White Blood Cell Levels Research Articles

Polystyrene microplastics facilitate renal fibrosis through accelerating tubular epithelial cell senescence

Microplastics (MPs), emerging contaminants, are easily transported and enriched in the kidney, suggesting the kidney is susceptible to the toxicity of MPs. In this study, we explored the toxicity of MPs, including unmodified polystyrene (PS), negative-charged PS-SO3H, and positive-charged PS-NH2 MPs, in mice models for 28 days at a human equivalent concentration. The results showed MPs significantly increased levels of UREA, urea nitrogen (BUN), creatinine (CREA), and uric acid (UA) levels in serum and white blood cells, protein, and microalbumin in urine. In the kidney, MPs triggered persistent inflammation and renal fibrosis, which was caused by the increased senescence of tubular epithelial cells. Moreover, we identified the critical role of the Klotho/Wnt/β-catenin signaling pathway in the process of MPs induced senescence of tubular epithelial cells, promoting the epithelial-mesenchymal transformation of epithelial cells. MPs supported the secretion of TGF-β1 by senescent epithelial cells and induced the activation of renal fibroblasts. On the contrary, restoring the function of Klotho can alleviate the senescence of epithelial cells and reverse the activation of fibroblasts. Thus, our study revealed new evidence between MPs and renal fibrosis, and adds an important piece to the whole picture of the plastic pollution on people's health.

Impact of Heat Stress on the Balance between Oxidative Markers and the Antioxidant Defence System in the Plasma of Mid-Lactating Modicana Dairy Cows.

Animal health is affected during heat stress as a result of impaired immune responses, increased production of reactive oxygen species, and/or a deficiency of antioxidants. This leads to an imbalance between oxidants and antioxidants and results in oxidative stress. Heat stress is usually measured in dairy cattle via the temperature-humidity index (THI). In the present study, we aimed at assessing the influence of incremental THI on the balance between oxidative markers and the antioxidant defence system in the plasma of Modicana cows. Twenty-four multiparous, mid-lactating dairy cows were divided into two groups on the basis of different levels of mean THI reached in the period of the previous week up until the day of blood and milk sampling (April THI1:55, May THI2:68, June THI3:71, July THI4:80). The blood samples were collected to measure reactive oxygen metabolites (ROM) and antioxidant defense markers (ferric reducing ability of plasma (FRAP), paraoxonase (PON), advanced oxidation protein products (AOPP), plasma thiol groups (SHp), as well as lipid-soluble antioxidant pro-vitamin (β-carotene) and vitamins (tocopherol and retinol). Milk characteristics, haematological values, and plasma biochemical metabolites were also evaluated. Results showed a significant increase in ROM (p < 0.05) and a significant decrease in PON (p < 0.05), AOPP (p < 0.05), and β-carotene (p < 0.001). Incremental THI significantly decreased levels of milk fat content, red and white blood cells, plasma glucose, and non-esterified fatty acids, while significantly increasing monocytes and the concentrations of β-hydroxybutyrate and creatinine, but not fructosamine. The results of the study show that heat stress significantly affects reactive oxygen species production and antioxidant parameters. Carotenoid supplementation should be considered to alleviate the impact of these effects.

Plain language summary of SUNLIGHT: trifluridine/tipiracil and bevacizumab for refractory metastatic colorectal cancer.

This is a summary describing the results from a phase 3 clinical trial called SUNLIGHT. The study looked at treatment with orally administered trifluridine/tipiracil plus intravenously administered bevacizumab in people with metastatic colorectal cancer (mCRC) that is refractory to treatment.This study included people whose cancer had grown or spread beyond its original location after no more than two previous treatments. People in the study received either the combination of trifluridine/tipiracil plus bevacizumab or they received trifluridine/tipiracil alone. The aims of the study were to see how long people lived after treatment with trifluridine/tipiracil plus bevacizumab compared with trifluridine/tipiracil alone and to find out how well the combination of trifluridine/tipiracil plus bevacizumab worked at slowing down the spread of the cancer. Researchers also looked at side effects from taking the medicines and at how treatment affected people's physical functioning. People in the combination group lived longer (a median of 10.8months) than people who received trifluridine/tipiracil alone (7.5months). In addition, the time it took for the cancer to worsen was longer for those who received the combination treatment (a median of 5.6months) compared with those who received trifluridine/tipiracil alone (2.4months). People's physical functioning took longer to worsen with combination therapy (a median of 9.3months) than it did with trifluridine/tipiracil alone (6.3months), as measured by the impact of treatment on people's ability to carry out daily living activities. The most common side effects in both treatment groups were low levels of white blood cells, known as neutrophils (neutropenia), nausea, and low levels of healthy red blood cells (anemia). The results from the study suggest that treatment with oral trifluridine/tipiracil plus intravenous (IV) bevacizumab could help people with refractory mCRC live longer and maintain good physical functioning, and it could slow the worsening of their cancer.Clinical Trial Registration: NCT04737187 (SUNLIGHT) (ClinicalTrials.gov).

Study of some physiological changes in patients with kidney failure in the city of Sirte

This study was conducted at Ibn Sina Teaching Hospital during the period from (27/1/2024) to (3/7/2024). This study aims to evaluate some physiological variables of renal failure patients undergoing hemodialysis. This study included following up 25 patients with chronic renal failure, and the different variables were compared with the same variables in 25 healthy people (not suffering from any disease). The blood variables were examined during this study, which included a study of the level of hemoglobin concentration, platelets, white and red blood cells, hematocrit, and biochemical variables in the blood serum such as triglycerides and cholesterol. The statistical results showed a significant decrease in all blood variables in renal failure patients compared to the healthy group, except for the number of platelets, which showed a very slight decrease. This decrease indicates the effect of renal failure on kidney function in producing red blood cells and regulating hemoglobin and hematocrit levels. This decrease is one of the main indicators of anemia, which is a common complication of renal failure. The results of biochemical tests showed a decrease in the average level of triglycerides and cholesterol. These results indicate a defect in the metabolism of fats due to renal failure, which increases the risk of heart disease. The current study concluded that there is a negative effect of patients with chronic renal failure in most of the physiological and biochemical variables studied compared to healthy people. Keywords: chronic renal failure, blood variables, physiological variables, biochemical variables.

Sex-specific association of peripheral blood cell indices and inflammatory markers with depressive symptoms in early adolescence

BackgroundPrevious studies have reported the correlation of dysregulated blood cell indices and peripheral inflammatory markers with depression in adults but limited studies have examined this correlation in early adolescents. MethodsThis study used data from the Chinese Early Adolescents Cohort Study, which was conducted in Anhui, China. Students' depression symptoms were repeatedly measured using the Chinese version of the Center for Epidemiological Studies Depression Scale for Children. Students' blood samples were collected in September 2019 and September 2021. The peripheral blood cell counts and inflammatory marker levels were determined using routine blood tests. Multivariable regression models were used to explore the associations between blood cell indices and adolescent depressive symptoms in both the whole sample and the sex-stratified samples. ResultsThe white blood cell (WBC) count, neutrophil count (NC), platelet (PLT) count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and systemic immune inflammation index (SII) were positively correlated with the severity of depressive symptoms during follow-up. The mean corpuscular volume (MCV), mean hemoglobin (HGB) volume (MCH), and mean corpuscular HGB concentration (MCHC) exhibited negative temporal correlations with depressive symptoms. Additionally, several sex-specific blood cell markers were correlated with depression. Male adolescents with increased red blood cell (RBC) and female adolescents with decreased HGB levels and upregulated WBC, NC, NLR, and SII levels exhibited severe depressive symptoms at follow-up. ConclusionsThese findings suggested the potential usefulness of peripheral blood cell indices in the assessment of depression in early adolescents.

Construction of a nomogram for early diagnosis of refractory Mycoplasma pneumoniae pneumonia in children.

Refractory Mycoplasma pneumoniae pneumonia (RMPP) has a serious, rapid progression that can easily cause a variety of extra-pulmonary complications. Therefore, the early identification of RMPP is crucial. This study aimed to construct and validate a risk prediction model based on clinical manifestations, laboratory blood indicators, and radiological findings to help clinicians identify patients who are at high risk of RMPP. We retrospectively analyzed the medical records of 369 children with Mycoplasma pneumoniae pneumonia (MPP) admitted to Xi'an Children's Hospital, China. The demographics, clinical features, laboratory data, and radiological findings between the RMPP group and the general Mycoplasma pneumoniae pneumonia (GMPP) group were compared and subjected to univariate and multivariate logistic regression analyses. The fever peak and duration of the children in the RMPP group (n=86) were higher and longer compared with those in the GMPP group (n=283) (P<0.05). There was a significant difference in the incidence of lobar pneumonia and pleural effusion in pulmonary imaging between the two groups (P<0.05). Laboratory tests showed that the children with RMPP had lower serum uric acid (SUA) and albumin (ALB) as compared with the GMPP group (P<0.05). White blood cells (WBCs), neutrophil count (NEP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) were higher in the RMPP group (P<0.05). Binary logistic regression analysis showed that the fever duration, pleural effusion, WBC, NEP, lactate dehydrogenase (LDH), CRP, NLR, and SUA levels were independent predictors of RMPP (P<0.05). The receiver operator characteristic (ROC) curve results showed fever duration, WBC, NEP, CRP, LDH, SUA, and NLR had good predictive value. The areas under the curve (AUCs) were 0.861, 0.730, 0.758, 0.837, 0.868, 0.744, and 0.713 and the best cutoff values were 10.50, 10.13, 6.43, 29.45, 370.50, 170.50, and 3.47, respectively. Finally, fever duration of more than 10.5 days, pleural effusion, WBC >10.13×109/L, NEP >6.43×109/L, CRP >29.45 mg/L, LDH >370.50 U/L, NLR >3.47, and SUA <170.5 µmol/mL constructed a prediction model of RMPP. According to internal validation, the mean AUC of the nomogram based on the development dataset was 0.956 [95% confidence interval (CI): 0.937-0.974] with good discrimination ability for predicting RMPP patients. The calibration plot and Hosmer-Lemeshow test (P=0.70) of the prediction model showed good consistency between the predicted probability and actual probability. Decision curve analysis (DCA) showed that the nomogram is clinically useful. The simple and easy-to-use nomogram can help clinicians, especially primary doctors, to make early diagnoses of RMPP.

Safety and efficacy of intrawound vancomycin powder in the prevention of lumbar surgical site infection: A prospective, double-blind, randomized controlled study.

To evaluate the safety and efficacy of intra-wound vancomycin powder in reducing surgical site infections (SSIs) after spine surgery. A prospective, double-blind, randomized controlled study. Patients who underwent posterior lumbar interbody fusion (PLIF) surgery from May 2021 to September 2022. Patients who underwent posterior lumbar interbody fusion (PLIF) surgery between May 2021 and September 2022 were included. Participants were randomized to the vancomycin treatment or control groups using block randomization (block size 4). Except for baseline and surgical data, the plasma levels of white blood cells, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), aspartate aminotransferase, alanine aminotransferase, and serum vancomycin concentration in the groups were analyzed on postoperative days (PODs) 1, 3, and 5. Vancomycin concentration was measured daily until the drainage tubes were removed. The primary outcomes were the 90-day vancomycin-related adverse reactions and SSI rates. Secondary outcomes were perioperative hematological parameters and vancomycin serum (drain) concentrations. A total of 156 participants (78 each in each group) were analyzed by an independent researcher. The follow-up rate was 91%. All participants were followed up for at least 90 days. The 90-day SSI rate in the vancomycin group was 1.3% (1/78), comprising one case of superficial infection. The SSI rate in the control group was 10.3% (8/78), comprising seven cases of superficial infection and one case of deep infection. Compared with that in the control group, the SSI rate in the vancomycin group was decreased by 87.5%, with a statistically significant difference (RR=0.125, 95% CI=0.016-0.976). Additionally, the vancomycin group demonstrated a statistically significant decrease in serum ESR on POD 3 (P=0.039) and CRP on POD 5 (P=0.024) compared to the control group. The local plasma concentration of vancomycin remained elevated for at least 4 days postoperatively, while the serum concentration of vancomycin remined low. Vancomycin-associated adverse reactions were not observed. Intra-wound application of vancomycin powder is a safe and effective procedure for reducing the risk of SSI during PLIF surgery.

Determinants of Mortality in COVID-19–Associated Opportunistic Fungal Infections

Abstract Background COVID-19–associated mucormycosis (CAM) affected over 50,000 people during the second wave of the pandemic in India. Epidemiological aspects of CAM were reported, but there is a lack of published literature on mortality and its determinants in CAM and other fungal infections. The present study investigated patterns and determinants of mortality in these patients. Methods The retrospective study reviewed case records of 390 patients, with at least 1 year of follow-up, for information related to demographics, epidemiology, clinical features, laboratory investigations, and treatment. The association between categorical variables was studied using the chi-square test of independence and logistic regression between 2 groups of those who survived and those who died during hospitalization or after discharge. Results A total of 157 (40%) patients did not survive; of these, 112 (29%) died during hospitalization and 45 (11%) had postdischarge mortality. The risk of mortality was associated with higher age, use of corticosteroids (odds ratio, 1.38; 95% confidence interval, 0.87–2.16), visual acuity &lt;3/60 at presentation, palate involvement, and abnormal levels of white blood cells and red blood cells. Conclusions The demographic, clinical, laboratory, and microbiological parameters may be predictors of mortality in patients of rhino-orbital-cerebral mucormycosis.

Study on the efficacy of He’s Tonglong Dashi Dashi Tang plus flavor combined with moxibustion in the postoperative period of ureteroscopic lithotripsy

Objective: To observe the effect of He’s Tongling Dashi Dai Shi Tang plus flavor combined with moxibustion on the efficacy of ureteroscopic lithotripsy after ureterolithotripsy. Methods: A total of 120 ureteral stone patients (admitted in August 2021–April 2023) were randomized into the control group and the study group, and the patients were treated with ureteroscopic lithotripsy; the patients in the control group (60 patients) were treated with conventional treatment after the operation, and the patients in the study group (60 patients) were treated with conventional treatment combined with He’s Tonglong Dashi Dai Shi Tang Plus Flavor and moxibustion, and clinical data of each group were compared. The clinical data of patients in the study group (60 patients) were compared with those of patients in the study group (60 patients), including stone clearance rate, postoperative complication rate, pain scores (visual analog pain scale (VAS)) at one week, two weeks, and three weeks postoperatively, C-reactive protein (CRP) level and white blood cell (WBC) level at one day and three weeks postoperatively. Results: The stone clearance rate of the study group (98.33%) was significantly higher than that of the control group (88.33%), [Formula: see text]; the postoperative complication rate of the study group (3.33%) was significantly lower than that of the control group (13.33%), [Formula: see text]; the VAS scores of the patients of the study group were lower than that of the control group at one week after surgery, two weeks after surgery and three weeks after surgery, [Formula: see text]; the VAS scores of the patients of the study group were lower than that of the control group, [Formula: see text]; and the VAS score of the patients of the study group was lower than that of the control group at one day and three weeks after surgery, [Formula: see text]. The CRP level and WBC level of the patients in the study group were lower than those in the control group in one day and three weeks after operation, [Formula: see text]. Conclusion: He’s Tonglong Dishi Dai Shi Tang plus flavor combined with moxibustion can enhance the efficacy of ureteroscopic lithotripsy, with a high rate of stone removal in the patients, a low rate of postoperative complications, mild postoperative pain, light inflammatory reaction, and a good recovery, so it is worthwhile to be applied.

Evaluation of calcium, phosphorus and some biochemical parameters in dogs with open and closed cervix pyometra

The aim of this study was to evaluate the changes in calcium, phosphorus and some biochemical parameters in dogs with open and closed cervix pyometra, which was then compared with a control group. A total of 62 bitches of age group 5-10 years old irrespective of breed were enrolled into the study. Control group consisted of 22 bitches which were clinically healthy and in luteal phase of the estrus cycle. On clinical examination, pyometra was diagnosed in 40 bitches while 23 out of 40 bitches had open-cervix pyometra and 17 of 40 bitches had closed-cervix pyometra. Evaluation of haematological changes revealed that there was increased white blood cell (WBC), total protein (TP), globulin, alkaline phosphatase (ALKP) while decreased glucose (Glu), albumin (Alb) and albümin globulin ratio in pyometra cases (p&amp;lt;0.001). The highest WBC and ALKP levels were detected in closed-cervix pyometra group (p&amp;lt;0.001). Calcium (Ca+2) levels had significant rise in open-cervix pyometra cases (p&amp;lt;0.05) while phosphorus (Phos) levels had tend to increase in closed-cervix pyometra cases (p=0.08). Also, Ca was directly correlated with Glu, Alb and TP while inversely correlated with WBC and blood urea nitrogen/creatinine (BUN/Crea). However, Phos was significantly associated with BUN and Crea (p&amp;lt;0.001; R=0.915 and R=0.860, respectively). As a result of this study, it was observed that the increased Ca levels in open-cervix cases and the elevated Phos levels in closed-cervix cases, were associated with the biochemical parameters related to hepatic and renal dysfunction in dogs with pyometra.

The effect of external fixator on bone metabolism in patients with open fracture of extremities.

This experiment aimed to explore the influence mechanism of external fixator on open fracture. A total of 128 patients with open tibiofibular fractures were included in this study. The patients were randomly divided into external fixator group (n=64) and control group (n=64) according to the order of admission. Double-blind controlled observation was used. The levels of osteocalcin (BGP), β-CTX, P1 NP, BALP, including haptoglobin (Hp), ceruloplasmin (CER), serum adrenocorticotropic hormone (ACTH), cortisol (COR), C-reactive protein (CRP), white blood cell (WBC) and interleukin-6 (IL-6) were recorded in different groups. The postoperative VAS score and quality of life were recorded. Log-rank was used to analyze the difference in postoperative adverse reaction rates among different groups. External fixation stent treatment increased BGP, PINP, and BALP expression and decreased β-CTX, Hp, CER, ACTH, COR, CRP, WBC, and IL-6 levels. Patients in the external fixation stent group had significantly lower VAS score quality of life scores and incidence of adverse events than the control group. External fixation stents protect open fracture patients by promoting bone metabolism.

Long-term treatment of SOD1 ALS with tofersen: a multicentre experience in 17 patients.

In Amyotrophic Lateral Sclerosis (ALS) patients with SOD1 mutation the intrathecal administration of tofersen slowed down the progression of disease in a controlled clinical study, but results were not statistically significant. In this multicentre, observational study, we evaluated a cohort of 27 ALS-SOD1 patients who were treated with tofersen, focussing on 17 patients who were followed for at least 48weeks (median period of 84weeks, range 48-108). We compared the clinical slopes, as measured by ALSFRS-R, MRC scale and Forced Vital Capacity, during tofersen treatment with retrospective data at 1year prior to therapy. Cerebrospinal fluid (CSF) and serum neurofilament light chains (NFL) were measured in all patients. Cumulative evaluation of the ALSFRS-R and MRC progression rates showed a statistically significant change during treatment with respect to the period prior to therapy (p = 0.023 and p = 0.007, respectively). The analysis of individual patients showed that nine of the seventeen patients substantially stabilized or slightly improved. Four patients deteriorated during treatment, while in the remaining patients the very slow course did not allow to identify significant changes. CSF and serum NFL concentration markedly decreased in the near totality of patients. Increased levels of white blood cells and proteins in the CSF were found in 60% of patients. Such alterations were clinically asymptomatic in all but two patients who showed an acute pure motor radiculitis, which responded to steroid therapy. Clinical findings and NFL analysis strongly suggest that tofersen may have a disease-modifying effect in a subset of SOD1-ALS patients.

Evaluation of candidemia risk factors and Candida species distribution in intensive care units among patients with and without COVID-19.

To assess the risk variables related to the types of candidemia for each patient, who was admitted into the intensive care unit regardless of the patient with or without complete diagnosis of COVID-19, during the period of March 2019 to December 2022. The evaluation comparison of demographic and clinical data of COVID-19 positive and negative patients with candidemia confirmed in blood, 113 cases were assessed. Variables such as gender, age, age of hospitalization, history of hospitalization, concurrently infection, The acute physiology and chronic health evaluation-II scores, comorbidity checking, intubation, central venous catheter use, parenteral nutrition use, steroid use, antibiotic use, lymphopenia, and laboratory variables were evaluated. Candida species distribution, antifungal susceptibility in blood culture were determined. Coronavirus disease-19 was present in 62.8% of cases confirmed candidemia, and these cases were significantly different from COVID-19 negative cases. Significance was found in more intubation, central venous catheter use, parenteral nutrition, and steroid therapy in Group 2. There was no significance with species distribution and associated infection. In total, COVID-19 positive had higher hemoglobin, aspartate aminotransferase, alanine transaminase, and white blood cell levels, which may be associated with the possibility of revealing and controlling candidemia. Candida albicans and Candida Parapsilosis (C. parapsilosis) are the species seen in infected COVID-19 patients, while C. parapsilosis and Candida tropicalis are found in non-COVID-19 ones. Risk factors were intubation, parenteral nutrition, central venous catheter, and steroid in the COVID-19 group.

Study the Effect of Tobacco Smoking (Cigarette and Hookah) on Some Blood Parameters in the Samples of Iraqi People in Al-Najaf Governorate

Abstract Background: The study of effective smoking is considered one of the challenges in sustainable development, where tobacco smoking (cigarettes and hookah) is one of the main etiology of cardiovascular and cancer diseases causing millions of deaths annually. Objectives: The current study aims to identify the effect of cigarettes and hookah on blood parameters in the population of Al-Najaf Governorate. Materials and Methods: The present study included 120 males and they were divided into cigarette smokers (n = 30), hookah smokers (n = 30), cigarettes and hookah smokers (n = 30), and nonsmokers (n = 30). They were distributed according to their age categories ranging from 15 to 74 years. Specimens of blood from all groups were collected to identify the hemoglobin (Hb), white blood cells (WBCs) count, red blood cells (RBCs), mean corpuscular volume (MCV), mean corpuscular Hb (MCH), and mean corpuscular Hb concentration (MCHC) in the blood. Results: The results revealed that the current study proved tobacco smoking has a significant effect on most blood parameters, as it had a significant effect on the level of Hb, WBCs, RBCs, MCH, and MCV (P &lt; 0.05) in tobacco smokers (15.2458 ± 1.5 g/dL, 12.35 × 103µL, 5.326 ± 0.775 × 106 µL, 29.721 ± 0.432 pg, 87.7312 ± 0.692 fL), respectively, compared with nonsmokers as a control group (13.5 ± 1 g/dL, 7.450 ± 0.398 × 103 µL, 4.847 ± 0.081 × 106 µL, 27.416 ± 0.915 pg, 79.6343 ± 3.623 fL). However, the effect was not significant on the level of MCHC (34.336 ± 0.599 g/dL) compared with a control group (33.99 ± 0.307 g/dL). Conclusion: The current study concludes that cigarettes and hookah smoking or both change the blood parameters, which are harmful to health. Therefore, smokers must be aware to measure their blood parameters continuously to keep their health healthy.

Clinical findings and electrocardiography predicted mortality among COVID-19 patients with pre-existing hypertension: A cross-sectional study of East Java Province, Indonesia.

To evaluate the factors associated with mortality among coronavirus disease-2019 patients with preexisting hypertension. The retrospective, cross-sectional study was conducted from June 15 to July 7, 2021, after approval from Dr Soetomo General Province Hospital, Indonesia, and comprised data from the coronavirus disease-2019 registry in the East Java province of Indonesia from March 2020 to June 2021. Data was collected for adult patients infected by coronavirus disease-2019 with pre-existing hypertension Data was analysed using SPSS 23. Of the 2,732 patients in the registry, 425(15.6%) with median age 56.5 years (interquartile range: 50-64 years) had pre-existing hypertension. Of them, 251(59.06%) were males, and 110(25.9%) had died while in hospital. Mortality was associated with older age; higher white blood cell counts at admission and lower platelet count (p<0.05). In addition, electrocardiogram parameters associated with mortality were faster heart rate and ST abnormality (p<0.05). Older age, high white blood cell level, lower platelet count, faster heart rate, and ST abnormality at admission were found to be the predictors of mortality among hospitalised coronavirus disease-2019 patients with pre-existing hypertension.

Is there a faster and easier method for assessing the severity of acute mesenteric ischemia?

Acute mesenteric ischemia (AMI) is a potentially fatal abdominal emergency. The estimation of the severity of AMI is of great importance since changes in disease severity may have different impacts on the treatment options. This study aims to define laboratory and radiological parameters that can successfully predict the severity of AMI. Data from 100 patients who were treated conservatively and underwent an operation with a diagnosis of AMI between the years 2010 and 2019 were reviewed. The patients were divided into 3 groups as those treated with a conservative approach (group 1), those with partial intestinal ischemia (group 2), and those with complete intestinal ischemia (group 3) according to the pathology results. Laboratory findings of the patients were recorded and matched with radiological findings. The white blood cell (WBC) count, neutrophil (NEUT) count, neutrophil/lymphocyte ratio, and C-reactive protein/albumin ratios were the considered distinctive parameters for distinguishing the third group from the first group. However, the same result cannot be applied to the first and the second groups since only the WBC and NEUT counts showed distinctive performance. The measurement of neutrophil/lymphocyte ratio, WBC, NEUT, and albumin levels can be used to predict the severity of AMI. We believe that evaluating these laboratory parameters will greatly prevent possible morbidity and mortality in the patient. Also, we were able to observe that the parameters used in predicting AMI severity can be verified with rapid and low-cost radiological imaging techniques.

Out-Patient versus In-Patient Arteriovenous Fistula Creation for Dialysis: Assessing Cost-Effectiveness Alongside Clinical Implications.

(1) Background: The surgical procedure to create an arteriovenous fistula (AVF) can be performed in either an ambulatory or in-patient hospital setting, depending on the case's complexity, the anesthesia type used, and the patient's comorbidities. The main scope of this study is to assess the cost-effectiveness and clinical implications of surgically creating an AVF in both ambulatory and in-hospital settings. (2) Methods: We conducted a retrospective observational study, in which we initially enrolled all patients with end-stage kidney disease (ESKD) admitted to the Vascular Surgery Department, Emergency County Hospital of Targu Mures, Romania, to surgically create an AVF for dialysis, between January 2020 and December 2022. The primary endpoint of this study is to assess the cost-effectiveness of surgically creating an AVF in an ambulatory vs. in-hospital setting by comparing the costs required for the two types of admissions. Further, the 116 patients enrolled in this study were divided into two groups based on their preference for hospitalization: out-patients and in-patients. (3) Results: Regarding in-patient comorbidities, there was a higher prevalence of peripheral artery disease (PAD) (p = 0.006), malignancy (p = 0.020), and previous myocardial infarction (p = 0.012). In addition, active smoking (p = 0.006) and obesity (p = 0.018) were more frequent among these patients. Regarding the laboratory data, the in-patients had lower levels of white blood cells (WBC) (p = 0.004), neutrophils count (p = 0.025), lymphocytes (p = 0.034), and monocytes (p = 0.032), but there were no differences between the two groups regarding the systemic inflammatory biomarkers or the AVF type. Additionally, we did not register any difference regarding the outcomes: local complications (p = 0.588), maturation failure (p = 0.267), and primary patency (p = 0.834). In our subsequent analysis, we discovered no significant difference between the hospitalization type chosen by patients regarding AVF primary patency failure (p = 0.195). We found no significant association between the hospitalization type and the recorded outcomes (all ps > 0.05) in both multivariate linear regression and Cox proportional hazard analysis. (4) Conclusions: In conclusion, there are no significant differences in the clinical implications, short-term and long-term complications of AVF for out-patient and in-patient admissions. Additionally, we found no variation in the costs associated with laboratory tests and surgical supplies for an AVF creation. Therefore, it is safe to perform ambulatory AVFs, which can reduce the risk of hospital-acquired infections and provide greater comfort to the patient.

Effect of saline irrigation temperature difference on postoperative acute pain and hypothermia during biportal endoscopic spine surgery.

Recently, enhanced recovery after surgery (ERAS) protocols have attracted attention; they emphasize on avoiding intraoperative hypothermia while performing lumbar fusion surgery. However, none of the studies have reported the protocol for determining the temperature of saline irrigation during biportal endoscopic spine surgery (BESS) procedure. This study evaluated the effectiveness of warm saline irrigation during BESS in acute postoperative pain and inflammatory reactions. Fifty-five patients who underwent BESS procedure were retrospectively analyzed for the incidence of perioperative hypothermia (< 36oC), postoperative inflammatory factors (white blood cells (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6), serum amyloid A (SAA)), and clinical outcomes (back visual analog scale (VAS) score, postoperative shivering). The patients were divided into the warm and cold saline irrigation groups. Hemoglobin, WBC, ESR, creatine kinase, and creatine kinase-muscle brain levels did not significantly differ between the warm and cold saline groups. The mean CRP, IL-6, and SAA levels were significantly higher in the cold saline group than in the warm saline group (p = 0.0058, 0.0028, and 0.0246, respectively); back VAS scores were also higher with a statistically significant difference until two days postoperatively (p < 0.001). During the entire procedure, the body temperature was significantly lower in the cold saline irrigation group, but the hypothermia incidence rate significantly differed 30min after the operation was started. Using warm saline irrigation during BESS is beneficial for early recovery after surgery, as it is associated with reduced postoperative pain and complication rates.

Metabolic flexibility associated with flight time among combat pilots of the Brazilian air force.

Fighter pilots must support the effects of many stressors, including physical and psychological exertion, circadian disturbance, jet lag, and environmental stress. Despite the rigorous selection of military pilots, those factors predispose to failures in physiological compensatory mechanisms and metabolic flexibility. We compared through NMR-based metabolomics the metabolic profile of Brazilian F5 fighter pilots with different flight experiences vs. the control group of non-pilots. We hypothesized that combat pilots have metabolic flexibility associated with combat flight time. We evaluated for the first time 34 Brazilian fighter pilots from Santa Cruz Air Base (Rio de Janeiro, RJ) allocated into three groups: pilots with lower total accumulated flight experience < 1,100h (PC1, n = 7); pilots with higher total accumulated flight experience ≥ 1,100h (PC2, n = 6); military non-pilots (CONT, n = 21). Data collection included anthropometric measurements, total blood count, lipidogram, markers of oxidative stress, and serum NMR-based metabolomics. In comparison with controls (p < 0.05), pilots exhibited decreased levels of white blood cells (-13%), neutrophils (-15%), lymphocytes (-20%), alfa-glucose (-13%), lactate (-26%), glutamine (-11%), histidine (-20%), and tyrosine (-11%), but higher isobutyrate (+ 10%) concentrations. Significant correlations were found between lactate vs. amino acids in CONT (r = 0.55-0.68, p < 0.001), and vs. glutamine in PC2 (r = 0.94, p = 0.01). Fighter pilots with lower experience showed a dysregulation in immune-metabolic function in comparison with controls, which seemed to be counteracted by the accumulation of flight hours. Those findings might have implications for the health preservation and operational training of fighter pilots.

Exploring Acute Kidney Injury Following Aortic Dissection: A Comprehensive Review of Machine Learning Models for Predicting Risk, Management Strategies, Complications, and Racial and Gender Disparities.

Both types of aortic dissection (AD), Stanford type A and type B, can result in complications such as acute kidney injury (AKI) and aortic rupture. Renal complications in AD arise from compromised renal perfusion affecting the renal arteries. Understanding the intricate connection between AD and AKI is crucial for navigating the complexities of tailored treatment and formulating specific management plans. Concerning machine learning models, in patients with type A aortic dissection, factors such as decreased platelet count on admission, increased D-dimer level, longer cardiopulmonary bypass duration, elevated white blood cell levels, the need for blood transfusion, longer aortic clamp time, extended surgery duration, advanced age, and an elevated body mass index were positively associated with the development of AKI. For the risk of AKI after type B aortic dissection, elevated Nt-pro brain natriuretic peptide, prolonged activated partial thromboplastin time, elevated admission systolic blood pressure, and a higher contrast agent requirement during operative repair were found to predict the risk. Male gender was associated with a higher risk of AKI, and nonwhite race was linked to a higher risk of AKI, a greater likelihood of requiring more urgent procedures, and lower levels of insurance coverage. The treatment of AKI following AD requires a multifaceted approach. Identifying and addressing the underlying cause, such as low blood pressure, renal artery involvement, or medication-induced injury, is crucial for effective management and preventing further kidney damage. Maintaining proper fluid balance is essential for improving renal perfusion, but careful monitoring is necessary to avoid complications. The evolving landscape of research, particularly in biomarkers and AI programs, reveals a promising role in predicting the risk for and managing AKI post-AD.