluster, whereas 8.8% had the Seoul virus. Seropositivity based on IgM titer >1:32 on admission was noted in 20.6%, and a 4-fold increase in IgG titer of 1:512 was observed in 11.8%. This study demonstrated that RT-nPCR targeting the L segment of hantaviruses is a more reliable diagnostic method compared to serological testing.

Clinical and laboratorial profile of patients with ATTR cardiomyopathy: comparison between wild type and p.Val142Ile forms in the Brazilian population

Abstract Background In Brazil, besides the wild type (wt) form, transthyretin amyloid cardiomyopathy (ATTR-CM) is predominantly caused by hereditary form with Val142Ile mutation. Considering that both forms occur in elderly people, the clinical presentation may be similar. We sought to compare the clinical presentation of patients with wt and Val142Ile mutation in a Brazilian cohort of ATTR-CM patients. Methods Among the 642 patients enrolled in REACT/SP, 283 presented ATTR-CM, being 85 wt and 90 Val142Ile patients. We compared the main clinical characteristics between groups. Results The wt in comparison to Val142Ile patients, respectively, presented: older age (78.4+/-8.5 vs 74.2+/-8.1 y.o., p = 0.0009); similar proportion of males (82% vs 81%, p=0.85); lower proportion of blacks (11% vs 39%, p=0.0001); similar prevalence of heart failure (HF) symptoms (85% vs 79%, p=0.33); higher prevalence of syncope (13% vs 2%, p=0.008) and Pacemakers (PM) implantation (8% vs 1%, p=0.027); similar prevalence of neuropathy manifestations (38% vs 51%, p=0.17); lower creatinine (1.5+/-0.8 vs 2.1+/-2.1 mg/dL, p=0.02) and NT-ProBNP levels (2860.0+/-2843.3 vs. 5488.3+/-5455.6 pg/ml, p=0.0001); reduced interventricular septal thickness (15.6+/-3.3 vs 17.0+/-3.3 mm, p= 0.006), posterior left ventricular (LV) posterior wall thickness (14.2+/-2.4 vs 16.2+/-4.4 mm, p=0.0003), higher LV ejection fraction (52.0+/-10.1 vs 48.2+/-13.6%, p=0.038), higher global LV longitudinal strain (8.6+/-8.7 vs 3.4+/-9.8, p=0.0003), smaller LV diastolic diameter (45.9+/-6.1 vs 43.0+/-7.3 mm, p=0.005) at 2D-Echocardiogram. Conclusions In the Brazilian population wt and Val142Ile patients had similar clinical presentation regarding HF and neuropathy symptoms, but higher prevalence of syncope and PM in wt patients. Conversely, Val142Ile patients presented more severe amyloid cardiac infiltration.

Clinical and Laboratory Profile, Parental Perception and Management of Micropenis in Childhood: Experience at a Referral Centre in Abidjan, Cote d'Ivoire

Clinical and Laboratory Profile, Parental Perception and Management of Micropenis in Childhood: Experience at a Referral Centre in Abidjan, Cote d'Ivoire