Laboratory Parameters In Patients Research Articles

Clinical and laboratory profile of patients with Kyasanur forest disease: A single-centre study of 192 patients from Karnataka, India.

Kyasanur forest disease (KFD) is a biphasic tick-borne viral fever that is endemic to 16 districts and five states of Southern India. The aim of this study was to describe the clinical/ laboratory manifestations of KFD. This is a retrospective cohort study of confirmed KFD patients admitted in our hospital between December 2018 and June 2019. The demographic, clinical and laboratory parameters of patients during the first and second phase of illness was recorded in a pre-defined case study form. A total of 192 patients from Karnataka were diagnosed with a mean age of 46.2 ± 15.6 years and a male preponderance (57 %). Fever (99 %), myalgia (52 %), headache (43 %), cough (14 %), conjunctival congestion (14 %), altered sensorium (13 %) and haemorrhagic manifestations (8%) were seen in the first phase. A total of 18 % of the patients came back with a second febrile episode. The features of meningoencephalitis were seen in 34 % of the patients during the second phase. Leucopenia, thrombocytopenia, and increase in liver enzymes, creatine phosphokinase (CPK) and activated partial thromboplastin time (APTT) was seen in the first phase but not in the second phase. Higher age, myocarditis, altered sensorium in the first phase, hypotension at admission, lower platelet count, elevated liver enzymes, higher APTT and CPK, were significantly associated with mortality. The primary care physicians or travel medicine practitioners should be aware of the distinct clinical and laboratory manifestations of KFD, including the ones that may signify requirements of higher levels of care.

Vitamin D status and its associations with clinical and laboratory parameters in patients with Addison's disease.

There is increasing evidence that several autoimmune diseases, as well as their activity, are associated with vitamin D (VD) deficiency. Our study aimed to evaluate the prevalence of VD insufficiency in patients with Addison's disease (AD), as well as to evaluate associations between VD concentrations and various clinical and laboratory parameters of the disease. We retrospectively analyzed medical records of 31 adult patients diagnosed with autoimmune Addison's disease, in whom serum VD was measured. We assessed correlations between serum VD and various clinical and laboratory parameters. R e s u l t s: 90.3% of AD patients had inadequate VD concentrations (<30 ng/mL), and 19.3% of them were found to be severely VD deficient (<10 ng/mL). Among assessed laboratory variables, only serum calcium concentrations significantly correlated with VD status (r = 0.53, p = 0.006). The mean serum VD concentration was significantly lower in patients with severe fatigue (15.17 ± 8.41 vs 26.83 ± 12.29 ng/mL, p = 0.011) and limited exercise capacity (12.38 ± 6.9 vs 21.63 ± 10.87 ng/mL, p = 0.016). C o n c l u s i o n s: This study demonstrates a high prevalence of VD deficiency in AD patients, as well as the association between low VD concentrations with symptoms such as severe fatigue or limited exercise capacity. Further studies are needed to clarify if impaired VD status is a risk factor in the pathogenesis of AD and to assess if VD supplementation improves the quality of life of AD patients.

The Significance of Blood Index and Biochemistry Index in Patients with Rheumatoid Arthritis

The aim of this study is to demonstrate the clinical significance of the platelet-to-lymphocyte ratio (PLR) and the ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) in patients with rheumatoid arthritis (RA). A total of 215 patients with RA, 115 patients with osteoarthritis (OA), and 303 healthy controls (HCs) were included in this study. Data on the AST and ALT levels were collected from liver function test reports, and data on the number of platelets and lymphocytes were obtained from a routine blood analysis. Moreover, all the laboratory parameters of patients with RA, patients with OA, and HCs were retrospectively analyzed. The results obtained in this study showed that patients with RA had the highest PLR and AST/ALT ratio, whereas HCs had the lowest ratios (p < 0.05). Receiver operating characteristic (ROC) analysis showed that PLR + AST/ALT can produce high sensitivity and moderate specificity, distinguishing patients with RA from HCs, with a sensitivity of 91.1%, specificity of 75.3%, and area under the ROC curve (AUC) of 0.907. Spearman's analysis showed the PLR is negatively correlated with the erythrocyte sedimentation rate and C-reactive protein levels (p < 0.005). Combined detection of PLR and AST/ALT is better than each indicator individually and can improve the diagnostic efficiency of RA.

Chest x-ray resolution after SARS-CoV-2 infection.

Aim To analyse the resolution of chest X-ray findings in relation to laboratory parameters in patients infected with acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a two- month followup. Analysis of chest X-ray findings in the first few months after the disease is the main goal of our work. Methods Out of the total of 343 patients chest X-ray findings were followed in 269 patients. Patients were divided into groups according to the severity of findings. D-dimer, inflammatory markers, blood cell count, neutrophil lymphocyte ratio (NLR) were analysed. Chest X-ray was analysed during the hospitalization on the day of admission, on the third, the seventh and the fourteenth day (scoring method was used). After discharge chest X-ray was performed in a two-week follow-up, then after one and two months, and after three months if necessary. Results Incomplete chest X-ray resolution was identified in 24 (39.34%) patients with severe, 27 (22.31 %) patients with moderate and in three (3.91%) patients with mild findings. Statistical significance was established in overall score by comparison between all groups (p<0.001), and in the moderate compared to the mild group (p=0.0051). The difference of NLR in the severe compared to the moderate group was observed (p=0.0021) and in the severe group compared to the mild group (p=0.00013). Conclusion Chest X-ray findings persisted mostly in the severe group followed by the moderate and mild ones. Long-term followup is necessary for the appropriate treatment and prevention of fibrosis, and reduction of symptoms.

Clinical Evaluation of Patients with COVID-19 Within the Framework of Comorbidities.

ObjectivesChronic systemic diseases (CSD) and cancer are closely related to the clinical course, severity and mortality of COVID-19 due to the immunosuppressive conditions caused by these diseases. The purpose of this study was to investigate the differences between the effects of cancer and CSD on the clinical and laboratory parameters of patients with COVID-19.MethodsThe study included patients who received inpatient treatment with the diagnosis of COVID-19 at Ondokuz Mayıs University between March 16, 2020, and December 1, 2020. The participants were divided into four groups as follows: Those without comorbidities (Group 1), those with only CSD (Group 2), those with only cancer (Group 3), and those with both CSD and cancer (Group 4). Comparative statistical evaluation was performed in terms of clinical symptoms, biochemical parameters, and admission to intensive care and survival.ResultsIn total, 750 patients were included: 242 patients in Group 1, 442 in Group 2, 27 in Group 3, and 39 in Group 4. The mean age of the patients was 57.1±9.4 years and 53.7% were male. Patients of Group 1 were significantly different from those of the other groups in terms of age, requirement for intensive care and intubation, complications, survival, white blood cell and lymphocyte count, neutrophil/lymphocyte ratio and levels of hemoglobin, lactic acid dehydrogenase, ferritin, D-dimer, and C-reactive protein (for each p<0.001).ConclusionNo difference was observed among laboratory parameters, intensive care admission, intubation need, complication frequency, and survival rates in patients with CSD or cancer. It was detected that all three groups with CSD and cancer were worse than Group 1 in terms of intensive care need, intubation, and survival.

More than 50 Long-Term Effects of COVID-19: A Systematic Review and Meta-Analysis

Background: COVID-19, caused by SARS-CoV-2, can involve sequelae that last weeks to months after initial recovery. The objective of this systematic review and meta-analysis is to identify studies assessing the long-term effects of COVID-19 and estimate the prevalence of each symptom, sign, or laboratory parameters of patients at a post-COVID-19 stage.Methods: In this systematic review and meta-analysis, LitCOVID (PubMed and Medline) and Embase were searched by two independent researchers. Studies published before 1st of January 2021 and with a minimum of 100 patients were included. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. Heterogeneity was assessed using the I2 statistics. PRISMA guidelines were followed.Findings: A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included. The follow-up time ranged from 15 to 110 days post-viral infection. The age of the study participants ranged between 17 and 87 years. It was estimated that 80% (95% CI 65-92) of the patients that were infected with SARS-CoV-2 developed one or more symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). In order to have a better understanding, there is a need for studies to stratify by sex, age, previous comorbidities, severity of COVID-19 (including asymptomatic), and duration of each symptom.Interpretation: From the clinical perspective, multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address after-COVID-19 care.Funding: National Institute for Neurological Disorders and Stroke (NINDS), and Houston Methodist Research Institute, Houston, TX.Declaration of Interests: SLL is an employee of Novartis Pharmaceutical Company; the statements presented in the paper do not necessarily represent the position of the company. The remaining authors have no competing interests to declare.

ОСОБЕННОСТИ ТЕЧЕНИЯ И КЛИНИКО-ЛАБОРАТОРНАЯ ОЦЕНКА COVID-19 ИНФЕКЦИИ У ПАЦИЕНТОВ С СОПУТСТВУЮЩЕЙ СЕРДЕЧНО-СОСУДИСТОЙ ПАТОЛОГИЕЙ

The infection caused by the SARS-CoV-2 coronavirus continues to spread throughout the world. The high social and medical significance of this disease has led to a tangible increase in the number of publications about COVID-19 in many well-known publications. Currently, there is no systematic analysis of information on the diagnosis and treatment of concomitant conditions in patients with coronavirus infection, therefore, in this article, we have analyzed the revealed changes in clinical and laboratory parameters in patients with coronavirus infection and concomitant cardiovascular pathology, as well as their significance for practical medicine. Objective. To assess the features of changes in the clinical and laboratory parameters of patients with COVID-19 and concomitant cardiovascular pathology and to find out their significance. Materials and methods. A randomized retrospective analysis of medical records of 82 patients was carried out on the basis of the 4 N. E. Savchenko State Clinical Hospital. Clinical and laboratory parameters of 82 men (age 54 ± 5.6 years) were studied for the period August 2020 - January 2021. The results of a detailed biochemical blood test, analysis of the acid-base state, hemostasiogram, and analysis for cardiomarkers were taken into account. All patients were divided into 3 groups: the first group - patients with the presence of COVID-19 without concomitant pathology, the second group - patients with the presence of cardiac pathology without coronavirus infection, the third group - patients with coronavirus infection and concomitant cardiovascular diseases (ischemic heart disease , arterial hypertension). Results. When comparing the values of biochemical blood test indicators in patients of the third group, with those in patients of the first group, it was revealed: an increase in the content of blood ferritin in 2.69 times (p &lt;0.05), C-reactive protein - in 2.13 times (p &lt; 0.05), activity of lactate dehydrogenase - 1.26 times (p &lt;0.05). When comparing the indicators of the third group with the second, an excess of triglycerides was found - 1.36 times (p &lt;0.05), LDL - 1.14 times (p &lt;0.05), atherogenic index - 1.36 times (p &lt;0.05), a decrease in the level of HDL - 1.37 times (p &lt;0.05). When comparing the values of the acid-base state in patients of the third group, with those in the patients of the first group, it was found: a decrease in PaO2 in 1.05 times (p &lt;0.05), and sO2 - in 1.14 times (p &lt;0.05 ). When comparing the values of hemostasiogram indicators, it was found: an increase in the content of fibrinogen in 1.09 times (p &lt;0.05), D-dimers - in 1.23 times (p &lt;0.05), INR - in 1.14 times (p &lt; 0.05) and a decrease in APTT in 1.09 times (p &lt;0.05). When comparing the values of clinical and laboratory indicators of these groups, an extension of the length of stay in the hospital was revealed: the number of bed-days in men increased 1.32 times (p &lt;0.05). It is worth noting that, apparently, in conditions of COVID-19 infection, complicated by concomitant cardiovascular pathology, the processes of using glucose as an energy substrate is inhibited. As a result, lactate becomes a new substrate. Conclusion: 1. In patients with COVID-19 and concomitant cardiovascular pathology, respiratory and tissue hypoxia is aggravated by circulatory hypoxia, which leads to more severe consequences of COVID infection and leads to an increase in the number of bed-days spent in the hospital. 2. The violation of energy supply processes is the most important factor, the cause of impaired glucose metabolism and leads to the development of tissue hypoxia. 3. The processes of inflammation in the body caused by COVID-19 infection are aggravated in conditions of concomitant cardiovascular pathology.

Клинико-лабораторный профиль пациентов с COVID-19, госпитализированных в инфекционный стационар г. Москвы в период с мая по июль 2020 года

Objective. Data of the clinical picture forms of the disease, management and diagnostic capabilities of patients with COVID-19 continue to be studied. Our study presents results from the analysis of clinical and laboratory parameters of patients with COVID-19 in the period May-June 2020, who were treated in an infectious diseases hospital in Moscow. Patients and methods. The analytical cohort included 444, 198 men, 246 women aged 18 to 95 years, who were identified with SARS-CoV-2 RNA. The severity of the disease was determined in accordance with the temporary clinical recommendations (version 6 effective April 28, 2020), NEWS. Results. The study of the clinical picture showed the variability of the spectrum of clinical manifestations of COVID-19. The most common symptoms were fever, weakness, myalgia, dry cough, shortness of breath, diarrhea. The severity of the infection was not associated with the patient's gender, but was significantly correlated with age and the presence of comorbid status, which included chronic lung diseases, obesity, diabetes mellitus, and cardiovascular diseases. Observations of patients with severe and extremely severe course revealed characteristic laboratory markers of severity. The main method of etiological diagnosis was the RT-PCR method for detecting SARS-CoV-2 RNA in the nasopharyngeal secret. To verify COVID-19, we used an additional PCR method, fecal testing for the detection of SARS-CoV-2 RNA. Key words: COVID-19, clinical features, risk factors, SARS-CoV-2 RNA, biological substrates

Динамика лабораторных показателей у пациентов ожогового отделения при проведении инфузионно- трансфузионной терапии

Динамика лабораторных показателей у пациентов ожогового отделения при проведении инфузионно- трансфузионной терапии

Programmed extracorporeal photochemotherapy in the complex treatment of systemic scleroderma

The choice of non-drug methods for the treatment of systemic scleroderma is currently very limited. Several studies show that extracorporeal photochemotherapy can improve kidney and lung function and reduce skin fibrosis in patients with systemic scleroderma. We studied the dynamics of clinical and laboratory parameters in patients with systemic scleroderma with an assessment before and after 12 months against the background of complex treatment, which included programmed extracorporeal photochemotherapy. Indications for inclusion in the study was the ineffectiveness of standard therapy with glucocorticoids and cytostatics or the impossibility of their use, as well as signs of an unfavorable prognosis of the disease: diffuse form, high skin count (14), rapid progression with a significant initial decrease in the glomerular filtration rate, forced vital capacity, high immunological activity (high titer of antinuclear factor and positivity for antibodies to Scl-70). When evaluating the results of complex treatment, a good clinical effect was observed in all patients: the induration of the skin decreased, the functionality of the lungs and kidneys increased. A significant decrease in the disease activity index was noted. These positive changes were the basis for a decrease in the daily dose of glucocorticoids. Significantly significant changes were observed in a decrease in the immunological activity of the disease: levels of C-reactive protein, erythrocyte sedimentation rate and immunoglobulin G, antinuclear factor titer and all types of circulating immune complexes. The results of our study confirm the data of other studies that demonstrated the positive effect of extracorporeal photochemotherapy as a component of the complex treatment of systemic scleroderma.

Patients with pemphigus vulgaris under pathology and on the background of prolonged use of high doses of glucocorticosteroid therapy – the possibility of influencing the glutathione system

Introduction. Pemphigus vulgaris (PV) is a life-threatening disease of the skin and mucous membranes that is associated with IgG antibodies that target several types of keratinocyte antigens and cause epidermal lysis (acantholysis) via intracellular signaling that activates apoptotic enzymes (apoptolysis).The aim of the study was to increase the effectiveness of treatment of patients with PV with the substantiation and development of modern methods of corrective therapy based on the study of indicators of changes in the balance of the thiol-disulfide system in the body of patients under pathological conditions and with prolonged use of high doses of glucocorticosteroid hormones (GCS).Materials and research methods. There were examined 30 patients with PV (4 men and 26 women), who were hospitalized in KU «Zaporizhzhya Regional Skin and Venereal Clinical Dispensary» ZOR, Zaporizhzhia. At the time of observation, most of the patients were aged 61-70 years. As a comparison group, 20 practically healthy people were examined, constituting a control group.Our studies were four-phase: before treatment; 2-3 weeks of maximum doses of glucocorticosteroids (stage I); 1.5-2 months before discharge from the hospital, when the patient was gradually reduced dose of systemic glucocorticosteroids and the selection of the optimal daily dose (stage II); after 5-6 months, when doses of hormones were minimal (2-3 tablets) in the absence of clinical manifestations of vesicles (stage III).Results. Our pathogenetic therapy by GCS significantly led to an increase in the level of reduced glutathione (GSH), so in particular after the third treatment stage it was at 1.52 ± 0.13 mkm / mg protein, exceeding the same rate of the first and second stages of GCS administration by 87.65 and 61.70%, respectively (p &lt;0.05). The course of GCS therapy in patients with PV contributed to the fact that the level of reduced thiols increased significantly during each stage of therapy of the examined patients, in particular in the third stage of maintenance GCS therapy reduced thiols were determined at 15.64 ±1.23 mM / mg protein, exceeding this marker of the second stage by 36.95%, and the value of reduced thiols of the first stage by 83.78% (p &lt;0.05). The value of reduced thiols of the group of patients with PV in the second stage was 11.42 ±1.08 mM / mg protein, and in the first stage – 8.51 ±0.92 mM / mg protein, the percentage difference between these therapeutic stages was determined in 34.19% (p &lt;0.05).Prescribing systemic GCS to patients with PV for three stages led to the restoration of the balance of the thiol-disulfide system in patients, which manifested itself in the form of a decrease in markers: oxidized glutathione and oxidized thiols; and also in the form of an increase in the level of markers of restorative processes – glutathione reductase, glutathione peroxidase, reduced glutathione, reduced thiols, exerting a systemic positive effect on the course of the pathological process, which was reflected both in the normalization of laboratory parameters in patients and clinically in the form of stable remission.Conclusion. GCS therapy helps to normalize the activity of the antioxidant system of the human body under conditions of PV pathology, which prevents deprivation of the glutathione chain of the thiol-disulfide system during activation of oxidative and nitrosative stress processes and prevents the development of decompensation of the antioxidant system as a whole with the development of damage to key cells and target organs.

ANTI-HYPERGLYCEMIC EFFECT OF KUNDRU (COCCINIA INDICA) ON PATIENTS OF DIABETES MELLITUS TYPE-2

The disease Diabetes or Madhumeha is well documented in all perennial sources of Ayurvedic wisdom. The present study was done to evaluate the efficacy of Bimbi (Coccinia indica) in the patients of Diabetes mellitus type-2 through single blind study. Total 30 patients were selected and divided into two groups, 15 patients in each group i.e., A (Bimbi) &amp; B (Barley). In this study it has been found that Madhumeha affects not only in elderly people but in adults too with slight female preponderance. The present study confirmed that after the treatment of 60 days, Bimbi (Coccinia indica) was found effective in treatment of Madhumeha and reduced majority of the symptoms of illness that including Prabootha mootrata (Excessive urination), Atitrushna (Excessive thirst), Avila mootrata (Turbid urine) and Dourbalya (Weakness). There was significant improvement in all the laboratory parameters in patients of Bimbi (Coccinia indica) treated group. The outcome showed that mean reduction in fasting blood sugar level was 19.86%, in PP blood sugar level was 24.52% and in HbA1c level was 8.4%.These outcomes suggest that the results of trial drug i.e., Coccinia indica (Bimbi) powder was highly significant at p-value &lt;0.001. The drug Bimbi showed effectiveness in reducing FBS, PPBS and HbA1c, as results were highly significant. Barley powder used as placebo didn't showed reduction in FBS, PPBS and HbA1c.

Laboratory criteria for the persistence of secondary hyperparathyroidism in patients with chronic kidney disease

Secondary hyperparathyroidism is a complication of chronic kidney disease in both the non-dialysis and dialysis stages. Even modern advances in drug therapy cannot change the fact that most CKD patients require surgical treatment. The purpose of the treatment of SHPT is to normalize mineral metabolism, prevent bone diseases and prevent extraosseous manifestations. One of the methods of surgical treatment is subtotal parathyroidectomy. Persistence or recurrence of the disease occurs in 5-30% of cases.Purpose of the study. To determine laboratory criteria for the persistence of SHPT in patients with chronic kidney disease on the second day after parathyroidectomy.Materials and methods. The study involved 118 patients with end-stage CKD with prolonged renal replacement therapy. All patients had clinical and laboratory signs of secondary hyperparathyroidism. In the period from 2009 to 2019, patients underwent subtotal parathyroidectomy. The patients were divided into two groups. This division was based on the presence of persistence or recurrence of the disease. The main group included 20 patients with laboratory signs of SHPT persistence; the comparison group included 98 patients without signs of disease’s persistence.Results. Analysis of changes in laboratory parameters in patients with persistence and in patients without signs of disease’s persistence revealed certain differences in their postoperative level. In all 118 cases, there was a significant decrease in PTH in the postoperative period - from 31.5 to 99.6%. Using ROC-analysis, a study was carried out of the possibility of using the degree of PTH reduction as a predictor of the persistent course of SHPT and the optimal cut-off thresholds were established. A decrease in the postoperative level of PTH by 90.9% or more indicates an effective PTE. The maximum value of the test specificity (1.000 (0.968; 1.000)) is achieved when the PTH reduction is 76.0%. At the same time, the maximum value - 1.000 (0.968; 1.000) - reaches the predictive value of a positive test result.Conclusions. Using the subtotal parathyroidectomy in our study, the persistent of SHPT occurred in 16.9% of cases. A decrease in PTH levels on the second day after surgery less than 76% comparatively to the preoperative level should be considered as a predictor of the development of disease persistence. A reduction in PTH of more than 90.9% may be an indication of sustained remission.

ОСОБЕННОСТИ КЛИНИКО-ЛАБОРАТОРНЫХ ПОКАЗАТЕЛЕЙ У ПАЦИЕНТОВ С РЕЦИДИВИРУЮЩИМИ АФТАМИ ПОЛОСТИ РТА НА ФОНЕ КИСЛОТОЗАВИСИМЫХ ЗАБОЛЕВАНИЙ ЖЕЛУДОЧНО-КИШЕЧНОГО ТРАКТА

Subject. Some features of the clinical picture, hygienic and microbiological state of the oral cavity, acidity and free-radical oxidation of the oral fluid in patients with recurrent aphthates on the background of acid-dependent diseases of the gastrointestinal tract are considered.&#x0D; The aim is to assess the relationship between clinical and laboratory parameters in patients with recurrent oral aphthae associated with acid-dependent diseases of the gastrointestinal tract.&#x0D; Methodology. A comprehensive clinical and laboratory examination of 58 young people with revealed recurrent aphthae of the oral cavity against the background of acid-dependent diseases of the gastrointestinal tract was carried out. The level of oral hygiene was assessed using the ONI-s index, the state of free-radical oxidation of the oral fluid - the "Chemilumimer-003" device, individual representatives of the normal flora were identified by inoculating the contents from the surface of aphthous elements on special differential diagnostic media of the HiCrome series. The acidity of the oral fluid was determined using a universal indicator litmus paper pH-1-14, short-term intragastric pHmetry was performed directly during fibrogastroduodenoscopy.&#x0D; Results. In 46.4 % of those examined, recurrent aphthae were found on the oral mucosa. In persons with chronic gastritis and duodenitis, the frequency of recurrences once a year was 37.9 %, 2-3 times a year ― 62.0, with the presence of chronic pancreatitis against the background of hyperacid gastric secretion ― 44.8 and 55.2, respectively. In patients with recurrent aphthae, a low level of oral hygiene, a violation of its microbiome, and a change in the acidity of the oral fluid were revealed.&#x0D; Conclusions. The presence of recurrent aphthae complicates individual oral hygiene, because accompanied by severe pain and paresthetic symptoms. This is manifested by an increase in the ONI-S index and a disturbance in the state of the normobiome in the form of an increase in the growth of resident microflora against the background of changes in the acidity of the oral fluid. Chemiluminescence indices correlate with the hygienic state of the oral cavity, qualitative changes in the normobiota and pH of the oral fluid in the studied clinical groups.

Functional subsets of circulating follicular helper T cells in patients with atherosclerosis.

Frequencies of circulating T follicular helper (cTfh) functional subsets vary in autoimmune diseases. We evaluated the frequencies and clinical relevance of functional subsets of cTfhs in patients with different degrees of stenosis. Blood samples were collected from high (≥50%) (n = 12) and low (<50%) stenosis (n = 12) groups and healthy controls (n = 6). Three subsets of cTfh cells including cTfh1 (CXCR3+CCR6‐), cTfh2 (CXCR3‐CCX6‐), and cTfh17 (CXCR3‐CCR6+) were detected by flow cytometry. The frequency of cTfh1 cells was higher in control (p = .0006) and low‐stenosis groups (p = .005) compared to high‐stenosis group. The percentages of cTfh2 and cTfh17 cells were increased in high‐stenosis compared to low‐stenosis (p = .002 and p = .007) and control groups (p = .0004 and p = .0005), respectively. The frequency of cTfh1 cells negatively correlated with cholesterol (p = .040; r = −.44), C‐reactive protein (CRP) (p = .015; r = −.68), erythrocyte sedimentation rate (ESR) (p = .002; r = −.79), neutrophil/lymphocyte ratio (NLR) (p = .028; r = −.67), and cTfh17 (p = .017; r = −.7244) in the high‐stenosis group. The percentages of cTfh2 and cTfh17 cells positively correlated with cholesterol (p = .025; r = .77 and p = .033; r = .71), CRP (p = .030; r = .61 and p = .020; r = .73), ESR (p = .027; r = .69 and p = .029; r = .70), NLR (p = .004; r = .76 and p = .005; r = .74), and with each other (p = .022; r = .7382), respectively, in the high‐stenosis group. The increased frequencies of cTfh2 and cTfh17 subsets and their correlation with laboratory parameters in patients with atherosclerosis may suggest their role in promoting the inflammatory response and atherosclerosis progression.

The importance of education in patients with metabolic syndrome with regard to their knowledge and attitudes about the disease, and the impact of education on laboratory parameters.

Aim A metabolic syndrome (MetS) increases the risk of heart disease and diabetes mellitus type 2, thus the aim of this study is to correlate the clinical and laboratory parameters in patients suffering from MetS who have previously had education compared to patients who have not had any education about a healthy lifestyle, and to check their knowledge and attitudes about healthy lifestyle. Methods The study included patients of both genders aged 18 - 70 years, diagnosed with MetS, who are members of the Association of Diabetics in Canton of Sarajevo. It used anthropometric parameters, laboratory findings, and an original, structured questionnaire about diet and frequency of physical activities. Results Clinical and laboratory parameters did not differ significantly between educated and uneducated patients, as well as habits in diet, physical activity, and knowledge about metabolic syndrome. The questions from the questionnaire have shown a good value of variance, suggesting that the questionnaire can be considered reliable. Conclusion This study showed that people with metabolic syndrome are not educated and motivated enough to change their lifestyle. The need for education of such patients is necessary.

Re: Prediction of Bacteriuria Based on Clinical or Laboratory Parameters in Patients with Indwelling Ureteral Stents before Ureterorenoscopy Should Not Substitute for Urine Cultures.

No AccessJournal of UrologyUrological Survey1 Nov 2020Re: Prediction of Bacteriuria Based on Clinical or Laboratory Parameters in Patients with Indwelling Ureteral Stents before Ureterorenoscopy Should Not Substitute for Urine Cultures Edward M. SchaefferMD, PhD Edward M. SchaefferEdward M. Schaeffer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001250AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Re: Prediction of Bacteriuria Based on Clinical or Laboratory Parameters in Patients with Indwelling Ureteral Stents before Ureterorenoscopy Should Not Substitute for Urine Cultures." The Journal of Urology, 204(5), p. 1077 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 204Issue 5November 2020Page: 1077-1077 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Edward M. Schaeffer More articles by this author Expand All Advertisement PDF DownloadLoading ...

Antimitochondrial Rather than Antinuclear Antibodies Correlate with Severe Drug-Induced Liver Injury

Introduction: A proportion of patients with drug-induced liver injury (DILI) present with autoantibodies, which has led to the current concept of autoimmune-like DILI. However, no standardized definition exists and the clinical relevance has not been studied in detail yet. Methods: 143 patients with DILI enrolled in a prospective study were analyzed. DILI diagnosis was based on the monocyte-derived hepatocyte-like cell test and supported by Roussel Uclaf Causality Assessment Method (RUCAM) and expert adjudication. Testing for antinuclear antibodies (ANA) and antimitochondrial antibodies (AMA) was performed using immunofluorescence. ANA titers ≥1:100 were considered positive and ≥1:400 clinically relevant; AMA positivity was considered at titers ≥1:100. Results: 67% exhibited ANA ≥1:100 and 29% ANA ≥1:400; 10% were AMA positive. There was no significant correlation between the ANA titers and the causative drug, while AMA positive patients had taken nonsteroidal anti-inflammatory drugs more frequently. No difference was seen regarding clinical characteristics or laboratory parameters in patients with ANA ≥1:400, while patients with positive AMA presented with higher aminotransferases, bilirubin, and international normalized ratio. Significantly higher proportions of patients with ANA ≥1:400 or AMA positivity exhibited elevated immunoglobulin G levels. AMA positivity but not elevated ANA titers correlated with a higher proportion of Hy’s law positivity. Conclusion: A closer look in a causality proven DILI cohort provided no evidence that presence of ANA titers is specific for DILI by a certain medication. AMA rather than ANA positivity was related to a more pronounced liver injury.

Associations of NT-proBNP and hepcidin levels with clinical and laboratory parameters in patients with heart failure with various severity of left ventricular systolic dysfunction

Data on hepcidin levels in patients with heart failure (HF) are contradictory and do not make clear its contribution to the progression of multiple organ failure. There remain a number of issues about the prognostic significance of the N-terminal pro-brain natriuretic peptide (NT-proBNP) in HF with preserved ejection fraction (EF). The authors suggested the relationships between these markers in decompensated HF, as well as their associations with other clinical and laboratory parameters.Aim. To identify the association of NT-proBNP and hepcidin levels with clinical and laboratory parameters in patients with HF with various severity of left ventricular (LV) systolic dysfunction.Material and methods. The study included 68 patients (29 women, 39 men; mean age — 72,3±11,7 years) hospitalized due to decompensated HF. Patients were divided into three groups: reduced (HFrEF) (n=20), mid-range (HFmrEF) (n=23), and preserved EF (HFpEF) (n=24). Upon admission, along with standard diagnostic tests, all patients were examined for NT-proBNP and hepcidin levels by enzyme-linked immunosorbent assay. Statistical processing was carried out using the software package Statistica 8.0.Results. NT-proBNP levels in the entire sample was 315,9 [129,9; 576,1] pg/ml. Significantly higher concentrations of NT-proBNP were found in patients with lower EF: 433,05 (346,8-892,6) pg/ml for HFrEF, 289,97 (185,9-345,3) pg/ml for HFmrEF pg/ml and 214,98 (207,37-562,31) pg/ ml for HFpEF (p&lt;0,05). At the same time, hepcidin levels in the HFrEF group (31,63 ng/ml [22,0; 71,6]) was significantly higher than in the HFmrEF (23,89 ng/ml [21,1; 27,9]) (p&lt;0,05) and HFpEF (26,91 ng/ml [18,6; 31,1]) (p&lt;0,05). In HFpEF patients, there was a correlation of hepcidin level with body mass index (r=0,47, p&lt;0,05) and chronic obstructive airway diseases (r=0,44, p&lt;0,05). A correlation of hepcidin level with cardiac arrhythmias (r=0,61, p&lt;0,05) was revealed in the HFmrEF group. In the HFrEF group, there were correlations of a significantly increased level of NT-proBNP (median — 433,05; 95% confidence interval: 346,8-892,6) with indicators of disease severity and multiple organ dysfunction: decrease in systolic blood pressure, cardiorenal syndrome, decrease in hemoglobin level and mean corpuscular hemoglobin concentration, characteristic of iron-deficiency anemia.Conclusion. Patients with lower EF showed higher NT-proBNP values and a trend towards higher hepcidin levels. Relationships of hepcidin and NT-proBNP levels with following clinical parameters were found: body mass index, presence of obstructive airway diseases, cardiac arrhythmias, as well as low cardiac output syndrome, cardiorenal syndrome and anemia.

PCSK9 in acute coronary syndrome: analysis of associations with clinical and laboratory characteristics

The article discusses a literature review reflecting the importance of identifying novel biomarkers in cardiology for improving conventional methods for diagnosing and stratifying risk in patients with acute coronary syndrome (ACS). Recently, more and more studies have published on such markers, in particular, on the proprotein convertase subtilisin/ kexin type 9 (PCSK9). The aim of this review was to analyze the associations of PCSK9 with clinical and laboratory parameters in patients with ACS. It has been demonstrated that the PCSK9 level in acute myocardial infarction is significantly increased. In patients with ACS, the level of PCSK9 is directly related to the duration of pain, the severity of coronary artery disease, familial hypercholesterolemia and lipid parameters, as well as the severity of coronary atherosclerosis according to the SYNTAX score. It was found that statin therapy before ACS significantly affects the association of PCSK9 with lipid profile. There are conflicting data on the associations of PCSK9 with the parameters of inflammatory response in ACS, as well as isolated evidence of the positive role of anti-IL-6 receptor monoclonal antibodies in ACS patients with dyslipidemia. The impact of PCSK9 on ACS prognosis is currently unstudied.